Philip S. Hench Walter Reed Yellow Fever Collection

Outline: The Conquest of Yellow Fever, by Philip Showalter Hench, December 5, 1947

12/5/47 enemy of
Spanish enemies versus disease Typhoid - US

1. (Prologue 1898) -
Get the hosp
name Spanish Am War - Explosion of Maine
Y F at San Juan; at Camaguez .
Peace - Parade of US troops.
American Intervention (July 1898 - Dec 1900) Y F - Cuba
as bad as old days {old
{epidemic
{(have med
{officers
convene

2. (1899) Y F in Havana unaffected by work of Wood & Gorgas
Wasdin & Giddings in Havana confirm Sanarelli
Agramonte " could not " "
Death of Woods officers ?
Reed & Typhoid fever

3. (1899) Reed & Carroll in Wash work on Sternbergs bacillus & Sanarelli's bac
(Reed's visit to Havana; ~~Lazear~~

4 (Jan - Mar 1900)
or Apr ~~Reeds coming & Going from Wash~~
Lazear enlists & goes to Cuba; hears that Reed is coming
Reeds [early] comings & goings ; discusses Y F with Lazear
Agramontes work (in U S with Reed & Carroll; in Cuba alone )
Reed & Carroll & L O Howard .
Mrs Lazear & others leave. /Build up sense of impending
/trouble.

Apr
5. May 1900 -
in Havana
Carter (1898) work
pub May 1900 Y F breaks out in Quemados
Start off with first victim at 102 Real
Quarantine rules & regulations of town & camp
Lazear ~~wood~~ 2 problems; malaria & Y F
May 24 - Lazear hunting for mosquitos: no Y F bodies in mosquitos Kean's list Peterson suicide

6. ( May in Wash) Meanwhile in Wash ----
Problems of Sternberg; what to do . what was cause?
(Review theories) mention Finlay briefly
Reeds non-Y F plans : sudden Y F plans
Y F board formed. May 24 & Reed & Carroll set off - June 21

7 Maj Edmunds illness & death
Kean's illness
Reeds arrival. June 25
First meeting of Board -

8.
June 25 thru
July 20 June [25 -] At first meeting of board Reed outline plans in order of importance to him
June 26 - Did Finlay visit Reed? ( Lampson ) If so could have give his work
but didnt sway Reed from charted course . Start of bacterial [& post mortem ] work in earnest
June 27 - July 2 Agramonte to Santa Clara - came back no wiser Precautionary start with mosquitos?
Lazear's restlessness - letters to
wife
Reed probably arranges trip to Wash

9. Story of Private Arthur ____ at Pinar del Rio
Background , cause of Getting in prison
Y F outbreak: Godfrey , Cooke (newly arrived)
Prisoner's death.

10. Keans suspicions re pernicious malaria
Agramonte to Pinar del Rio - July 19
Reed " " " " -- July 21
(Lazear " " " " -- ?) Here on next chapter)
Reeds thoughts as result of Pinar del Rio - winged agent
Could Finlay be right after all? Reed wrote up neg paper?

11. Finlay up to Aug 14, 1881	Chapter on Finlay. (& Delgado) Background Y F work - early Finlay convinced - wrote paper --"----- Report of Aug 14, 1881 Finlay rose & commenced speaking "-----
12. Finlay 1881 - 1900	( Reaction to Finlays talk) Reaction of profession - look up medical & newspapers . Finlays own personal reaction as told by self. Finlays further work - all in vain.
13.	Aug 1-1900 Board meets; Have Reed re-reading Finlays paper ("-----) just before other members arrived. Reed reviews situation in light of Pinar del Rio observations Reeds predicament: He had arranged to go back to Wash & orders had just arrived but in light exciting Pinar trip wished now didn't have to go. However duty ( Typhoid report) not unmixed with pleasure seeing family again Duty to outline work to be done in his absence: Husar Volunteers! Aug 2. Reed & Truby sailed
14 Aug 3 to Aug 25	Lazear supremely ready & eminently fitted . {Qualifications: { Firm believer in theory { Knowledge of mosquitos & malaria { Pre-board suspicions re mosquitos & Y F { Growing Finlay mosquitos but nothing done with them yet { First 9 cases -- failures
15) Aug 27 to Aug 31 am	- Lazear innoculates Carroll; lack of belief; broke rules Carrolls illness; question of diagnosis Diagnosis - no malarial parasites!! (End with M D looking looking thru microscope at smears , negative - (Aug 31: 9 am) obvious [tentative] conclusion Y F!! Was it Y F? Wait for more def signs
16 Aug 31	--(rest of that day) Lazears probable state of mind ( uncertainty, confusion, exhaltation fear re Carroll, determination to carry on further experiments Selection of Dean; should he or should he not do it. No authority to do so. Should he discuss plans with anyone (Camp Co? Heavens no. Kean? Agramonte? Why should he ? Close [chapter] on innoc of Dean When for arrives wait for 1 - def diag of Carrolls case (2 - onset Dean's illness All he could do now - watch & work----& pray!

17) (Sept 1 - Sept 6) Sept 1 - " 2 or 3 - " 5 - " 6	Carrolls illness. Carrolls case diagnosed Y F.; Carroll removed to ward Reed notified of cable? Dean dizzy pm Dean ill!! Did Lazear (& Ag ?) cable Reed. (see Agramonte Senate 26.) I don't believe so as Agr later admitted in letter to Finlay that he (Agr) knew nothing about Lazears first 2 cases	Deans progress
18 (Sept 6 - 18) Sept 18 -	Lazears Triumph! Lazear's doings; letter to ~~wife~~ mother, to wife. Carroll convalescing - Sept 11 (letter to wife Sept 13) Dean " - Sept 17. (Agramonte doing his own separate work; Reed in Wash - how much did Reed know?) All well: then --- Lazear sick!!!
19 (Sept 18-25)	Lazears Illness & Death Description of illness. Speculations on source of Y F Agramonte left on furlough Sept 22 Lazears death - end chapter at 9 ²⁵ pm	( Anxiety in Wash in Balto but none in Boston where Mrs L was ignorant of illness
20 (night of Sept 25 - Sept 26	Duties connected with Lazears death a) Trubys duties re notify Kean; fumigate room; get belonging's notebook. b) Kean wired re death that night Search for Mrs Lazear Story of how Mrs L received death-message - Sept 26 am Funeral of J Lazear That night Mrs L dry eyed & tense alone with new born baby alone!!! What happened? What happened?!!
21 (first week in Oct). Oct 3- Oct 4-	Truby ponders notebook. Mrs Lazear's visit to Reed in Wash; Reed knew very little Reed arrived at Mantanzas , met Kean " " in Havana; a thousand questions on lips What had happened?!! Truby tells Reed re notebook.	must have been there or else he would have told Mrs L more had it been in Oct.
22 (Oct 5-13)	Writing Prelim Note Reed studies notes & writes "prelim note" Discusses with Kean further plans Keans advice Reed & Kean visit Wood. Wood agrees! Told ag to find camp site.

23) (Oct 13 - Oct 23) Oct 13- Oct 14-20 Oct 23 (?)	Reeds trip back to U S Reed left Havana for Wash & consult with Sternberg and to give Prelim report (Did Carroll accompany Reed? on convalescent trip) Reed enroute to U S (Oct 19 - "Reed now in this city "- Sternberg. trip to Indianopolis. Set stage for Reeds speech
24) Oct 24 "about Nov 1" --	Reed at Indianapolis (& return to Cuba) Reed rose to speak --- Reaction at convention " " press Appraisal of reaction; justification for both sides -- for doubters & for believers Hurry back to Cuba to silence doubters once & for all!	Letter to Mrs Lazear fr Reed
25)Nov 1-20 ~~Nov 20 --~~ Nov 20 -- Nov 20 -- Dec 8 (4 pm) Dec 8 -	Establishment of Camp L; where established & description Call for Volunteers: would he or wouldn't he get them? Kissinger & Moran volunteer.; Benigno volunteers for pay Camp Lazear opened for business Kissinger first to "get the business "! Failures on Kissinger, Moran, Benigno & Presedo Board discouraged. Then --- midnight Kissinger became ill
26) Dec 9 - Dec 12-15	Reeds excitement; letter to his wife (Reed going thru same experiences as Lazear had; preliminary failures: tenacious belief; success; exhaltation. Like ripened fruit falling off tree the cases of Benigno, Presedo & Fernandez ripened & broke! Now Reed ready for " argumentum ad hominum " First cases proved Lazears work; time of incubation ~~now~~ [Could] Reed ~~could~~ [now] prove only the mosquito could do it? a) not air --> Moran experiment planned (Bldg 1) b) " fomites --> Cooke et al (" 2)
27) Dec 21, 1900 --	Experiments in Bldg 1 Describe bldgs; etc World at large & even some associates [still] believed fomites more dangerous than mosquitos. Describe first few days of fear (until Dec 25 when Moran became ill)

28) Dec 21-22 Dec 22 Dec 25 Dec 24 [-Jan 3] -- Dec 31 --	Experiments in Bldg #2 Moran bitten Banquet in Havana to Honor Finlay; Finlays speech Moran developed Y F Rejoicing in Bldg 1. Martinez, Alvarez & Jernegan bitten & M & A devel Y F (Jeregan didn't.) New Years eve letter
29)	Wind-up Experiments (Jan 1901) Inoculations with infected blood to susceptibles & later to immunes Weatherwalks refuses further experiments Shared Reed volunteer? Andrus volunteers & becomes seriously ill - Jan 28 Reed's great anxiety over Andrus Reed regained courage & continued experiments, this time on West (why by mosquito bite?) Hanberry & Sontag (Jan 31 - Feb 10
30 [Feb 6, 1901]	Reed's paper at Pan-American Congress Havana Discussion at Congress Reaction in lay & medical circles Feb 7 or 8 (?) Reed left Havana, never to return
31)	Work of Gorgas - summer & fall 1901
32)	Carrolls return to Havana; experiments in fall 1901
33)	Corporates by Gorgas & Guiteras -- fatal results in 3 cases including Miss Maass.
34	Reaction of medical world -- quick confirmations " " press & lay world 1901-1902 " of die-hards.
35	Results: Cuba & Southern U S cleaned up Panama Canal Early honors for Reed Reeds death

36)	Aftermath (touch on briefly) Controversies between Finlay & U S experiments " by Agramonte & Carroll " between pro-Finlayites" & pro-Reedites. "Time measures all things ---" My own appraisal of relative contributions "Enough glory for all": Later honors for all
37	Epilogue What happened to Camp L? (Sidney Howards prediction) Let it rest in peace, an honored battlefeld .