Red oozes from the patient's gums. He has a rushing headache and the whites of his eyes look like lemons. His tongue may soon turn black. He will likely die within days.
Here is the true story of how four Americans and one Cuban tracked down a killer, one of the word's most vicious plagues: yellow fever. Set in fever-stricken Cuba, the reader feels the heavy air, smell the stench of disease, hear the whine of mosquitoes biting human volunteers during the surreal experiments. Exploring themes of courage, cooperation, and the ethics of human experimentation, this gripping account is ultimately a story of the triumph of science.
About the Author
To research this book, Suzanne Jurmain used primary sources of memoirs, medical log books and documents from the doctors who were actually involved in the conquest of yellow fever. She lives with her husband in Los Angeles and has two adult children - and one large golden retriever.
Read an Excerpt
MEETING THE MONSTER
The young man didn't feel well. First, there was the chill: an icy, bone-freezing chill in the middle of a warm summer evening. Then there was the terrible crushing headache. His back hurt. His stomach twisted with pain. And then he was hot, boiling hot, with a fever that hovered around 104 degrees. His skin turned yellow. The whites of his eyes looked like lemons. Nauseated, he gagged and threw up again and again, spewing streams of vomit black with digested clots of blood across the pillow. Sometimes he cried out or babbled in delirium. Violent spasms jolted his body. It took two grown men to hold him in his bed as a nurse wiped away the drops of blood that trickled from his nose and mouth. Nights and mornings passed. Then, five days after that first freezing chill, the young man died: another victim of a terrible disease called yellow fever.
Doctors didn't know what caused it. They couldn't cure it. But they knew that yellow fever was a killer. For centuries the disease had swept through parts of the Americas and Africa, leaving behind a trail of loss and misery. It turned cities into ghost towns and left the local graveyards filled with corpses. In New Orleans, Dr. Kennedy took sick and collapsed while he was tending patients. In Philadelphia, Dr. Hodge's little girl caught the fever, turned yellow, and died in two short days. And when the sickness killed the Memphis snack shop woman Kate Bionda, she left behind her husband and two small children. The fever struck the rich. It struck the poor. It killed the humble, and it humbled the important. Jefferson Davis, president of the Confederate States of America during the U.S. Civil War, lost his son to yellow fever. George Clymer, who'd signed the Declaration of Independence, watched helplessly as the sickness struck his wife and family. And every single year the illness took its toll. In 1793, 4,044 people in Philadelphia died during a plague of yellow fever. New Orleans counted 8,101 yellow fever deaths in 1853. And when the disease hit Memphis, Tennessee, in 1878, 17,000 citizens sickened in a single month. Stores closed. Work stopped. Thousands fled, and those who remained wandered through a nightmare city — where sick children huddled next to dying parents and hungry dogs roamed the silent streets searching for their lost dead masters.
"Yellow fever [is] ... an enemy which imperils life and cripples commerce and industry," Surgeon General John Woodworth told the U.S. Congress in 1879. And he was right. In one single century — between 1800 and 1900 — the disease sickened approximately 500,000 U.S. citizens and killed about 100,000.
The question was, what could be done about it?
By the 1890s doctors had found that many illnesses are caused by one-celled microscopic organisms called bacteria. With the help of this new knowledge, they taught the public how to kill these dangerous bacterial "germs" with things like heat and disinfectant. They also learned how to use dead or weakened germs to make vaccines — special types of medicine that prevent illness by forcing a living body to produce its own disease-fighting substances. Slowly, physicians began to conquer deadly sicknesses like cholera, typhoid, anthrax, and diphtheria. But yellow fever still raged. Researchers studied the disease. Doctors argued about the cause. Scientists peered through their microscopes, looking for the yellow fever germ. But there was no progress. Each year the hot summer weather brought on yellow fever epidemics. Each year desperate people burned clothing, bedding, and even buildings that had housed yellow fever victims in hopes of stopping the disease. Frantic doctors bled the sick, stuck them in mustard baths, dosed them with opium, or gave them drugs that might make them vomit out the germ — but nothing helped. Each year thousands of people caught the disease. Thousands died of it. And then, suddenly, something happened — something that at first didn't seem to have anything to do with yellow fever or with medical science.
On February 9, 1898, the U.S. battleship Maine blew up in the harbor of Havana, Cuba. Two hundred and sixty-eight American servicemen were killed. U.S. officials told a shocked nation that Spanish government agents had deliberately caused the explosion. And by the end of April the United States had decided to go to war with Spain.
In the next four months American soldiers beat the Spanish army in Cuba. They beat the Spanish navy in the Pacific. And when the Spanish-American War ended in July, the victorious U.S. forces had won the right to govern Cuba and Puerto Rico (two islands off the southern coast of Florida), as well as the Pacific Ocean islands of Guam and the Philippines. Unfortunately, the war had also brought the United States face-to-face with another deadly enemy: yellow fever.
Because of the disease, the newly conquered Cuban territory was a deathtrap. Yellow fever epidemics swept the country. Visitors often contracted the illness soon after landing on the island's shores. Some U.S. troops had already died of the disease in Cuba, and Washington officials were alarmed.
What would happen to American soldiers in Cuba if a full-scale epidemic broke out on the island? Or, worse, what would happen if homecoming U.S. troops carried yellow fever back to North America? That was the kind of thinking that gave United States officials nightmares.
Something had to be done.
Somehow the country had to find a way to prevent more attacks of yellow fever.
But before U.S. scientists could stop or cure the disease, they had to understand it. They had to know what caused the sickness. They had to know what spread it. And it was important that they find out soon.
On May 24, 1900, the U.S. government sent orders to four American army doctors. Their mission was to go to Cuba and find the cause of yellow fever.CHAPTER 2
"FEEDING THE FISHES"
June 21–24, 1900
The USS Sedgwick lurched, and Major Walter Reed, M.D., promptly threw up. The ship was barely out of New York. Already he was seasick. And now, now that he was facing the biggest, most important challenge of his whole career, Dr. Walter Reed didn't need to waste time leaning over the rail and doing what he called "feeding the fishes."
For roughly twenty years, Reed had dreamed of being able to do something big, something important, something that he hoped would "alleviate human suffering." It was a dream he'd had when he was a young army doctor tending settlers, soldiers, and Apaches on lonely frontier outposts. It was something he'd thought about when he went back to school at age thirty-nine to study bacteriology — a brand-new branch of medical science that dealt with the disease-causing germs that researchers called bacteria. For ten more years Reed had hoped to make a major contribution while he did research and taught students at the U.S. Army Medical School in Washington, D.C. And now, finally, at age forty-nine, he had a chance to take on the most exciting and important project of his whole career. Just a few weeks earlier, the U.S. Army had ordered Dr. Walter Reed to go to Cuba, head a team of three other doctors, and find the cause of yellow fever.
But where was he going to start? Before leaving Washington, Reed had read the latest medical books and done some preliminary experiments. He'd looked at scientific articles on yellow fever, and he'd also talked to people who'd spent time studying the illness. By now he knew that there were several current theories on the cause of the disease, and he could tick off on his fingers the first three items that had to be investigated.
First was an idea suggested by Dr Giuseppe Sanarelli. A few years earlier this Italian researcher had announced that a type of bacteria called Bacillus icteroides was the cause of yellow fever. That sounded good. But Reed's recent experiments had shown that Bacillus icteroides actually caused a pig disease called hog cholera. Now scientists were arguing about which research results were right, and Walter Reed knew that his team would have to find a way of settling the issue. That was a big project, and it was only the beginning.
Next on the list was an old theory — one that had been around for years. It claimed that healthy people got the disease by touching clothing, bedding, or furniture that had been used by yellow fever patients. That idea was so popular that it had appeared in medical books. Many health authorities believed it. So did many doctors. Of course, no scientist had ever proved the theory to be true. But it was definitely a matter for Reed and his assistants to consider.
And then, finally, there was another idea. A very different one. For almost twenty years, in more than one hundred experiments, a Cuban doctor named Carlos Finlay had tried to prove that mosquito bites caused yellow fever. Time and time again, the Cuban scientist had attempted to show that bugs could carry the disease by letting mosquitoes he thought might be infected with the germ bite groups of healthy patients. But none of Finlay's patients ever developed a truly clear-cut case of yellow fever from the bites. The experiments were unsuccessful. Many scientists laughed at the Cuban doctor's failures. The mosquito theory didn't seem to fit the facts, and no one understood why Finlay still continued to believe it. Maybe, some people said, the Cuban doctor was "touched." Others came right out and called him "crazy." Even Reed's boss, the surgeon general of the army, George Sternberg — a leading American bacteriologist — thought that the mosquito theory was a joke. Investigating it was "useless," he told Reed. And there was a good chance that the army surgeon general was right. Most sensible scientists did think the mosquito theory sounded pretty flaky. And Bacillus icteroides? Well, because of his own research, Reed privately thought that was probably pretty flaky, too.
But, of course, what Reed thought didn't matter. Science wasn't about opinions or theories. It was about facts. And Reed's job was clear. With the help of his team, he had to find the facts. He had to test each one of the theories.
He had to find out — once and for all — if any of them was right. And if all three current theories were wrong, Reed would have to come up with a new idea — and test that. It was a big job. A tough one. But if Reed and his team could do it ... if somehow they could find the cause of yellow fever, it might help scientists prevent the disease — or cure it.
But that was all in the future.
At the moment, the only cure Reed really needed was a remedy for seasickness. In a letter to his wife and daughter, he said that there seemed to be "two or three tons of brick in ... [his] stomach."
And when the USS Sedgwick rolled again, Dr. Walter Reed leaned over, threw up, and "fed the fishes."CHAPTER 3
June 25, 1900
The sun was warm. The sea was blue. The orange juice, black coffee, and dry toast had stayed down. And Walter Reed was standing at the rail watching as his ship steamed past wharves, past the wreck of the battleship Maine, and into the harbor of Havana, Cuba.
When the ship docked at around eleven, Reed was ready to move. An epidemic of yellow fever had recently broken out in the Cuban town of Quemados. Some people in Havana were also sick with the disease. Even the chief U.S. medical officer for Western Cuba, Reed's good friend Major Jefferson Kean, had come down with the illness several days earlier. There was no time to waste.
Reed quickly loaded his bags into a carriage and drove through the bustling city streets of Havana and across eight miles of country roads until he reached the U.S. Army post at Camp Columbia. After dropping his bags at the Officers' Quarters, he was off again, dashing across the grounds to visit Major Kean in the camp's yellow fever hospital just outside the base.
There the news was good. Kean's case was fairly mild. He was expected to live. At the bedside Reed probably chatted like any other visitor, but he must have also assessed the patient with a scientific eye. Was Kean's skin yellow? Was his temperature high? Were his gums bleeding? What had he been doing in the days before he got sick? Had he been near mosquitoes? Infected clothing? Reed had read descriptions of yellow fever, but this was the first live case he'd ever seen. He was hungry for information. He wanted clues. But he couldn't spend the rest of the day at Kean's bedside. If Reed was going to get the research started, he had to organize his team.
The first meeting had already been called, and late in the afternoon Reed walked onto the garden patio outside Camp Columbia's Officers' Quarters to greet the three men he'd be working with.
They were all there, formally dressed in their crisp white tropical army uniforms. On one side was the tall, thin, balding Dr. James Carroll, a blunt, outwardly charmless man who seemed to be more comfortable looking through a microscope than making conversation. Near Carroll was the chatty Cuban-born, U.S.-educated Dr. Aristides Agramonte, looking like a dandy with his pointed, curled mustache. And rounding out the group was the quiet, bearded, darkly handsome Dr. Jesse W. Lazear.
All of the men had graduated from medical school. All had studied bacteriology, and together they brought a wealth of talent to the project. Carroll had a real passion for lab work. Agramonte, an honors graduate of Columbia University Medical School, had already spent time investigating yellow fever. And Lazear, a former college football player who'd studied medicine in both the United States and Europe, had headed one of the clinical labs at America's prestigious Johns Hopkins University. All three men had worked with Reed in the past, and they listened intently as the chief scientist outlined his program.
The first job, Reed told his colleagues, was to prove that Bacillus icteroides was — or was not — the cause of yellow fever.
That would take a lot of lab work, and each scientist would have his own specific job.
Agramonte would do autopsies. He'd surgically open the bodies of deadyellow fever victims and take out samples of blood, stomach, heart, kidney, and other organ tissues.
Carroll, the best bacteriologist, would take those samples to the lab. He would place tiny amounts of the tissue Agramonte harvested in tubes or dishes filled with a food substance like gelatin or bouillon. Then he would watch to see if any of the tissue samples grew Bacillus icteroides or any other bacteria that might prove to be the cause of yellow fever.
Lazear would help examine the bacteria and tissues under a microscope.
Reed would coordinate the work and help out wherever he could. That covered the important points. But there was one thing more. As he looked around at his assistants, Reed said that he hoped the group would stick closely to his plan. Finding the cause of yellow fever was a tremendous challenge, and he wanted the men to combine their efforts and attack the problem as a team.
Everyone agreed. Work was scheduled to start the following morning. And, as they left the meeting, the four men must have known they were about to start a very dangerous project. People who had had yellow fever were immune. They couldn't possibly get the disease again. But none of the men on Reed's team had ever had a full-blown attack of yellow fever. Reed had certainly never had the disease. Neither had Lazear or Carroll. Though there was a chance that the Cuban-born Agramonte might have had a very mild case as a small child, he was not definitely immune. And all four doctors knew that by being on the fever-stricken island of Cuba, by coming close to sick patients, and by studying bacteria in the lab, they were running a serious risk of getting yellow fever.(Continues…)
Excerpted from "The Secret of the Yellow Death"
Copyright © 2009 Suzanne Jurmain.
Excerpted by permission of Houghton Mifflin Harcourt Publishing Company.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
A Note to the Reader,
Meeting the Monster,
"Feeding the Fishes",
The First Clue?,
"I Have No Such Thing",
"Did the Mosquito Do It?",
"Doctor, Are You Sick?",
Sorting It Out,
"We Are Doing It for Medical Science",
Glossary of Scientific Terms,
About the Author,
What People are Saying About This
"With plenty of gory details . . . Even reluctant readers will respond to the gruesome descriptions of the disease and of brave volunteers . . . Quotations from the doctors’ letters and later accounts by other participants gives the story an immediacy heightened by conversational writing full of questions and cliffhangers . . . powerful exploration of a disease that killed 100,000 U.S. citizens in the 1800s."Kirkus Reviews
Most Helpful Customer Reviews
I really liked this book. The books talks about the scientist who found the transfer of yellow fever from the mosquito to human. It tells you almost step by step how it was tested and how they had to get human subjects willing to get infected to see what was happening. The book has really nice pictures that enhance what is being talked about in the text. Yellow fever isn¿t something we have to deal with now but it is still out there. This book will be a great tool in the classroom because it can be used to address many different scientific issues such as human testing.
A compelling account of how early medical researchers discovered and isolated the causes of yellow fever in the early part of the 20th century.Don't start this book if you have just eaten, and I might make the same recommendation for the following description of the symptoms that open The Secret of the Yellow Death: at onset, an icy chill, followed by a crushing headache, yellowing skin and the whites of eyes the color of lemons, delirium and blood-clotted vomit come next and violent spasms. Within three days a victim could be dead.You would think that something this virulent would have had its heyday during the plague years, hundreds of years ago, but the outbreak that consumed Cuba and eventually lead to the discovery of the yellow fever virus happened barely 100 years ago. That a combined team of scientists from the United States and Cuba solved the mystery through dogged determination despite a general disbelief among other scientists that mosquitoes were the carrier gives the story its tension. After all, if it wasn't mosquitoes, then what was the cause? Heading up the team was Walter Reed, a doctor who was sure that the source of the outbreak that was sweeping across Cuba could be discovered. Even from a distance, when he was called back to the States, Reed kept contact with the team of four other doctors who attempted to actively manufacture ill patients in order to prove their theories. Even as they had successes, managing to grow carrier mosquitoes and getting them to bite willing recruits, some managed to avoid illness. At each turn it is as if the solution is within reach and then comes another setback. But with each trial and set of circumstances they learn a little more until, finally, they isolate the virus and understand the gestation period and the crucial timing necessary to replicate the illness in a controlled setting. But many of the doctors involved died before the final results were discovered and understood by those who carried their efforts forward. It's a compelling mystery because of the variables that must be discovered both through trial and error and because little was known or understood about the simple organisms known as viruses. Jurmain has chosen to get close to the story, to use primary source material to reconstruct the narrative of how the scientists worked to come to a conclusion. She admits early on that she is unable to include source material for the Cuban doctors involved because that material is unavailable. It would be nice to think that some day normalized relations between Cuba and the US might give us the full picture of the story, but as it is written there are few missing gaps of consequence and the story doesn't suffer for the lack.While not profusely illustrated it does contain plenty of photos from the era that remind the reader just how crude the practice of medicine was just 100 years ago. The crude hospital and research facilities, the crude metal syringes, and the handwritten medical charts all add to the overall mood of the story, yellowed with age and looking for all the world like they might still carry the sickness with them. There is an appropriate creepiness to The Secret of the Yellow Death and that will be a huge part of its appeal to readers. Gross when it needs to be, creepy and disgusting in a scientific setting, and the constant question ¿ are they ever going to figure this out? ¿ combine for a compelling read.
Yellow fever was a horrifying disease that killed thousands. Between 1800 and 1900, it killed 100,000 Americans, and the U.S. Surgeon General labeled it "...an enemy which imperils life and cripples commerce and industry." in 1900, Major Walter Reed was ordered to go to Cuba with three other Army doctors to find the cause of this dread disease, and hopefully either a cure or a way to prevent the spread of yellow fever. One of the key players in this drama was Cuban Dr. Carlos Finlay, who had theorized that mosquito bites spread the disease, but he had been unable to clearly prove it. The team of doctors and Army volunteers used the scientific method to work through a number of possible causes -- with some success, some failure, and some inconclusive results. The pressure to succeed and solve the mystery was tremendous, as lives quite literally depended upon the team's work. The layout of this book is excellent, with illustrations and photos on every spread, each one important to the text on that page. There are exceptional source notes, divided by chapter in the back, so it's easy to tell how well researched this is. 7th grade and up!
The intriguing and exciting story of US Army Major Walter Reed, MD and his dedicated group of fellow physicians and researchers who set out to uncover the true cause of Yellow Fever, the scourge of tropical and semi tropical areas across the globe.
Just over one hundred years ago, a disease called yellow fever periodically ravaged cities in both the United States and Cuba. But despite the best efforts of doctors and scientists, no one had discovered the source of the devastating illness, or the cure. Determined to put a stop to the outbreaks and save future generations from harm, a team of army doctors set out for Cuba to face the disease head on. Working with a Cuba physician, this team conducted experiments on human subjects, so devoted to their cause they included themselves in some. Even when the results suggested their best guesses were wrong, they pushed forward. One doctor eventually gave his life to the fever, but not before he'd started the rest of the team down the right path, to finally determine the cause of the illness and eliminate it. THE SECRET OF THE YELLOW DEATH tells the story of those doctors in a straight-forward narrative style that will appeal even to readers who are not generally fond of non-fiction. The urgent need to understand the disease, and the risks the team and their volunteers take to gain that understanding, make the book at times as suspenseful as any work of fiction. Jurmain also clearly explains the scientific facts, and includes many photographs and illustrations to bring this time in history to life. Recommended to anyone interested in science and medical mysteries.