Disease, Tropical. Tropical disease has plagued American forces from the colonial period to modern times. Malaria, dysentery, dengue, and yellow fever (all endemic to the United States), as well as schistosomiasis, yaws, leishmaniasis, filariasis, and scrub typhus (all from other areas), have decimated garrisons and overwhelmed combat troops. To conquer or contain tropical disease, the U.S. military, sometimes cooperating with civilian scientists, developed preventive techniques, therapies, and cures. Collaborative research controlled and even vanquished most tropical diseases except for malaria, whose parasite became immune to traditional antimalarials, and whose prevention and cure remain elusive.
The military historically follows standard civilian practice regarding contagion, diagnosis, and treatment. Before the
Civil War, physicians did not suspect mosquitoes as transmitters, blamed fever on the climate or air, and often could not distinguish one fever from another, treating them with emetics, chinchona bark, bleeding, mercury, wine, aromatics, snakeroot, or arsenic compounds. During the
Mexican War, physicians at the Veracruz hospital treated yellow fever with quinine sulfate, first extracted from chinchona bark in 1820, to reduce the fever; mustard plasters and baths to help the circulation; and mercurials to evacuate the bowels. About 28 percent of victims died in the spring and summer of 1847. More prevalent was diarrhea or dysentery, which accounted for one‐third of all hospital admissions. Quinine proved highly beneficial in treating malaria. During the Civil War, the
Union army had plenty of quinine, but the disease scourged the
Confederate army, which occupied infested areas and had limited supplies. Better sanitation in the post–Civil War period helped curtail communicable disease among troops.
The
Spanish‐American War (1898) forced the U.S. Army to lead a fight against tropical disease. American forces could not garrison the islands they had won without controlling yellow fever, typhoid, malaria, and dengue. The work of Maj.
William C. Gorgas of the Medical Corps in Havana (1899) and (as colonel) in Panama (1904–06) in preventive medicine halted epidemics of typhoid, dysentery, and yellow fever, and made possible construction of the Panama Canal. Maj.
Walter Reed and the Army Medical Board in the autumn and winter of 1900–1901 proved scientifically that the mosquito served as intermediate host for the yellow fever parasite. Reed was indebted to Dr. Carlos Finlay of Cuba, Sir Patrick Manson of Britain, and Maj. Ronald Ross of the British army, each of whom had helped prove that the mosquito was the carrier of disease. Their research pioneered the science of tropical medicine. During the early twentieth century, army medical research boards, such as the Philippine Tropical Disease Board, conducted investigations and began control measures that drastically reduced disease around U.S. bases at home and overseas.
By World War II, the development of vaccines, due largely to support from the Rockefeller Foundation, had eliminated yellow fever and typhus. Improvement of field sanitation controlled the dysenteries. Wartime research under the aegis of the National Research Council improved chemotherapy for the prevention and treatment of malaria and secured development of a powerful insecticide: DDT. Those advances, plus the work of army and navy malaria control units, and the enforcement of malaria discipline by personnel (taking atabrine tablets and wearing protective clothing) reduced incidence to historic lows. In the Southwest Pacific, monthly rates fell from 251 per 1,000 in December 1943 to 62 per 1,000 in November 1944: malaria no longer impeded campaigns.
During the
Vietnam War, however, despite research to find better antimalarial drugs or a vaccine, chloroquine‐resistent falciparum malaria from Southeast Asia threatened the U.S. armed forces. Drug‐resistant malaria continues to be the most important military medical problem of the tropics.
[See also
Caribbean and Latin America, U.S. Military Involvement in the;
Casualties.]
Bibliography
E. C. Andrus et al., eds., Advances in Military Medicine Made by American Investigators Working Under the Sponsorsphip of the Committee on Medical Research, 1948.
John Z. Bowers and Elizabeth F. Purcell, eds., Advances in American Medicine: Essays at the Bicentennial, vols. 1, and 2, 1976.
François Delaporte , The History of Yellow Fever. An Essay on the Birth of Tropical Medicine, 1991.
Mary Ellen Condon‐Rall and and Albert E. Cowdrey , The Medical Department: Medical Service in the War Against Japan, 1998.
Mary Ellen Condon‐Rall
