The Secret of the Yellow Death

by Suzanne Jurmain

] (see [>]).

  Moran, John (1876–1950). John Moran was one of only two civilians who participated in the experiments as volunteers. Moran was born in Ireland and came to the United States as a boy. He worked in a grocery store and as an assistant to a woman doctor before enlisting in the U.S. Army Hospital Corps. After completing his army service in Cuba, he remained at Camp Columbia as a “clerk-typist-secretary.” Moran never did become a doctor. After the Reed experiments ended, Moran became a sanitary inspector and helped stamp out mosquitoes during the building of the Panama Canal. He later became a businessman and served as a U.S. Army captain during World War I. Moran received the Congressional Gold Medal and also wrote several descriptions of his experiences with the team entitled “Walter Reed’s Human Guinea Pigs (By One of Them),” “My Date with Walter Reed and Yellow Jack,” and “Memoirs of a Human Guinea Pig”—all of which are available online through the Hench yellow fever collection at the University of Virginia (see [>]).

  Olsen, William (1874–1932). Private Olsen, a member of the hospital corps, received the Congressional Gold Medal after being injected with blood from a yellow fever patient. He is #17 in the photo on [>].

  Pinto, Alva Sherman. Although he did not win a medal and his name is not usually listed, researchers know that Dr. Pinto volunteered to be bitten in some of Lazear’s early experiments. His first name is sometimes listed as Albert or Alvin. He is #2 in the photo on [>].

  Sonntag, Charles (1872–1937). Sonntag, a member of the hospital corps, participated in the mosquito experiments and received the Congressional Gold Medal. He is #41 in the photo on [>].

  Weatherwalks, Edward (1874–1916). A member of the army hospital corps, Weatherwalks participated in the infected clothing and bedding experiments. After his return from Cuba, he married and had a son. Unfortunately, he died at age forty-two without knowing that he had received the Congressional Gold Medal for his services.

  West, Clyde (1877–1943). Private West participated in the mosquito experiments and was awarded the Congressional Gold Medal. He is #40 in the photo on [>].

  THE SPANISH IMMIGRANT VOLUNTEERS

  Benigno, Antonio. Señor Benigno was described as a cheerful man who loved eating sweet potatoes so much that Reed teasingly called him “Boniato,” which means “sweet potato” in Spanish. Benigno was the first of the Spanish volunteers to get yellow fever from the bite of an infected mosquito.

  Fernandez, Nicanor. Señor Fernandez took part in both the mosquito and blood injection experiments and developed yellow fever.

  Martinez, José. Although he did not become sick the first time he was bitten by infected mosquitoes, Señor Martinez came down with the disease after being bitten again in a later experiment.

  Presedo, Becente. Señor Presedo took part in both the mosquito and blood injection experiments and developed yellow fever.

  THE REED TEAM VOLUNTEERS

  Carroll, James (1854–1907). Born in England, Carroll worked as a lumberjack and soldier before studying medicine. He contracted yellow fever after a mosquito bite and his case helped explain the cause of yellow fever (see [>], [>]).

  Lazear, Jesse (1866–1900). Lazear was the first member of the Reed team to do intensive mosquito research. Although he died of yellow fever during experiments, his work and illness helped answer vital questions about the disease (see [>]).

  Glossary of Scientific Terms

  AUTOPSY: the process of cutting open and examining a corpse to find out the cause of death.

  BACTERIA: tiny living one-celled organisms that can be seen individually only under a microscope. Some useful types of bacteria help living creatures digest food and allow humans to make cheese and vinegar. Other harmful bacteria may cause ear infections, tonsillitis, and deadly diseases like pneumonia and tuberculosis. When people become sick with illnesses caused by bacteria, they are often treated with powerful bacteria-killing drugs called antibiotics.

  BACTERIOLOGY: the study of bacteria.

  CELL: a small unit of living matter that can breathe, reproduce, take in food, and eliminate waste products. A human body is composed of about a million specialized types of cells. A tiny animal called an amoeba is made up of only one. Although there are a few exceptions, most cells are so small, they can be seen only under a microscope.

  CULTURE: microorganisms (such as bacteria) or body cells that have been grown in laboratory plates or tubes containing a food such as bouillon or gelatin.

  HYPOTHESIS: a theory

  IMMUNE: unable to get a disease.

  INCUBATOR: an ovenlike device. It is used in laboratories to keep cultures warm so that the microorganisms or body cells will grow.

  LARVA: a young, immature insect that does not look like or have the same lifestyle as an adult. A mosquito larva, for example, lives in water, looks like a worm, and eats tiny plants and animals. The word larva refers to one young insect. Many young insects at this stage of growth are called larvae.

  PROBOSCIS (PRONOUNCED PRO-BOS-KISS): an organ that looks like a nose. Although it looks like a type of nose, an insect’s proboscis is used for eating, not breathing. A mosquito’s proboscis, for example, contains knifelike parts that allow the bug to stab through skin and tubes that allow the insect to suck in the blood it feeds on.

  SCALPEL: a special type of knife used by surgeons.

  VACCINE: a substance made from killed or weakened germs that prevents a living creature from getting a particular type of sickness by forcing its body to produce disease-fighting substances. Vaccines are used to prevent people from getting illnesses such as flu, smallpox, chicken pox, yellow fever, and polio.

  VIRUS: a very tiny, very simple type of germ that is so much smaller than bacteria that it usually cannot be seen under an ordinary microscope. Viruses cause colds and many other diseases such as flu, polio, yellow fever, chicken pox, smallpox, and AIDS.

  Chapter Notes

  A Note on Sources: The story of the conquest of yellow fever has been told many times for adults, notably in several biographies of Walter Reed and in two excellent recently published books: Molly Caldwell Crosby’s The American Plague, and Yellow Jack by John R. Pierce and Jim Writer. It is also the subject of Yellow Jack, a highly fictionalized, critically acclaimed Broadway play written by Sidney Howard in collaboration with Paul de Kruif. To me, however, the story comes through most intensely in the letters and memoirs of the people who were actually involved. I am, therefore, extremely grateful to the UCLA Biomedical Library for providing access to various published primary materials, to the New York Academy of Medicine for allowing me to view the only surviving experimental log book kept by Reed’s team, and especially to the University of Virginia, which has made it possible to view the letters, documents, articles, and photographs in the magnificent Philip S. Hench Walter Reed Yellow Fever Collection online.

  I. Meeting the Monster

  The young man didn’t feel well: This description of a severe case of yellow fever comes from multiple sources, including Downs, pp. 451–53; Kissinger, p. 3; Altman, pp. 131–32; Oldstone, p. 49; Pierce and Writer, pp. 1 and 154; Crosby, pp. 157–59, 162–65. One of the best descriptions of yellow fever, written by Dr. William Currie during the 1793 epidemic in Philadelphia, can be read in Dickerson, p. 16.

  “Yellow fever [is] . . . an enemy”: Pierce and Writer, p. 73, quoting Surgeon General John Woodworth’s Report to Congress, Jan. 29, 1879.

  By the 1890s doctors had found: Doctors knew about the existence of bacteria in the early 1890s; viruses were not discovered until later.

  how to kill . . .“germs”: The techniques for killing germs listed in the text are the ones known in the 1890s. Antibiotic drugs were not developed until the 1920s.

  battleship Maine blew up: Although Spanish agents were blamed for causing the disaster at the time, many scholars now believe that the explosion was caused by an accidental spark that blew up the ship’s ammunition supplies.

  Their mission was to . . . find the cause of yellow fever: Although the actua
l order spoke vaguely about “pursuing scientific investigation with reference to the infectious diseases” in Cuba, the surgeon general of the army, George Sternberg (who was actually in charge of the mission), sent a separate letter to Walter Reed (the chief researcher) ordering him to pay “special attention to questions relating to the etiology [cause] and prevention of yellow fever.” When the team arrived in Cuba, it was clear that yellow fever was the sole focus of their work. For more information, see Pierce and Writer, p. 121, and Crosby, p. 133.

  2. “Feeding the Fishes”

  “feeding the fishes”: Letter written by Walter Reed to his wife on June 4, 1900, quoted in Blossom Reed, p. 2.

  “alleviate human suffering”: Letter written by Walter Reed to his wife on Dec. 31, 1900, quoted in Blossom Reed, pp. 22–23.

  The experiments were unsuccessful: Reed in “The Propagation of Yellow Fever” notes that in one hundred experiments between 1881 and 1895 Finlay produced three cases of “mild albuminuric fever” (a name that indicates that these patients might have developed mild cases of yellow fever). Pierce and Writer, p. 82, say Finlay believed that he produced twelve cases of yellow fever by using infected mosquitoes. These results, however, were not accepted by the scientific community for two reasons: first, because the cases were so mild that it was not clear that the disease was actually yellow fever, and second, because Finlay’s subjects were not quarantined and the experiments were done in areas where yellow fever was so prevalent that it was not clear whether Finlay’s patients had gotten yellow fever from mosquitoes or another source.

  “touched”: Finlay, p. 94.

  “crazy”: Pierce and Writer, p. 81.

  “useless”: Letter written by Henry Hurd to Caroline Latimer on Feb. 11, 1905.

  “two or three tons”: Letter written by Walter Reed to his wife on June 24, 1900, quoted in Blossom Reed, p. 2.

  3. Plans

  Lazear would help examine the bacteria: Hench, p. 8, says that in addition to this Lazear was supposed to work on mosquito research. I have not mentioned this in the text because Hench’s statement seems to be contradicted by Lazear’s July 15, 1900, letter to his wife in which he expresses frustration over the team’s preoccupation with Bacillus icteroides and says, “I . . . want to do work which may lead to the discovery of the real organism.”

  4. Going Nowhere

  “precious wife”: Letter written by Walter Reed to his wife, July 2, 1900.

  “a large Cork helmet”: Letter from Walter Reed to his wife, July 7, 1900.

  “I have said nothing about yellow fever”: Letter from Walter Reed to his wife, July 8, 1900.

  “dull,”. . . “germs for their own sake”: Letter from Jesse Lazear to his wife, July 15, 1900.

  team didn’t seem to be taking those ideas very seriously: Reed may actually have been more interested in other avenues of research than Lazear realized. His interest, however, may have been discouraged by his boss, the surgeon general of the army, George Sternberg, who was particularly anxious to solve the problem of Bacillus icteroides. In a letter to Caroline Latimer (Feb. 11, 1906) Henry Hurd notes, for example, that when Reed discussed the possibility of mosquito research with Sternberg prior to going to Cuba, Sternberg called the mosquito work a “useless investigation.”

  “I. . . want to do work”: Letter from Jesse Lazear to his wife, July 15, 1900.

  5. The First Clue?

  “leak”: Anon., “Viral hemorrhagic fevers.”

  6. Bugs

  Dr. Jesse Lazear had been thinking about bugs: For information on Lazear’s early interest in mosquitoes, see Hench, p. 7; Crosby, p. 146; and Pierce and Writer, p. 142.

  Now all four doctors were willing to admit: The importance of the Pinar del Rio incident as a first clue is clear from Reed’s “The Propagation of Yellow Fever.” In that article he points out that Pinar del Rio seemed to show that infected clothing and bedding did not play a role, but that the researchers suspected that some insect had flown into the guardhouse. Although there are no diaries that tell us exactly what the researchers thought and when they thought it, it is clear from other records that the thrust of the investigation changed after the Pinar del Rio incident. This incident may also have given Reed the excuse he needed to counter Sternberg’s negative ideas about insect research and begin investigating the mosquito hypothesis.

  possibly in late July: I have based my description of the visit to Dr. Finlay on the account in Agramonte’s “Inside Story of a Great Medical Discovery” and information about Finlay’s theory. It is, however, hard to tell from available sources when this important visit took place or, indeed, who was present. Researchers at the Hench Collection at the University of Virginia (see their brief biography of Jesse Lazear on their website) have suggested that Lazear visited Finlay in June and then started to grow mosquitoes from eggs that the Cuban scientist provided. Hench doesn’t give a date, but he says that the visit was made by Lazear alone or possibly by Lazear and Reed. Agramonte says the team decided to concentrate on mosquito research in August and implies that the team met with Dr. Finlay as a group. Carroll, in a letter to Robert M. O’Reilly (Aug. 29, 1906) says the visit took place prior to Reed’s August 2 departure for the United States. This could possibly indicate a date in July, because that would have given the team time to raise mosquitoes for the August experiments. It is, however, certainly possible that more than one meeting took place or that various members of the team met separately with Finlay at different times. Unfortunately, unless new pieces of documentation turn up, there is no way to resolve this dispute.

  “cigar-shaped”: Bean, p. 127.

  raise . . . mosquitoes that had never been exposed to any illness: Today scientists know that female mosquitoes can pass the yellow fever germ to offspring through their eggs, but the Reed team didn’t have this information.

  animals didn’t get yellow fever: Scientists now know that certain types of monkeys and white mice can get yellow fever, but in Reed’s time people thought that the disease affected only humans.

  Agramonte was not present: No one knows why Dr. Agramonte was not at this meeting. It is possible that he was consulted earlier, that he was unavailable because he was at his lab in Havana, or that the members of the team didn’t bother to discuss this issue with Agramonte because his possible immunity to yellow fever meant that he would not be a good candidate for such experiments.

  all three doctors were prepared to face it: In his book Who Goes First, Lawrence Altman suggests that Reed left for the United States the next morning because he was scared of participating in these dangerous experiments. I would note, however (and this opinion is also expressed by Pierce and Writer, p. 145), that Reed’s letters show that he had been planning to go home for some time before this meeting. Crosby, p. 147, also points out that because of the unreliable shipping schedules, it would have been impossible for Reed to run away suddenly. Besides, as has been mentioned in the text, Reed had already indicated his willingness to risk his life simply by coming to Cuba and carrying out experiments. Given this information, there seems to be no reason to think that Reed acted like a coward.

  “a soldier’s chances”: Letter from James Carroll to the Editor, June 26, 1903.

  7. “ I Have No Such Thing”

  another healthy volunteer: In addition to members of the team, another doctor, Dr. Alva Sherman Pinto (whose name is sometimes listed as Albert or Alvin), also volunteered to be bitten in these experiments. See Crosby, p. 154.