J R Army Med Corps 2004; 150: 221-224 J R Army Med Corps: first published as 10.1136/jramc-150-03-12 on 1 September 2004. Downloaded from

FAMOUS FIGURES

Walter Reed USMC The Walter Reed Hospital and Centre, the Millbank of the United States Army Medical Corps, is an impressive place to visit. It is a building of history, dignity and worth. But who was the man it was named after? His story is worth recounting. Walter Reed came from a Methodist background and was a Southerner. The youngest of five children, one daughter and four sons, of the Reverend Lemual Reed, he was born in a four roomed cottage in Gloucester, County Virginia on 13th September 1851. The family were truly Christian, read their Bibles daily and also the novels of Sir Walter Scott. Their family story is a happy and fulfilled one. Ten years after his birth, abolitionists, and some Negroes, seized the US arsenal at Harper’s Ferry. The US government sent Colonel Robert E Lee to put down the revolt. John Brown, the abolitionists’ leader was arrested and then hanged. The Civil War then began. Although the Methodists had no part in slavery, they remained loyal to the South, and the Reverend Lemuel’s their generation of uncaring managers and two elder sons joined the Confederate Army. politicians. It was, perhaps, his disaffection The whole family later suffered with all the with what he saw in Bellvue Hospital, where South when their revolt was lost. Their he had begun his clinical training, and later mother died, said to be worn out with the in Brooklyn, that led him to revolt against anxieties of the war. The pessimism and civilian conditions. But Bellvue, which was sadness, together with an aloofness which one of the oldest medical schools, having

the young Walter acquired stayed with him been founded as long before as 1658 when http://militaryhealth.bmj.com/ all his life and he was never ‘one of the members of the Dutch East India Company boys’. of New Amsterdam had set aside space for He decided to enter Virginia University care of the sick and old – again, moved by (which had been founded by Thomas their own strict Protestant beliefs. Jefferson) to study medicine. That course, One thing Bellvue Hospital had which which included Theology, was much shorter took Reed’s eye was a 24 hour ambulance than the Arts one, but a higher pass mark service. This had been organised by Dr was demanded. Much anatomy was insisted William Hammond, Surgeon General of the on, but it was said that there were no tiny Medical Corps, when the civil war microscopes or clinical thermometers. began, and reflected his experience with the Another strange thing was that this degree Union Army. Ten ambulances stood on on October 1, 2021 by guest. Protected copyright. course did not provide access to patients. duty at the hospital stables and set out at a For this, new graduates – MDs as the gallop when an emergency was announced Americans continue to call them – had to on the, still new, telegraph system. An MO travel to the big teaching hospitals in went with the driver to deal with whatever Baltimore, Philadelphia, Boston or to the the trouble turned out to be. corrupt city of New York. Just as happened One other job Reed did enjoy was his Dr JSG Blair OBE here until the mid-fifties, a new medical appointment, at only 22 years of age, as KStJ TD TAVRD BA graduate did not have to do any house Assistant Sanitary Officer of the Brooklyn CHM DLitt (honoris training, but could put up his plate the day Board of Health. At the same time he fell causa) FRCS FRCP after graduation. in love with Miss Emilie Lawrence, whom FICS DRCOG However, Reed wished to be properly he met at church and who would later FRHISTS FSA (scot) trained. His moral background made him become his wife. Their marriage was true World Vice President, angry at watching the quacks arriving in their and theirs was a life long and faithful union. International Society for the History of Medicine luxurious carriages together with coachmen All these may have been factors in causing and footmen, to do little more than glance at him to decide to undertake a new life which The Brae, the patients. By contrast the hard working he believed was to be worth while and 143 Glasgow Road, doctors in the Poor Law hospitals made benefit his fellow men. This was to join the Perth, PH2 OLX little money and were little supported by Army Medical Corps. 222 Famous Figures J R Army Med Corps: first published as 10.1136/jramc-150-03-12 on 1 September 2004. Downloaded from

Walter Reed was not unique in his Now he learned what bacteriology and decision to join the Army. Very many other immunology were really about. He worked young men were having the same idea. In under Halstead and met William Osler. late 1873 there were 500 candidates sitting Here he was also fortunate in meeting men the Army Medical Corps entrance who were not only highly intelligent, but examination, to fill 30 vacancies. The field had that so rare of qualities in academic was large, the places available small. The places – absence of jealousy when a younger entrance tests lasted five hours a day for six man showed high ability and promise. The days and included Greek, Latin, French, academic part of Walter Reed’s life now mathematics and history as well as medical came to fruition. Yet another fortunate subjects. He passed and his papers are coincidence occurred. The new Surgeon preserved – they show his depth of General, George Stanberg, though he knowledge and range of ability. Yet his would be a good example of the senior acceptance letter commented that his officer who tried to claim credit due to his ‘acquaintance with foreign literature was juniors, and of lesser intelligence himself, not up to the expected standard’. How decided to establish an Armed Forces many today would have passed the Medical School. Of course, who would be examination which Reed sat? But now he asked to work in its laboratory and could wear his ceremonial uniform museum, but Reed complete with smart sword. Major Reed needed an assistant and His first posting was to Arizona. His asked that James Carroll, whom he had got Commanding Officer told him his priority to know at the Johns Hopkins, be was to take the posting and not to get transferred to Washington. Carroll was an married – he had asked for leave to do this Irish working class man who, like so many first. After a journey reminiscent of those of others, had crossed to seek his fortune in the NS Era he found himself at the harsh the United States, joined the US Army, was and uninviting frontier with its Aden-like promoted Sergeant and then became what dry and dusty climate. Reed actually asked is now known as a male charge nurse. He Emilie to join him, which she did, also by had shown particular aptitude as a horse carriage. Meanwhile, he grew a laboratory assistant. Now they would work military moustache but he never acquired together over many years. Carroll, the older the more standard full beard sported by man, was at first happy to work under most medical officers of the time. Reed’s direction. However, in later years he The usual run of postings for a junior MO felt hurt when he saw his contributions had went on – Nebraska was succeeded by been neglected and he had not been given Mount Vernon Barracks in Alabama. Most credit for what he had done in the of his patients were Indians and, as ever, discoveries published after Reed’s death. He

most diseases were infectious. The Army is not alone in this (1). http://militaryhealth.bmj.com/ MOs were forbidden even to use the word From now onwards, Walter Reed became ‘tuberculosis’, they had to call it ‘pulmonary an accepted member of the scientific and disease’. During this phase of Reed’s social establishment, becoming a member service it was said that his honesty, and of higher medical societies and taking part refusal to swear or tell tales, did not win him in their discussions over the whole range of favour in the Officers’ Messes. His epidemic diseases and their possible causes. Southern background was also a cause of ill At this time there was much argument over ease for some fellow officers. He had the the use of animals for experimentation and misfortune to have to watch more than one Reed was appointed a member of the US ruthless massacre of so-called ‘rebellious Government’s Joint Committee on Indians’, including that of Little Big Horn, vivisection. It was also known that on October 1, 2021 by guest. Protected copyright. where a massacre of 21st century style experimental immunisation was commonly proportions took place by the US Cavalry. carried out on ‘unclaimed children’ in local Reed, now aged 40, and with a growing authority orphanages. This was ironic, as child, asked for a four month period to will soon be seen. pursue scientific studies. The new Surgeon Infectious disease was, of course, the most General, Jediah Hyde Baxter was, most serious problem for the civil communities unusually for a senior rank of the time, and especially for the Armed Services. On eager to promote more regular officers into 18th December 1897, the British Medical such a post. He agreed that Walter Reed Journal published Ross’ monumental article should go to the new, year old, Johns on malaria and its parasite. Ross showed Hopkins Hospital in Baltimore and study that the plasmodium underwent changes pathology and bacteriology. Reed described within the anopheles mosquito. Then it this as a ‘stroke of kindly providence’ and was discovered that the mosquito carried surely he was right. It was to be the turning the causative agent, which then entered the point in his life. patient’s blood when bitten by it. Reed was At ‘the Johns’ Reed was suddenly made one of the first in the US to demonstrate the aware of the host of great advances and parasite in human red blood cells. ideas from Europe – from Pasteur to Lister. In the United States the most dreadful 223 J R Army Med Corps: first published as 10.1136/jramc-150-03-12 on 1 September 2004. Downloaded from infectious disease was yellow fever. It could bacterium theory. Reed undoubtedly appear at any place in summer and autumn; learned from Finlay, it was a pity he did not no one realised the significance of its give Finlay more later acknowledgment. absence during winter. The course of In the first experimental camp the first yellow fever was inexorable and death came thing was to exclude the role of fomites as after a frightening and short course. the carrier.The camp was filled with grubby Hundreds of thousands died of objects. Next Reed had to recruit sufficient haemorrhagic ‘black vomit’ and were volunteers to agree to be bitten by the terrified to the point of madness. It was the mosquito. This was a major moral decision. special plague of the whole North American At once the Spanish language paper of continent. From the first properly reported Cuba, Discussion, reported epidemic of Santa Lucia in 1604 a ‘A rumour has reached us of a happening succession had followed. The attempt by so horrible and so monstrous that we feel the confident French to construct the compelled to publish it – to those immigrants Panama Canal in 1881 onwards was who remain for a short time in Tricornia (the destroyed by the disease and de Lesseps Camp) is offered one dollar a day.. being taken himself was imprisoned in 1892 after in groups of 30 or 40 men… they are shut up in financial scandals had become known. special habitations in which are released large The cause was hotly debated. Different numbers of mosquitos which have bitten schools of thought scorned their opponents. individuals with yellow fever. The object of this The ‘yellow fever bacillus’ was held by one study on humans is to find out if the contagion school to be the cause and the name of is due, or may be due, to the inoculation from Guiseppe Sanarelli was associated with this these bites. If the workman takes ill and dies the view. Reed and his military superior experiment has successfully demonstrated that disagreed. Fomites and clothing, dirty the disease is indeed due to such an baggage and patients’ personal belongings inoculation’. were believed to be the carriers. The affair Major Reed had, however, made his plan came to a head during the ill-fated war with great care. He had consulted the against Cuba. Spanish Consul and made clear what the There was a short phase of proposed stakes were. He had had letters of consent colonisation by the United States which set written in Spanish, including an ‘informed out to conquer the island after one of their consent form’. In the long term it has to be battleships was sent to ‘protect American said his project’s importance did not interests’ during an internal uprising in completely mitigate what he was asking 1895. An ultimatum was sent to Spain and those men to do. troops were sent to ‘clear out an illegal ‘The undersigned understands perfectly regime’. Plus ça change. The war took the well that in the case of development of

armed forces by surprise as usual. In Yellow Fever in him, that he endangers his http://militaryhealth.bmj.com/ particular the Medical Corps was under life to a certain extent but it being impossible strength with only 177 commissioned for him to avoid infection during his stay on officers and 750 enlisted men; the politicans this island he prefers to take the chance of wished to send in an Army Corps. contracting it intentionally in the belief that Although the US Army was soon successful he will receive from the said Commission it had overlooked the fact that it was right in the greatest care and medical service’. the Yellow Fever season. There were only There were two parts of this experimental 1000 killed in combat, but nearly 21,000 camp. In one part was the dirty chamber, sick with Typhoid fever, with a death rate of filled with soiled bedding, excrement, blood 7.6%. Yellow fever during that July infected and sweat. In this part three men, two 2000 soldiers but its death rate was 80%. private soldiers and one officer, were shut on October 1, 2021 by guest. Protected copyright. After a long period of argument, orders up for over a fortnight. In the other, and and counter-orders, angry utterances by more comfortable part, were those who high ranks and anger if their opinion was were to be bitten by specially grown questioned sensibly by a junior or ‘outsider’ mosquitoes. Reed did not ask any US and attacks at the rival Marine Medical soldier to take part, but one, Private John E Service, a plan was agreed. It would take Kissinger, did so. It was said that Reed the form of a clinical trial. Reed was given saluted him for his action. The experiment authority to construct a special custom- began early in November. built camp where the trial was to be carried The rest, as is often said, is history. Reed out. This was in Cuba and was approved by proved that the mosquito was the carrier of no less a person than Leonard Wood, US the causative organism of Yellow Fever. On Governor of the Island. One Dr Carlos 9th December Reed wrote in triumph to his Finlay, the son of an expatriate Scottish wife after Kissinger had contracted the father and Parisian mother, and born in infection: Cuba, had insisted that the common ‘Rejoice with me sweetheart, as aside from the household misquito Aedes augypti was the diphtheria antitoxin and Koch’s discovery of carrier of the causative creature, whatever it the Tubercle Bacillus, this will be regarded as the was. Like Reed, he did not believe in the most important work scientifically this century. 224 Famous Figures J R Army Med Corps: first published as 10.1136/jramc-150-03-12 on 1 September 2004. Downloaded from

I do not exaggerate and I would shout for very Walter Reed did not reach the highest joy that Heaven has permitted me to establish rank in spite of his undoubted worth. He this wonderful way of propagating Yellow Fever. became unwell and died in 1902. His It was Finlay’s theory and he deserves much widow received an inadequate pension. credit, but he did nothing to prove it, and it was rejected by all including General Sternberg… its importance to Cuba and the United States Reference cannot be estimated. Kean says the discovery is 1. Merlin Pryce (1902-1976) and Penicillin; an worth more than the cost of the Spanish war, Abiding Mystery, Dr Emrys Wyn Jones and Professor R. Gareth Wyn Jones, Vesalius, Vol viii, including lives lost and money expended’. No 2, December 2002. http://militaryhealth.bmj.com/ on October 1, 2021 by guest. Protected copyright.