Dos micróbios aos mosquitos: Febre amarela e a revolução pasteuriana no Brasil (review)

Jaime Larry Benchimol. Dos micróbios aos mosquitos: Febre amarela e a revolução pasteuriana no Brasil. Rio de Janeiro: Editora Fiocruz, Editora UFRJ, 1999. 498 pp. R$ 35.00.

The history of yellow fever is deeply intertwined with the history of science, medicine, and society in Brazil. The best-known event in this history is the successful campaign directed by Oswaldo Cruz around 1904 against the Aedes aegypti mosquito in Rio de Janeiro. This effort followed the methods suggested by the U.S. Army Commission on yellow fever and used by William Gorgas in Havana a few years before. The Brazilian campaign raised Cruz to a position of national and international prominence. This achievement included the construction of a scientific institution where Carlos Chagas developed most of his original research on the disease that carries his name. Much less known is what the Brazilian scientists, physicians, and people believed regarding yellow fever during the late nineteenth century, before Cruz's success.

Jaime Larry Benchimol's book is a major contribution to this little-known history. The title, "From microbes to mosquitoes," refers to the transition from the reception of Pasteurian ideas to the consensus around the methods used by Cruz against mosquitoes. This process comprises vivid debates that take place in learned journals but also in newspapers; interventions of major figures of Brazilian politics, such as the Emperor Pedro II; European scientific stars, such as Louis Pasteur, Émile Roux, and Robert Koch; and fascinating local characters.

The most prominent Brazilian character in this story is Domingos José Freire, who mistakenly believed he had discovered both the cause of the disease (which he called Criptococcus xanthogenicus) and a vaccine (basically elaborated with what today is known as aspirin). His discovery was celebrated as a major local achievement; a scientific institute was created around it, and the vaccine was used for years in Rio de Janeiro and other cities of Brazil: between 1883 and 1894, 8,815 Brazilians and 3,539 foreigners were vaccinated. Freire became an intellectual leader of a loose political conglomerate formed by university students, supporters of a republican form of government, and abolition movements against Brazil's imperial regime. In addition, he was named a directive member of international academic meetings and societies, appointments that he propagandized in his home country.

Benchimol also provides a unique international perspective on yellow fever research during the late nineteenth century, including detailed descriptions of the work by the Mexican Manuel Carmona y Valle, the Brazilian João Batista de Lacerda, and the Montevideo-based Italian bacteriologist Giuseppe Sanarelli, each of whom had a different theory of the etiology of the fever. He also discusses the context and content of the disapproval of Freire's work by the American physician George Sternberg, who visited Rio de Janeiro, and the similarities and differences between the work of Carlos Finlay, who first put forth the theory that the Aedes aegypti mosquito transmitted the disease, and of Walter Reed, who headed the U.S. Army Commission on yellow fever in Havana.

Benchimol stresses continuity between the medical traditions of the nineteenth century and the adaptation of bacteriology. Using different strategies and seeking diverse allies, Freire tried to make his work amenable to bacteriological, epidemiological, and clinical circles. He also made efforts to create bridges between traditional miasmatic ideas and the new Pastorian ideas. For example, he stated that his vaccine was especially suited for foreigners who visited Brazil in the hot season because native races were relatively immune to yellow fever and epidemics dwindled after summer--ideas of miasmatic origins. According to Benchimol, during Freire's peak moments of popularity there was no sharp break between miasmatic and Pasteurian medical ideas in Brazil, and no insurmountable distance between Rio de Janeiro and European medical centers. Only when Cruz achieved scientific prominence did an official story emerge...