University of Virginia Library

18. CHAPTER XVIII

History, of course, had not been standing still during
the years that Walter Reed was unwittingly treading the path to
fame. Since the Civil War the United States had undergone great
changes, the greatest of which were the passing of the frontier
and the country's shift from a primarily farming to a primarily
manufacturing economy.

By 1898 the last of the Indian outbreaks was eight years
behind us, and the fearful Geronimo was soon to join the Dutch
Reformed Church. The Union proudly numbered forty-five states.
184.

The population had doubled. Tourists and traveling salesmen
could go by rail almost anywhere in the country.

Manufacturers were making more and more goods for home
consumption and for export abroad, and our new industrial economy
was giving the country new wealth, new power, new horizons. Our
interest in foreign affairs, already whetted by our need for over-
seas markets, was suddenly riveted to them by the outbreak of the
Spanish-American War early in 1898.

We had been wrangling with Spain off and on for some
years about her island Cuba, which was just then in a state of
armed revolt against the aged and feeble monarchy. After the
United States Ship Maine was blown up in Havana harbor on Feb-
ruary 15th, 1898, the wrangling stopped and the fighting began.
War was declared on April 25th. Thousands of enthusiastic young
men hurried to enlist.

Lawrence Reed was one of them. He had been out of school
almost two years, working for a local coal company. He still
wanted to go into the ARmy, but had failed to obtain an appoint-
ment to West Point. There were, at that time, two ways of getting
a commission besides being graduated from the Military Academy.
One was to enlist, and after two years' service take the examin-
ation for a second lieutenancy. The other was to be designated
as a civilian by the War Department to take the examination.
Someone, however, had to recommend you to the War Department be-
fore it would select you as a candidate. Lawrence's employer,
Mr. Parke Agnew, was a friend of President McKinley's. He thought
a great deal of his young employee and asked him if he would like
to have a letter from McKinley recommending him for the examination.
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Lawrence, naturally, could have liked nothing better. When the
letter came, he hurried downtown to file it at the War Department.
Unfortunately, there were so many young men who wanted
to take the examination, and so many genial political gentlemen
who recommended them, that the War Department was flooded with
their letters. It therefore announced that no recommendations
would be considered except those having a red line under the as-
pirant's name. Mr. Agnew again applied to the President and ob-
tained another letter, this one with Walter Lawrence Reed clearly
underscored in red. Lawrence filed it at the War Department, too,
and waited for the announcement of the list of lucky men who
would be permitted to compete. In due course it was published.
His name was not there.

This called for explanation. The President himself had
recommended him, and he wanted to know why he had been passed
over. He decided to find out.

The horse car let him off near the State, War and
Navy Building and he ran up the wide flight of steps into the
building. It was a beehive these early June days. Elderly clerks
who looked as though they had been under wraps since the Civil War
scuttled nimbly through the corridors. Voices murmured and rose
in the offices. Doors slammed, footsteps were brisk, official
brows knit. Lawrence went to the fifth floor to see the clerk
with whom he had left his letter.

An elderly man, he had a mouth hedged about with gray
whiskers, and mild eyes protected by spectacles. When Lawrence
explained his errand, he looked stricken.

“It was just a mistake, Mr. Reed,” he said miserably,
“A most unfortunate oversight.”

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“Can't it be corrected now, sir?” Lawrence wanted to know.
“I'm pretty anxious to try for a commission.”

“I suppose it could be,” the old man admitted reluctantly,
“if you want to bad enough. If you care to take the matter higher
up, you can probably get on the list.”

“Well, what's wrong with that?”

“Nothing, I suppose. Except that it would put this office
in a very bad light, make trouble for it.”

“For you?”

“Well, yes. It seems to have been my fault. But you go
ahead if you want to.”

Lawrence looked at him and noted his mild, weak eyes, his
clerical stoop, his shiny coat. You couldn't get a poor old fel-
low like this in trouble, he thought wretchedly, it would be in-
human. There went his chance for a commission, but there wasn't
any choice that he could see.

“Never mind, then,” he said gruffly. “Let's forget it. Good-
bye.”

“Wait a minute, son!” The relief in the old gentleman's
voice was almost touching. “What are you going to do?”

“I'm going down to Washington Barracks and enlist! I'll
earn my commission!”

An hour later, hot and flushed, Lawrence arrived at the
Army Medical Museum and went to his father's office. Reed looked
up from his work in surprise -it wasn't like his son to pay un-
expected calls at the laboratory.

“Hello, Lawrence. What brings you here?”

“Father,” Lawrence came abruptly to the point, “will you
give me your permission to enlist? I've just been to the bar-
racks, and Dr. de Schon turned me down because I'm not twenty-one.
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I need your permission.”

“And why do you want to enlist?”

“I want to earn a commission.”

Reed got up slowly and eyed the tall young man. In words his
son never forgot, he inquired, “Young man, if the President of the
United States would accord you the unusual privilege of selecting
your own examining board, do you think that you could find three
officers who would pass you?”

The reproachful query conjured up the guilty memory of neg-
lected studies and mediocre marks. His father questioned his a-
bility to earn a commission, Lawrence realized with a pang. If he
answered no, his father would withhold permission. He would have
to say yes.

“I think so, Father,” he answered steadily.

“Very well, Lawrence,” Reed agreed quietly. “I'll give you
a note with my permission. You can take it back to de Schon.”

The United States Army in June, 1898, accepted Walter Law-
rence Reed as a buck private. When he retired from it forty-two
years later, he had risen to the rank of major general. Events
had not justified his father's misgivings.

* * *

With the war in progress, disease, the United States quickly
found, was a farm more dangerous enemy than Spain. Fewer than
sixteen hundred American soldiers stopped bullets in the
whole course of the fighting, but the mortality from sickn illness
was frightful. Everybody seemed to get sick in the camps. Malaria,
typhoid, dysentery ravaged the untrained, ill-equipped troops hast-
ily assembled with almost no sanitary precautions in the big
training camps in the United States. As the death rate climbled
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steadily through the hot summer of 1898, and the Army's under-
staffed, under-equipped medical department struggled stoutly to
keep up with its duties, the costliness of the penny-pinching
policies applied to the Corps for so many years became glaringly
apparent.

In the financial panic four years earlier Congress, un-
impressed with the increasing prestige and scope of the Medical
Corps and eyeing the War Department's budget with an axe in its
ready hand, had lopped fifteen doctors from its already inadequate
staff, reducing it to a hundred and ten. At the same time it had
prohibited the employment of contract doctors. In spite of this
treatment, the Corps had profgressed under Sternberg. So that of-
ficers could keep up with current medical developments, important
new literature was regularly sent to them, and the use of the Sur-
geon General's Library was extended to them by mail and express.
Modern equipment, including laboratory apparatus and operating
rooms, had been installed in post hospitals; and a training school
for the Hospital Corps, as well as the Army Medical School, had
been established. Sternberg's personal eminence had been emphasized
by his election to the presidency of the American Medical Associa-
tion in 1897.

Faced by war, Congress hastily restored the fifteen of-
ficers to the Corps, again authorized the employment of contract
surgeons, and set aside the absurdly inadequate sum of twenty
thousand dollars, out of a war budget of fifth millions, for use
in safeguarding the health of an army suddenly expanded to
ten times its normal size. Short-handed, without reserve sup-
plies and nearly penniless, the Medical Corps was almost
hopelessly handicapped at the start.

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Teh The campaigns of the SapnishSpanish-American War were fought
in Cuba, Puerto Rico and the Phillippines during May, June,
July and the first week of August, 1898. At the close of the war,
however, the men assembled in training camps were not immediately
disbanded for fear that they would spread their diseases all over
the country. Early in the war Reed had been anxious to get a re-
sponsible position in the field where his knowledge of Army routine
and methods of sanitation would be useful. Too often, however,
the important medical commands were given by authorities who
should have known better to civilian doctors who, however, patri-
otic and professionally capable, knew nothing of military procedure
and lacked training in camp sanitation.

Swallowing his chagrin, Reed had remained at his teaching
post. It was not until mid-August -the war was already over -
that he had an opportunity for valuable service. Then, with
Dr. Victor C. Vaughan and Dr. Edward O. Shakespeare, both eminent
sanitarians and majors of volunteers, he was appointed to a board
to investigate the causes of the typhoid epidemics that prevailed
in almost every camp.

By that time everybody had to admit, however reluctantly,
that there was some typhoid, although the diagnosis of malaria,
or even acute indigestion, was greatly preferred wherever it could
decently be made. There was little inclination among the medical
officers to irritate the public, already angry over the inefficient
management of the whole war, with the news that a dangerous disease
was epidemic among the soldiers.

All three board members were thoroughly familiar with
the current view of typhoid. It was generally believed that it
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was caused by a specific germ, Eberth's bacillus, and was spread
by contaminated drinking water. It was not known to be transmitted
by any other agency, although flies were suspected. It could be
diagnosed by a laboratory process known as Widal's test, and, at
autopsy, recognized by certain pathological findings. It could
also, on the basis of its symptoms, easily be confused with mal-
aria, but malaria itslef itself could be identified by the finding
of the malarial plasmodium in the blood on microscopic examination.
Given the proper equipment and a doctor who could make Widal's
test and recognize the plasmodium, there was no excuse on earth
for confusing the two diseases. There were still, however, few
medical men in the country so trained, and the Army board found,
on arriving at Camp Alger in nearby Virginia on the morning of
August 20th, that there was not a microscope in the camp.

By the end of their first day's work, all three men real-
ized that the first thing to do was to get a scientific diagnosis
of the fever. The camp doctors insisted that it was malaria. The
three inspectors were sure it was typhoid.

“But Major Reed,” one of the doctors handed him a sheaf of
temperature charts, “look at the temperature curves. In each case
it's a typical malarial curve, up, down, up, down.”

Reed glanced through them. The curve was, undoubtedly, un-
like the characteristically steady fever of typhoid victims.

“Mmmmmmm,” he said non-committally. “By the way, have you
done any autopsies?”

“Autopsies? And have the papers all over us? There's
enough public clamor without increasing it by doing autopsies.”

In the doherty wagon on the way back to Washington Reed re-
marked, “Those fever charts, up and down like an intermittent fe-
191.

ver -I wonder if they suggest the same thing to you that they do
to me?”

Shakespeare smiled. “I guess so, doctor.”

“It's typhoid, all right,” Vaughan agreed, “in disguise.
They're administering drugs to reduce the fever, so of course it
goes down. Then when the drug wear off, up it mounts again. The
action of the drug gives the steady fever, typhoid, the appear-
ance of the intermittent one, malaria.”

“That's the way I see it, too,” Reed concurred. “However,
Widal's and the microscope will settle it for good.”

They did. Each one of the hundred cases at Camp Alger
which the board believed to be typhoid, and the camp doctors thought
was malaria, turned out on laboratory analysis to be typhoid.
Would it be the same at the rest of the camps? the board wondered.
They immediately requested the Surgeon General to establish a diag-
nostic laboratory at each large camp; he agreed to do so, and they
left Washington for further investigation.

Traveling in the private car lent them by the Southern
Railroad, the three doctors, accompanied by a good chef, an atten-
tive porter and a secretary, arrived early in September at Jack-
sonville, Florida, where the Seventh Army Corps was encamped under
the command of Fitzhugh Lee, a nephew of Robert E. Lee's and him-
self a Confederate veteran.

The medical officers at Jacksonville, like those at Alger,
were sure they were dealing with malaria. Typhoid was a water-
borne disease -everybody knew that -they reminded the board.
Their water supply, from deep artesian wells, was unquestionably
pure.

There was no good debating, the three doctors saw. It was
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proof that was needed, not argument. They requested the medical
officers to select two hundred “malaria” cases, and sent them in
hospital trains to the Army diagnostic laboratory run by Carroll
at Fort Myer, near Washington, and to leading hospitals in Balti-
more, Boston and other cities. Every single case was pronounced
typhoid. The camp doctors were convinced. They had to be.

The thing “everybody knew,” that typhoid was due to bad
water, did not explain this epidemic. In scientific research,
Reed knew, you could take nothing for granted -least of all the
things “everybody knows.”

Since water was not causing the epidemic, what was? Reed and
his colleagues, trained observers, looked around. They had already
been struck by the bad sanitary conditions at the camp. Could they
be responsible?

A large tent camp had, naturally, no bathrooms with running
water. At Jacksonville the latrines were at regular intervals
cleaned and the contents carted away by scavengers. This disagree-
able labor, the board noted, was often carelessly performed, so
that some of the filth spilled in the roads, dried and mingled with
the dust, was tracked throughout the camp and blown about by the
widn wind. Flies swarmed on it, then flew to the camp kitchens and
mess halls and lighted on the food. The regiments having the poor-
est disposal methods also had the highest proportion of typhoid.
This certainly suggested, the board members agreed, that both wind
and flies might be carrying Eberth's bacill vicious little germ
from victim to victim.

If it could be spread by wind and flies, why not by con-
tact with soiled clothes and bedding, even by the touch of a dirty
hand? Wasn't it possible that the men were spreading the bacillus
directly from one to another by what the board called “comrade in-
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fection”? It seemed quite likely that they were.

Now, the investigators felt, they were getting somewhere:
the fever was certainly typhoid; just as certainly, it was not
being carried by water; there was reason to think that wind and
flies and comrade infection were spreading it. The thing to do,
plainly, was to attack the possible cause, filth, and see if that
did any good.

The board began to inspect the regiments, their camping
grounds, kitchens, tents and latrines. It had, of course, no en-
forcement power, but it could make emphatic recommendations. When
they came to the Third Nebraska, of which William Jennings Bryan
was colonel, the doctors presented their credentials and in-
vited the commander to join them in the inspection of his regi-
ment. All had been bad; the Third Nebraska was no exception.

“Colonel Bryan,” Reed addressed him with his disarming
smile, “Vaughan and Shakespeare are on this commission because they
know about camp sanitation. I am on it because I can damn a col-
onel.” He proceeded to lecture the astonished orator sternly on
the duty of a Commanding Officer to care for the health and clean-
liness of his troops.

The episode, Reed supposed, was closed. If only these civ-
ilians, suddenly blooming in uniforms, could be made to understand
the importance of sanitary measures in military life! It would be
worth all the unpleasantness, all the hurt feelings. No one of
the board mentioned the incident to Lee, at whose mess they ate.

But he heard of it somehow. It was probably too good a
story to keep -the Army medical officer scolding the loquacious
Boy Orator of the Platte to a standstill. A few days later, Lee,
rather insistently, invited the board to stand with him on the
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platform while he reviewed the troops. As the regiments tramped
past the three doctors stood respectfully behind the general. Fin-
ally he turned to them.

“Step up, please, gentlemen. Here comes the Third Nebraska.
Salute the colonel as he passes,” he suggested, with a little smile.

* * *

Chickamauga, in Tennessee, was the next camp
on the list. Sixty thousand men had camped there during Julne and
July, some still remained, and not a regiment had escaped typhoid.
Here the water from shallow wells and the river was definitely
contaminated. Also the soil of the whole camp had been fouled
by the carelessness of troops who knew they would soon move on.
The rocky ground made digging latrines difficult, moreover,
and the earth was unabsorptive. It was hard to fix the blame of
for the wretched and filthy situation, unless it could be fastened
on the ignorance of camp sanitation that prevailed among the En-
gineer Corps and the line officers. Most of the medical men, too,
were far from being sanitary experts; and what good recommendations
they could make were usually snubbed.

The troops still stationed at Chickamauga Park were despon-
dent and ill. Their Commanding Officer was no more cheerful than
his men.

“Doctor,” he whispered, drawing Vaughan aside, “do you
know what the word Chickamauga means?”

“No, what?” the plump, matter-of-fact man of science asked.

“River of Death!”

“You don't say. Interesting, these Indian names.”

The officer nodded somberly. “There's no use you fellows
going around trying to figure if it's malaria, or typhoid, or how
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it comes. It's the Chickamauga fever, and it's from the miasma.
Every night you can feel it, a foul damp that rises off the River
of Death and creeps through the whole camp.”

Giving this explanation the credence it deserved, the board
tried an experiment. Observing that typhoid occurred more rarely
among regiments that arte in screened tents, they scattered lime
in the latrines and then watched flies, their feet white with
it, later crawling over tables and food in unscreened messes.

Now they were sure of flies, and equally sure, from further
observation, about comrade infection. It would be interesting,
they thought, to find out next how long it took the bacillus, from
the time it entered a man's digestive tract, to lay him low. Con-
veniently, fifty trained nurses just then arrived from Chicago;
the first came down with typhoid ten days later. The conclusion,
later confirmed, was that the incubation period of the germ was t
about ten days.

Now reports of the board's studies were beginning to reach
the camps, and when they arrived at Camp Meade, in Pennsylvania,
they found that the camp doctors were disinfecting all bedding,
clothes, tents and other possibly soiled articles of each victim.
This practice, soon adopted in all the camps, caused an abrupt
decline in the number of new cases.

From mid-October, when they returned to Washington, until
the following June, Vaughan and Shakespeare, working at the Army
Medical Museum during the day and in their rented room on K Street
at night, went over the huge mass of statistics and other data
that they had collected at the camps. From detailed analysis of the
records of almost a hundred regiments they were able to draw cer-
tain conclusions about typhoid which still stand. They confirmed
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their original beliefs that typhoid is due to Eberth's bacillus
and does not develop even in fouled soil in the absence of the
bacillus; that Widal's test and autopsy can always identify it;
that it need never be confused with malaria, which can always be
identified by the plasmodium in the blood. They altered, however,
their earlier belief that it was largely water-borne: air and
water accounted for only twenty-two percent of the cases they had
studied, comrade infection for sixty-two and flies for fifteen.
These findings were the last word on typhoid until the discovery,
several years later, of the existence of carriers, people who have
recovered from the disease and continue, unaccountably, to
produce the bacillus in thein intestinal tract.

* * *

While his friends toiled over the typhoid material,
Reed was assigned to other duties. Late in October he went on a
trip to Natural Bridge, Virginia, to see if two hotels there could
be converted into military hospitals. Having decided that they
could not, he made a hasty trip to Lynchburg, where his brother
Jim was then living.

As he grew older, he realized, he valued his association
with his oldest brother increasingly, especially since it was fif-
teen years since he had seen either Chris, who was a judge in Kan-
sas City, or Tom, a merchant in Kansas. Jim, now an elderly min-
ister like Pa, met him at the station, and they started walking
together up the hill to the car line. With his empty sleeve, mem-
ento of Antietam, pinned in his coat pocket, Jim still walked
with the quick long stride of his youth, and laughed when his
youngest brother, puffing, mentioned that they were in no hurry.

“You take the hill like a breeze,” Reed said breath-
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lessly, “and I'm about winded. How do you keep so young, Jimmy?”

“I didn't spend a hard summer riding all around the country
inspecting camps,” Jim reminded him, “and the life of a rural min-
ister, although not exactly strenuous, does involve some walking.”

“It's good to see you so well, Jim. You seem to feel just
as young as ever. I wish I could say as much for myself.”

Jim, seeing the lines of weariness and strain in his face
that had been absent even a year ago, at Pa's funeral, said anx-
iously, “You need some rest, Walter. You're tired. We'll spend
a quiet evening at home, and if you feel like it, maybe you'll
tell us a little about your typhoid work. The children are dying
to hear about it. They think their military uncle is quite a fellow.”

In Washington again, Reed continued his usual work of
teaching and research, and met with Vaughan and Shakespeare as
often as possible to discuss the typhoid studies. In the middle
of April, 1899, he was sent to Cuba to investigate the epidemic of
“pernicious malaria” at the camp at Puerto Principe. It was, of
course, typhoid. He was miserably seasick going and coming on
this first trip to Cuba, and, poor man, he had many more such ex-
cursions ahead of him. By the first of June, 1899, he was back
in Washington again, in time to tell Vaughan and Shakespeare good-
bye.

That month the typhoid board was disbanded. Although its pre-
liminary report, which contained criticisms and recommendations on
the sanitary organization of the Army, had been published in Jan-
uary, the board's studies were not completed. Splitting the re-
maining sick reports between them, Vaughan and Shakespeare took
them home, and agreed to meet the next June at Atlantic City to
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write a full report on the board's findings.

* * *

The war, happily, had been short. Hostilities were offic-
ially opened late in April, 1898, and the peace protocol was
signed the following August 12th. Our lack of preparation and in-
efficiency had been appalling (the War Department's conduct was
later the subject of an investigation), but Spain's decrepitude
had been fatal. We won easily.

The war had some interesting results. The United States,
now that it had some island possessions -Puerto Rico and the Phil-
ippines -and was occupying Cuba, was beginning to think of itself
as a world power and to take a livlier interest in foreign affairs.
At the same time, much of the lingering bitterness of the Civil
War was wiped out in the new unity of national feeling.

A new set of heroes, too, had arisen to replace the totter-
ing gaffers of the Civil War. The image of Teddy Roosevelt, or-
ganizer of the Rough Riders, his teeth bared in a strenuous smile,
was familiar to every newspaper reader. Dr. Leonard Wood's dizzy
ascent from captain in the Medical Corps to brigadier general and
military governor of Cuba was known to everyone. Admiral Dewey,
for his destruction of the Spanish fleet in Manila Bay, was sudden-
ly subjected to the rigors of unrestrained hero-worship. Young Mr.
Richard Pearson Hobson, who had tried -and failed -to bottle up
the Spanish ships in Santiago Bay by sinking a collier across the
mouth of the harbor, became, for his pains, “the most kissed man
in America.”

The typhoid board won little public attention, however,
and there is no record that any attempts to kiss its members
199.

were made by an enthusiastic public. This oversight notwithstand-
ing, their work had not been insignificant. They had did much to
dispel a dangerous misconception about the spread of a serious com-
mon disease, and thus contributed greatly to its prevention.

200.