» Full Dark, No Stars - Stephen King's new novella questions mankind's ability to trust others.
[02.21.2011 by Bridget Doyle]


 » The Top 30 Albums of 2010 - Fashionably, fabulously late, our favorite music (and believe me, there was a LOT) of 2010, the year that some have called the best year for music ever. And only some of those fools work here. Plenty of usual suspects, lots of ties and a few surprises that I won't spoil, including our unexpected #1.
[12.24.2010 by The LAS Staff]


 » Live: Surfer Blood/The Drums at Lincoln Hall, Chicago, IL - Remember when Weezer used to put together records that you could sing along to and rock out to? That's what Surfer Blood's show was like!
[11.04.2010 by Cory Tendering]

Music Reviews

Screaming Females - Castle Talk
»Screaming Females
Castle Talk
Don Giovanni
Trent Reznor & Atticus Ross - The Social Network [Original Soundtrack]
»Trent Reznor & Atticus Ross
The Social Network [Original Soundtrack]
The Null Corporation
Deerhunter - Halcyon Digest
Halcyon Digest
No Age - Everything in Between
»No Age
Everything in Between
Sub Pop
Robyn - Body Talk Pt. 1/ Body Talk Pt. 2
Body Talk Pt. 1/ Body Talk Pt. 2
The Walkmen - Lisbon
»The Walkmen
Fat Possum

May 14, 2008
Rating: 8/10

The arrival of summer brings hot, hazy afternoons perfect for a cold drink and a swim, warm evenings ideal for dinners on decks and patios, the air tinged with the scent of backyard grilling and the fecund flowering of honeysuckle and magnolias. And then there are the mosquitoes. Today they prove little more than an annoyance, their bloodthirstiness mitigated by a spray of Off! and maybe a bug zapper for good measure. But in the summer of 1878, the wispy insects, thriving from heavy spring rains and breeding in open cisterns and privies, carried yellow fever, a virus that would decimate the city of Memphis, with the death toll surpassing that of the San Francisco earthquake, the Chicago fire, and the massive Johnstown flood of 1889 combined.

In The American Plague: The Untold Story of Yellow Fever, the Epidemic That Shaped Our History, Molly Caldwell Crosby provides a vivid and engaging account of the fever's horrific ravages and of the heroic individuals who risked their lives, and often lost them, in an effort to combat the disease.

Originating in the jungles of West Africa, yellow fever spread to the western hemisphere via the slave trade, to the West Indies, and for two centuries was feared more than any other disease in North America. In the United States alone, the disease struck half a million people, killing 100,000. In fact, the nation's capital moved from Philadelphia to Washington, D.C., in 1793 as the result of a yellow fever epidemic. But no epidemic proved more devastating than that of the 1878 outbreak in Memphis, Tennessee.

Throughout her study, Crosby demonstrates an exceptional gift for crafting vivid, evocative imagery, and nowhere is that talent clearer than in her arresting descriptions of the horrors of yellow fever. Describing the stages of the disease, Crosby writes:

"It hit suddenly in the form of a piercing headache and painful sensitivity to light . . . But the pain worsened, crippling movement and burning the skin. The fever rose to 104, maybe 105 degrees, and bones felt as though they had been cracked. The kidneys stopped functioning, poisoning the body. Abdominal cramps began in the final days of illness as the patient vomited black blood brought on by internal hemorrhaging. The victim became a palate of hideous color: Red blood ran from the gums, eyes, and nose. The tongue swelled, turning purple. Black vomit roiled. And the skin grew a deep gold, the whites of the eyes turning brilliant yellow."

By the end of the 1878 epidemic, over 5000 people had died in Memphis - almost a third of the population that hadn't fled the city - with a total of 20,000 lives lost in the Mississippi Valley. But alarming statistics and lurid details only begin to demonstrate the horror and tragedy of that summer. Crosby relates stories of priests, nuns, preachers, and doctors who courageously remained in the city to care for the sick and dying, adding an emotional depth to the book. Sustaining a steady narrative proves problematic, though, as many of the people she introduces were among those in the final death toll.

Hubris at the local and national levels of government further exacerbated the tragedy. At the time, doctors and scientists could only speculate as to the cause of yellow fever. One prominent theory held that the disease spread by exposure to filth; another suggested it entered cities through railroads and ships. Before the outbreak, Dr. Robert Wood Mitchell, a member of Memphis' Board of Health, urged the other members of the board to call for a quarantine of goods coming up the Mississippi River, given that New Orleans had had several outbreaks of the fever in the past. Worried that a quarantine would stir panic and would stall commerce, the other members ignored Mitchell's pleas. The John D. Porter, carrying goods from the Emily B. Souder, a steamer that traveled from Havana to New Orleans, brought yellow fever to Memphis.

Echoed by events of more recent times, Federal response to the epidemic in Memphis was dismissive. With Elmwood Cemetery increasingly "bloated with shallow graves," President Rutherford B. Hayes responded to city officials' urgent request for help by writing, "I suspect the Memphis sorrow is greatly exaggerated by the panic-stricken people. We do all we can for their relief." By the time Hayes understood the gravity of the situation, little could be done.

In the second half of the book, the scene shifts to Cuba as Crosby details Walter Reed's unflagging search to discover yellow fever's origin and how it spread. In the Spanish-American War only 385 U.S. soldiers died in action; the remaining deaths -- more than 2500 -- came from yellow fever. With soldiers stationed in Cuba following the war and the country an important cog of American trade, Reed was initially sent to Cuba by Surgeon General George M. Sternberg to research ways to improve sanitary conditions in military camps as a means of eliminating disease. Though the measures taken dramatically lowered cases of typhoid and dysentery, they did nothing to slow yellow fever.

Reed returned to Cuba in the summer of 1900 as head of the Yellow Fever Commission. Along with James Carroll, Jesse Lazear, and Aristides Agramonte, his main assignment from Sternberg was to assess the validity of Dr. Giuseppe Sanarelli's claim that bacteria caused yellow fever. Before Reed left for Cuba, Sternberg told him looking for a connection between mosquitoes and yellow fever "has already been decided to be a useless investigation."

But the Commission's research steered them toward the work of Dr. Charles Finlay, a Cuban doctor who twenty-one years earlier presented a paper positing mosquitoes as the vectors of yellow fever. The medical community, convinced the disease was contagious and spread by bacteria, filth, or contact with a victim, dismissed Finlay's ideas, deriding him as the "Mosquito Man." But Finlay would be vindicated.

The team devised a test that would demonstrate incontrovertibly that mosquitoes served as the vectors of the disease. On an isolated stretch of land dubbed Camp Lazear (named in honor of the American physician, who died of yellow fever at age 34 after apparently subjecting himself to mosquito testing) they constructed two buildings. In Building No. 1, the Infected Clothing Building, men exposed themselves to fever-related filth. "They dressed in the filthy clothing that had been worn by dying patients," Crosby writes, "they covered their cots in sheets stained with black vomit, and then they spent the next twenty nights the same way." Building No. 2, the Infected Mosquito Building, was divided into the "safe side" for the control group and the mosquito-rich side, where a volunteer, John Moran, allowed himself to be bitten repeatedly. Four days later he came down with the fever, eventually making a full recovery. Reed had the proof he needed.

The harrowing human experimentation certainly raises ethical questions; however, Reed, unlike some doctors before and after him who utilized unsuspecting test subjects, used only volunteers and provided consent forms. Many of the volunteers were soldiers. As Crosby writes, "From the time of the American Revolution through World War I, a soldier knew his odds of dying from dysentery, cholera, typhoid, smallpox, influenza, or yellow fever were greater than those on the battlefield, so volunteering for human experiments might not seem as much of a psychological departure as it would today."

Reed and his team conducted further experiments, discovering how the disease was carried in the blood of the mosquitoes and the victims. His work laid the groundwork for future research, which led eventually to Max Theiler's development of the yellow fever vaccine in 1929.

Crosby closes her book by examining modern cases of yellow fever, particularly urban outbreaks in parts of Africa, addresses modern research of the virus, and offers a glimpse of what effect an epidemic could have in the United States today. Though the tenor of her conclusion comes off as perhaps a bit alarmist in places, it's fair to say the medical advantages we have over our predecessors could leave us vulnerable to growing lax toward the disease. And as the history Crosby presents demonstrates, underestimating the disease can prove costly.

Jason Middlekauff
No biographical information is currently available.

See other articles by Jason Middlekauff.



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