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David Oshinsky: The Many People Who Helped End Polio in America

David Oshinsky, in the LAT (4-10-05):

[David M. Oshinsky is a history professor at the University of Texas at Austin and the author of"Polio: An American Story," published this month by Oxford University Press.]

Fifty years ago this week, one of the great breakthroughs in medical history was announced. A polio vaccine, produced by Jonas Salk and a team of researchers at the University of Pittsburgh, was finally declared to be safe and effective. Salk became an instant hero, America's first celebrity-scientist, a miracle worker in a starched white lab coat.

Gifts and honors poured in. The House and Senate awarded him a Congressional Gold Medal, one the nation's highest honors. At a ceremony for Salk in the White House, President Eisenhower struggled to keep his feelings in check.

"Nothing could have been more impressive," wrote a reporter who had followed Ike for years,"than this grandfather … telling Dr. Salk in a voice trembling with emotion, 'I have no words to thank you. I am very, very happy.'"

There was good reason to celebrate. Polio was among America's worst nightmares in the years following World War II — a horrific childhood disease on the rise at the beginning of the baby boom. It arrived each summer, killing thousands of children and paralyzing thousands more. Movie theaters stood empty, swimming pools were padlocked, local newspapers kept a running count of victims, youngsters struggled to use crutches and leg braces, and hospital wards were lined wall-to-wall with iron lungs.

The story of polio has become, in large part, the story of Jonas Salk — his roots, his education, his relationship to the March of Dimes (prime funder of polio research), and his bitter battle with researcher Albert Sabin in the race for a vaccine.

Salk favored a killed-virus vaccine, while Sabin and most other researchers favored a live-virus version, which produced stronger immunity. But Salk's was safer and could be developed more quickly, giving it an edge in the vaccine competition.

What is too often lost in this hagiography is the extraordinary role played by other scientists, the ones who blazed the trail that Salk followed to completion. Two of the most prominent were women: Dorothy Horstmann at Yale and Isabel Morgan at Johns Hopkins University.

Horstmann arrived at Yale in 1942. Experimenting on chimpanzees, she set out to find the pathogenesis of polio — its route through the body.

She succeeded in showing that poliovirus circulated briefly in the blood before entering the central nervous system. This meant that a vaccine designed to raise antibody levels in the bloodstream might be able to neutralize the poliovirus before serious harm was done.

In a letter to Horstmann in 1953, John F. Fulton, Yale's distinguished historian of medicine, raved that she had made"medical history."

At Johns Hopkins, meanwhile, Morgan, a lone female researcher, took the logical next step. The daughter of Thomas Hunt Morgan, who won the Nobel Prize for his work on chromosomes and heredity, she had come from the Rockefeller Institute, where, according to one colleague,"few PhD ladies ever had much of a chance for advancement."

Morgan and Horstmann became magnets for human interest stories. Portrayed in one piece as a"young lady with unswept blond hair and sparkling blue eyes" who liked nothing more than to"fuss and putter about the kitchen," Morgan described her research as requiring"patience and an intuitive sense — a combination of which women particularly possess.""Girls," she added,"should be encouraged to reach for the heights too."

At Johns Hopkins, Morgan's experiments to immunize monkeys against polio brought very promising results. In the late 1940s, her primates, vaccinated with a killed-virus solution, were able to withstand high concentrations of live poliovirus without succumbing to the disease. None showed the telltale symptoms of paralysis.

But in 1949, in the prime of her career, the 38-year-old Morgan left Johns Hopkins to marry and become a homemaker. Had she remained, it's quite possible she would have beaten Jonas Salk to the killed-virus polio vaccine. The next step involved the testing of children, one she never got to take.

"It was a tremendous blow for Hopkins and for polio research, but everyone understood," a friend recalled."Isabel had a choice to make, and she made it."

In the 1960s, following the death of her stepson in a plane crash, Morgan took a consulting job in biostatistics at the Sloan-Kettering Cancer Institute in Manhattan. She died in 1996, without ever returning to polio research.

Horstmann never married. She devoted her life to science, pursuing the mysteries of infectious disease, including the development of a measles vaccination.

Along the way, Horstmann became the first female professor of medicine at Yale (1961), the first woman in the university to hold an endowed chair (1969) and an elected member of the National Academy of Sciences (1975).

Today, a bust of Isabel Morgan hangs in the Polio Hall of Fame in Warm Springs, Ga., while a portrait of Dorothy Horstmann, who died in 2001, hangs in a gallery of luminaries at the Yale School of Medicine. They are the only women honored on those walls.

History books tend to associate medical breakthroughs with a single name — Alexander Fleming's discovery of penicillin or Walter Reed's conquest of yellow fever — but the truth is that most were collaborative efforts.

In remembering the brilliance of Jonas Salk this week, it is wise to recall the help he received — not the least from Morgan and Horstmann — in following his path to conquering polio.