Historia de la medicina en Cuba History of Medicine in Cuba

By Dr. E. B. Barnet, Technical Delegate of the Department of Health and Charities of the Government
of Cuba to the P.-P. I. Exposition.

In view of the fact one of the most brilliant discoveries of the age (fully as important no tropical America as that of the immortal Jenner), the transmission of yellow fever by the mosquito, was made in Cuba, and that with this discovery is connected the name of the eminent Cuban physician Dr. Carlos J. Finlay, and on account of his recent death it would appear opportune at this time to go into the life history of this illustrious man. His death occurred in Havana, Cuba, on August 20th, having reached the age of 82 years.

The work of Finlay has opened up the heretofore closed path of progress and civilization in tropical America. Without detracting in the least from the merits of Drs. Reed, Carroll, Agramonte, Lazear, Gorgas and others who contributed in the practice of exterminating the mosquito as a measure of sanitation, it is possible to declare that without the Finlay theory, the gigantic work of the Panama Canal could never have been accomplished.

The same sanitary plan which was carried out in Cuba, was enforced at the Canal Zone, thus confirming the ideas of this brilliant mind.
In an address delivered at Baltimore in April 1901, Dr. Walter Reed made the following statement: "to Dr. Carlos J. Finlay must be given, however, full credit for the theory of the propagation of Yellow Fever by the mosquito".

Dr. Carlos J. Finlay was born in the city of Puerto Principe (now Camagüey) in the Island of Cuba, on the 3^rd of December, 1833. His father was Edward, a Scotch physician, and his mother Isabel de Barrés, a native of France. While still in his infancy, the family moved to Havana, where the boy grew to his eleventh year, residing at times in the capital and at times in Guinimar. He received at the same time his school education at the hands of his aunt Anna.

In 1844 Finlay was sent to France and studied in a school at The Havre until 1846 when he had to return to Cuba on account of an attack of chorea. He returned to Europe in 1848 to complete his education in France, but the revolutionary movements of that year obliged him to remain for a short time in London, and during one year in a school at Mentz on the Rhine. He entered college at last in Rouen where he continued his studies until 1851 when he returned to Cuba to convalesce from an attack of typhoid fever. Later on he came to Philadelphia, Pa., where he graduated in Medicine on the 10th of March, 1855, from the Jefferson Medical college, and incorporated his diploma in the University of Havana in 1857, and began the practice of his profession.

In 1860-61 we find him in Paris following the hospital clinics and taking up some special studies, specializing somewhat in ophthalmic surgery. In 1865 he married in the city of Havana, Miss Adela Shine, a native of the Island of Trinidad, still alive and a gifted woman who has faithfully and tenderly taken an active interest in all his endeavors. They have founded a family much esteemed in the social circles of Havana.

In 1881 he came to Washington representing the colonial government of Cuba at the International Sanitary Conference. He chose this occasion to make public for the first time his views on the transmission of Yellow Fever by an intermediary agent.

At the session of the Royal Academy of Sciences, in Havana, August 14^th , 1881, he have out his memorable theory of the transmission of Yellow Fever by the mosquito, reporting at that time a series of experiments that he had made on human beings, by which he claimed to prove the theory. In the communication he stated with all preciseness that for Yellow Fever to propagate it was necessary to have three conditions, viz: (1) The existence of a Yellow Fever patient into whose capillary vessels the mosquito is able to drive its sting and to impregnate it with virulent particles, at an appropriate stage of the disease. (2) That the life of the mosquito be spared after its bite on the patient until it has a chance of biting the person in whom the disease is to be reproduced. (3) The coincidence that some of the persons whom the same mosquito happens to bite thereafter shall be susceptible of contracting the disease.

Since that date (1881) he never ceased in his tenacious endeavor to prove the truth of these propositions. He studied very carefully the habits of  the Stegomya or Culex mosquito, Desv., as it was then called. He studied the anatomy of the insect and determined its manner of feeding and breeding under varying conditions of temperature and atmospheric pressure, also the geographic distribution of the mosquito, and by most ingenious experiments he proved the truth of his doctrine.

Upon these facts, discovered and analyzed by him, he explained with mathematical preciseness, as we do now, all the phenomena of the epidemiology of Yellow Fever.

These were fundamental bases of the modern doctrine, but they made so little impression that it needed twenty years more, and the coincidence of the intervention of the United States in the war for the independence of Cuba, before the men of science returned to think of the matter.

The glory of Finlay is comparable with that of Jenner and Manson. Working independently, the latter in Amoy, the former in Havana, they laid the foundation of the doctrine of the transmission of diseases by blood-sucking insects. Their discoveries, as said before, do not in the least detract from the merit of their successors. Smith and Kilbourne, Grassi, Ross, Koch, Reed, Lazear, Carrol, Agramonte, Laveran, Bruce and others, as the work of these cannot lessen the glory of the initiators.

At the breaking out of the Spanish-American war, Dr. Finlay, who was then 65 years old, came to Washington to offer his services to the American Government, and insisted with his friend Dr. Sternberg, then Surgeon-General of the Army, to be sent to the field. He took part in the campaign around Santiago where he did not fail to speak, as he ever did when the opportunity offered, of the benefits that might be obtained if his theories were accepted.

On his return to Havana, in 1898, he brought his views to the attention of the Army Medical Officers, the government and the medical press in the United States. He wrote at that time a complete plan of campaign against Yellow Fever on the same lines which were subsequently followed with the brilliant results now familiar to all of us.

Those acquainted with the facts can never forget the impression made upon them by manner of Dr. Finlay in receiving the various commissions that went to Cuba, taking advantage of the new order of things, to study tropical disease. Full of generous enthusiasm he would explain his views and show his copious notes, records, experiments that might be undertaken.

In 1900, the U.S. Army Medical Commission met with the same reception, and Dr. Finlay handed to them the mosquitoes with which they commenced the experiments that definitely proved the theories he had been maintaining for twenty years previously. With what generous interest he followed the experiments of this commission recognizing freely the incompleteness of his own procedures, admiring with an almost infantile candor the methods of  technic, and  the demonstrative results that were developing! His admiration extended from the work itself, with affectionate demonstrations to the men  who were engaged in it, the members of the commissions and the men who submitted themselves to the experiments.

Upon the expiration of the first American intervention, in 1902, the Cuban government did justice to the illustrious compatriot, appointing him Chief Heath Officer and President of the Superior Board of Heath. Since this date, Dr. Finlay left the island on several occasions to attend various meetings on sanitary matters in the United States. Wherever he went his charming personality attracted the most sincere demonstrations of affection and respect, a tribute at once to his genius and his great virtues. At the XXXI session of the American Public Heath Association, held at Washington, in October 1903, he was elected President for the meeting which was successfully celebrated at Havana, in January of 1905.

Many are the honors which have been tendered to Dr. Finlay by institutions and publications at home and abroad. The medical profession of Havana, together with officers of the American Army, presided by General Wood, celebrated with a great banquet and the presentation of a statuette, symbolic of genius, the triumph of Dr. Finlay in 1900.

His Alma Mater, the Jefferson Medical College of Philadelphia, gave him the honorary title of LL. D.  He was also elected honorary fellow of the College of Physicians of Philadelphia.

The Liverpool School of Tropical Medicine, in 1901, granted him the Mary Kingsley Medal for meritorious work in that branch of pathology, an honor that Finlay divides with such men as Manson and Ross. The Provisional Government of Cuba and the University of Havana joined in the solemnity of the presentation of the medal.

In 1908 the French Government made him an Officer of the Legion of Honor, the insignia being presented by the French Minister at the Academy of Sciences.

The Government of the second intervention, at the instigation of Col. J. R. Kean, U.S.A., and following a recommendation of the First Medical Congress of Cuba, granted him a life pension and ordered the publication of his papers, which have been issued in a big volume.

In 1911 he was elected a Corresponding Member of the French  Academy of Medicine.

The Scientific societies have always received his communications with respect even at the time when his ideas appeared to be absurd. And it could not well be otherwise, if we consider the character of the man: genial, kindly, jovial, modest, strong in the rectitude of his principles, which were founded on the most profound reverence for the truth and a devotional religious spirit.

Dr. Finlay's capacity for work was extraordinary. In the midst of the labors of active practice, and the frequent productions of papers on various medical subjects in which he generally proved himself to be ahead of his compatriots, he would find, for instance, time to decipher an old Latin manuscript, with the necessary gathering of data from historic, heraldic and philologic sources, to prove that the old Bible in which the manuscript appears was owned by the Emperor Charles V; or he would take up problems in the higher mathematics, chess and philology. In the midst of the harassing occupations of a great administrative office, and when he had passed his seventieth year, he mastered the complicated subject of immunity and the theories of Metchnikoff, Ehrlich, Buchner and others, presenting his own conception of the intricate problem.

Though Finlay's work is most varied in character, and though it bears throughout the stamp of great originality, it is all thrown in the shade by the great labor and genial conceptions that he devoted to the problems of Yellow Fever. This may be expressed in very few words: he discovered the fact that Yellow Fever is transmitted by the bite of one species of mosquito, and he invented a sure method for the extinction of the disease.

The members of the American Army Commission, Drs. Reed, Carroll, Agramonte, and Lazear, and such men as Manson, Chaille, Boice, Marchoux, Blanchard, Gorgas, Kean, General Wood and others, has given to Dr. Finlay the credit he deserves.

In his native country, Cuba, there has already been laid the cornerstone of the monument which will perpetuate the memory of this great investigator, indefatigable worker and illustrious benefactor.

"Great as our satisfaction must be, how much greater must have been that of the man, great as he was modest, who has made all this possible through a mental effort equaled by very few in the history of the human mind".