Customer Reviews

The American Plague: The Untold Story of Yellow Fever, the Epidemic that Shaped Our History

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This is the first book by a young author from Memphis, Tennessee, and while not without shortcomings, it's a better start than most. Crosby describes some key moments in our fight against this nasty disease, starting with a general overview, moving to the ghastly epidemic that devastated Memphis, then to the scene of the critical triumph in Cuba, and finally to the contemporary world and the potential that yellow fever has for a breakout. Along the way she conveys a good sense of what her home town was like in the 1870s, as well as the hardships faced by the medical staff and volunteers in Cuba. The book is as much a peek into life in some highly stressed places as a medical story.

Crosby's random jumping from scene to scene, however, creates a sense of disjointedness that detracts from the book's interest. One gets the impression that what she really wanted to write was a book about "Memphis," not one about yellow fever. This is entirely fine, and choosing to focus on Memphis as plague city certainly establishes a niche for her product. But how does it connect to the scene in Cuba where the seeds of the fever's defeat are first sown? There have been far more comprehensive treatments of Walter Reed's operation there, and Crosby contributes nothing new and notable, nor does she tie Reed's work strongly back to the subject that is obviously her passion. Quite possibly she felt obliged to include this material simply to make the text long enough to interest a publisher; it's not hard to imagine that her researches had pretty thoroughly mined out the information available on Memphis during the plague years, and it wasn't enough for a stand-alone book. However, continuity would have been better if, for example, she had done just a bit more work on the other epidemics that occurred between the Memphis catastrophe and the triumph in Cuba.

The above criticism sounds harsher than it is intended to be. This is by no means a bad book; rather, it's quite a good one that is worth reading for those with an interest in either the disease or the city, and it has its definite moments of drama and eloquence. Crosby should be congratulated for taking on this subject, and we can reasonably expect that she'll learn from her mistakes here and produce works on comparably interesting subjects as she grows as an author.

For as long as we have had illnesses, we have tried to understand them; the earliest of understandings was that some angry deity was sending down punishment for some sort of transgression. It's an explanation that still satisfies many people. Yellow fever could be seen as vengeance direct from God. It was a disease spawned in Africa, and Europeans involved in the slave trade were especially stricken. There is no reason that a yellow fever epidemic has never infested Asia, except that there was no African slave trade there. It infested all of the American colonies, but when the Atlantic slave trade was abolished in the northern states, it went away, continuing in the southern ones. Gods were not involved in the illness, however, or at least their involvement is less direct than the virus that causes the dreadful symptoms and death, or the mosquito that carries the virus. In _The American Plague: The Untold Story of Yellow Fever, the Epidemic That Shaped Our History_ (Berkley), Molly Caldwell Crosby details the ravages of the epidemics, the process by which the disease was brought under some control, and the fears that it might again become a player on the world's pathology stage.

Crosby lives in Memphis, and the first part of her book tells of the epidemic there of 1878. The passages describing the disease within the city's neighborhoods are a combination of Faulkner and Poe. The disease sounds dreadful. The disease had come to Memphis from Havana, borne by the steamer _Emily B. Souder_ up the Mississippi, and starting in July 1878, Memphis residents began dropping; it is a dismal and scary tale. The second half of Crosby's book tells the more familiar story of the eventual understanding of how the disease worked. Walter Reed and his fellow investigators managed to overcome the irrational resistance of doctors that mosquitoes could bear the illness, doing so by starkly effective experiments. There was one ward, the Infected Clothing Building, where the three unfortunate inhabitants would be sealed in along with the detritus of patients who had had the disease, including clothes and sheets soiled with sweat, vomit, and feces. They used those very clothes and sheets, but still, theirs was the experimental group that was safer; none of them came down with the illness. That was not so in the Infected Mosquito Building; fortunately for Reed's work, the inhabitants became deathly ill with yellow fever, but were nursed back to health.

Knowing that the mosquito bears the virus allowed the prevention programs that killed mosquitoes and eliminated standing water where the larvae and eggs grow. These were admirable and effective measures. We know now the virus that causes the illness, and we have a vaccine for it. The use of the vaccine has fallen off, however, and yellow fever is making new inroads in Africa. Crosby makes the point that although we don't have steamers like the _Souder_ anymore, container ships and airplanes are effective carriers of infected mosquitoes or humans, and global warming is making the range of the mosquito greater. We know that viruses have an amazing capacity to mutate into forms that can catch us off our guard. Yellow fever also might be a handy pathogen for a terrorist to deploy. How likely are we to see a plague like that of Memphis again? "Anyone's guess" is the answer given here. The heroic efforts to understand the disease, well described in Crosby's narrative, have produced no reason to be more confident than that.

Molly Caldwell Crosby has written a nice medical mystery--the causes and cure for the dread Yellow Fever.

Yellow Fever is a nasty disease, featuring high fever, severe headache, undue sensitivity to light, extreme pain, shutdown of kidneys, abdominal cramps, and so on. And, given the disease's name, (page 2) ". . .the skin grew a deep gold, the whites of the eyes turning brilliant yellow."

Yellow fever began its course in Africa, and was transported to the New World through the slave trade. The major part of the narrative begins in 1878, with the great breakout of Yellow Fever in Memphis, Tennessee. Crosby notes that (page 13) "By the end of that year, it would suffer losses greater than the Chicago fire, San Francisco earthquake, and Johnstown flood combined." The devastation was great. In July of 1878, the population of the city was around 47,000. By September, 19,000 remained in the city and 17,000 of them had Yellow Fever, if the statistics are to be believed. Chapter 4 aptly describers the situation: "A City of Corpses."

After the epidemic in Memphis, some scientists began to consider what the cause of the disease might be. Carlos Finley argued that mosquitoes were the cause (correctly); however, when he gave his presentation to a learned society, his stuttering etc. undermined his argument. He was labeled (page 85) "Mosquito Man" and a "crank" and a "crazy old man."

The next episode was the Spanish-American War. One byproduct of this was American soldiers in Cuba suffering from Yellow Fever. Dr. Walter Reed was named to head a team to determine causes and how to address the disease. Experimentation on humans (no wonder that we now have guidelines for research on human subjects) led to identification of a particular type of mosquito as the carrier. As time went on, a vaccine was developed. In the process of isolating the cause, however, many died, a number of whom were scientists who allows mosquitoes to bite them. Crosby quotes one doctor later saying that (page 223): "I can think of no other disease that killed so many scientists studying it."

The author concludes the volume by noting some recent outbreaks of Yellow Fever. Does this portend future outbreaks in the United States? Perhaps Crosby is a bit alarmist here. Nonetheless, this is a fine and relatively brief medical detective story, as Walter Reed and others tracked down the cause of this killer disease.

The second half (or so) of this book is a good story about US Army doctor Walter Reed and his men, and Carlos Finlay, investigating the cause of Yellow Fever in Cuba. Molly Crosby is a good biographer and writes well about individuals and their experiences. Unfortunately, the first part of the book tries to tell a history of the 1878 Yellow Fever epidemic that centers in Memphis, and intertwines the stories of several people in that city. It never quite gels, certainly doesn't coherently connect with the later writing on Reed's work in Cuba. Crosby does not have the knack for writing about science like Steven Johnson in the "Ghost Map", nor does she alternate well between writing history, sociology and biology the way William Rosen did in "Justinian's Flea." Maybe Walter Reed's accomplishments might have been better introduced with the outbreaks of Yellow Fever in the military campaign by British in Cuba and later, the French in Haiti, instead of trying to connect it to the Memphis outbreak. Judging the writing by the book's title, "The American Plague," the book fails. However, as source material for students about the story of scientifically proving that mosquitos spread yellow fever, I wouldn't hesitate to recommend the latter parts.

This book is as infectious as the disease it describes. I was drawn in from the very first page, and remained captivated until the very last. Crosby presents the details of the Memphis epidemic in stunning, vivid and gruesome detail. She describes the biology and pathogenesis of Yellow Fever in bold, accurate, and easily understandable terms. However, the book's crowning achievement is its description of the work of the Yellow Fever Commission in Cuba, and the experiments that lead to the discovery of the Aedes mosquito as the vector. If you love the history of medicine, then you'll love this book.

This is a very good book. More than dates and events, the author descibes the often confused efforts to understand this nasty disease. Also, without much hyperbole, you get to see the amazing heroism of the volunteers and doctors on Walter Reed's team. This is not a virology textbook, but mostly the science part is accurate, if too descriptive at times. The story of the Memphis epidemic is very-very good: find out how impossible it is to control an epidemic when no one understands the disease.
I would highly recommend this book to anyone interested in the history of medicine.

In 'The American Plague' Crosby illuminates a yellow fever epidemic in compelling fashion. The characters, including the mosquitoes, are given time to breathe and come to life. For a non-academic historical analysis this is a pretty good effort, particularly with regard to the research on Memphis. If you want to fill in the historical gaps, in particular the jump from Memphis to Cuba, supplement this fine bit of descriptive writing with Margaret Humphreys "Yellow Fever and the South." In the meantime, sit back and allow Crosby to transport you to a time and place of unimaginable circumstance.

THE AMERICAN PLAGUE: THE UNTOLD STORY OF YELLOW FEVER, THE EPIDEMIC THAT SHAPED OUR HISTORY tells of a virus so destructive that one outbreak cost more lives than the Chicago Fire, the San Francisco Earthquake and the Johnstown flood combined. THE AMERICAN PLAGUE narrows the focus to Memphis' near destruction from the epidemic, and the researchers who battled to find a cure and prevention tactics. History, science and public health issues blend in a lively writing style which lends to acquisition not only by college-level holdings strong in the health sciences, but by public institutions with leisure browsers in health history.

Diane C. Donovan
California Bookwatch

Yellow fever, the West African slave trade's gift to the New World, rips through vulnerable populations like a hot knife through butter. In 1801, Napoleon brought 25,000 troops to put down a Haitian slave revolt; 23,000 died from the fever. (That's why he was in such a rush to ditch the Louisiana Territory, and Jefferson knew a bargain when he saw one.) In 1878, the mosquito-borne virus arrived in Memphis TN, and people started dropping like flies. Molly Caldwell Crosby does a great job describing the city's atmosphere before the fever and its descent into hell as Yellow Jack claims more and more victims.

There were heroic efforts by caregivers who didn't understand the disease but who nonetheless tended to the dead and dying. Crosby describes doctors, and nuns, who knew they'd eventually catch the fever but who worked as hard as they could, for as long as they could, to comfort the sick. Inspiring and scary! Yellow fever isn't the kind of fever that lets you lapse into delirium after a day of discomfort. It's a hemorrhagic fever, which means you bleed from body parts you didn't even know you had. The Brits called it "Black Vomit" because internal bleeding causes the sufferer to vomit blood.

Crosby then focuses on the ultimately successful efforts of Walter Reed and company, military doctors who set up camp in Cuba and doggedly pursued the cause of the disease. Some of these men deliberately infected themselves with the virus in order to prove that mosquito exposure was to blame, and that mosquito control would rein in the disease. Because of Reed and his team, and at least in the Western Hemisphere, we have managed to subdue the Fever.

Reed's campaign goes to show that the many of the greatest military victories occur not on the battlefield but in hospitals.

This is a well-written and interesting book, although I wish some of the chapters went into a bit more detail. Yellow fever isn't quite gone; in some parts of the world, it's still doing its dirty work. To understand this battle-hardened public enemy, read this book.

It kept my interest from start to finish. I found myself reading certain chapters over a second time to digest some of the information. I especially enjoyed the mini biography of Walter Reed.