Tuesday, 3 December 2013

Carlos Finlay

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Carlos Finlay
Finlay Carlos 1833-1915.jpg
Carlos Finlay
Born Juan Carlos Finlay y Barres
December 3, 1833
Puerto Príncipe (Camagüey), Cuba
Died August 20, 1915 (aged 81)
Havana, Cuba
Nationality Cuban
Alma mater Jefferson Medical College
Known for Mosquito and yellow fever research
Carlos Juan Finlay (December 3, 1833 – August 20, 1915) was a Cuban physician and scientist who identified the role of mosquitoes in spreading yellow fever.


Early life and education

Finlay was born Juan Carlos Finlay y Barres, in Puerto Príncipe (now Camagüey), Cuba, of French and Scottish descent. He reversed the order of his given names to "Carlos Juan" later in his life. In 1853 he attended Jefferson Medical College in Philadelphia, Pennsylvania. He graduated in 1855, and completed his studies in Havana and in Paris. Afterwards he settled in Havana and opened a medical practice.
For 20 years of his professional life, renowned Cuban physician and scientist Carlos J. Finlay stood at the center of a vigorously debated medical controversy. The etiology of yellow fever -- its causes and origins -- had puzzled medical practitioners since the earliest recorded cases of the disease in the fifteenth and sixteenth centuries. Periodic epidemics of yellow fever ravaged the population of Finlay's native Cuba, particularly affecting the citizens of Havana, where he set up a medical practice in 1864. Finlay was intensely interested in epidemiology and public health, and his initial work on cholera -- the result of a severe outbreak of the disease in Havana in 1867 -- challenged the received wisdom of medical authorities.
His conclusion that the disease was waterborne, though later verified, was rejected by publishers at the time. Finlay soon afterwards began research on yellow fever, publishing his first paper on it in 1872. Here the same keen observations and logical deductions which informed his analysis of cholera lead him to propose in 1881 that the Culex mosquito be "hypothetically considered as the agent of transmission of yellow fever." This time the paper was published, but the wide professional circulation of The Annals of the Academy of Medical, Physical, and Natural Sciences of Havana did not assure Finlay of widespread support. Indeed, only one other Cuban physician, Claudio Delgado, rallied to Finlay's side in those early years.

Professional career

Finlay's work, carried out during the 1870s, finally came to prominence in 1900. He was the first to theorize, in 1881, that a mosquito was a carrier, now known as a disease vector, of the organism causing yellow fever: a mosquito that bites a victim of the disease could subsequently bite and thereby infect a healthy person.[1] A year later Finlay identified a mosquito of the genus Aedes as the organism transmitting yellow fever. His theory was followed by the recommendation to control the mosquito population as a way to control the spread of the disease.
El Obelisco, Finlay's memorial in Havana
His hypothesis and exhaustive proofs were confirmed nearly twenty years later by the Walter Reed Commission of 1900. Finlay went on to become the chief health officer of Cuba from 1902 to 1909. Although Dr. Reed received much of the credit in history books for "beating" yellow fever, Reed himself credited Dr. Finlay with the discovery of the yellow fever vector, and thus how it might be controlled. Dr. Reed often cited Finlay's papers in his own articles and gave him credit for the discovery in his personal correspondence.[2]
In the words of General Leonard Wood, a physician and U.S. military governor of Cuba in 1900: "The confirmation of Dr. Finlay's doctrine is the greatest step forward made in medical science since Jenner's discovery of the vaccination [for smallpox]."
This discovery helped William C. Gorgas reduce the incidence and prevalence of mosquito-borne diseases in Panama during the American campaign from 1903 onwards to construct the Panama Canal. Prior to this, about 10% of the workforce died each year from malaria and yellow fever.
In the municipality of Marianao now within the city of Havana, there is a monument honoring Dr. Finlay. This monument has the shape of a syringe and it is usually referred to as El Obelisco (The Obelisk). Finlay was also commemorated on a 1981 Cuban stamp.[3] A statue commemorating Dr. Finlay is located on the bayfront in Panama City, near the canal he helped make possible. The UNESCO Carlos J. Finlay Prize for Microbiology is named in his honor.
Dr. Finlay was a member of Havana's Royal Academy of Medical, Physical and Natural Sciences. He was fluent in French, German, Spanish, and English, and could read Latin. His interests were widespread and he wrote articles on subjects as varied as leprosy, cholera, gravity, and plant diseases. But his main interest was yellow fever, and he was the author of 40 articles on this disease. His theory that an intermediary host was responsible for the spread of the disease was treated with ridicule for years. A humane man, he often took on patients who could not afford medical care. As a result of his work, Dr. Finlay was nominated seven times for the Nobel Prize in Physiology or Medicine, but it was never awarded to him.[4] He received the National Order of the Legion of Honour of France in 1908.
Finlay himself recognized the difficulties inherent in his revolutionary proposal: "I understand but too well," he concluded in the now famous 1881 paper, "that nothing less than an absolutely incontrovertible demonstration will be required before the generality of my colleagues accept a theory so entirely at variance with the ideas which have until now prevailed about yellow-fever." From 1881 to 1900, Finlay pursued a campaign of 102 experimental inoculations on human volunteers, with the aim of demonstrating both the truth of his hypothesis and the possibility of inducing immunity to the disease. Finlay did believe that he had produced cases of yellow fever by mosquito inoculation, although the larger public health community remained skeptical. George Miller Sternberg, later to become Surgeon General of the United States Army, offered an essential critique of Finlay's experiments: that the participants were never sufficiently isolated from the general population to eliminate the possibility of contracting fevers from sources other than Finlay's mosquitoes. This and the inconsistency with which fevers developed in the experimental participants kept the mosquito theory on the margins. Nevertheless, Finlay's expertise gained a place for him among the leading public health practitioners in Havana, and his advice and experiences proved invaluable to the United States Army Yellow Fever Commission. When the Commission decided to test the mosquito theory, Finlay provided the mosquitoes, and with the Commission's first scientifically valid success, Walter Reed wrote triumphantly, "The case is a beautiful one, and will be seen by the Board of Havana Experts, to-day, all of whom, except Finlay, consider the theory a wild one!" The full run of experiments at Camp Lazear vindicated Finlay's two-decade-long struggle. In the glow of that early success, Reed acknowledged that "it was Finlay's theory, & he deserves much for having suggested it." William Crawford Gorgas, who later applied the results of the experiments to a public health campaign which made possible the construction of the Panama Canal, characterized Finlay's contribution in this way: "His reasoning for selecting the Stegomyia as the bearer of yellow fever is the best piece of logical reasoning that can be found in medicine anywhere." Finlay concluded his career as the Chief Sanitary Officer of Cuba, a position he held for eight years before retiring in 1909.


Finlay died on 20 August 1915 from a stroke caused by severe brain seizures in his home in Havana, Cuba.
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