4.0 out of 5 stars
Review, February 20, 2009
This review is from: The History of Yellow Fever: An Essay on the Birth of Tropical Medicine (Hardcover)
This is the review I had to submit for my entomology class, figured someone may get some use of it.
Delaporte's History of Yellow Fever is played out as a scientific detective story. Instead of the main character being a human, it's the disease. While tracing the story, Delaporte demonstrates the practical value of an epistemological approach to the history of science. Throughout the essay Delaporte debunks many of the misnomers and myths surrounding the identification of the cause of yellow fever. He thoroughly goes into the politics of the situation by showing how the scientists stole ideas from one another and tried to conceal the fact that they had done so. One thing Delaporte tries to do throughout the essay is to keep it unbiased. He accomplishes this relatively well by showing both sides of the story yet near the end overdoes it by giving too much information on the subject. Delaporte keeps this book interesting by making this time period in history into a story, instead of presenting the reader with dry facts.
Delaporte begins his essay by demonstrating the different versions of the discovery of the infectious agent. He does this by showing two drawings. The first depicts Carlos Finlay, a Cuban physician/scientist, showing his American colleagues a sample of the suspected disease vector (the mosquito). Most of the Americans seem disinterested in Finlay's ideas, even though those men were studying the same disease. This picture was painted by a Cuban artist and was designed to show the America's obliviousness towards Cuban contributions. The second picture, drawn by an American artist, depicts their scientists working hard in the field. They are infecting a Cuban man with the disease by letting an infected mosquito bite the man. These two pictures set up the conflict between the Americans and Cubans, which arises later in the essay. This was a very effective tactic because it clearly shows the conflict between the two, which the later part of the essay could not capture in over thirty pages.
Yellow fever reaches the limelight by creating a small epidemic on the U.S.S Plymouth, an American naval gun ship. This prompts an investigation by the U.S Government. They investigate the normal causes: weather, unsanitary conditions and the condition of the food and water supplies. At the same time Finlay is also investigating the disease because of its devastating affects on the men working in the Panama Canal (10% of the men died each year from Malaria and Yellow Fever). Finlay noticed that the disease could not be spread from human to human and, it was prevalent in hot and humid areas. Early speculations by scientists were that the disease was being spread through the air and was caused by a toxin. The affects of this disease caused nearly 85% of the infected individuals to perish during this time. Symptoms of the viral infection included: hemorrhaging, high fever and a yellow coloring to the skin--where the disease gets its name.
In order to show all sides of the story, Delaporte dedicates a chapter to the research of British physician Patrick Manson. Manson, who is not credited for his contributions, first proposed the use of a mosquito as a disease vector. Manson was studying the parasite that causes filariasis; he went on to show that the parasite used mosquitoes as transportation to shuttle itself to humans, which ended in the disease, filarisis. After reading about Manson's research, Finlay began to think about yellow fever in the same way. He narrowed his examination to any bloodsucking organism, namely ticks, fleas, lice, bugs, leaches, mosquitoes and sand flies. By using his knowledge of the area Finlay chose mosquitoes band eliminated all others because those were found outside of the infection zone. He further narrowed the field down to three types of mosquito: Aedas simpasaloni, A. Africanus and A. Aegypti. Even though Cuban historians and Finlay himself deny any influence of Manson in the development of this new disease vector, the author rightly points out the contribution of Manson. It was still unknown to Finlay whether the mosquitoes transmitted the disease through biting humans or deposited them into the drinking water. Since insects transmitted no other disease known at the time, Finlay concentrated on transmission of the disease by fecal/blood-tainted water. This type of transmission was well known because the ever-prevalent cholera used the same vector, but Finlay (and later Reed) eliminated it because there appeared to be no connection between his disease, feces, and water. Though Finlay was crucial in establishing how the disease was transmitted, he was unable to ever do a controlled study where he infected a subject.
Once Finlay began publishing his ideas, they weren't taken seriously because they contained many holes. He could explain the holes, but then he would have to admit where he got the ideas. This left the door open for other scientist to join the game of identifying the culprit behind yellow fever. Two men by the name of Walter Reed and João Baptista de Lacerda were at the forefront. These scientists were convinced that the cause of the infection was a bacterium, which Finlay missed due to his inferior science. Delaporte makes this prejudice against Finlay apparent several times throughout the text, but only sparsely shows Finlay's own prejudice. Lacerda was very dedicated to the job and within a year of beginning his studies, he succumbed to the Fellow Fever. Reed, on the other hand, was vital in the development of tropical medicine. Reed built upon Finlay's research, which he claimed as his own, by actually infecting a subject with the disease in a controlled study. Reed used several techniques that would most certainly be banned in modern research. One such technique was forcing several men to stay a hut that was covered in a combination of blood, vomit and feces of those that had been infected. This technique, though brutal, was effective in letting Reed know that nothing other than mosquitoes could transmit the disease, further fortifying Finlay's research. Delaporte goes on to show that the scientists actually infected humans by having them bitten by contaminated mosquitoes. These interesting aspects of the essay show how primitive the science was in comparison to how they discovered the disease vector.
With a general idea concerning how the disease was transmitted, Reed and many of his colleagues attempted many times to develop a vaccine with no results. Conversely, Finlay recommended that governments spray chemicals to attempt to limit the number of the disease carrying mosquitoes. Governments employed Finlay's recommendation and saved many men working on the Panama Canal by spraying the area with insecticides. Once the ideas about the disease were publicized by Reed, the disease got much more recognition in the scientific community. This sparked a large debate between Reed and Finlay about who really developed the idea. Delaporte sets this up very well in that he shows both sides of the story by giving the actual clams made by the men. Though Reed was able to do more tests on the disease it was Finlay (and Manson) who came up with the disease vector, something Reed was unwilling to acknowledge. In the end, there is really no winner, but instead both men are jointly recognized for their contributions in the area of tropical medicine.
As the essay winds down, Delaporte breaks away from his story telling and begins tossing out several irrelevant ideas and often repeats many of his established points. The book ends with Delaporte telling the reader about the statues erected for Finlay and some of the other accomplishments of Reed and Finlay. This seems to be a good way to end the books, if it was short and sweet, but Delaporte spends more time talking about the future than he did when he explained the much more fascinating aspects to their research.
One disappointed facet of the essay is that the men involved never get to find out the cause of the disease and without further investigation, the reader won't either. This book shows a great leap in the knowledge of tropical diseases and demonstrated how insects can transmit diseases. Other than the ending, this is a book I would highly recommend to any person who enjoys reading about science. It is full of early research techniques and shows how scientists used to do things before modern conveniences were available. An unfortunate thing Delaporte does throughout the text is that he refers to the pathogen as a virus. While this is true, he takes away from the mystery of the story by outing the culprit prematurely and it devalues the struggle the men went through in attempt to find the cause of the disease. My overall rating of this book would be a B+.
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