Poliomyelitis and the Neurologists: The View from England, 1896-1966

Bulletin of the History of Medicine

Volumn 71, Issue 2, 1997, Pages 249-272

  Hardy, Anne ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; EPIDEMIC; HISTORY; HUMAN; NEUROLOGY; POLIOMYELITIS; UNITED KINGDOM; UNITED STATES;

DISEASE OUTBREAKS; ENGLAND; HISTORY, 19TH CENTURY; HISTORY, 20TH CENTURY; HUMANS; NEUROLOGY; POLIOMYELITIS; UNITED STATES;

EID: 0031154639     PISSN: 00075140     EISSN: None     Source Type: Journal    
DOI: 10.1353/bhm.1997.0089     Document Type: Article

References (153)

1. John R. Paul, A History of Poliomyelitis (New Haven: Yale University Press, 1971), p. 107.
2. Ibid., p. 53.
3. Ibid., pp. 31-33, 54-56.
4. Ibid., p. 107.
5. Ibid.
6. See ibid.; Naomi Rogers, Dirt and Disease: Polio before FDR (New Brunswick, N.J.: Rutgers University Press, 1992); Tony Gould, A Summer Plague: Polio and Its Survivors (New Haven: Yale University Press, 1995).
7. See ibid.; Naomi Rogers, Dirt and Disease: Polio before FDR (New Brunswick, N.J.: Rutgers University Press, 1992); Tony Gould, A Summer Plague: Polio and Its Survivors (New Haven: Yale University Press, 1995).
8. See ibid.; Naomi Rogers, Dirt and Disease: Polio before FDR (New Brunswick, N.J.: Rutgers University Press, 1992); Tony Gould, A Summer Plague: Polio and Its Survivors (New Haven: Yale University Press, 1995).
9. "World-wide Prevalence of Acute Poliomyelitis" (leading article), Brit Med. J., 1937, 2: 533.
10. Gould, Summer Plague (n. 6), p. 161.
11. Ibid., pp. 161-62.
12. W. H. Bradley, "Reports of Official Delegates - England and Wales," in Poliomyelitis: Papers and Discussions Presented at the First International Poliomyelitis Conference (Philadelphia: J. B. Lippincott, 1949), pp. 335-36, quoted in Gould, Summer Plague, p. 161.
13. W. H. Bradley, "Reports of Official Delegates - England and Wales," in Poliomyelitis: Papers and Discussions Presented at the First International Poliomyelitis Conference (Philadelphia: J. B. Lippincott, 1949), pp. 335-36, quoted in Gould, Summer Plague, p. 161.
14. See, for example, "Rest for Acute Poliomyelitis" (leading article), Brit. Med. J., 1926, 2: 947-48.
15. Until the 1920s, it was traditional for Queen Square staff to be associated with the practice of medicine or surgery in other institutions. With the establishment of neurological departments in most teaching hospitals after ca. 1920, and with the increasing amount of care required by neurological patients, this tradition gradually broke down: Gordon Holmes, The National Hospital, Queen Square, 1860-1948 (Edinburgh: E. & S. Livingstone, 1954), p. 7.
16. The history of specialization, both of individual specialties and of broader patterns, has been neglected for twentieth-century England, and is beyond the scope of this article. For the history of orthopedic surgery, see Roger Cooter, Surgery and Society in Peace and War: Orthopaedics and the Organization of Modern Medicine, 1880-1948 (Basingstoke: Macmillan, 1993). Older histories remain the principal resource for neurology and pediatrics; see Holmes, National Hospital (n. 12), and Herbert C. Cameron, The British Paediatric Association 1928-1952 (London: British Paediatric Association, 1952). Epidemiology and virology did not achieve professional recognition in hospitals and universities in Britain until the 1920s; the history of these disciplines in Britain in the twentieth century remains unwritten.
17. The history of specialization, both of individual specialties and of broader patterns, has been neglected for twentieth-century England, and is beyond the scope of this article. For the history of orthopedic surgery, see Roger Cooter, Surgery and Society in Peace and War: Orthopaedics and the Organization of Modern Medicine, 1880-1948 (Basingstoke: Macmillan, 1993). Older histories remain the principal resource for neurology and pediatrics; see Holmes, National Hospital (n. 12), and Herbert C. Cameron, The British Paediatric Association 1928-1952 (London: British Paediatric Association, 1952). Epidemiology and virology did not achieve professional recognition in hospitals and universities in Britain until the 1920s; the history of these disciplines in Britain in the twentieth century remains unwritten.
18. The history of specialization, both of individual specialties and of broader patterns, has been neglected for twentieth-century England, and is beyond the scope of this article. For the history of orthopedic surgery, see Roger Cooter, Surgery and Society in Peace and War: Orthopaedics and the Organization of Modern Medicine, 1880-1948 (Basingstoke: Macmillan, 1993). Older histories remain the principal resource for neurology and pediatrics; see Holmes, National Hospital (n. 12), and Herbert C. Cameron, The British Paediatric Association 1928-1952 (London: British Paediatric Association, 1952). Epidemiology and virology did not achieve professional recognition in hospitals and universities in Britain until the 1920s; the history of these disciplines in Britain in the twentieth century remains unwritten.
19. F. M. R. Walshe, "Infantile Paralysis," J. Roy. Soc. Arts, 1945, 95: 533.
20. Ibid., pp. 532-33. These views were shared by a number of orthopedic surgeons. The surgeons, however, had a somewhat more limited interpretation of teamwork. Ernest Hey Groves, for example, professor of surgery at the University of Bristol, declared that the subject of poliomyelitis "should bring pathologist, neurologist, and surgeon into close touch with the general practitioner" (Ernest W. Hey Groves, "The Treatment of Infantile Paralysis with a Plea for the Reorganization of our Hospital System," Brit. Med. J., 1925, 1: 492-496, quotation on p. 492. See also Sir Robert Jones, "An Address on the Treatment of Paralysis in Children," ibid., 1922, 1: 705-708, especially p. 705; Harry Platt, "The Early Mechanical Treatment of Acute Anterior Poliomyelitis," ibid., 1924, 1: 266-67. I am indebted to Roger Cooter for the Platt reference.
21. Ibid., pp. 532-33. These views were shared by a number of orthopedic surgeons. The surgeons, however, had a somewhat more limited interpretation of teamwork. Ernest Hey Groves, for example, professor of surgery at the University of Bristol, declared that the subject of poliomyelitis "should bring pathologist, neurologist, and surgeon into close touch with the general practitioner" (Ernest W. Hey Groves, "The Treatment of Infantile Paralysis with a Plea for the Reorganization of our Hospital System," Brit. Med. J., 1925, 1: 492-496, quotation on p. 492. See also Sir Robert Jones, "An Address on the Treatment of Paralysis in Children," ibid., 1922, 1: 705-708, especially p. 705; Harry Platt, "The Early Mechanical Treatment of Acute Anterior Poliomyelitis," ibid., 1924, 1: 266-67. I am indebted to Roger Cooter for the Platt reference.
22. Ibid., pp. 532-33. These views were shared by a number of orthopedic surgeons. The surgeons, however, had a somewhat more limited interpretation of teamwork. Ernest Hey Groves, for example, professor of surgery at the University of Bristol, declared that the subject of poliomyelitis "should bring pathologist, neurologist, and surgeon into close touch with the general practitioner" (Ernest W. Hey Groves, "The Treatment of Infantile Paralysis with a Plea for the Reorganization of our Hospital System," Brit. Med. J., 1925, 1: 492-496, quotation on p. 492. See also Sir Robert Jones, "An Address on the Treatment of Paralysis in Children," ibid., 1922, 1: 705-708, especially p. 705; Harry Platt, "The Early Mechanical Treatment of Acute Anterior Poliomyelitis," ibid., 1924, 1: 266-67. I am indebted to Roger Cooter for the Platt reference.
23. Ibid., pp. 532-33. These views were shared by a number of orthopedic surgeons. The surgeons, however, had a somewhat more limited interpretation of teamwork. Ernest Hey Groves, for example, professor of surgery at the University of Bristol, declared that the subject of poliomyelitis "should bring pathologist, neurologist, and surgeon into close touch with the general practitioner" (Ernest W. Hey Groves, "The Treatment of Infantile Paralysis with a Plea for the Reorganization of our Hospital System," Brit. Med. J., 1925, 1: 492-496, quotation on p. 492. See also Sir Robert Jones, "An Address on the Treatment of Paralysis in Children," ibid., 1922, 1: 705-708, especially p. 705; Harry Platt, "The Early Mechanical Treatment of Acute Anterior Poliomyelitis," ibid., 1924, 1: 266-67. I am indebted to Roger Cooter for the Platt reference.
24. Edward Farquhar Buzzard, "Opening Paper" (British Medical Association Annual Meeting; section of orthopaedics and the diseases of children; discussion on the early diagnosis and treatment of acute poliomyelitis), Brit. Med. J., 1921, 2: 225-27.
25. Rogers, Dirt and Disease (n. 6), chaps. 1, 5.
26. Robert L. Summitt, ed., Comprehensive Pediatrics, 3d ed. (St Louis: C. V. Mosby, 1990), p. 858.
27. Ralph D. Feigin and James D. Cherry, eds., Textbook of Pediatric Infectious Diseases, 3d ed., 2 vols. (Philadelphia: W. B. Saunders, 1992), 2: 1708; M. T. Parker and L. H. Collier, eds., Topley and Wilson's Principles of Bacteriology, Virology, and Immunity, 8th ed., 5 vols. (London: Edward Arnold, 1990), 4: 137.
28. Ralph D. Feigin and James D. Cherry, eds., Textbook of Pediatric Infectious Diseases, 3d ed., 2 vols. (Philadelphia: W. B. Saunders, 1992), 2: 1708; M. T. Parker and L. H. Collier, eds., Topley and Wilson's Principles of Bacteriology, Virology, and Immunity, 8th ed., 5 vols. (London: Edward Arnold, 1990), 4: 137.
29. The development of explanatory frameworks for disease is notably explored in the recent collection edited by Charles E. Rosenberg and Janet Lynne Golden, Framing Disease: Studies in Cultural History (New Brunswick, N.J.: Rutgers University Press, 1992).
30. Report of the Islington Medical Officer of Health, originally published in fall 1914; republished as "Notes of the Week: Disinfection after Poliomyelitis," Med. Officer, 1915, 13: 51.
31. For the origins of the concept of the carrier, and its early application in American public health practice, see Judith Walzer Leavitt, "'Typhoid Mary' Strikes Back: Bacteriological Theory and Practice in Early Twentieth-Century Public Health," Isis, 1992, 83: 608-29. See also John C. G. Ledingham and Joseph A. Arkwright, The Carrier Problem in Infectious Diseases (London: Edward Arnold, 1912) .
32. For the origins of the concept of the carrier, and its early application in American public health practice, see Judith Walzer Leavitt, "'Typhoid Mary' Strikes Back: Bacteriological Theory and Practice in Early Twentieth-Century Public Health," Isis, 1992, 83: 608- 29. See also John C. G. Ledingham and Joseph A. Arkwright, The Carrier Problem in Infectious Diseases (London: Edward Arnold, 1912) .
33. In the discussion that follows, the term England is used in the sense of "England and Wales" to the exclusion of Scotland and Ireland. This usage has been determined by the statistical material, which is derived from the records of the Registrar-General for England and Wales.
34. Ferrier's opinion is cited in an anonymous obituary: "Thomas Buzzard," Brit. Med. J., 1919, 1: 59.
35. See Paul, Poliomyelitis (n. 1), pp. 74-76.
36. Thomas Buzzard, "Presidential Address," Clin. Soc. Trans., 1896, 29: lviii.
37. Ibid.
38. Ibid.
39. William Pasteur, "An Epidemic of Infant Paralysis Occurring in Children of the Same Family," Clin. Soc. Trans., 1897, 30: 143-50.
40. See Frederick E. Batten, "The Epidemiology of Poliomyelitis," Proc. Roy. Soc. Med., 1910-11, 4: 198-221; idem, "Acute Epidemic Poliomyelitis," Pub. Health, 1911-12, 25: 51- 64, especially p. 56. See also idem, "Has Acute Anterior Poliomyelitis Been Unusually Prevalent during This Summer?" Lancet, 1902, 2: 707 , and idem, "A Lecture on Acute Poliomyelitis and Encephalitis," Lancet, 1902, 2: 1677-79.
41. See Frederick E. Batten, "The Epidemiology of Poliomyelitis," Proc. Roy. Soc. Med., 1910-11, 4: 198-221; idem, "Acute Epidemic Poliomyelitis," Pub. Health, 1911-12, 25: 51-64, especially p. 56. See also idem, "Has Acute Anterior Poliomyelitis Been Unusually Prevalent during This Summer?" Lancet, 1902, 2: 707 , and idem, "A Lecture on Acute Poliomyelitis and Encephalitis," Lancet, 1902, 2: 1677-79.
42. See Frederick E. Batten, "The Epidemiology of Poliomyelitis," Proc. Roy. Soc. Med., 1910-11, 4: 198-221; idem, "Acute Epidemic Poliomyelitis," Pub. Health, 1911-12, 25: 51- 64, especially p. 56. See also idem, "Has Acute Anterior Poliomyelitis Been Unusually Prevalent during This Summer?" Lancet, 1902, 2: 707 , and idem, "A Lecture on Acute Poliomyelitis and Encephalitis," Lancet, 1902, 2: 1677-79.
43. See Frederick E. Batten, "The Epidemiology of Poliomyelitis," Proc. Roy. Soc. Med., 1910-11, 4: 198-221; idem, "Acute Epidemic Poliomyelitis," Pub. Health, 1911-12, 25: 51- 64, especially p. 56. See also idem, "Has Acute Anterior Poliomyelitis Been Unusually Prevalent during This Summer?" Lancet, 1902, 2: 707 , and idem, "A Lecture on Acute Poliomyelitis and Encephalitis," Lancet, 1902, 2: 1677-79.
44. Batten, "Epidemiology of Poliomyelitis" (n. 30), p. 216.
45. See the remark by Shirley Murphy, the London County Council Medical Officer of Health, in the discussion that followed Batten's paper to the Royal Society of Medicine: ibid., p. 223.
46. Editorial, "Acute Poliomyelitis and Cerebro-spinal Fever," Brit. Med. J., 1911, 2: 1614; editorial, "Compulsory Notification of Poliomyelitis," ibid., p. 245; untitled note, ibid., p. 1028.
47. Editorial, "Acute Poliomyelitis and Cerebro-spinal Fever," Brit. Med. J., 1911, 2: 1614; editorial, "Compulsory Notification of Poliomyelitis," ibid., p. 245; untitled note, ibid., p. 1028.
48. Editorial, "Acute Poliomyelitis and Cerebro-spinal Fever," Brit. Med. J., 1911, 2: 1614; editorial, "Compulsory Notification of Poliomyelitis," ibid., p. 245; untitled note, ibid., p. 1028.
49. See, for example, Batten, "Epidemiology of Poliomyelitis" (n. 30), p. 218.
50. Ibid., p. 226.
51. Batten, "Acute Epidemic Poliomyelitis" (n. 30), p. 62.
52. Frederick E. Batten, "Polioencephalitis and Poliomyelitis," in Seventeenth International Congress of Medicine (London: Frowde, 1913), 14 vols., 17 (10): 145-61; idem, "Acute Poliomyelitis," Brain, 1916, 39: 115-211; idem, Acute Poliomyelitis: Its Nature and Treatment (London: John Bale, Sons, and Danielsson, 1916).
53. Frederick E. Batten, "Polioencephalitis and Poliomyelitis," in Seventeenth International Congress of Medicine (London: Frowde, 1913), 14 vols., 17 (10): 145-61; idem, "Acute Poliomyelitis," Brain, 1916, 39: 115-211; idem, Acute Poliomyelitis: Its Nature and Treatment (London: John Bale, Sons, and Danielsson, 1916).
54. Frederick E. Batten, "Polioencephalitis and Poliomyelitis," in Seventeenth International Congress of Medicine (London: Frowde, 1913), 14 vols., 17 (10): 145-61; idem, "Acute Poliomyelitis," Brain, 1916, 39: 115-211; idem, Acute Poliomyelitis: Its Nature and Treatment (London: John Bale, Sons, and Danielsson, 1916).
55. See Batten, Acute Poliomyelitis (n. 37), pp. 88-95; "F. E. Batten," Munk's Roll (London: Royal College of Physicians, 1955), 4: 426; William Osler, "Royal Society of Medicine: Exhibition of Cases," Brit. Med. J., 1912, 2: 1389.
56. See Batten, Acute Poliomyelitis (n. 37), pp. 88-95; "F. E. Batten," Munk's Roll (London: Royal College of Physicians, 1955), 4: 426; William Osler, "Royal Society of Medicine: Exhibition of Cases," Brit. Med. J., 1912, 2: 1389.
57. See Batten, Acute Poliomyelitis (n. 37), pp. 88-95; "F. E. Batten," Munk's Roll (London: Royal College of Physicians, 1955), 4: 426; William Osler, "Royal Society of Medicine: Exhibition of Cases," Brit. Med. J., 1912, 2: 1389.
58. See, especially, Arthur S. MacNalty, Epidemic Diseases of the Central Nervous System (London: Faber & Gwyer, 1927).
59. See Paul, Poliomyelitis (n. 1), pp. 92-93.
60. It is worth remembering, however, that notifications reflected only a portion of the cases, many of which went unrecognized. It was commonly observed in orthopedic departments that the numbers of polio-crippled children presenting for treatment considerably exceeded the numbers that would have been predicted on the basis of notification. The number of children in special schools provided further evidence. See Groves, "Treatment of Infantile Paralysis" (n. 15), p. 493; John A. H. Brincker, The Notifiable Diseases of the Nervous System as They Affect Children of School Age," J. Roy. Sanit. Inst., 1927, 48: 92-96.
61. It is worth remembering, however, that notifications reflected only a portion of the cases, many of which went unrecognized. It was commonly observed in orthopedic departments that the numbers of polio-crippled children presenting for treatment considerably exceeded the numbers that would have been predicted on the basis of notification. The number of children in special schools provided further evidence. See Groves, "Treatment of Infantile Paralysis" (n. 15), p. 493; John A. H. Brincker, The Notifiable Diseases of the Nervous System as They Affect Children of School Age," J. Roy. Sanit. Inst., 1927, 48: 92-96.
62. The seven were Westmorland, Lincolnshire, Essex, Kent, Hampshire, Somerset, and Cornwall.
63. Austin Bradford Hill, "Poliomyelitis in England and Wales between the Wars," Proc. Roy. Soc. Med., Sect. Epidemiol. Prevent. Med., 1954, 47: 795-806, especially p. 798.
64. Alex M. Watts, "Infantile Paralysis in Broadstairs," Pub. Health, 1926-27, 40: 114-16. For Broadstairs and its schools see Barrie Wootton, Early Broadstairs and St Peter's in Old Photographs (Stroud, Glos.: Alan Sutton, 1992), pp. 71-79.
65. Alex M. Watts, "Infantile Paralysis in Broadstairs," Pub. Health, 1926-27, 40: 114-16. For Broadstairs and its schools see Barrie Wootton, Early Broadstairs and St Peter's in Old Photographs (Stroud, Glos.: Alan Sutton, 1992), pp. 71-79.
66. Watts, "Infantile Paralysis" (n. 44), p. 116.
67. Reginald Miller (letter), "Epidemic Polio-encephalomyelitis in Schools," Brit. Med. J., 1926, 2: 1018-19.
68. Ibid.
69. Times (London), 15 November 1926, p. 11; 18 November, p. 10.
70. Times (London), 15 November 1926, p. 11; 18 November, p. 10.
71. Dawson of Penn is best known for his involvement in planning for the provision of health care by the state, but he had a wider career as a "man of affairs." He chose to regard his elevation to the peerage in 1920 as "an invitation from the State to the medical profession to take a larger share in national life," and thereafter concerned himself widely in medically related issues: "Viscount Dawson of Penn," Munk's Roll (London: Royal College of Physicians, 1955), 4: 446-49.
72. Times, 16 November 1926, p. 15.
73. The debate continued in the pages of the Times for some weeks: see the letters from A. H. Henderson, 18 November 1926, p. 10;
74. Sir Brian Donkin, 19 November, p. 10;
75. Rev. R. H. Owen, 20 November, p. 12;
76. J. A. Fort, 23 November, p. 10;
77. Judge Lailey and Dr. S. G. Moore, 26 November, p. 15;
78. Rev. R. H. Owen, 27 November, p. 13;
79. Canon G. L. Richardson, 3 December, p. 10; and also the leading article on 1 December 1926, p. 15.
80. Miller, "Epidemic Polio-enencephalomyelitis" (n. 46), p. 1019. See also Reginald Miller (letter), Times, 17 November 1926, p. 15.
81. Miller, "Epidemic Polio-enencephalomyelitis" (n. 46), p. 1019. See also Reginald Miller (letter), Times, 17 November 1926, p. 15.
82. William W. C. Topley, First, Second, and Third Milroy Lectures on Experimental Epidemiology, Lancet, 1926, 1: 477-84, 531-37, 645-51.
83. Sheldon F. Dudley, "The Spread of Droplet Infection in Semi-isolated Communities," Medical Research Council, Special Report Series, no. 111, 1927, pp. 1-61.
84. See Collier's summary of Topley and Dudley's research: James Collier, "Personal Observations upon the Clinical Features of Poliomyelitis," Lancet, 1927, 1: 321-26.
85. Ibid., pp. 321, 325-26.
86. James Collier, "An Address on the Epidemiology and Pathology of Poliomyelitis," Brit. Med. J., 1927, 1: 751-53. See also the discussion in F. M. R. Walshe, "Some Points in the Epidemiology of Poliomyelitis," J. Roy. Sanit. Inst., 1927, 48: 81-86.
87. James Collier, "An Address on the Epidemiology and Pathology of Poliomyelitis," Brit. Med. J., 1927, 1: 751-53. See also the discussion in F. M. R. Walshe, "Some Points in the Epidemiology of Poliomyelitis," J. Roy. Sanit. Inst., 1927, 48: 81-86.
88. For the complexities of public health policy in respect to carriers, see Leavitt, "'Typhoid Mary'" (n. 22).
89. F. M. R. Walshe, "Poliomyelitis," in "Report on a Discussion at the Medical Society of London," Brit. Med. J., 1927, 1: 282-83.
90. Walshe, "Some Points" (n. 57), p. 84.
91. Ibid., p. 85.
92. Ibid., pp. 83-86. The American research to which Walshe referred was that of A. C. Knapp, Edward S. Godfrey, and W. Lloyd Aycock, "An Outbreak of Poliomyelitis Apparently Milk-Borne," JAMA, 1926, 87: 635-39. At about the time that Walshe made this point, Aycock took it further in his own investigation of the Broadstairs outbreak: William L. Aycock, "A Milk-Borne Epidemic of Poliomyelitis," Amer. J. Hygiene, 1927, 7: 791-803. The Broadstairs outbreak seems to have been one of the few poliomyelitis outbreaks that was proved to be milk-borne.
93. Ibid., pp. 83-86. The American research to which Walshe referred was that of A. C. Knapp, Edward S. Godfrey, and W. Lloyd Aycock, "An Outbreak of Poliomyelitis Apparently Milk-Borne," JAMA, 1926, 87: 635-39. At about the time that Walshe made this point, Aycock took it further in his own investigation of the Broadstairs outbreak: William L. Aycock, "A Milk-Borne Epidemic of Poliomyelitis," Amer. J. Hygiene, 1927, 7: 791-803. The Broadstairs outbreak seems to have been one of the few poliomyelitis outbreaks that was proved to be milk-borne.
94. Ibid., pp. 83-86. The American research to which Walshe referred was that of A. C. Knapp, Edward S. Godfrey, and W. Lloyd Aycock, "An Outbreak of Poliomyelitis Apparently Milk-Borne," JAMA, 1926, 87: 635-39. At about the time that Walshe made this point, Aycock took it further in his own investigation of the Broadstairs outbreak: William L. Aycock, "A Milk-Borne Epidemic of Poliomyelitis," Amer. J. Hygiene, 1927, 7: 791-803. The Broadstairs outbreak seems to have been one of the few poliomyelitis outbreaks that was proved to be milk-borne.
95. The published version of this paper omitted the second half of the sentence, but it was cited in full by John Brincker later in the year: see Collier, "Personal Observations" (n. 55), p. 321; Brincker, "Notifiable Diseases" (n. 41), p. 94. For an example of these "hot disputes" in the daily papers, see the Times correspondence cited in n. 51 above.
96. The published version of this paper omitted the second half of the sentence, but it was cited in full by John Brincker later in the year: see Collier, "Personal Observations" (n. 55), p. 321; Brincker, "Notifiable Diseases" (n. 41), p. 94. For an example of these "hot disputes" in the daily papers, see the Times correspondence cited in n. 51 above.
97. The published version of this paper omitted the second half of the sentence, but it was cited in full by John Brincker later in the year: see Collier, "Personal Observations" (n. 55), p. 321; Brincker, "Notifiable Diseases" (n. 41), p. 94. For an example of these "hot disputes" in the daily papers, see the Times correspondence cited in n. 51 above.
98. See F. M. R. Walshe, "A Paper on Poliomyelitis," Brit. Med. J., 1933, 2: 1197-1200; James Purdon-Martin, "The Bearing of Recent Work on Certain Aspects of Poliomyelitis," ibid., pp. 1200-1202. Purdon Martin's early experience of encephalitis lethargica as a houseman in Liverpool in 1920-21 aroused his interest in the basal ganglia, which remained his principal interest for the rest of his life: see "James Purdon Martin," Munk's Roll (London: Royal College of Physicians, 1984), 7: 323.
99. See F. M. R. Walshe, "A Paper on Poliomyelitis," Brit. Med. J., 1933, 2: 1197-1200; James Purdon-Martin, "The Bearing of Recent Work on Certain Aspects of Poliomyelitis," ibid., pp. 1200-1202. Purdon Martin's early experience of encephalitis lethargica as a houseman in Liverpool in 1920-21 aroused his interest in the basal ganglia, which remained his principal interest for the rest of his life: see "James Purdon Martin," Munk's Roll (London: Royal College of Physicians, 1984), 7: 323.
100. See F. M. R. Walshe, "A Paper on Poliomyelitis," Brit. Med. J., 1933, 2: 1197-1200; James Purdon-Martin, "The Bearing of Recent Work on Certain Aspects of Poliomyelitis," ibid., pp. 1200-1202. Purdon Martin's early experience of encephalitis lethargica as a houseman in Liverpool in 1920-21 aroused his interest in the basal ganglia, which remained his principal interest for the rest of his life: see "James Purdon Martin," Munk's Roll (London: Royal College of Physicians, 1984), 7: 323.
101. F. M. R. Walshe, "The Treatment of Acute Poliomyelitis," Brit. Med. J., 1935, 2: 733-35; "Poliomyelitis in Boarding Schools," Lancet, 1946, 1: 972-73 .
102. F. M. R. Walshe, "The Treatment of Acute Poliomyelitis," Brit. Med. J., 1935, 2: 733- 35; "Poliomyelitis in Boarding Schools," Lancet, 1946, 1: 972-73 .
103. For Sister Kenny see Paul, Poliomyelitis (n. 1), chap. 32; Gould, Summer Plague (n. 6), pp. 85-89 et seq.
104. For Sister Kenny see Paul, Poliomyelitis (n. 1), chap. 32; Gould, Summer Plague (n. 6), pp. 85-89 et seq.
105. Editorial, "The Kenny Treatment of Poliomyelitis," Brit. Med. J., 1942, 2: 639. See also the editorials "Fact and Fancy in Poliomyelitis," ibid., 1943, 2: 141-142; "The Kenny Method Criticized," ibid., 1944, 1: 627.
106. Editorial, "The Kenny Treatment of Poliomyelitis," Brit. Med. J., 1942, 2: 639. See also the editorials "Fact and Fancy in Poliomyelitis," ibid., 1943, 2: 141-142; "The Kenny Method Criticized," ibid., 1944, 1: 627.
107. Editorial, "The Kenny Treatment of Poliomyelitis," Brit. Med. J., 1942, 2: 639. See also the editorials "Fact and Fancy in Poliomyelitis," ibid., 1943, 2: 141-142; "The Kenny Method Criticized," ibid., 1944, 1: 627.
108. For interest in Kenny see the citations in the preceding note. For notice of Burnet's work, see "New Light on Poliomyelitis from Australia" (leading article), Brit. Med. J., 1940, 2: 123. For discussion of Paul's findings, see the editorial, "Poliomyelitis Virus in Stools and Sewage," ibid., p. 711; The Route of Infection in Poliomyelitis" (leading article), ibid., 1941, 2: 811-12. For Seddon's work on Malta, see "Epidemiology of Poliomyelitis" (report of a meeting at the Royal Society of Medicine), ibid., 1943, 2: 686-87; Thomas Agius, Albert E. Bartolo, C. Coleiro, and Herbert J. Seddon, "Clinical Features of the Poliomyelitis Epidemic in Malta, 1942-43," ibid., 1945, 1: 759-63; Hyman G. G. Bernstein, John M. P. Clark, and Ronald E. Tunbridge, "Acute Anterior Poliomyelitis among Service Personnel in Malta: An Account of an Epidemic," ibid., pp. 763-67; "Poliomyelitis in Malta" (leading article), ibid., pp. 773-74.
109. For interest in Kenny see the citations in the preceding note. For notice of Burnet's work, see "New Light on Poliomyelitis from Australia" (leading article), Brit. Med. J., 1940, 2: 123. For discussion of Paul's findings, see the editorial, "Poliomyelitis Virus in Stools and Sewage," ibid., p. 711; The Route of Infection in Poliomyelitis" (leading article), ibid., 1941, 2: 811-12. For Seddon's work on Malta, see "Epidemiology of Poliomyelitis" (report of a meeting at the Royal Society of Medicine), ibid., 1943, 2: 686-87; Thomas Agius, Albert E. Bartolo, C. Coleiro, and Herbert J. Seddon, "Clinical Features of the Poliomyelitis Epidemic in Malta, 1942-43," ibid., 1945, 1: 759-63; Hyman G. G. Bernstein, John M. P. Clark, and Ronald E. Tunbridge, "Acute Anterior Poliomyelitis among Service Personnel in Malta: An Account of an Epidemic," ibid., pp. 763-67; "Poliomyelitis in Malta" (leading article), ibid., pp. 773-74.
110. For interest in Kenny see the citations in the preceding note. For notice of Burnet's work, see "New Light on Poliomyelitis from Australia" (leading article), Brit. Med. J., 1940, 2: 123. For discussion of Paul's findings, see the editorial, "Poliomyelitis Virus in Stools and Sewage," ibid., p. 711; The Route of Infection in Poliomyelitis" (leading article), ibid., 1941, 2: 811-12. For Seddon's work on Malta, see "Epidemiology of Poliomyelitis" (report of a meeting at the Royal Society of Medicine), ibid., 1943, 2: 686-87; Thomas Agius, Albert E. Bartolo, C. Coleiro, and Herbert J. Seddon, "Clinical Features of the Poliomyelitis Epidemic in Malta, 1942-43," ibid., 1945, 1: 759-63; Hyman G. G. Bernstein, John M. P. Clark, and Ronald E. Tunbridge, "Acute Anterior Poliomyelitis among Service Personnel in Malta: An Account of an Epidemic," ibid., pp. 763-67; "Poliomyelitis in Malta" (leading article), ibid., pp. 773-74.
111. For interest in Kenny see the citations in the preceding note. For notice of Burnet's work, see "New Light on Poliomyelitis from Australia" (leading article), Brit. Med. J., 1940, 2: 123. For discussion of Paul's findings, see the editorial, "Poliomyelitis Virus in Stools and Sewage," ibid., p. 711; The Route of Infection in Poliomyelitis" (leading article), ibid., 1941, 2: 811-12. For Seddon's work on Malta, see "Epidemiology of Poliomyelitis" (report of a meeting at the Royal Society of Medicine), ibid., 1943, 2: 686-87; Thomas Agius, Albert E. Bartolo, C. Coleiro, and Herbert J. Seddon, "Clinical Features of the Poliomyelitis Epidemic in Malta, 1942-43," ibid., 1945, 1: 759-63; Hyman G. G. Bernstein, John M. P. Clark, and Ronald E. Tunbridge, "Acute Anterior Poliomyelitis among Service Personnel in Malta: An Account of an Epidemic," ibid., pp. 763-67; "Poliomyelitis in Malta" (leading article), ibid., pp. 773-74.
112. For interest in Kenny see the citations in the preceding note. For notice of Burnet's work, see "New Light on Poliomyelitis from Australia" (leading article), Brit. Med. J., 1940, 2: 123. For discussion of Paul's findings, see the editorial, "Poliomyelitis Virus in Stools and Sewage," ibid., p. 711; The Route of Infection in Poliomyelitis" (leading article), ibid., 1941, 2: 811-12. For Seddon's work on Malta, see "Epidemiology of Poliomyelitis" (report of a meeting at the Royal Society of Medicine), ibid., 1943, 2: 686-87; Thomas Agius, Albert E. Bartolo, C. Coleiro, and Herbert J. Seddon, "Clinical Features of the Poliomyelitis Epidemic in Malta, 1942-43," ibid., 1945, 1: 759-63; Hyman G. G. Bernstein, John M. P. Clark, and Ronald E. Tunbridge, "Acute Anterior Poliomyelitis among Service Personnel in Malta: An Account of an Epidemic," ibid., pp. 763-67; "Poliomyelitis in Malta" (leading article), ibid., pp. 773-74.
113. For interest in Kenny see the citations in the preceding note. For notice of Burnet's work, see "New Light on Poliomyelitis from Australia" (leading article), Brit. Med. J., 1940, 2: 123. For discussion of Paul's findings, see the editorial, "Poliomyelitis Virus in Stools and Sewage," ibid., p. 711; The Route of Infection in Poliomyelitis" (leading article), ibid., 1941, 2: 811-12. For Seddon's work on Malta, see "Epidemiology of Poliomyelitis" (report of a meeting at the Royal Society of Medicine), ibid., 1943, 2: 686-87; Thomas Agius, Albert E. Bartolo, C. Coleiro, and Herbert J. Seddon, "Clinical Features of the Poliomyelitis Epidemic in Malta, 1942-43," ibid., 1945, 1: 759-63; Hyman G. G. Bernstein, John M. P. Clark, and Ronald E. Tunbridge, "Acute Anterior Poliomyelitis among Service Personnel in Malta: An Account of an Epidemic," ibid., pp. 763-67; "Poliomyelitis in Malta" (leading article), ibid., pp. 773-74.
114. For interest in Kenny see the citations in the preceding note. For notice of Burnet's work, see "New Light on Poliomyelitis from Australia" (leading article), Brit. Med. J., 1940, 2: 123. For discussion of Paul's findings, see the editorial, "Poliomyelitis Virus in Stools and Sewage," ibid., p. 711; The Route of Infection in Poliomyelitis" (leading article), ibid., 1941, 2: 811-12. For Seddon's work on Malta, see "Epidemiology of Poliomyelitis" (report of a meeting at the Royal Society of Medicine), ibid., 1943, 2: 686-87; Thomas Agius, Albert E. Bartolo, C. Coleiro, and Herbert J. Seddon, "Clinical Features of the Poliomyelitis Epidemic in Malta, 1942-43," ibid., 1945, 1: 759-63; Hyman G. G. Bernstein, John M. P. Clark, and Ronald E. Tunbridge, "Acute Anterior Poliomyelitis among Service Personnel in Malta: An Account of an Epidemic," ibid., pp. 763-67; "Poliomyelitis in Malta" (leading article), ibid., pp. 773-74.
115. Donald F. Johnstone, "Some Mistaken Diagnoses in the Common Infectious Fevers," Brit. Med. J., 1944, 2: 555-59, see especially p. 558. Poliomyelitis was commonly diagnosed only after paralysis had set in; quite apart from the wide variety of types of paralysis consequent on polio, the relative rarity of the condition meant that many general practitioners, especially in country districts, were unfamiliar with its specific clinical features. 70. Ibid.
116. Ibid.
117. "Poliomyelitis" (leading article), Brit. Med. J., 1947, 2: 135-36. See also Registrar- General's Statistical Review of England and Wales, 1946 and 1947, 1951, 1 (Text): 124-25.
118. "Poliomyelitis" (leading article), Brit. Med. J., 1947, 2: 135-36. See also Registrar-General's Statistical Review of England and Wales, 1946 and 1947, 1951, 1 (Text): 124-25.
119. William H. Bradley, "Poliomyelitis," J. Roy. Sanit. Inst., 1954, 74: 526; Arthur H. Gale and Edward P. Hargreaves, "History of Poliomyelitis in Cornwall and Devon," Brit. J. Prevent. Soc. Med., 1953, 7: 180-93.
120. William H. Bradley, "Poliomyelitis," J. Roy. Sanit. Inst., 1954, 74: 526; Arthur H. Gale and Edward P. Hargreaves, "History of Poliomyelitis in Cornwall and Devon," Brit. J. Prevent. Soc. Med., 1953, 7: 180-93.
121. "Poliomyelitis" (n. 72), p. 135; W. Howlett Kelleher, "Some Clinical Observations on the Present Outbreak of Acute Poliomyelitis," Brit. Med. J., 1947, 2: 291-95.
122. "Poliomyelitis" (n. 72), p. 135; W. Howlett Kelleher, "Some Clinical Observations on the Present Outbreak of Acute Poliomyelitis," Brit. Med. J., 1947, 2: 291-95.
123. The Ministry of Health film, Polio Diagnosis and Management (1947), London: National Film and Television Archives, British Film Institute. See also Editorial, "New Poliomyelitis Measures," Brit Med. J., 1947, 2: 260.
124. The Ministry of Health film, Polio Diagnosis and Management (1947), London: National Film and Television Archives, British Film Institute. See also Editorial, "New Poliomyelitis Measures," Brit Med. J., 1947, 2: 260.
125. Editorial, "Poliomyelitis Film," Brit. Med. J., 1947, 2: 303.
126. The Ministry of Health film, Johnny Green in His Fighting Chance (1949), London: National Film and Television Archives, British Film Institute. See also "Epidemiological Notes: Film for the General Public," Brit. Med. J., 1949, 2: 342.
127. The Ministry of Health film, Johnny Green in His Fighting Chance (1949), London: National Film and Television Archives, British Film Institute. See also "Epidemiological Notes: Film for the General Public," Brit. Med. J., 1949, 2: 342.
128. "New Poliomyelitis Measures" (n. 75), p. 260.
129. Annotation, "Paralytic Poliomyelitis," Brit. Med. J., 1949, 1: 488-89; William Ritchie Russell, "Paralytic Poliomyelitis: The Early Symptoms and the Effect of Physical Activity on the Course of the Disease," ibid., pp. 465-71.
130. Annotation, "Paralytic Poliomyelitis," Brit. Med. J., 1949, 1: 488-89; William Ritchie Russell, "Paralytic Poliomyelitis: The Early Symptoms and the Effect of Physical Activity on the Course of the Disease," ibid., pp. 465-71.
131. "William Ritchie Russell," Munk's Roll (London: Royal College of Physicians, 1984), 7: 514-15.
132. Ibid. See also "William Ritchie Russell," Lancet, 1980, 2: 1385. The structure of funding for polio research in Britain remains to be explored. Available funds were much smaller than in the United States: see Walshe, "Infantile Paralysis" (n. 14), p. 527.
133. Ibid. See also "William Ritchie Russell," Lancet, 1980, 2: 1385. The structure of funding for polio research in Britain remains to be explored. Available funds were much smaller than in the United States: see Walshe, "Infantile Paralysis" (n. 14), p. 527.
134. Ibid. See also "William Ritchie Russell," Lancet, 1980, 2: 1385. The structure of funding for polio research in Britain remains to be explored. Available funds were much smaller than in the United States: see Walshe, "Infantile Paralysis" (n. 14), p. 527.
135. See Roy M. MacLeod, "Law, Medicine and Public Opinion: The Resistance to Compulsory Health Legislation, 1870-1907," Pub. Law, Summer 1967, pp. 106-28, 188-211; Dorothy Porter and Roy Porter, The Politics of Prevention: Anti-vaccinationism and Public Health in Nineteenth-Century England," Med. Hist., 1988, 32: 231-52; Jane Lewis, "The Prevention of Diphtheria in Canada and Britain 1914-1945," J. Soc. Hist., Summer 1987, 20: 163-76.
136. See Roy M. MacLeod, "Law, Medicine and Public Opinion: The Resistance to Compulsory Health Legislation, 1870-1907," Pub. Law, Summer 1967, pp. 106-28, 188- 211; Dorothy Porter and Roy Porter, The Politics of Prevention: Anti-vaccinationism and Public Health in Nineteenth-Century England," Med. Hist., 1988, 32: 231-52; Jane Lewis, "The Prevention of Diphtheria in Canada and Britain 1914-1945," J. Soc. Hist., Summer 1987, 20: 163-76.
137. See Roy M. MacLeod, "Law, Medicine and Public Opinion: The Resistance to Compulsory Health Legislation, 1870-1907," Pub. Law, Summer 1967, pp. 106-28, 188- 211; Dorothy Porter and Roy Porter, The Politics of Prevention: Anti-vaccinationism and Public Health in Nineteenth-Century England," Med. Hist., 1988, 32: 231-52; Jane Lewis, "The Prevention of Diphtheria in Canada and Britain 1914-1945," J. Soc. Hist., Summer 1987, 20: 163-76.
138. Gould, Summer Plague (n. 6), pp. 148, 164; "Medical Notes in Parliament: Poliomyelitis Vaccine," Brit. Med. J., 1956, 1: 299, 579-80, 1551. Earlier British vaccination plans had been discouraged by "the Cutter incident," which occurred in April 1955, when 204 children in California and Idaho contracted polio after being treated with contaminated Salk-type vaccine issued by the Cutter Laboratories of Berkeley, California. The "incident" notwithstanding, Canada. France, Germany, and South Africa, as well as Denmark, had all begun to manufacture and administer polio vaccine by mid-1955. See Paul, Poliomyelitis (n. 1), p. 438. See also "Medical Notes in Parliament: The Salk Vaccine in Britain," Brit. Med. J., 1955, 1: 1099; "Poliomyelitis Vaccine Trials Deferred," Br. Med. J., 1955, 1: 1539-40, especially p. 1539.
139. Gould, Summer Plague (n. 6), pp. 148, 164; "Medical Notes in Parliament: Poliomyelitis Vaccine," Brit. Med. J., 1956, 1: 299, 579-80, 1551. Earlier British vaccination plans had been discouraged by "the Cutter incident," which occurred in April 1955, when 204 children in California and Idaho contracted polio after being treated with contaminated Salk-type vaccine issued by the Cutter Laboratories of Berkeley, California. The "incident" notwithstanding, Canada. France, Germany, and South Africa, as well as Denmark, had all begun to manufacture and administer polio vaccine by mid-1955. See Paul, Poliomyelitis (n. 1), p. 438. See also "Medical Notes in Parliament: The Salk Vaccine in Britain," Brit. Med. J., 1955, 1: 1099; "Poliomyelitis Vaccine Trials Deferred," Br. Med. J., 1955, 1: 1539-40, especially p. 1539.
140. Gould, Summer Plague (n. 6), pp. 148, 164; "Medical Notes in Parliament: Poliomyelitis Vaccine," Brit. Med. J., 1956, 1: 299, 579-80, 1551. Earlier British vaccination plans had been discouraged by "the Cutter incident," which occurred in April 1955, when 204 children in California and Idaho contracted polio after being treated with contaminated Salk-type vaccine issued by the Cutter Laboratories of Berkeley, California. The "incident" notwithstanding, Canada. France, Germany, and South Africa, as well as Denmark, had all begun to manufacture and administer polio vaccine by mid-1955. See Paul, Poliomyelitis (n. 1), p. 438. See also "Medical Notes in Parliament: The Salk Vaccine in Britain," Brit. Med. J., 1955, 1: 1099; "Poliomyelitis Vaccine Trials Deferred," Br. Med. J., 1955, 1: 1539-40, especially p. 1539.
141. Gould, Summer Plague (n. 6), pp. 148, 164; "Medical Notes in Parliament: Poliomyelitis Vaccine," Brit. Med. J., 1956, 1: 299, 579-80, 1551. Earlier British vaccination plans had been discouraged by "the Cutter incident," which occurred in April 1955, when 204 children in California and Idaho contracted polio after being treated with contaminated Salk-type vaccine issued by the Cutter Laboratories of Berkeley, California. The "incident" notwithstanding, Canada. France, Germany, and South Africa, as well as Denmark, had all begun to manufacture and administer polio vaccine by mid-1955. See Paul, Poliomyelitis (n. 1), p. 438. See also "Medical Notes in Parliament: The Salk Vaccine in Britain," Brit. Med. J., 1955, 1: 1099; "Poliomyelitis Vaccine Trials Deferred," Br. Med. J., 1955, 1: 1539-40, especially p. 1539.
142. Gould, Summer Plague (n. 6), pp. 148, 164; "Medical Notes in Parliament: Poliomyelitis Vaccine," Brit. Med. J., 1956, 1: 299, 579-80, 1551. Earlier British vaccination plans had been discouraged by "the Cutter incident," which occurred in April 1955, when 204 children in California and Idaho contracted polio after being treated with contaminated Salk-type vaccine issued by the Cutter Laboratories of Berkeley, California. The "incident" notwithstanding, Canada. France, Germany, and South Africa, as well as Denmark, had all begun to manufacture and administer polio vaccine by mid-1955. See Paul, Poliomyelitis (n. 1), p. 438. See also "Medical Notes in Parliament: The Salk Vaccine in Britain," Brit. Med. J., 1955, 1: 1099; "Poliomyelitis Vaccine Trials Deferred," Br. Med. J., 1955, 1: 1539-40, especially p. 1539.
143. Gould, Summer Plague (n. 6), pp. 173-74.
144. Registrar-General's Statistical Review of England and Wales, 1963, 1965, Pt. I, Table 22, p. 291.
145. The effects of poliomyelitis are with us still. The recent discovery of the late effects of polio poses problems for patients, clinicians, and neurologists; see Gould, Summer Plague (n. 6), pp. 205-15.
146. See Med. Officer, 1909, 1: 943.
147. See, for example, Feigin and Cherry, Pediatric Infectious Diseases (n. 19), p. 1708; Topley and Wilson, Principles (n. 19), 4: 174.
148. See, for example, Feigin and Cherry, Pediatric Infectious Diseases (n. 19), p. 1708; Topley and Wilson, Principles (n. 19), 4: 174.
149. See Gould, Summer Plague (n. 6), for the history of the National Foundation's activities. F. M. R. Walshe drew attention to the disparate funding levels available to researchers in England and America, although he admitted that this was not the sole cause of the limited English contribution to poliomyelitis research: Walshe, "Infantile Paralysis" (n. 14), p. 527.
150. See Gould, Summer Plague (n. 6), for the history of the National Foundation's activities. F. M. R. Walshe drew attention to the disparate funding levels available to researchers in England and America, although he admitted that this was not the sole cause of the limited English contribution to poliomyelitis research: Walshe, "Infantile Paralysis" (n. 14), p. 527.
151. Rosemary Stevens, Medical Practice in Modern England: The Impact of Specialization and State Medicine (New Haven: Yale University Press, 1966); idem, American Medicine and the Public Interest (New Haven: Yale University Press, 1971).
152. Rosemary Stevens, Medical Practice in Modern England: The Impact of Specialization and State Medicine (New Haven: Yale University Press, 1966); idem, American Medicine and the Public Interest (New Haven: Yale University Press, 1971).
153. As indicated above (n. 13), patterns of specialization in twentieth-century England require more detailed exploration and elucidation.