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TROPICAL MEDICINE: an ILLUSTRATED HISTORY of the PIONEERS This Page Intentionally Left Blank TROPICAL MEDICINE: an ILLUSTRATED HISTORY of the PIONEERS TROPICAL MEDICINE: AN ILLUSTRATED HISTORY OF THE PIONEERS This page intentionally left blank TROPICAL MEDICINE: AN ILLUSTRATED HISTORY OF THE PIONEERS G C Cook MD, DSc, FRCP, FRCPE, FRACP, FLS Visiting Professor, University College, London, UK PARIS • AMSTERDAM • BOSTON • HEIDELBERG • LONDON • NEW YORK • OXFORD PARIS • SAN DIEGO • SAN FRANCISCO • SINGAPORE • SYDNEY • TOKYO Academic Press is an imprint of Elsevier Academic Press is an imprint of Elsevier 84 Theobald’s Road, London WC1X 8RR, UK 360 Park Avenue South, New York, NY 10010-1710 30 Corporate Drive, Suite 400, Burlington, MA 01803, USA 525 B Street, Suite 1900, San Diego, California 92101-4495, USA First edition 2007 Copyright © 2007 Elsevier Ltd. All rights reserved No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise without the prior written permission of the publisher Permissions may be sought directly from Elsevier’s Science & Technology Rights Department in Oxford, UK: phone (ϩ44) (0) 1865 843830; fax (ϩ44) (0) 1865 853333; email: [email protected]. Alternatively you can submit your request online by visiting the Elsevier web site at http://elsevier.com/locate/permissions, and selecting Obtaining permission to use Elsevier material Notice No responsibility is assumed by the publisher for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions or ideas contained in the material herein. Because of rapid advances in the medical sciences, in particular, independent verifi cation of diagnoses and drug dosages should be made British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress ISBN: 978-0-12-373991-9 For information on all Academic Press publications visit our web site at books.elsevier.com Typeset by Charon Tec Ltd (A Macmillan Company), Chennai, India www.charontec.com Printed and bound in Great Britain 07 08 09 10 11 10 9 8 7 6 5 4 3 2 1 CONTENTS PREFACE ix PROLOGUE xv 1 Early pioneers of ‘medicine in the tropics’ 1 2 Origins of the formal discipline: background factors 33 3 Patrick Manson (1844–1922): father of the newly-formed speciality, fi lariasis research, and founder of the London School of Tropical Medicine 51 4 Alphonse Laveran (1845–1922): discovery of the causative agent of malaria in 1880 67 5 Ronald Ross (1857–1932): the role of the Italian malariologists, and scientifi c verifi cation of mosquito transmission of malaria 81 v vi CONTENTS 6 Carlos Finlay (1833–1915): yellow fever research in southern America 103 7 James Cantlie (1851–1926): tropical surgeon, university administrator, and founder of the (Royal) Society of Tropical Medicine and Hygiene 115 8 George Carmichael Low (1872–1952): an underrated pioneer, and contributor to the (Royal) Society of Tropical Medicine and Hygiene 127 9 David Bruce (1855–1931): Malta fever, nagana, and East African trypanosomiasis 145 10 The schistosomiasis saga: Theodor Bilharz (1825–62), Robert Leiper (1881–1969), and the Japanese investigators 157 11 Joseph Everett Dutton (1874–1905): West African trypanosomiasis and relapsing fever 167 12 The causative agent of visceral leishmaniasis (kal-azar): William Leishman (1865–1926) and Charles Donovan (1863–1951) 177 13 Leonard Rogers (1868–1962): the diseases of Bengal, and the founding of the Calcutta School of Tropical Medicine 183 14 Aldo Castellani (1877–1971): research in the tropics, and founding of the Ross Institute and Hospital for Tropical Diseases 197 15 Neil Hamilton Fairley (1891–1966): medicine in the tropics, and the future of clinical tropical medicine 211 16 Alexandre Yersin (1863–1943), and other contributers in solving the plague problem 219 CONTENTS vii 17 Andrew Balfour (1873–1931): pioneer of preventive medicine in the tropics and fi rst Director of the London School of Hygiene and Tropical Medicine 225 18 Some less well-documented pioneers 233 19 ‘Back-room’ and lay pioneers of the specialty 243 20 Politicians and entrepreneurs: the Chamberlains (father and son), Alfred Jones and Herbert Read 251 EPILOGUE 261 APPENDICES 263 INDEX 267 This page intentionally left blank PREFACE This book is primarily an account of the individuals who made major contribu- tions to, and indeed shaped, the formal discipline of tropical medicine in the late nineteenth and early twentieth centuries; in fact in the latter years of Victoria’s reign (see Figure A).1 The origin(s) of this discipline (dominated by a handful of ‘prima donnas’) is very largely a result of much foresighted action by the Seamen’s Hospital Society, coupled with the enthusiasm of several politicians of a bygone era. As recently as 2001, however, a Harveian Orator at the Royal College of Physicians spoke as though this discipline and ‘medicine in the tropics’ were one and the same. He concentrated on: malaria, snake bite and rabies, and concluded:2 In the 350 years of its history, this is the fi rst Harveian Oration to be devoted to Tropical Medicine; I hope that this is a sign that my speciality has at last [now that the formal disci- pline is in steep decline] been accepted into the mainstream of medicine in this country. Those who have worked for long in warm climates will, however, recognize that ‘medicine in the tropics’ has existed since time immemorial, and that it should be clearly demarcated from the rise and fall of the formal discipline. ix x PREFACE FIGURE A Queen Victoria (1819–1901) (reproduced courtesy of The Wellcome Library, London). Lloyd and Coulter, in their classic text Medicine and the Navy 1200–1900, have admirably summarized the difference between the two:3 For the historian of medicine, the fact that Naval Surgeons [before the development of the formal specialty] had more experience of tropical diseases [my italics] than any other branch of the profession … as Sir Patrick Manson recognized when he founded that dis- cipline in England. It cannot be pretended that they made much use of their experience because, for the most part, they were not outstanding members of their profession. None the less, they were by no means more backward than their colleagues on land before the days when the germ theory of disease replaced the atmospheric or climatorial pathology which prevailed up to the last decade of the [nineteenth] century. Whatever new advances were made in medical practice (and they were not numerous before the days of Lister and Pasteur) they were adopted in the [Naval] service with commendable promptness. PREFACE xi Thus, experience in the Caribbean, Africa and the ‘jewel in the Crown’ – India4 – pre-dated the development of the formal discipline, as did the practice of medi- cine in the West African Squadron. But even before this, much information on the diagnosis and management of disease acquired in tropical countries had been gathered over many centuries. Andrew Balfour (1873–1931)5 recognized this when he recalled, in his Presidential Address to the Royal Society of Tropical Medicine and Hygiene in 1925:6 There is in one sense no such thing as tropical medicine … many of the most erudite writ- ings of Hippocrates are concerned with maladies which now-a-days are chiefl y encoun- tered under tropical or sub-tropical conditions. An anonymous contributor to the British Medical Journal for 1913, summariz- ing the position a century before this, wrote:7 The study of tropical diseases [my italics] was obviously in its infancy in 1813; but there were indications that British medical men in India and in the West Indies were beginning to turn their attention to it, being forced to it indeed by the mortality from such maladies which was making itself felt in the troops stationed abroad and among the sailors manning the Indiamen and the fi ghting frigates of the time. There were no such schools of tropical medicine in those days such as are to be seen now; but there was already a clear indica- tion of the necessity which was to be laid upon Great Britain of the later nineteenth and of the earlier twentieth centuries to send forth of the best of her medical sons to discover the cause of Malta fever, to unravel the problem of sleeping sickness, and to learn to slay many another scourge existing in these tropical countries over which she has been placed as ruler, and for which she has already paid a price in blood. Thus, before development of the formal discipline, much of the practice of ‘med- icine in the tropics’ fell under the heading of hygiene, defi ned by the Oxford English Dictionary as:8 That department of knowledge or practice which relates to the maintenance of health; a system of principles or rules for preserving or promoting health; sanitary science. The development of the ‘formal discipline’, which focused largely on teach- ing the medical offi cers of numerous British colonies situated in warm climates about the ‘exotic’ diseases which the Western practitioner knew little or noth- ing about, has with some justifi cation been branded colonial medicine by some medical historians; Patrick Manson (1844–1922; see Chapter 3) was clearly the founding father of the discipline. According to G C Low (1872–1952; Chapter 8), an important but grossly under-recognized pioneer of the discipline, it was estab- lished during a 20-year period, 1894–1914.9 It is also crucially important to appreciate that ‘medicine in the tropics’ encompasses not only the ‘exotic’ infections (which have enormous geographi- cal variations, e.g.
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