Paralysed with Fear Also by Gareth Williams TEXTBOOK OF DIABETES, editions 1–3, with John Pickup (1991–2002) HANDBOOK OF DIABETES, editions 1–3, with John Pickup (1992–2004) OBESITY: SCIENCE TO PRACTICE, with Gema Frühbeck (2009) ANGEL OF DEATH (2010) Paralysed with Fear The Story of Polio Gareth Williams Professor of Medicine, Faculty of Medicine & Dentistry, The University of Bristol Illustrations by Ray Loadman © Gareth Williams 2013 Softcover reprint of the hardcover 1st edition 2013 978-1-137-29975-8 All rights reserved. No reproduction, copy or transmission of this publication may be made without written permission. No portion of this publication may be reproduced, copied or transmitted save with written permission or in accordance with the provisions of the Copyright, Designs and Patents Act 1988, or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, Saffron House, 6–10 Kirby Street, London EC1N 8TS. Any person who does any unauthorized act in relation to this publication may be liable to criminal prosecution and civil claims for damages. The author has asserted his right to be identifi ed as the author of this work in accordance with the Copyright, Designs and Patents Act 1988. First published 2013 by PALGRAVE MACMILLAN Palgrave Macmillan in the UK is an imprint of Macmillan Publishers Limited, registered in England, company number 785998, of Houndmills, Basingstoke, Hampshire RG21 6XS. Palgrave Macmillan in the US is a division of St Martin’s Press LLC, 175 Fifth Avenue, New York, NY 10010. Palgrave Macmillan is the global academic imprint of the above companies and has companies and representatives throughout the world. Palgrave® and Macmillan® are registered trademarks in the United States, the United Kingdom, Europe and other countries ISBN 978-1-349-45292-7 ISBN 978-1-137-29976-5 (eBook) DOI 10.1057/9781137299765 This book is printed on paper suitable for recycling and made from fully managed and sustained forest sources. Logging, pulping and manufacturing processes are expected to conform to the environmental regulations of the country of origin. A catalogue record for this book is available from the British Library. A catalog record for this book is available from the Library of Congress. Let me assert my fi rm belief that the only thing we have to fear is fear itself. President Franklin D. Roosevelt (1882–1945), First Inaugural Address to the American Nation, 4 March 1933 In memory of my parents, Joan and Alwyn And to Caroline, Tim, Jo, Sally and Pippa June and Geoff * * All royalties from sales of this book will help to support the Edward Jenner Museum at Dr. Jenner’s House, Berkelely, Gloucestershire (UK registered charity number 284085). Visit “http://www.jennermuseum.com” www.jennermuseum.com Contents List of Figures viii Acknowledgements xii A Gentle Introduction xv 1 A Plague from Nowhere 1 2 The Crippler 26 3 The Virus That Never Was 54 4 Germs of Ideas 69 5 Lost in Transmission 89 6 Fear Is the Key 111 7 First Do No Harm 138 8 Dead or Alive 168 9 Front Runner 192 10 Poles Apart 218 11 In the Opposite Corner 248 12 Loose Ends and a Gordian Knot 267 13 Looking Forward to a Retrospective? 296 Notes 307 Bibliography 337 Index 345 List of Figures 1.1 Adult human skeleton, showing marked shortening and growth failure of the right leg, consistent with polio or another paralysing disease of childhood 6 1.2 Ruma, guardian priest of the Temple of Astarte in Memphis, whose right leg shows deformities typical of polio 7 1.3 Jacob von Heine (1800–79), German orthopaedic surgeon and manufacturer of walking machines, who wrote the first comprehensive clinical account of polio in 1840 9 1.4 Karl Oscar Medin (1847–1927), Professor of Paediatrics in Stockholm, whose study of the 1887 Swedish epidemic showed that polio was a systemic illness that did not necessarily paralyse 12 1.5 Ivar Wickman (1872–1914), Swedish paediatrician who concluded from a polio outbreak around Trästena that polio was an infection that spread from person to person 14 1.6 The brain and vertebral column, with the spinal canal removed to show the inside of the spinal canal that runs through the middle of the vertebrae 18 1.7 The spinal cord. The protective meninges are partly cut away to show the anterior and posterior rami on each side merging to form the spinal nerve 19 1.8 Cross-section of spinal cord, showing the anterior and posterior horns of the grey matter 19 1.9 Karl Landsteiner (1868–1943), Professor of Pathology in Vienna, who showed in 1908 that polio could be transmitted from man to monkey, and that the infectious agent was a filterable virus 22 2.1 Possible outcomes of an acute attack of polio 28 2.2 Time-course of symptoms during an acute attack of polio 29 2.3 Permanent deformities of polio in a boy 33 2.4 Lumbar puncture 38 2.5 Map showing the Hudson Bay polio outbreak of 1948–49 44 2.6 Parents on the outdoors observation platform, looking at their child in the polio isolation ward at Blegdams Hospital, Copenhagen, August 1952 46 2.7 Young woman being ventilated by hand through a tracheostomy, Blegdams Hospital, Copenhagen 47 3.1 ‘Rough on Rats’, an arsenic-based rat poison which was widely used in the United States during the early twentieth century 61 3.2 ‘Ginger Jake’, an alcoholic tonic that evaded Prohibition restrictions because of its ‘medicinal’ status 63 List of Figures ix 3.3 Advertisement for DDT-impregnated wallpaper, as carried in many popular magazines in the United States during the 1950s 65 4.1 Edward C. Rosenow (1875–1966), tireless promoter of the ‘poliomyelitic streptococcus’ 72 4.2 Rosenow’s ‘filter-passing micrococci’, drawn for a paper in 1918 74 4.3 Hideyo Noguchi (1876–1928), who left Japan to work in the United States with Simon Flexner 77 4.4 Simon Flexner (1863–1946), founding Director of the Rockefeller Institute for Medical Research, New York, and polymath medical researcher 78 4.5 An early electron micrograph of poliovirus particles 84 5.1 The human nose, showing the olfactory nerves running through the ‘cribriform plate’ into the olfactory bulb 95 5.2 Information and consent form for nasal spraying to try to prevent polio, as printed in newspapers in Toronto and Ontario, spring 1936 98 5.3 Biting stable-fly (left) and bed-bug (right), two non-carriers of polio 101 5.4 Thomas Weller (1915–2008), Frederick Robbins (1916–2003) and John Enders (1897–1985) at the 1954 Nobel Prize award ceremony in Stockholm 108 6.1 Incidence of polio (per 100,000 people) in Sweden and the United States, between 1931 and 1953 115 6.2 Women and children fleeing New York, July 1916 118 6.3 Franklin D. Roosevelt (1882–1945) at the poolside during his first visit to Warm Springs, October 1924 123 6.4 President Franklin D. Roosevelt and Basil O’Connor (1892–1972), counting dimes in the White House 125 6.5 Patricia Carey (born 1916) and Frederic Morena (1893–1960), with Mimi Morena, on the set of This Is Your Life, 18 January 1960 132 6.6 The first March of Dimes poster (1946), showing Donald Anderson from Prineville, Oregon 134 6.7 Ward of iron lungs in Los Angeles County Hospital during the polio outbreak of 1952 135 7.1 Visiting time in the polio isolation ward, Blegdams Hospital, Copenhagen, 1952 142 7.2 Baby strapped into a Bradford Frame during the epidemic in Ontario, Canada, 1937 143 7.3 Deformities of polio and a solution – an exercise machine to help rebuild strength in paralysed limbs, designed and built by Jacob von Heine 145 7.4 Callipers (leg irons), to keep a paralysed leg straight and prevent the knee from buckling 146 7.5 Sister Elizabeth Kenny (1880–1952), Australian therapist and iconoclast, teaching with the help of polio patient Nona Bibeau, ca 1950. Kenny’s views on the management of polio divided the medical profession around the world 150 7.6 Girl in an iron lung during the polio epidemic in Israel, 1958 152 x List of Figures 7.7 The ‘Emerson respirator’ design of iron lung, here in use during the polio outbreak on Rhode Island, United States in 1953 155 7.8 Improvised ‘iron lung’, built from plywood, plasticine and paper in 12 hours by Chief Officer S.G. Robinson and Second Engineer J.D.A. Bright of the New Zealand Shipping Company, in mid-Pacific in spring 1956 157 7.9 Child being ventilated in a ‘cuirass’, Toronto, 1937 160 8.1 Cowpox lesions on the hand of Sarah Nelmes, who provided the blister fluid for Jenner’s first vaccination on 14 May 1796 170 8.2 Edward Jenner vaccinating a child in his home, The Chantry, in Berkeley 172 8.3 William H. Park (1863–1939), Director of the Pathology, Bacteriology and Disinfection Laboratories in New York from 1893 to 1936 178 8.4 William Park and Maurice Brodie (1903–39), co-developers of an ill-fated polio vaccine based on formalin-inactivated poliovirus – a precursor of Jonas Salk’s vaccine, some 20 years later 180 8.5 John A. Kolmer (1886–1962), microbiologist and Director of the Research Institute of Cutaneous Medicine in Philadelphia during the 1930s, when he developed an attenuated polio vaccine 181 9.1 Jonas Salk (1914–95) 193 9.2 Jonas Salk, vaccinating a girl in Pittsburgh during the field trials of his vaccine, spring 1954 206 9.3 ‘It works and is safe’.