The American Plague: The Untold Story of Yellow Fever, the Epidemic that Shaped Our History - Molly Caldwell Crosby (2006)

Part III. Cuba, 1900

Chapter 20. Blood

Just before the New Year of the new century, the board began injecting blood taken from yellow fever victims into volunteers. With trepidation in his tone, Reed had written to Surgeon General Sternberg to ask if he would still like the board to conduct blood experiments. At that point, Reed was certain yellow fever was in the blood and transmitted through the bite of a mosquito. Injecting patients with yellow fever-thick blood would undoubtedly produce more cases, and thus far, the board had been lucky enough and vigilant enough to nurse all of their yellow fever cases back to health. Not one fatality had occurred. This was probably due in part to the fact that only healthy, young volunteers were accepted, but it was also thanks to Dr. Roger Post Ames, the camp’s yellow fever specialist who had, by far, the highest success rate in nursing victims of yellow jack back to health. His success may have been in his psychological approach to patients. He and his male nurse, Lambert, were known to talk away the fear and panic that often came with the fever. He instilled confidence in the men and once told a group of soldiers that, “No doctor should ask a man to submit to a disease unless he knows he can cure him.” Ames was from New Orleans and had survived the 1878 epidemic as a child; he believed that the mild childhood case had given him immunity. He was wrong.

With a resounding “yes” from the surgeon general to continue to the final phase of experiments using blood, the board planned to use four volunteers who would receive gradually decreasing doses of infected blood. The blood also had to be “ripe,” having been drawn from a patient in the first few days of fever. The word ripe seems ironic given that it usually implies harvesting something that has grown sweet, full and fleshy. Blood, the scientists would find, was indeed ripe; but the fruit of their harvest would instead be disease.

The first volunteer received the full dose—2cc—of ripe blood from one of Reed’s yellow fever subjects. Within four days he was stricken with a nonfatal case of yellow fever. Then, 1.5cc of blood was drawn from his veins and injected into the second volunteer. In two and a half days, the second volunteer came down with a “pretty infection,” according to Reed. The blood flowed from one volunteer to the next, the yellow fever virus floating in it like leaves swept in a current.

After that, the board’s experiments stalled while they waited for additional volunteers. At last, two more came forward. A private from the Hospital Corps was injected with 0.5cc of ripe blood taken from a recently fatal case of yellow jack and fell feverish two days later. Four control subjects, Kissinger, Moran and two Spaniards, all of whom had suffered previous cases of yellow fever during the experiments, were injected with ripe blood. None of the control subjects contracted the fever, proving that their previous cases had provided immunity. All that was needed now was the fourth and final blood experiment, and Reed could return to his lab in the States to dissect mosquitoes and begin hunting for the agent causing yellow fever.

On the morning of January 24, 1901, John H. Andrus reported to work in the board’s lab as usual. He was a twenty-two-year-old member of the Hospital Corps who had been assigned in October to work with Reed, Carroll and their assistant, Neate, in the lab. Andrus’s job, like Jesse Lazear’s had once been, was the raising and caring for the lab’s mosquitoes—their “pets.” Andrus captured the mosquitoes from stagnant water in epidemic-ridden areas and raised them in the jars of the lab, even allowing the females to bite him when blood was needed for the next generation of eggs.

Andrus was busy with his pet mosquitoes that morning when Reed and Carroll entered the lab in mid-argument. Neither seemed to acknowledge Andrus as they bickered about the blood of one of their volunteers. The blood was ripe, and the window of time for injecting it into a new volunteer was narrowing, but the board had just learned that their fourth volunteer had backed out. Reed was frustrated and impatient. He had already waited two weeks for the final volunteers to come forward, and he was anxious to finish the study. Reed decided he would be the fourth volunteer.

Carroll pleaded with him not to—as a test subject, Reed could not have been a poorer choice. He was thirty years older than most of the volunteers and was continuing to suffer from some kind of stomach distress. Inoculating himself would essentially be suicide. Carroll himself, still struggling to recover from his bout of yellow fever months before, had barely survived. Lazear had already been lost.

Reed was convinced that by standing in as the fourth volunteer, he could also prove or disprove a new theory of Carlos Finlay’s. Finlay believed one generation of mosquitoes could transmit yellow fever to the next. Reed had been bitten repeatedly by second-generation mosquitoes without infection, so he was either immune to the fever, or Finlay’s experiments were wrong. What better way to prove both theories than this final blood experiment?

Andrus listened to the two men argue throughout the day until, at last, Reed’s temper flared. As Reed left the lab, he declared that he would be inoculated tomorrow, and there was no use in discussing it further.

The next morning, Andrus returned to the lab to find Carroll, as usual, at the microscope on the long, wooden lab table. The morning sun brightened the lab, lighting the room and giving a silver patina to the collection of vials, jars and test tubes. John Andrus nervously approached Carroll and asked if he himself might take the inoculation in place of Major Reed. Carroll looked up from his microscope, impressed and disappointed, and answered no. Reed was determined to test Finlay’s theory as well as his own, and no one else would qualify for both experiments. Andrus reminded him that he had been feeding second-generation mosquitoes for weeks in the lab to keep the females alive; he, like Reed, could perform both experiments at once.

When Reed arrived at the lab that morning, Carroll sent Andrus on an errand, so that the two men could talk. Andrus never knew what was said, but when he returned, Reed asked if he realized what he was doing. Andrus had, in fact, nursed a number of cases of yellow jack, and he had seen many men die of it—but he had no noble intentions of saving Walter Reed’s life by risking his own. He later wrote: “I knew something of what proof of the mosquito theory would mean to humanity. I knew that Major Reed was the main spring that made the work of the Board tick and that if he was sick of yellow fever and had a slow recovery . . . the work would all but stop.”

By 12:15 that afternoon, Andrus was seated in a chair with his sleeve rolled up. The doctor swabbed the skin on his arm with an alcohol-soaked cotton ball and slid the needle in, slowly plunging 1cc of ripe blood. “I knew that, from the instant that needle pierced my skin,” Andrus wrote, “no power on earth could prevent my getting yellow fever.”

Soon after the experiment, John Andrus was sent by ambulance to Camp Lazear to await further results. He was assigned to a small tent and allowed to roam the camp, while he waited for the virus to take up residence in his bloodstream. One of the first things he did was write to his mother that he had been detailed to accompany a cavalry troop into the interior of Cuba, where he would not be able to send mail again for the next three weeks. Adding to his anxiety was the fact that Dr. Roger Post Ames, the doctor solely credited with nursing every volunteer back to health during the yellow fever experiments, was himself sick with yellow fever.

Three days later, alone in his tent, John Andrus felt a chill come on. He had complained of a headache for the last couple of days, but had shown no signs of fever. His temperature soared to 103.6 degrees. Andrus’s face was flushed, and his eyes grew glassy. He remembered being lifted into the two-mule ambulance that would carry him to the yellow fever hospital, but he never remembered arriving there.

The official report states that by the time John Andrus arrived at the hospital, his temperature was over 104 degrees and his pulse raced at 120. Restless, he complained of bright lights, a searing headache and a backache. He vomited several times. Andrus had a severe case of yellow fever.

Reed wrote to the surgeon general, “Should he die, I shall regret that I ever undertook this work. The responsibility for the life of a human being weighs upon me very heavily just at present, and I am dreadfully melancholic. Everything is being done for him that we know to do.” Reed’s guilt must have consumed him. He had voluntarily allowed another man to stand in his place, to exchange his life for Reed’s.

Eleven days after the initial attack, John Andrus was making a slow recovery, but with complications. Dr. Roger Post Ames heard of the case from his own sick bed. After all nurses had left his station, Dr. Ames ordered his assistant, Lambert, and another man to carry his own cot to the yellow fever ward where he could examine and hopefully help Andrus. With time, and the help of Dr. Ames, Andrus recovered fully.

Forty years later, John H. Andrus would lie in Walter Reed Hospital in Washington, D.C., where he would spend the rest of his life bedridden due to spinal problems he attributed to his case of yellow fever. Though doctors could never find the true cause for his paralysis, Andrus wrote, “I would rather think my condition is due to my humble part in the work of Major Reed and his Yellow Fever Board than from some mysterious and unaccountable cause.”

The final blood experiments answered a number of questions about yellow fever. Not only was the virus living in the blood of mosquitoes but also in that of humans. Their discovery explained why an epidemic could plague a city for an entire season. And, though the people may die off or flee, the loaded mosquitoes only grow more prolific until the air itself seems steeped in poison.

Nature had found the perfect place to hide the yellow fever virus. It seeded itself and grew in the blood, blooming yellow and running red.