Oetoher 6, 1967

Dr. %lgene P. c8iRpball
Ghlef, lhlth Dllrialon
Agency for International Dewlopmtit
Urdted States A.I.D. Won to 18insil
u/o Amedean ma86y
RI.0 de JanebQ, aFad1

   ?hroughthekind~aofDr.krrtia CPrmriPgr,Ibars 6ernthe
mmumentalvol.umewhichhaebeen~~ on the uork of Prof. Eenriqu*

dabcha Un,devot&a~olltlytohle stud&ear ontyphua fever.

   ~attenrtionheobeen direetedparUcularlyt;o the note8 onthe
rclentlflc life of Mocha IAm, which la presented in Portuguese, lCqllsh,
and tlmuan.  Forconwmi.emce,I ehall refer to t&e Bnglbhversionaad
speclflcally to the folloulag sentence on page 568:

"lb& later, dting the 1928 epidemic of yellow fewr in Rio,
thatanatomo-clinic concept as based onRocha U.a~`e fi#lingr
received rtlrrstf?ulL confimation thmughthe carefulcl..%tical
observatloarmde bydlnval l&m and aleo aemdtoeutablish
the 8smtemati.c restmrch of euch ledoa a8 a rout&net procedure

to cliriiy
Parreirae'

   For your informatlonaud forwhateverueeyoumaycare to a&o of
it, 1: uould have you knou that I have recently gons uver the document&km
regarding the developmmt of the timerotome andviscerotoqyin Brasilia
connectionwith the review of a paper 8ubmAtted thmq& Prof.J.Rocirigues
da Sllva to Dr. Robert Wateon for publloatlon in The American Journal of
TropiealHedic5neandiQq#ene.

   The tllaing of the developmentofvietmrotoqyir erarentiallyae
folloua t

    1.  (I have not had an oppmtuadty to consult b&a Uma'r 1921
publications aDahpmtanciapratica das les&rr do flgado uafebre amarella.*
8s~. Med. de Eamburgo, Anno 2, p. 336.)

    2.  In April 1928, Dr. Id. I$;. Connor of the Rockefeller Fourxiation
authorlaed the routine coLlectionof Uwrtkeeue from the bodier ob chil-
dren and young adulte d@ng atffirtarw=ia, Sergipe, to detendaP the presence


Dr.Eugem P.campbell                 October& 1967

or absence of yellou fever.  (This initiative did notprogress, apparently
because of the to-do caused by the invasion of Rio de Janeiro by yellou
fever which was recognized the following month.)

   3. In 1928, U. H. Hoffmann, of Cuba, advocated, in papers in
     Spanish, and English, the collection of pathological material
for epidemiological studies of yellow fever.

   &. In April1930, the Yellow Fewr Service of the Rockefeller
Foutqiation in north Brazil, in Belbm, in Natal, and in Mossox- made
arrangemnta forthe systematic collection of liver tissue for the discovery
of yellow fever.

    5.  On June 10, on a ait to the Yellow Fewr Service in Richteroy
with Dr. Alcides Lint8, Dr. Decio Parreiras, and Dr. Alvaro de Adrade, I
learned of the routine collection of pathological material in suspect yel-
loufewrareasinthe State of Riode Janeiro. (Apparentlytheuorkin
the State of Rioand in the north beganat approximately the same time,
entirely independently the one of the other. To the Yellou Fewr Service
in the State of Rio de Jandro goes the credit for the first suoceaaful
collection of liver tissue with non-mdical personnel at points away from
a State capital.)

   6. On June 26, arrangementa were made for Dr. E. R. RickaM to
attempt the collection of liver tissue from the Municlpio of Rasareth in
Pernambuco through the method used in the State of Rio, namely, by arming
the regi&ars with scalpel and scisaora and making them responsible for
collecting liver sections from indicated emsea. Rr. Rfckard was loath to
have laymen runnl.ng the risk of infection in this manor, and put hilnself
to devising an instnugent for the removal of liver tissue.

    7.  C&I July 10, Dr. Rickard showed me the first instlllllllsnt made
after his design,  This inat~ntwasinalmoetfinalforsr, rsceiviag
only one minor modifioation up to the present tima.

   8, Since Linta, Andrade, Parr&r-, and I had discussed the need
for such an instrument on June 10, I took pain8 to advice Dr. Redo of
Rickard*s inatrunaent on July 22.

   9. Rarly in August application for a Federal patent uaa made for
the Rickard instrument in the name of J. Tomaz Alvea. This patent VW
never completed, its purpose being mainly to prevent the patenting of any
rival instrument.

    10.  ti August 1, Dr. Dedo Parreixw ordered an inatrummt according
to a different design from Lutz, Ferrando, and Company. This instmamt
was similar to the Rickard design in that it consisted of but two piecest
a basic framework andamovable blade. The Parreiraeiustrumentwas, I
belleve, deUvered home time in September; it uaa among the effect8 of the


Rr.Bugene P.CampbelI                  iktober 6, 1967

Yellar Fever Service of the State of Rio de Janeirowhenthiswaa amalga-
matedwith theCooperativeYel.lrvPeverService onthe fir&of December
1930.

   11, The Parreirasiaatnuebntwastried outextensivelybyths
Viscerotomy Se&ion of the Cooperatiw Yellow Pewr Sexvice, which reported
it completely un8uitabl.e for the intended purpose. It vaa eventually rele-
gatedtothemaaeumofthe Service. Sofarae IknoW,Dr. k?dra8'8
instraarntwas newrputin productlon noruBed exceptasa demon&ration
ofhovnottomake a vis+cerotomet.

  12. Th~tennW.scerotoas~uaa suggestedbyDr.I_arioBi~o on         _
August26,l93Oto designate the Pickardlnst~nt. (Thiswas before
the Parreiraa model was out of the rrhop,)

   13.  !lYhe Rickardviacsrotome hasbesnmaxHacturedinthe thousands
in South Ameriea and ha8 been duplicated in Icnrdon and in -8. The tern
~vizmerotoppb* hasbaenasedinthe deacripidon of the Bidmrdins~~
and Vi.sceroto~ to designate its t&ad in the COl&mtiOn of liver tiasu~.

  4. IWio F%weiraa began about 1938, afbr Dr. Ridcard had left
3rasil,to claim priority.  I tooknowrittenactionatthet%ne sincothe
documentationwa8 clear;youmightsee theRevistadeP&giene e&&de
gblica AnnoV, Ro.1, Jazmary1931, @Yellow Fever Service in Iforth Rrazbil
&ikuazy 1 to August 31, 1930 ,v for the original publication. (I haw
fromthebeg%nniqg inthir andin other publications credited the Yell.@
Fewr Service of the State of Bode Jandrouitb the firstcollectionof
liver sectlou from interior point8 way from a State capital. I have
never credited the Parmiraa instnanmnt with anypartinthe developwbnt
of the Rickardinstruvmnt,norin the method thatwasfinallywedinthe
collection of liver tissue.  (Youmightrreet                                  9
Vol. 19, Ho. 3  p. 544-546, Ry 1934* and th
P6bU.cac Vol. 6 ,Bos.2 and3,Febntuegand
  R-r, Rickardhas beeadeadaince l95Oorl951, Bwnso,Idonot like

to aeehiework credited to anotherinthe countryuherehe did do much to
promote the fieldwork of the yellow fever program* @stata momentwhen
viscerotoqyis once more becoming importantbecawe of the reinfestation
with Aedee aegypt&,

  Foryourfurtherinformation,Iwouldpoint out that BobHatsonhaa
furnished much af thei.nfoxtnationIhave li8tedherrr toDr.J.Rodrigws
da Silva.

8irR2erely yours,