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The other Dr Finlay

BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7210.618 (Published 04 September 1999) Cite this as: BMJ 1999;319:618
  1. P P Mortimer, virologist
  1. London

    Two blocks along the left bank of the Seine from the Eiffel Tower is the Rue du Docteur Finlay. Eponymous streets abound in France, but most are dedicated to French notables, and rarely if ever fictional ones Spring to mind though he may, therefore, we are not dealing here with the junior partner at Tannochbrae.*

    Instead, the doctor in question is Carlos Juan Finlay. The street sign describes Finlay as “Mèdecin et chercheur cubain, 1833-1915.” This is too brief a description to do justice either to Finlay's cosmopolitan background or his universal influence. For Finlay was of Scottish, French, and Irish stock, and is generally credited with having been first to propose that yellow fever was spread by mosquitoes. He suggested, in 1881, that this mortal disease, so prevalent in the cities of South and Central America and the southern United States, as well as in west Africa, was spread by Stegomyia fasciata (now known as Aedes aegypti).

    Later in the 1880s Finlay did experiments in which volunteers were exposed to mosquitoes that had fed on yellow fever patients. His purpose was to discover whether transmission might occur by this route and whether, due to attenuation, those so exposed might have been safely immunised. Better known successors of Finlay, such as Walter Reed, went on to confirm insect transmission of yellow fever and a little later, in India, Ronald Ross showed that anophelene mosquitoes transmitted malaria. Ross's work, unlike Finlay's, attracted a Nobel Prize.

    The next generation of researchers demonstrated that Aedes aegypti was also a frequent vector of dengue, and a third generation, in the shape of Lloyd, Theiler, and Smith, attenuated the yellow fever virus by multiple passage in chick embryos to prepare the yellow fever vaccine, 17D, that is still in universal use 60 years later.

    The comparative neglect of Carlos Finlay is probably explained by the fact that no one country could legitimately lay claim to him. His father, also a doctor, had been born in Hull of Scottish parents and had trained in Rouen under the famous Dr Flaubert (father of the yet more distinguished Gustave). Finlay's mother was French. He himself was born in Camaguey, Cuba, but was schooled at French lycèes, trained in medicine at the Jefferson College, Philadelphia, and practised most of his life in Havana.

    Proper recognition of Finlay's work was hampered by the rival claims of American, British, and other investigators into insect borne disease, at a time when national rivalries were intense. In particular, it was suggested that Finlay had borrowed his idea from Manson, who was investigating the transmission of filariasis at about the time that Finlay proposed mosquito borne transmission of yellow fever. True or not, Finlay took no steps to rebut the suggestion. As his obituary in the Journal of the American Medical Association of 28 August 1915 remarks: “He lacked the genius for self-exploitation and having established his doctrine modestly lived on with no thought of further recognition.”

    If that really was his intention then he succeeded. It was left to the generosity of the French, first to make the doctor from Cuba an officer of the Lègion d'Honneur, which they did in 1908 and then, on 9 October 1934, to name a Paris street after him In Britain Finlay, a cultured man with mainly Scottish antecedents, has, so far as I know, not been commemorated. Even the splendid frieze cut into the stonework of the London School of Hygiene and Tropical Medicine, where a whole football team (with reserves) of Finlay's distinguished contemporaries in the field of infectious and tropical diseases is named, omits him. Manson and Ross are given their due, but not Finlay. No wonder we merely think of Tannochbrae.

    Footnotes

    • *In the 1960s there was a popular television serial in Britain called Dr Finlay's Casebook. It was set in a Scottish village general practice where Dr Finlay was the junior partner.

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