The Tropical World of Samuel Taylor Darling: Parasites, Pathology, and Philanthropy (review)

In 1903, American medical knowledge and practice were being transformed by bacteriological science, and America was flexing its industrial and economic muscles in a variety of Progressive Era programs and reforms. Samuel Taylor Darling graduated from the College of Physicians and Surgeons of Baltimore that year and began post-graduate work in pathology at Baltimore City Hospital. Darling’s talents in the pathological and bacteriological laboratory were recognized early on by William Henry Welch, Dean of the Johns Hopkins University Medical School. A timely recommendation from Welch to the Isthmian Canal Commission in Panama created the opportunity for the young pathologist to enter the world of tropical medicine.

Sam Darling began his work as a ward interne at Ancon Hospital in Panama in February 1905 as work on the canal was getting underway, but was soon promoted to “Physician” and then “Pathologist” at Colon Hospital and, in 1906, as “Chief of the Board of Health Laboratory.” Over the next nine years Darling organized and directed all pathological, toxicological, chemical, and bacteriological analysis and research connected with the Canal project. In that time he became a subject matter expert on malaria, the major disease threat for construction crews, and was largely responsible for the implementation of efficient and effective vector control. He investigated and studied a wide range of parasites and bacteria, discovered a new disease, histoplasmosis, and contributed to the education of his colleagues through lectures and in the literature. Darling’s comprehensive interests and abilities in tropical medicine and public health, however, went beyond the laboratory, indeed beyond the Panama Canal project. This broader world view of tropical medicine impressed those he worked for and with, such as Colonel William C. Gorgas, Chief Medical Officer, Dr. Henry Rose Carter, Chief Quarantine Officer, and Dr. Joseph LaPrince, Chief Sanitary Inspector for the Isthmian Canal Commission, and directed him toward larger endeavors.

The International Health Board of the Rockefeller Foundation, upon strong endorsements from Gorgas and Simon Flexner, selected Darling to head the Hookworm Commission to the Far East in 1915. The commission’s intensive work on Java, Malaya, Sumatra, and Fiji not only defined the epidemiology of the disease, but also new and effective treatment and preventive regimens.

The International Health Board recognized, however, that public health programs designed to combat the major tropical diseases—malaria, yellow fever, and hookworm—were paralyzed by a dearth of trained public health experts world-wide. An attempt to correct this in South America, led to Darling’s next assignment. In May 1917, he was nominated as Professor of Hygiene and Director of Hygienic Laboratories at the medical school in São Paulo, Brazil in a five-year cooperative effort to create a school of public health. While the program was mostly successful, politics hindered the project and poor health brought Darling home in early 1921.

After recovering from surgery at Johns Hopkins Hospital, Darling returned to the International Health Board and assignment as director of the Station for Field Studies in Malaria in Leesburg, Georgia; malaria was still a problem in the United States in 1923. Then two years later he gave in to his medical wanderlust, accepting a position on the Malaria Committee of the Health Section of the League of Nations, which planned to evaluate the malaria status of Italy, Greece, Palestine, Egypt, and Morocco. It would be his last journey into the tropical world. He died a tragic and untimely death in a single auto accident on a lonely desert road near Beirut in May 1925.

Samuel Taylor Darling’s story is a compelling one. His achievements are the products of a well prepared, organized, methodical, scientific mind and a tremendous amount of meticulous field and laboratory work. They represent not the eureka moment discovery that makes headlines, but rather the slow, and often times tedious, work that results in progress. Herein lies the value of Dr. Chaves-Carballo’s...