Rose Carter (1852 - 1925)
Walter Reed and Jefferson Randolph Kean,
Henry Rose Carter was a native Virginian and a graduate of the
University of Virginia. Carter obtained a civil engineering degree
from Virginia in 1873 and also undertook post-graduate work in
mathematics and applied chemistry the next year. Subsequently,
however, Carter's interests turned towards medicine, and he completed
a medical degree at the University of Maryland in 1879. The same
year Assistant Surgeon Carter joined the Marine Hospital Service
-- later the United States Public Health Service -- and the young
surgeon rose steadily through the ranks, ultimately attaining
the position of Assistant Surgeon General in 1915.
initial assignments with the Hospital Service placed him at the
center of the yellow fever maelstrom. In 1879 he was detailed
to Memphis and other Southern cities, then in the throes of a
second year of devastating epidemics. Here began, as his colleague
T. H. D. Griffitts observed, Carter's "lifelong interest
in the epidemiology and control of yellow fever."
After several years of clinical practice in various Marine
hospitals, Carter resumed a direct confrontation with yellow fever
when his orders for duty with the Gulf Coast Maritime Quarantine
assigned him to Ship Island, Mississippi, in 1888. Here and at
subsequent quarantine station postings around the Gulf, he quietly
championed a thorough review and rationalization of quarantine
policies, with a view toward establishing uniform regulation,
more thorough disinfection of vessels, and minimized interference
with naval commerce. Crucial to the success of these activities
was Carter's attention to the incubation period of yellow fever,
which his on-site observations indicated to vary between 5 and
7 days. At the time the official literature stated with far less
precision a variance of between 1 and 14 days; Carter's work
consequently greatly increased the efficiency and effectiveness
of quarantine operations.
yellow fever continued to menace the temperate coastline of the
United States, and Carter ably directed the Health Service's epidemiological
control efforts in numerous threatened regions. In conjunction
with this sanitary work for the 1898 season, Carter made detailed
notes on the development of yellow fever at Orwood and Taylor,
Mississippi. The isolation of these communities enabled him to
identify more reliably the phenomenon of a delay between the initial
cases of yellow fever in a locality and the subsequent appearance
of secondary infection -- a delay two to four times longer than
the incubation period of the disease in an infected person. Carter
called this interval between the primary and secondary cases "the
period of extrinsic incubation," and he defined its "usual
limits . . . [as ranging] from ten to seventeen days."
he was able to publish his conclusions, Carter took the helm of
the quarantine service in war-time Cuba. There, in 1900, he met
U. S. Army Yellow Fever Commission
member Jesse Lazear. Carter had finally
arranged for his paper's publication that year in the New Orleans
Medical and Surgical Journal, and gave a draft to Lazear.
"If these dates are correct," Carter later recalled
Lazear saying, "it spells a living host." The theory of mosquito transmission long advanced
by Cuban scientist Carlos J. Finlay
began to seem more likely. And indeed it was. The Commission's
experiments in 1900-1901 irrefutably proved the mosquito vector
and established the extrinsic incubation period at twelve days.
Shortly after these successes Reed saluted Carter, "I know
of no one more competent to pass judgment on all that pertains
to the subject of yellow fever. You must not forget that your
own work in Mississippi did more to impress me with the importance
of an intermediate host than everything else put to-gether."
long and distinguished sanitary career took him to the Panama
Canal Zone in 1904, where he served as Chief Quarantine Officer
and Chief of Hospitals for five years. He undertook detailed
investigations and control measures of malaria in North Carolina
and elsewhere in the South, and became a founder of the National
Malaria Committee. With the support of the Rockefeller Foundation
International Health Board, he undertook additional investigation
and control measures for yellow fever in Central and South America.
His expertise recommended him to the Peruvian government, which
named Carter Sanitary Advisor in 1920-1921. Health problems at
the end of his life compelled Carter to withdraw from active fieldwork,
though he remained a highly valued consultant to the Health Board
and a much-beloved and respected teacher for a new generation
of sanitarians. Carter closed his career researching and writing
the manuscript that his daughter Laura Armistead Carter edited
and published posthumously in 1931: Yellow Fever: An Epidemiological
and Historical Study of its Place of Origin.
 "Conversation between Drs. Carter, Thayer,
and Parker," 1924, Henry Rose Carter Papers, Claude Moore
Health Sciences Library, Department of Historical Collections
and Services, Box 1.
 Letter from Walter Reed to Henry Rose Carter, 26
February 1901, Philip S. Hench Walter Reed Yellow Fever Collection,
Claude Moore Health Sciences Library, Department of Historical
Collections and Services, accession number: 02447001.