MAJOR REED’S WORK IN HAVANA; 
How He Proved That Yellow Fever Is Transmitted Only 
By One Species Of Mosquito And That Articles 
Used Or Soiled By Patients Do Not 
# lc?un>r,r 
Carry Infection. 
Non-Immunes Slept for Days in Soiled Bedding of Yellow |Fever Cases, in Sealed 
Room, With No III Effect—Afterwards Promptly Infected by MtF§dtfiTo—Tlie Sub- 
sequent Campaign in Havana—Yellow Fever Wiped Out There After 150 Years 
Supremacy. 
The appearance of yellow fever in 
New Orleans and the determination of 
Dr. White, head of the Federal forces 
sent here, of the State and City Boards 
of Health and of practically the whole 
of the medical fraternity to appeal to 
the whole community for co-operation 
in the effort to apply successfully the 
dogma that yellow fever is transmit- 
ted only by a certain species of mos- 
quito has aroused intense interest in 
the subject of the causation of yellow 
fever epidemics. Some details are 
given here of the wonderful results of 
the experiments of the commission 
headed by Major Walter Reed of the 
United States Army in Cuba, results 
which, it is claimed, have enabled the 
authorities to make Havana, the home 
of yellow fever, practically immune 
after 150 years of constant fever. The 
whole credit of the development of the 
theory into a scientific fact is due to 
Major Reed, who, with other officers 
and privates of the United States 
Army, risked their lives in the demon- 
stration. Assistant Surgeon Lazear 
lost his life in the attempt. Major 
Reed succumbed three years ago to an 
attack of appendicitis in the city of 
Washington. 
Major Reed a Brilliant Virginian. 
Major Walter Reed was born in 
Gloucester county, Virginia, in 1861. 
He was the son of the Rev. Lemuel 
Sutton Reed. He received a fair pri- 
mary education and then went to the 
University of Virginia to study medi- 
cine, graduating in 1868, when only 17 
years of age. He secured a second 
degree at Bellevue Medical College in 
New York and then served in the 
Bro. \Iyn and Blackwell’s Island Hos- 
pital. Before he was 21 he was a 
district physician in New York, and at 
22 was one of the five inspectors of 
the Board of Health of Brooklyn. He 
went jnto the United States Army as 
Assistant Surgeon with the rank of 
First Lieutenant in 1875, and during 
the next eighteen years served in Ari- 
zona, Nebraska, Dakota and in the 
Southern and Eastern States. He was 
always an indefatigable student and a 
pioneer. In 1890 he went to Balti- 
more, working in the laboratories of 
Johns Hopkins University. In 1893 he 
was made surgeon with the rank of 
Major and was detailed in Washing- 
ton as Curator of the Army Medical 
Museum and Professor of Bacteriology 
at the Army Medical School. He won 
high praise for his writings and be- 
came an expert in investigating the 
causes of epidemic diseases at mili- 
tary posts and in making sanitary in- 
spections. During the Spanish-Amer- 
ican war he was selected as the head 
of a board to study the causation and 
spread of typhoid in the camps of the 
volqnteer troops, and the report of the 
commission, a monumental work, is 
now in course of publication by the 
Government and is expected to serve 
as a basis for future study of the epi- 
demiology of typhoid fever. 
His great work in Cuba, in demon- 
strating that yellow fever is trans- 
mitted by the mosquito, is thus briefly 
described in a memoir published last 
year by the Walter Reed Memorial 
Association at Washington. 
Sent to Cuba to Study Yellow Fever. 
“In June, 1900, Major Reed was sent 
to Cuba as president of a board to 
study the infectious diseases of the 
country, but more especially yellow 
fever. Associated with him were Act- 
ing Assistant Surgeons James Carroll, 
Jesse W. Lazear and A. Agramonte. 
At this time the American authorities 
in Cuba had for a year and a half en- 
deavored to diminish the disease and 
mortality of the Cuban towns by gen- 
eral . sanitary work, but while the 
health of the population showed dis- 
tinct improvement and the mortality 
had greatly diminished, yellow fever 
apparently had been entirely unaffect- 
ed by these measures. In fact, owing 
to the large number of non-immune 
foreigners, the disease was more fre- 
quent than usual in Havana and in 
Quemados, near the camp of Ameri- 
can troops, and many valuable lives of 
American officers and soldiers ha4 
been lost. “Reed was convinced from the first 
that general sanitary measures alone 
would not check the disease, but that 
its transmission was partly due to an 
insect. 
“The fact that malarial fever, caused 
by an animal parasite in the blood, is 
transmitted from man to man through 
the agency of certain mosquitoes had 
been recently accepted by the scien- 
tific world; also, several years before, 
Dr. Carlos Finlay of Havana had ad- 
vanced the theory that a mosquito 
conveyed the unknown cause of yel- 
low fever, but did not succeed in 
demonstrating the truth of his theory. 
“Dr. H. R. Carter of the Marine Hos- 
pital Service had written a paper 
showing that although the period of 
incubation was only five days, yet a 
house to which a patient was carried 
did not become infected for from fif- 
teen to twenty days. 
“To Reed’s mind this indicated that 
the unknown infective agent has to 
undergo a period of incubation of from 
ten to fifteen days and probably in the 
body of the biting insect. 
Sanarelli Theory Disproved. 
“Up to this time the most generally 
accepted theory as to the. causation of 
yellow fever was that of Sanarelli, 
who claimed that the bacillus icete- 
roids discovered by him was the speci- 
fic agent of the disease. Major Reed, 
in association with Dr. Carroll, had, 
however, already demonstrated that 
this bacillus was one widely dissemi- 
nated in the United States, and bore 
no such relation to yellow fever. 
“In June, July and August, 1900, the 
commission gave their entire attention 
to the bacteriological study of the 
blood of yellow fever patients and the 
postmorten examination of the organs 
of those dying of the disease. In 
twenty-four cases where the blood was 
repeatedly examined, as well as in 
eleven carefully studied autopsies, 
bacillus ieeteroids were not discov- 
ered, nor was there any indication of 
the presence in the blood of a specific 
cause of the disease. 
“Application was made to General 
Leonard Wood, the military governor 
of Cuba, for permission to conduct ex- 
periments on non-immune persons, and 
a liberal sum of money requested for 
the purpose of rewarding volunteers 
who would submit themselves to ex- 
periment. 
“It was indeed fortunate that the 
military governor of Cuba was a man 
who, by his breadth of mind and spe- 
cial scientific training, could readily 
appreciate the arguments of Major 
Reed as to the value of the proposed 
work. 
“Money and full authority to proceed 
were promptly granted, and to the 
everlasting glory of the American sol- 
dier, volunteers from the army offered 
themselves for experiment in plenty, 
and with the utmost fearlessness. 
Dr. Lazear Dies a Hero. 
"Before the arrangements were en- 
tirely completed Dr. Carroll, a member 
of the commission, allowed himself to 
be bitten by a mosquito that twelve 
days previously had filled itself with 
the blood of a yellow fever patient. 
He suffered from a very severe attack, 
and his was the first experimental 
case. Dr. Lazear also experimented on 
himself at the same time, but was not 
infected. Some days later, while in 
the yellow fever ward, he was bitten 
by a mosquito and noted the fact care- 
fully. He acquired the disease in its 
most terrible form and died a martyr 
to science and a true hero. 
“No other fatality occurred among 
the brave men who in the course of the 
experiments willingly exposed them- 
selves to the infection of the dreaded 
disease. 
“A camp was especially constructed 
for the experiments, about four miles 
from Havana, christened Camp Lazear 
in honor of the dead comrade. The 
inmates of the camp were put into 
most rigid quarantine and ample time 
was allowed to eliminate any possibil- 
ity of the disease being brought in 
from Havana. 
“The personnel consisted of three 
nurses and nine non-immunes, all in 
the military service, and included two 
physicians. 
“From time to time Spanish immi- 
grants, newly arrived, were brought in 
from the immigrant station; a person 
not known to be immune was not al- 
lowed to leave camp, or if he did was 
forbidden to return. 
“The most complete record was kept 
of the health of every man to be ex- 
perimented upon, thus eliminating the 
possibility of any other disease than 
yellow fever complicating the case. 
The Wonderful Experiments. 
“The mosquitoes used were especial- 
ly bred from the eggs and kept in a 
building screened by wire netting. 
When an insect was wanted for an ex- 
periment it was taken into a yellow 
fever hospital and allowed to fill itself 
with the blood of a patient; afterward, 
at varying intervals from the time of 
.this meal of blood it was purposely ap- 
plied to non-immunes in camp. 
“In December five cases of the dis- 
ease were developed as the result of 
such applications, in January three 
and in February two, making in all ten, 
exclusive of the cases of Drs. Carroll 
and Lazear. Immediately upon the 
pearance of the first recognized 
symptoms of the disease, in any one 
of these experimental cases, the pa- 
tient was taken from Camp Lazear to a 
yellow' fever hospital, one mile distant. 
Every person in camp was rigidly pro- 
tected from accidental mosquito bites, 
and not in a single instance did yellow 
fever develop in the camp except at the 
will of the experimenters. The experi- 
ments were conducted at a season 
when there was the least chance of 
naturally acquiring the disease and the 
mosquitoes used were kept active by 
maintaining them at a summer temper- 
ature. 
“A completely mosquito-proof build* 
ing was divided into two compartments 
by a wire screen partition; infected 
insects were liberated on one side only. 
A brave non-immune entered and re- 
mained long enough to allow himself 
to be bitten several times. He was at- 
tacked by yellow fever, while two sus- 
ceptible men in the other compart- 
ment did not acquire the disease, al- 
though sleeping there thirteen nights. 
This demonstrates in the simplest 
and most certain manner that the in- 
fectiousness of the building was due 
only to the presence of the insects. 
“Every attempt was made to infect 
individuals by means of bedding, 
clothes, and other articles that had 
been used and soiled by patients suf- 
fering with virulent yellow fever.” 
Dr. Carroll’s Convincing Report. 
“Naturally yellow fever is transmit- 
ted by the mosquito, and always and 
only by the mosquito. The harmless- 
ness of fomites has been fully demon- 
strated by our experiments in 1900 and 
1901, in which three young Americans 
slept for twenty consecutive nights in 
a room from which mosquitoes were 
excluded garnished with articles soiled 
with discharges from fatal and other 
cases of yellow fever. Three and four 
large boxes were packed and unpacked 
each morning by these non-immunes, 
who suffered no disturbance of health 
from these exposures. The room was 
twenty feet by fourteen feet, double- 
walled, tightly sealed, heated to above 
90 degrees Fahrenheit and dark. 
“Two other non-immunes then occu- 
pied the room for twenty nights, while 
additional articles of bedding and 
clothing were added. They slept in. 
the garments and between the sheets- 
that had covered cases of yellow fever, 
some of which were fatal. The result 
of the second attempt was nil. A third 
attempt was then made with two addi- 
tional non-immunes, equally without 
success. Not the slightest indisposi- 
tion followed close and intimate con- 
tact with this repulsive material in any 
case. Temperatures and pulse rates 
were recorded at regular and frequent 
intervals. Four of these seven non- 
immunes were subsequently infected 
by blood-injections and by means of 
infected mosquitoes.” 
Another kind of experiment was in- 
cluded in the Cuban investigations of 
yellow fever. A room was prepared so 
as to preclude the possibility of infec- 
tion by fomites (infected articles). 
Every article contained in the room 
had been previously disinfected and 
was thoroughly clean. The only possi- 
ble means of infection with yellow 
fever was by infected mosquitoes, lib- 
erated in -the room containing the 
human subjects of the experiment. 
Yellow fever promptly followed the 
introduction of mosquitoes into the 
room. 
The Reed memoir continues: 
What Experiments Proved. 
“Besides the experimental cases 
caused by mosquito bites, four non-im- 
munes were infected by injecting blood drawn directly from the veins of yel- 
low fever patients in the first two days 
•f the disease, thus demonstrating the 
presence of an infectious agent in the 
blood at this early period of the at- 
tack. 
“Even the blood serum of a patient, 
passed through a bacteria-proof filter, 
was found to be capable of causing 
yellow fever in another person. 
“The details of the experiments are 
most interesting, but it must here suf- 
fice to briefly sum up the principal 
conclusions of this admirable board of 
investigators of which Reed was the 
master mind: 
“1. The specific agent in the causa- 
tion of yellow fever exists in the blood 
of a patient for the first three days of 
his attack, after which time he ceases 
to be a menace to the health of others. 
“2. A mosquito of a single species, 
stegomyia faciata, ingesting the blood 
of the patient during this infective 
period is powerless to convey the dis- 
ease to another person by its bite until 
about twelve days have elapsed, but 
can do so thereafter for an indefinite 
period, probably during the remainder 
of its life. 
“3. The disease cannot be spread in 
any other way than by the bite of the 
previously infected stegomyia. Articles 
used or soiled by patients do not carry 
infection. 
“These conclusions pointed so clear- 
ly to the practical method of extermi- 
nating the disease that they were at 
ence accepted by the sanitary authori- 
ties in Cuba and put to the test in Ha- 
vana, where for nearly a century and a 
half, by actual record, the disease had 
never failed to appear annually. 
Fever Leaves Havana After 150 Years. 
“In February, 1901, the chief sani- 
tary officer in Hanava, Major W. C. 
Gorgas, Medical Department of the 
United States army, instituted meas- 
ures to eradicate the disease, based en- 
tirely on the conclusions of the com- 
mission. Cases of yellow fever were 
required to be reported as promptly as 
possible, the patient was at first rigidly 
isolated, and immediately upon the re- 
port a force of men from the sanitary 
department visited the house. All the 
rooms of the building and of the 
neighboring houses were sealed and 
fumigated to destroy the mosquitoes 
present. Window and door screens 
were put up and after the death or re- 
covery of the patient his room was 
fumigated and every mosquito de- 
stroyed. A war of extermination was 
also waged against mosquitoes in gen- 
eral, and an energetic effort made to 
diminish the number bred by draining 
standing water, screening tanks and 
vessels, using petroleum on water that 
could not be drained, and in the most 
systematic manner destroying the 
breeding places of the insect. 
“When the warm season returned a 
few cases occurred, but by September, 
1901, the last case of yellow fever orig- 
inated in Havana, since which time the 
city has been entirely exempt from the 
terrible disease that had there kept 
strong hold for a hundred and flftj 
years. Cases are now admitted int( 
Havana from Mexican ports, but ar« 
treated under screens with perfect im 
munity in the ordinary city hospitals 
The crusade against the insects also 
caused a very large decrease in ma- 
larial fevers. 
More recent investigations into the 
cause and spread of yellow fever have 
only succeeded in verifying me work 
of Reed and his commission in every 
particular and adding very little to our 
knowledge of the disease. 
“Later researches by Guiteras in 
Havana, by the Public Health and Ma- 
rine Hospital Service in Vera Cruz, 
and lastly by the delegation from the 
Pasteur Institute of Paris in Rio da 
Janeiro, all confirm in the most con- 
vincing manner both the accuracy and 
comprehensiveness of the conclusions 
of the American commission. It has 
been well said that Reed’s experiments 
will always remain as models in the 
annals of scientific research, both for 
the exactness with which they were 
adapted to the points to be proved and 
the precautions taken that no experi- 
ment should be vitiated by failure to 
exclude all possible sources of error. 
“Appreciation of Reed’s work was 
instant in the scientific world. Honor- 
ary degrees from Harvard University 
and the University of Michigan were 
conferred upon him, learned societiei 
and distinguished men delighted t< 
honor him, and after his death Con 
gress voted a special pension to hit 
widow.” 
H, A. Thiberge Printing Co. Ltd 428 Camp St. N. o. 
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