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Toward Responsibility in International Health: Death following Treatment in Rockefeller Hookworm Campaigns, 1914–1934

Published online by Cambridge University Press:  07 December 2011

Steven Palmer
Steven Palmer
Affiliation:
Department of History, University of Windsor, 401 Sunset Ave., Windsor, Ontario, Canada N9B 3P4; e-mail: spalmer@uwindsor.ca
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Late in October 1926, a poor man from Bucamaranga, Colombia, wrote a letter to the richest man in the world. Juan de la Rosa Quintero Parra informed John D Rockefeller that his ten-year-old son, José Vicente, had “died suddenly as a result of a purge administered by the Bureau of Uncinariasis”, the local incarnation of the Rockefeller Foundation's global project to eradicate hookworm disease. The death of the boy, who worked full-time as a streetsweeper for the municipality, had been “a serious blow since he was the only one who contributed to the support of the family consisting of seven young children”. Having heard of Mr Rockefeller's generosity, Quintero appealed to him for assistance, thanked him in advance for the attention he would give to the matter, and hoped that Divine Providence would spare the great philanthropist's life for many years to come. He mailed the letter to Rockefeller Foundation headquarters at 61 Broadway in New York City, the same address where, probably unbeknownst to him, bits of his son's organs had been sent following a post-mortem. Quintero Parra's letter came to the attention of either the 84-year-old patriarch or his son, John D Rockefeller, Jr, the Foundation's president. Their executive secretary, F M Read was instructed to make inquiries into the death of the child, José Vicente Quintero.

Type
Articles
Information
Medical History , Volume 54 , Issue 2 , April 2010 , pp. 149 - 170
Copyright
Copyright © The Author(s) 2010. Published by Cambridge University Press

References

1Juan de la Rosa Quintero Parra to John D Rockefeller, 30 Oct. 1926, and ‘Report of case of poisoning by anthelmintic’, Bound Volumes (hereafter BV) 27, Record Group (hereafter RG) 5, Rockefeller Foundation Archives (hereafter RFA), Rockefeller Archive Center (hereafter RAC). The quotations are from the translation of the letter; the original is not in the file. D B Wilson to F M Read, 21 Jan. 1927, BV 27, RG 5, RFA-RAC.

2‘Report on seven deaths among twelve cases of chenopodium poisoning in Colombia’, RG 5, series 3, box 27, folder 164, RFA-RAC.

3Wilbur A Sawyer, ‘Memorandum to the General Director: deaths following the administration of anthelmintics in Colombia’, BV 27, RG 5, RFA-RAC.

4Anne-Emanuelle Birn, Marriage of convenience: Rockefeller international health and revolutionary Mexico, Rochester, NY, University of Rochester Press, 2006, pp. 87–8; Soma Hewa, Colonialism, tropical disease and imperial medicine: Rockefeller philanthropy in Sri Lanka, Lanham, MD, University Press of America, 1995, pp. 81, 86.

5Raymond B Fosdick, The story of the Rockefeller Foundation, 2nd ed., New Brunswick, NJ, Transaction, 1989, pp. 44–7; John Farley, To cast out disease: a history of the International Health Division of the Rockefeller Foundation (1913–1951), Oxford University Press, 2004, pp. 158–67.

6On the Rockefeller Sanitary Commission in the US South, see John Ettling, The germ of laziness: Rockefeller philanthropy and public health in the new South, Cambridge, MA, Harvard University Press, 1981. On the initial stages of the IHB hookworm project, see Steven Palmer, ‘Migrant clinics and hookworm science: peripheral origins of international health, 1840–1920’, Bull. Hist. Med., 2009, 83 (4): 676–709; Marcos Cueto (ed.), Missionaries of science: the Rockefeller Foundation and Latin America, Bloomington, IN, Indiana University Press, 1994; Farley, op. cit., note 5 above; idem, Bilharzia: a history of imperial tropical medicine, Cambridge University Press, 1991, pp. 72–80; Fosdick, op. cit., note 5 above. Among case studies are Christian Brannstrom, ‘Polluted soil, polluted souls: the Rockefeller hookworm eradication campaign in São Paulo, Brazil, 1917–1926’, Hist. Geog., 1997, 25: 25–45; Rita Pemberton, ‘A different intervention: the International Health Commission/Board, health, sanitation in the British Caribbean, 1914–1930’, Caribbean Q., 2003, 49 (4): 87–103; Ligia María Peña Torres and Steven Palmer, ‘A Rockefeller Foundation health primer for U.S.-occupied Nicaragua, 1914–1928’, Can. Bull. Med. Hist., 2008, 25 (1): 43–69; Warwick Anderson, Colonial pathologies: American tropical medicine, race, and hygiene in the Philippines, Durham, NC, Duke University Press, 2006, pp. 194–206.

7Z S Pawlowski, G A Schad, G J Stott, Hookworm infection and anaemia: approaches to prevention and control, Geneva, World Health Organization, 1991, pp. 3–5; Richard W Ashford and William Crewe, The parasites of homo sapiens: an annotated checklist of the protozoa, helminhths and arthropods for which we are home, London and New York, Taylor and Francis, 2003, pp. 69–70; David I Pritchard, R J Quinnell, P J Hotez, J M Hawdon and A Brown, ‘The immunobiology of hookworm infection’, in Celia V Holland and Malcolm W Kennedy (eds), The geohelminths: Ascaris, Trichuris and hookworm, Boston, Dordrecht, and London, Kluwer Academic Publishers, 2002, pp. 143–65.

8On this point, see Ilana Löwy, ‘“Intervenir et représenter”: campagnes sanitaires et élaboration des cartographies de l’ankylostomiase’, Hist. Phil. Life Sci., 2003, 25: 349–50.

9‘Report of case of poisoning by anthelmintic’, BV 27, RG 5, RFA-RAC. For a portrait of what a poor working boy’s life in a small Latin American city might have been like at this time, see the autobiographical sketch by Carlos Luis Fallas (b. 1909), ‘Autobiografía’, Marcos Ramírez, 4th ed., San José, Editorial Costa Rica, 1986, pp. 9–11; the book, originally published in 1952 as Marcos Ramírez: aventuras de un muchacho, is a delightful, lightly fictionalized memoir of Fallas’ childhood on the streets of San José, Costa Rica, 1915–1924.

10Pritchard, et al., op. cit., note 7 above, p. 147.

11Ettling, op. cit., note 6 above, p. 25; and Rockefeller Foundation (hereafter RF)-IHB, ‘Introduction’, Bibliography of hookworm disease, New York, RF, 1922, pp. xxii–xv; also, pp. 327–56 on publications on anthelmintics for hookworm, 1880–1921.

12Ettling, op. cit., note 6 above, pp. 228n.12, 165–7; Farley, op. cit., note 5 above, p. 41n. On children’s distaste for thymol, Daniel M Molloy, ‘Second annual report on work for the relief and control of uncinariasis in Nicaragua for the period January 1st 1916 to December 31st 1916’, p. 23, RG 5, series 3, box 150, folder 1787, RFA-RAC.

13A K Bond, ‘Death after wormseed’, Maryland M. J., 1897, 37: 289–90.

14The chemistry of oil of chenopodium was studied in the US by Edward Kremers and E K Nelson of the bureau of chemistry at the US Department of Agriculture. Dutch tropical disease researchers, H Vervoort and Wilhelm Schüffner, based on research in the Netherlands East Indies, presented a paper to the 1912 International Congress on Hygiene and Demography in Washington, DC, advocating the superiority of chenopodium in the treatment of hookworm disease. See Murray Galt Motter, Hookworm disease: the use of oil of chenopodium in its treatment, Washington, Government Printing Office, 1914, p. 2.

15Rockefeller Foundation, Annual report, 1915, pp. 214–21.

16Robert M Levy, ‘Oil of chenopodium in the treatment of hookworm infections’, JAMA, 1914, 43 (22): 1946–9; also in this vein was Motter, Hookworm disease (see note 14 above). Motter worked in the Division of Pharmacology of the United States Public Health Service.

17On this controversial character, see Farley, op. cit., note 5 above, pp. 12–13; Anderson, op. cit., note 6 above, pp. 180–205; and his own memoirs, Victor Heiser, An American doctor’s odyssey: adventures in forty-five countries, New York, W W Norton, 1936.

18Victor Heiser, ‘Report upon the experiences of physicians in the Orient with oil of chenopodium in the treatment of over 100,000 cases of uncinariasis and other intestinal parasitic diseases’, pp. 1, 5, RG 5, series 2, box 63, folder 408, RFA-RAC.

19Rockefeller Foundation, Annual report, 1915, pp. 214–16.

20Rockefeller Foundation, Annual report, 1916, pp. 220, 246–7.

21Rockefeller Foundation, Annual report, 1917, pp. 116.

22Levy, op. cit., note 16 above, pp. 1947–9.

23‘Report of case of poisoning by anthelmintic’, BV 27, RG 5, RFA-RAC.

24Confusingly entitled ‘Deaths following treatment, vol. 1, 1915–1934’, and ‘Deaths following treatment, 1922–1933, vol. 1’, the progeny of the binders is not known. It can be inferred that they were both begun just prior to 1 November 1926 due to comments made in the frontispiece. The volumes are currently catalogued as ‘Deaths following treatment, vol. 1, 1915–1934’, BV 27, and ‘Deaths following treatment, 1922–1933, vol. 1’, BV 30–31, RG 5, RFA-RAC.

25‘Chronological table of contents, deaths following treatment with chenopodium’, BV 27, pp. 1–17, and ‘Chronological table of contents, deaths following treatment with carbon tetrachloride chenopodium mixture’, BV 30, pp. 1–6, both RG 5, RFA-RAC.

26D B Wilson to F M Read, 21 Jan. 1927, BV 27, RG 5, RFA-RAC.

27Two deaths that occurred in Nicaragua in 1919 were attributed by the supervisor to severity of hookworm disease in one case, and to malnutrition in the other; see D M Molloy, ‘Report on work for the relief and control of hookworm disease in Nicaragua from September 22, 1915 to December 31, 1920’, p. 13, RG 5, series 2, box 34, folder 202, RFA-RAC. For Mexican responses of this kind, see Birn, op. cit., note 4 above, p. 87.

28Louis Schapiro to Wickcliffe Rose, 17 March 1916, RG 5, series 1.2, box 29, folder 450, RFA-RAC.

29Emmett I Vaughan, ‘Report on work for the relief and control of hookworm disease in Guatemala from March 15, 1915 to December 31, 1920’, p. 6, RG 5, series 2, box 31, folder 184, RFA-RAC.

30M E Connor, ‘Notes on Guatemala’, n.p., 2 June 1917, RG 5, series 2, box 31, folder 184, RFA-RAC

31Excerpt from communication from Dr Hackett to bulletin of National Academy of Medicine, Brazil, 1921, 93 (2).

32Samuel Darling to Frederick Russell, 12 Sept. 1925 BV 27, RG 5, RFA-RAC.

33William Salant, ‘The pharmacology of the oil of chenopodium with suggestions for the prevention and treatment of poisoning’, JAMA, 15 Dec. 1917, 69 (24): 2016–17. Another study that determined that chloroform was more effective against hookworm, was Maurice C Hall and Winthrop D Foster, ‘Oil of chenopodium and chloroform as anthelmintics’, JAMA, 30 June 1917, 68 (26): 1961.

34Samuel T Darling, M A Barber and H P Hacker, ‘The treatment of hookworm infection’, JAMA, 23 Feb. 1918, 70 (8): 499, 504.

35David A Roth, ‘Some dangers of the chenopodium treatment’, South. Med. J., Nov. 1918, 11 (11): 733–4.

36Sandra L Orellana, Indian medicine in highland Guatemala: the pre-Hispanic and colonial periods, Albuquerque, NM, University of New Mexico Press, 1987, p. 109. See also John K Crellin and Jane Philpott, A reference guide to medicinal plants: herbal medicine past and present, Durham, NC, Duke University Press, 1990, pp. 269–70, which notes that the vernacular name “American wormseed” (also referred to as Jerusalem oak, oak of paradise, wormseed, Mexican tea, and pigweed) was used for various chenopodium species, notably Chenopodium botrys—a confusion over taxonomy due to hybridization and the “morphological plasticity of character” of Chenopodium ambrosoides var. anthelminticum. See also Julia F Morton, Atlas of medicinal plants of Middle America, Bahamas to Yucatan, Springfield, Charles C Thomas, 1981, p. 176.

37Henri Pittier, Ensayo sobre plantas usuales de Costa Rica, Washington, DC, H L and J B McQueen, 1908, pp. 60–1.

38Draft notes for first quarter report from Guatemala, 1915, p. 4. RG 5, series 3, box 140, folder 1653, RFA-RAC.

39República de Costa Rica, Reglamento del Depto de Ankylostomiasis, n.p., n.d. [Imprenta Nacional, 1917], p. 17; copy found in RG 5, series 2, box 28, folder 170, RFA-RAC.

40J W Burres, ‘Report for the first quarter—Guatemala, 1919’, RG 5, series 3, box 140, folder 1657, RF-RAC. Deworming on the full moon was also noted by the IHB officer in rural Panama; see Lewis Hackett to his mother, 14 Oct. 1914, Hackett Papers, RFA-RAC; and Lewis Hackett to Wickliffe Rose, 7 Sept. 1914, RG 5, series 3, box 152, folder 1832, RFA-RAC. De-worming at the time of a full moon may be related to an ancient empirical appreciation of the lunar periodicity of reproduction in invertebrates, including worms; see George Sarton, ‘Lunar influences on living things’, Isis, 1939, 30 (3): 425–51, p. 505. In Nicaragua many people also thought the moon a factor in the operation of the purgative accompanying the vermifuge; see Molloy, op. cit., note 12 above, p. 23.

41Bond, op. cit., note 13 above.

42Crellin and Philpott, op. cit., note 36 above, p. 270.

43Molloy, op. cit., note 12 above, p. 28.

44‘Deaths following treatment, 1922–1933’, BV 30, RG 5, RFA-RAC.

45Molloy, op. cit., note 12 above, p. 28.

46Rockefeller Foundation, Annual report, 1913–14, p. 71.

47Elizabeth Fee, Disease and discovery: a history of the Johns Hopkins School of Hygiene and Public Health, 1916–1939, Baltimore, Johns Hopkins University Press, 1987, pp. 165–6.

48S T Darling and W G Smillie, Studies on hookworm infection in Brazil, First Paper, New York, Rockefeller Institute for Medical Research, 1921, p. 36.

49Wilson G Smillie, Studies on hookworm infection in Brazil, 1918–1920, Second paper, New York, Rockefeller Institute for Medical Research, 1922, pp. 21–2; capitalization in original.

50‘Chronological table of contents—oil of chenopodium’, and ‘Chronological table of contents—carbon tetrachloride-chenopodium mixture’; W T Burres, ‘Report on work for the relief and control of hookworm disease in Guatemala from March 15, 1915, to December 31, 1919’, pp. 5–7, RG 5, series 2, box 31, folder 184, RFA-RAC.

51Daniel M Molloy, ‘Report on work for the relief and control of hookworm disease in Nicaragua from September 22, 1915 to December 31, 1920’, p. 14, RG 5, series 2, box 34, folder 202, RFA-RAC; also see Molloy, op. cit., note 12 above, pp. 24–30.

52Harry M Marks, The progress of experiment: science and therapeutic reform in the United States, 1900–1990, Cambridge University Press, 1997, p. 47.

53The 1905 quote from Flexner is cited in Marks, ibid., p. 50.

54Farley, op. cit., note 5 above, p. 19.

55Wickliffe Rose to Fred C Caldwell, 7 Feb. 1921, RG 5, series 3, box 153, folder 1843, RFA-RAC.

56C Williamson to Frederick Russell, 13 March 1925, BV 27, RG 5, RFA-RAC.

57George E Vincent to Thomas Debevoise, 2 April 1929, BV 27, RG 5, RFA-RAC.

58Memorandum from Hector H Howard, 21 March 1929, BV 27, RG 5, RFA-RAC.

59D B Wilson to F M Read, 21 Jan. 1927, BV 27, RG 5, RF-RAC.

60Robert Baker, ‘The history of medical ethics’, in W F Bynum and Roy Porter (eds), Companion encyclopedia of the history of medicine, London and New York, Routledge, 1993, vol. 2, pp. 852–97, on pp. 871–2.

61Susan E Lederer, Subjected to science: human experimentation in America before the Second World War, Baltimore, Johns Hopkins University Press, 1995, pp. 1, 11–12.

62Martin A Pernick, A calculus of suffering: pain, professionalism, and anesthaesia in nineteenth-century America, New York, Columbia University Press, 1985.

63Lederer, op. cit., note 61 above, pp. 11–12.

64Samuel Darling and W G Smillie, ‘Report of field research work on hookworm infection of the Institute of Hygiene, Part 1’, p. 2, RG 5, series 2, box 23, folder 138, RFA-RAC. On Smillie’s experimental approach, see Farley, op. cit., note 5 above, pp. 161–2. The Brazilian experiments are discussed by Brannstrom in order to describe the social geography of the areas in question, op. cit., note 6 above, pp. 40–1.

65Darling and Smillie, op. cit., note 48 above, p. 34.

66Hackett, op. cit., note 31 above.

67Rafael Uscátegui Mantilla to the Rockefeller Foundation, 22 Jan. 1929, BV 27, RG 5, RFA-RAC; on clannish physicians, Max Olaya Restrepo, ‘Médicos santandereanos destacados en la primera década del siglo’, Crónicas Médicas de Santander, Dec. 1999, 2 (6): 155–9.

68Emilio Quevedo, Catalina Borda, Juan Carlos Eslava, Claudia Mónica García, et al., Café y gusanos, mosquitos y petróleo. El tránsito desde la higiene hacía la medicina tropical y la salud pública en Colombia, 1873–1953, Bogotá, Universidad Nacional de Colombia, 2004, pp. 202–28, 252–5. See also Emilio Quevedo, et al., ‘Knowledge and power: the asymmetry of interests of Colombia and Rockefeller doctors in the construction of the concept of “Jungle Yellow Fever”, 1907–1938’, in Can. Bull. Med. Hist., 2008, 25 (1): 71–109; and Christopher Abel, Health care in Colombia, c.1920–c. 1950: a preliminary analysis, London, Institute of Latin American Studies, 1994, p. 7.

69Rafael Uscátegui Mantilla to G Bevier, 11 Sept. 1929, BV 27, RG 5, RFA-RAC.

70Lewis Hackett, ‘Excerpt from 3rd quarter report on activities for the relief and control of uncinariasis in Brazil, from 1 January 1917 to 30 September 1917’, p. 4, BV 27, RG 5, RFA-RAC.

71Andrew Warren to Frederick Russell, 15 July 1926, RG 5, series 1.2, box 258, file 3282, RFA-RAC; cited in Birn, op. cit., note 4 above, p. 88.

72Memorandum to Dr Russell concerning case of anthelmintic poisoning, José V Quintero, p. 2, BV 27, RG 5, RFA-RAC.

73Thomas Debevoise to George E Vincent, 5 April 1929, BV 27, RG 5, RFA-RAC.

74Hector Howard to G Bevier, 11 July 1929, BV 27, RG 5, RFA-RAC.

75Receipt for 100 pesos signed before two witnesses by Juan de la Rosa Quintero Parra, verified by G Bevier, Colombian mission supervisor, BV 27, RG 5, RFA-RAC.

76Juan de la R Quintero Parra to Frederick Russell, 12 Oct. 1929, BV 27, RG 5, RFA-RAC.