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HYGIETHICS: SALK VACCINE—MILESTONE OR MILLSTONE
By Therese Gay
DR. SHELTON’S HYGIENIC REVIEW
AUGUST, 1955
Just about a month ago today the American public was presented with what was publicized as one of the great milestones of medical history, the Salk Anti-Polio Vaccine. At the time I got out an article on the contrived look of the unprecedented promotion of the new vaccine. Through an unfortunate set of circumstances it never did get to San Antonio to meet the deadline.
The article was entitled "Salk Vaccine, Science or Enterprise." It dealt more with the peculiar conditions surrounding the unveiling of this monument of medical advance than with the vaccine itself—the soap-opera props employed to put it over, how it was timed to fall on the anniversary of FDR’s death in melodramatic fashion to play on the sympathy and sentiment, for whatever it was worth to the Purse of the American people through the March of Dimes collection campaign. I touched on various aspects of the great hoax that was being perpetrated by the seeming collusion between profit and progress; how NBC jumped the gun and broke the release time by an hour; how half a dozen giant pharmaceutical houses had it ready for the market even before the fateful V day when the great men of science, medicine and the press were invited to hear the miracle pronouncement that polio had been conquered.
I spoke of how parents were fooled about what was shot into their children in order to make the 1954 testing program effective; how statistics had been handled to make a good case for the vaccine; how medical societies throughout the land were cautioning physicians against profiteering and black-marketing; how the research wizards had studiously avoided any approach or premise that even hinted at causal relationships; how the 25 million said to have been spent on its research program had been mulct from the American public through the Polio Foundation’s collection campaigns, and how that self-same public was the last to be let in on the secret; how the favored drug houses had invested many millions in new equipment and materials long before the safety of the vaccine had been publicly established, and how they were outspoken in their expectations of increasing their investments tenfold before the year was out, with even brighter prospects for the years to come; how politicians, preachers, physicians, professional publicists, the press, and the rest of the army of panderers of the public good all joined in the hosannas and hailed the new Messiah of Medicine, Jonas Salk, M.D., as one of the great benefactors of mankind, etc., etc. And, like any self-respecting Hygienist just must, when confronted with such a stupendous spectacle of studied scientific stupidity, I dealt in a bit of prophecy,—yes, even at the risk of being labeled a Hygienic crank.
The prophecy was to the effect that all that glitters is not gold; that in the present instance there wasn’t enough known about the vaccine to warrant or justify the universal inoculation program that was to follow the announcement, enthusiasm to the contrary notwithstanding; that in my humble Hygienist opinion the worst was yet to come.
WELL, the prophecy was borne out, but all too soon—and with a directness of action, or should I say reaction, that in a couple of weeks the fait accompli was threatened with fiasco, and the flexuous mind of the press was forced to turn the ferris-wheel of its imagination in all directions to stave off the stench that threatened to wreck the whole enterprise. The unexpected occurrence of a high percentage of afflictions and several deaths threw the whole program into a tailspin of chaos and confusion. Frankly the whole country was scared out of its wits—and with good reason. In fact, the first good reason it had shown. The government called off the mass inoculations. Towns, cities and states were in a dither of indecision. The parents who early consented and whose children had already been given their initial shots were living in a vacuum of panic and dread anxiety. The President stepped in, Congressmen and Senators started calling for an investigation. Salk, his colleagues and government officials were locked in long hours of conference to get at the bottom of the bottom that had just fallen out of their ill-founded dreams.
The press had a field day of headlines that was unprecedented even in its own mottled career. Reevaluation became the theme of the delay. One of the vaccine producing laboratories on the west coast was made the face-saving scapegoat. The nobby Mrs. Hobby was run through the grinder for being asleep at the switch and even threatened with Luce-ing her job. Errors in production, errors in government control of testing, errors in the type of preservative employed were screeched across the nation’s news wires. All kinds of errors were put forth except the basic error of the vaccine itself.
The rest is all history—the kind you buy at the newsstands every day—the kind the public has been educated to retain only until the next edition comes out—the kind that has little effect on the public consciousness because it isn’t allowed to set long enough to take hold.
It is now a month and millions of headlines away. At the risk of being called a boasting "I-told-you-so" I could very well use my first article and thus spare myself the toil of the present one. But in the light of subsequent happenings, another attempt to expose this newest affront to human health and the dignity of the individual is justified—so here goes—I’ll fire away again and let the shots fall where they will.
First, let us break the word "Poliomyelitis" down. Polio is a prefix meaning gray. Myel means the spinal cord. And, as we all know by various experiences with it, itis mean inflammation. Put them all together and they spell "Poliomyelitis," an inflammation of the grey matter of the cord. Current medical belief holds that this inflammatory condition of the spine is brought about by a group of three viruses that are thought to invade the human body through portal openings in the mouth and the nose, and through cuts and wounds. After they (the viruses) gain entrance to the body they spread along the nerve fibers to different parts of the central nervous system. Specifically, the paralyzing type of polio is considered an acute infection of the anterior horns of the gray matter of the spinal cord, causing such damage and destruction to the nerve cells that early paralysis develops, the extent and character of which is determined by the particular site of involvement and the number of cells attacked. It may affect a single muscle, a single limb or the entire body. The viruses are supposedly spread by contact with discharges from the nose, throat and bowels of diseased persons, or carriers of the virus. The incubation period is said to range from 4 to 18 days. It strikes in the summer and the fall, and generally hits its peak between August and September.
The respiratory centers are often affected as a complication of the earlier symptoms, rendering the breathing mechanism incapable of functional movement. This is called bulbar polio and its victims are kept alive only by the use of the iron lung, a mechanical device that substitutes for the normal diaphragmatic movements. The greatest incidence is amongst children, hence the name infantile paralysis. But it also attacks adults as well. Pregnant women have a better than average susceptibility to the disease. The symptoms that precede the onset of paralysis are fever, sore throat, headache, vomiting, fatigue, stiffness of the neck, constipation, diarrhea and, in some cases, pain in the extremities, (to the Hygienist, as vague an assortment of diagnostic factors as one could ever hope to meet up with.)
The inability to move the affected parts of the body is due to the destruction of the particular nerve cells related to the motor activity of those parts. The virus is commonly excreted in the stools for six to eight weeks after the disease has struck. It is said, too, that the virus may be found in the throat for a short time at the outset of the illness.
The usual procedure followed when polio struck a community was to close down the swimming pools and the playgrounds and, where the disease became widespread, to close down the schools as well. Those afflicted were isolated for two to four weeks. There was no drug or serum considered specifically effective until the advent three years ago of gamma globulin, a human blood fraction containing antibodies. There wasn’t much in the way of treatment until Sister Kenny came along with her original concept of water-cure methods for the relief of pain and specialized physiotherapy for the restoration of movement, wherever it was deemed possible.
It is believed that there are many more cases unreported, due to mildness of symptoms and wrong diagnoses, than there are cases reported. The disease is relatively new to the United States though it is said to be ancient in origin. It was not recognized here until 1894. Today it is found in all parts of the world, and temperate climates resembling our own favor it. It is not a disease of the impoverished nor of the well-to-do. Yet there appears to be a parallel between the rising living standards of the nation and the ever-mounting yearly epidemics of the crippling disease. The first epidemic took place in New York City in 1907. The 1916, 1931, 1949 and 1952 epidemics reached the greatest proportions. In a few short years the disease changed from one of rarity to one of epidemic yearly recurrence and the medical mind has been in a state of desperate and constant search for some solution in the form of an immunizing agent.
Research was the answer. But research took money, and lots of it. Destiny came to the rescue in the unfortunate affliction of our late President, Franklin Delano Roosevelt. This circumstance touched off the organization of the National Foundation for Infantile Paralysis and the resulting annual March-of-Dimes campaigns, which have collected 270 million dollars in the 17 years since their inception. These monies are purportedly used equitably for alleviating the discomfort of polio’s suffering victims and for the deemed research necessary for its conquest.
Here indeed was big business! And, as everyone who isn’t living in a cloud knows, big business has to produce. Research indeed was the answer. So—out of courage and generosity, out of sympathy and sentiment, out of tender-hearted pity for the poor suffering kiddies who annually fell victim to this modern plague, the people (sic!) determined that polio had to be licked and that American scientists were the ones to do it. Fancy science going chauvinistic! But scientists are ever beset with their own unsolved problems and are ever wary of taking on new ones. So science had to be organized. Thus the grant-in-aid was thought up and, believe you me, big business never conceived of a better stunt to shake some of the lead-thargy out of the pants of the lazy tinkerers that comprise the great majority of researchers. Especially is this true when renewal time approaches. At that time there’s an aura of OR ELSE in the air that gives a magic spurt to scientific inquiry. Now, organization spells efficiency. So, all the threads of the polio research fabric had to be pulled together—that is, all the threads that fit into the color scheme, thus automatically ruling out all undesirable hues and shades (of though:).
Well, they researched to the very beginning of polio in this country, and found there was nothing until 1909, when Doctor Karl Landsteiner proved that polio was caused by a virus and not by the bacteria the medical profession had long sought in vain to find. Landsteiner discovered that this virus could grow only in the spinal nervous tissues of monkeys or humans. (Maybe this was the answer to Jekyll and Hyde complex instead!) ,The years that followed showed very little in the way of successful polio research. The key to the failures of these un-productive years turned up, it is said, when in 1949 Drs. Bodian and Howe of Baltimore discovered there were three well-defined types of polio virus instead of the single type heretofore thought to exist. This is about the time Dr. Salk first enters the picture for Salk was one of the four laboratory directors, singled out by the Polio Foundation to verify the findings of Bodian and Howe, a project that took three years to complete.
1949 turned up another related project in the research of Dr. Enders of Harvard, who showed that polio virus could be grown in non-nervous tissue cultures in test tubes, thus freeing research, as it were, from total reliance on monkeys. Up until this time the cultures in which the virus was grown were considered unacceptable for producing a commercial vaccine for human injection. Salk then took on from Enders’ work and found, as Enders had already, that monkey kidneys were the most successful virus-growing tissue, at least up until that time. All that remained was to find the best broth in which to grow the tissue cells. Salk settled for one that was developed by Dr. Parker of Toronto. Now all the ingredients of a successful vaccine were at hand. The problem of live virus vaccine as against the killed virus vaccine was booted about furiously, and to this day it still is. Salk was the first, I believe, to suggest a dead virus vaccine as a more practical means of protection. In opposing his theory many of his colleagues hold that a live virus with the paralyzing sting bred out of it gives the patient a mild non-paralyzing disease that induces a lifetime immunity. The "dead-virusers" are said to be more concerned with the element of risk, claiming that the live virus can always turn to a paralytic type.
Salk, of course, is a dead-to-center dead viruser. Salk’s being chosen for this job was no matter-of-chance happening. In his medical student days at New York University he was one of the bacteriology pupils of Dr. Thomas Francis, Jr., head of the department. Was it fate spinning the wheel? Let’s see. After graduation and internship at Mt. Sinai Hospital in New York, the National Research Counsel, on the basis of some work he had done as a student on flu virus under Dr. Francis, awarded Salk a fellowship at the University of Michigan, where he worked again under Dr. Francis. Together they developed the flu vaccine now on the market. It just so happens that this very same Dr. Francis was in charge of the evaluation of the whole polio project sponsored by the Foundation, and it was he whose history-making report on that fateful April day stirred the nation and the world into a frenzy and enthusiasm that exceeded anything ever before accorded a medical discovery. The reception and reaction well befit the dawn of a new era. To return to Salk—the Francis influence was felt again. When the University of Pittsburgh decided to set up a virus laboratory of its own, Salk was asked to take over. He transferred his work to Pittsburgh where he has been ever since, and where the final stages of the vaccine research were carried on. There may be no implications in the association of Drs. Francis and Salk, but the sequence and turn of favorable events surely points a finger of suspicion, especially at the big business aspect. Personally, I prefer to think of them as a happy combination that unfortunately worked the wrong side of the street. The respective parts each played in the huge drama must remain conjecture, but it was Salk who came in for the big hero worship. At any rate both helped forge another link in the chain of medical advance that is fast reducing the human race to a state of medical mesmerism. It doesn’t take too much imagination, with things going as they are, to calamitously view the supposed success over the summer scourge as the beginning of our fall.
The Hygienic perspective naturally rejects the whole affair and shares none of the enthusiasm for this newest millennium. We’ve seen far too many of them. To our way of thinking, all the vaccines and all the antibodies they can arouse do not answer the basic questions of where do the viruses come from; why do they attack as they do in the good old summertime; and how do they get into the human body? As I understand it, medicine has failed to definitely establish a true portal of entry for the virus, and this has brought forth the further controversy of endogeniety and exogeniety. There are many theories. Some investigators consider the virus as an enzyme-like substance with a deranged cell proclivity. Others see the virus as a biochemical substance that goes haywire. Others think oh well, why go on? Your guess is a good as theirs. As far as we are concerned, it all boils down to this: We don’t see why we should put our bodies to the extra effort of producing antibodies, to combat dead viruses, to produce artificial immunity to something we needn’t have had in the first place. Frankly, it all sounds too Quixotic. Moreover, windmills are out of style. We now have windbags and not imaginary ones either.
But to get back to Salk. Despite the unquestioned brilliance of his mind, in our opinion he is barking up the wrong alley. The logic of that mind cannot make up for the incorrectness of its premise. In this game of polio research (and that’s what it has turned out to be) he intercepted the ball and carried it across the line to a delusive touchdown. It so happens the goal posts of victory happened to be his own,, and, well—"that, wont win any games." In the final score, if I may continue the metaphor, I’m sure the superior ground strategy of polio will easily overpower the aerial astigmatics of Salk and his team. Any qualified coach or judge would advise Salk to discard his theoretical illusions and reconstitute his attack and defense formations on more practical considerations than the color of his opponents’ uniforms or some similar superficies. This might explain to him the fact that polio cannot be beaten by concentrating on its symptoms because they’re simply a camouflage when evaluated on a prima-facie basis. The Hygienist does not accept symptoms at their current face value. He uses them as legal tender to gain entrance to the deeper vaults of the human body wherein the foundation stones of disease are more easily discernible. As these stones are laid so does he deduce the weaknesses in the human structure. In this way the active as well as the potential factors are brought out into the clear light of scientific evaluation; etiology and prognosis are more truly estimated; and acute and chronic disturbances are nipped in the bud of their origin. The fact is nobody, Salk included, can follow the phantasmagoria of symptomatology and come to a true understanding of any disease for the simple reason that symptoms are only symptoms, not causes, Or is that too elementary for men of Dr. Salk’s caliber?
His error is not one of logic but rather of the superficial premise upon which he launched his whole research program. Mankind’s error exists in its being constantly deluded by the specious type of reasoning men of medicine employ and base their conclusions on. We forget that logic is a means to an end, that it can serve the villain and the saint, the misguided and the well grounded, the people and their exploiters. In this instance, the end served is surely not ours, for had it been, Salk would have probed deeper than the symptoms of polio to get to the underlying bottom of the problem.
He would have explored other approaches. He would have considered other premises than the germ theory of the disease. He might have given thought to the possibility that perhaps virology was not the only beginning to so serious a study. He might have glanced back through history’s pages and refreshed his memory on the course of pellagra in our south; on the scourge of scurvy; on the incredible incidence of beriberi among the white rice eating peoples of the Orient. He might even have seen the related significance of this latter condition to the present problem of polio in the symptoms of its advanced stages known as polyneuritis, in which control of the muscles of the feet, legs and arms, and in severe cases of the trunk too, is affected. He might have learned that these too were epidemic diseases and were endlessly ascribed to various germs, and that in the final analysis all medical research in their behalf turned out to be meaningless medical meandering down the insidious avenue of infection; proving that medical research, if not a disease in itself, is surely a pathological compulsion in most cases.
In the end pellagra, scurvy and beriberi turned out to be diseases of dietary deficiency that could be controlled by the simple process of putting back into the nutriment of nature some of the vital elements that commerce saw profit in removing. These and many more correlatives could he have seen had his immunological perspective recognized the true relationship of Virology to Symptomology, as that of tweedledee and tweedledum. Hygienists do not discredit the presence of the three guilty viruses. We say that they are merely a symptom of polio rather than the cause. And we openly admit our skepticism of any approach to the problem of polio that systematically or unwittingly ignores the basic enervating and toxemic forces that nurture the soil of its growth in the human body.
Furthermore, we look askance on any data that disregards the clues inherent in the study of the comparative eating habits of our own rich country with its high polio rate as against the eating habits of the poor countries of the East with their low polio incidence. Our superiority in the matter of advanced sanitation and hygiene apparently offers no advantages in the way of polio prevention, or at least not where our respective diets remain the same. The one clear spot in the statistical panorama is the difference in the overall consumption of white sugar. Explicitly, their’s is but a fraction of ours. It may stun you to learn that in the year 1939 the per capita consumption of white sugar in China, where only sporadic cases of polio were seen, was 3.2 lbs., whereas in the United States 103.2 lbs. per person were consumed. I understand from good authority that this pattern ran true in the epidemics of 1949 and 1952, which were the most severe in our history.
This is not a rare and isolated statistical item. The United States Army documented well the figures of our soldiers contracting the disease in the Philippines, in China and in Japan—with no outbreaks among the native children. The Surgeon General’s Office has reports filed away concerning the 1945 outbreak amongst our troops in the Philippines, when 250 were afflicted with the disease, with 50 deaths resulting—but with no outbreaks amongst the natives. The only plausible answer here, and one which has been reported by a few honest investigators, exists in the fact that the American soldier was allowed to take his eating habits along with him. He was permitted to stuff himself with ice cream, soda pop, candies, pastries, etc. With all due respect to his great fighting ability he was coddled into ill health by the misguided generosity of the Army authorities, perhaps to recompense for some of the ghastly aspects of that systematic decimation of human beings called war. In one account I read the following: "Ice cream manufacturing equipment generally soon followed combat equipment."
In war as in peace polio seems to strike under similar conditions. The pattern of epidemiologic statistics clearly indicate a correlation between sugar consumption and epidemic outbreaks of polio in the various countries of the world. Our own country is perhaps the best example of this trend of figures. Salk might have studied the effect of white sugar on our calcium levels and learned something of calcium waste and its effect on nerve nutrition.
I do not pretend to have made a special study of polio, to have any data or knowledge difficult of access, or to have any special qualifications that permit me to speak with authority. But I refuse to close my eyes to what surely appears as worthwhile evidence just because it does not fit into the running crossword puzzle of rigged science that right now has even its instigators and promoters in a state of hopeless confusion.
If Salk was really the well grounded man he should have been, he would not have followed so quickly in the footsteps of the witch hunters bent upon finding an epidemic-borne virus for the disease. But then he might not have found it so easy to retain the sponsorship that enabled him to carry out the project. Researchers are well aware that funds available for research are earmarked with if’s, and’s and but’s, and that they all spell conformity in big fat letters. It’s got to be a virus! It’s got to be specific! And it’s got to equate with some manufacturing scheme! "OR ELSE, Mr. Researcher, you’re gonna have to get off of your hands and seek your own way in the cold, cold world." It’s easy to see how seif-preservation can gain an easy ascendancy over the nobler impulses of race preservation. Picture an idealistic young research genius (who by some special moral stamina is reluctant to relinquish his standards) up against the dilemma of compromise or starvation. It isn’t long before integrity gives way to passive acceptance of the philosophy "Well, a guy’s got to live." And the downfall of an honest soul is well on its way.
Frankly, I don’t know that such a thing as pure research exists today except in isolated cases and in the small remains that minds disposed to science never lose. Yet, where in the world is true research more needed than in the biological sciences? And where in the world is it more bungled than in our own great country where human health has become the most profitable means of mass exploitation yet devised, and where research has become a football in and out of science, and where all the avenues of public health education are aimed at the enslavement of the mass mind to the promptings of the total medical industry.
The newspapers and the airways play up with sickening sentimentality the noble sacrifices of the dedicated doctors who daily sacrifice their own personal interests by working in the wards, the clinics, the hospitals and the laboratories. They feed us glowing word pictures of little children, victims of leukemia roaming around cancer wards awaiting the noble ministrations of the doctor. They show polio victims being given the chance to learn to walk again. . . on crutches! They describe the various institutions and dramatically paint the altruism of those doctors engaged in helping the youngsters rout out some of the scars that follow in the wake of their afflictions. But do they tell you those kiddies are there because of medicine’s failure to serve the public need? Do they tell you that those little spastics are bearing the cross for the mistakes of medicine? Do they tell you that those innocent little victims of polio, diabetes, cerebral palsy, nephrosis, rheumatic heart, etc., are living symbols of the low standard of medical practice? And as for their touching sentiments—are they as sentimental in reporting the investigations of those able men who disagree with current medical fancies? Not by a long way!
They either ignore or scorn those whose results contradict the efforts of medicine. The miracle of the Salk Vaccine is not the miracle of hope we were told to accept. It is the miracle of sensational overselling. Even the President admitted this. To put it in the words of one of Salk’s henchmen, Dr. Robert A. Moore, Vice Chancellor of the University of Pittsburgh Schools of the Health Professions: "Health is too important to hide under a bushel. We have something to sell, and if we are convinced our product is good, let us use the same techniques others use in our society to sell their products." (Emphasis mine.) This statement speaks for itself. Does the learned Doctor not realize the potential for harm he’s condoning? Does he not realize the callousness of his attitude? I’m wondering what he actually means by "good." Good to sell or good to take? AND what, does he mean by "health"? Falling for every gimmick medicine and the drug industry parades before our eyes?
Before we can consider the new vaccine the dawn of a new era it had better dawn on us to get rid of the old. The change we need is not merely a switch of affections to a new vaccine (heaven knows they come too often). What we need is to get rid of the whole nonsensical apothecary of medicine and to adopt a sane approach that will start at the bottom of things and not somewhere in the middle of nowhere, as Salk did.
And that approach must of necessity aim at the unity of disease—not at one of its manifestations. Salk and all he represents in method and philosophy see health only in terms of a suppression of symptoms. We Hygienists look upon health as a high standard of physiological efficiency. We say this difference is not only a matter of philosophy, but that it is a starting point that leads on one side to an endless hunt for techniques of covering up or masking the setbacks we bring on to ourselves by incorrect living; and on the other side to a system of honest inquiry into the real foundations of health. We say with Byron, "The best prophet of the future is the past." On the past record of medicine we must reject the work of Dr. Salk and his team of co-workers. In short, we look upon the new vaccine as a bane rather than a boon to humanity, however slow its accumulative effects may appear in the records.
As for immunity to polio and all the other disease designations, we Hygienists choose to keep faith with our principle of vital fitness. We consider the integrity of our physical economy the only real safeguard against any of the incursions of ill health, whatever the symptom complex may be. We view the phenomenon of artificially-induced immunization as the mere prelude to a pathological change of venue, a delaying action and therefore an obstruction of the laws of physiology.
We say you just cannot beat disease by preventing its symptoms. True prevention must start with the elimination of cause. We contend the elimination of polio must follow the same course lest it leave worse evils in its tracks. No, we do not think it’s Polio’s last summer at all. As for the vaccine, its mistakes are already apparent. Its consequences only time can evaluate. Salk’s statement, on his day of glory, to the effect that he would like the prevention of mental ills to be his next target, confirms my contention that research can become a compulsive neurosis. As a follow-up of his work we have been threatened with vaccines for the common cold, for sneezing and, there have been hints, even for cancer. Come to think of it, it may not be too long before they come up with one for thinking. Maybe Salk’s work has paved the way for it, too. We wish we could think disease could be whitewashed so simply. We just can’t, and look the figures of our national health in the face. Those figures belie the efficiency of the vaccines. the serums, the drugs and all the rest of the claptrap of the medicine man.
It is regrettable that man has long confused promise with performance and hope with illusion; that in the fatuity of his dreams the lessons of the past have eluded him; and that despite his sad experience he continues to patiently bear the burdens that error places in his path. In the cool sobering light of retrospect, when the mind dwells on the ledger of man’s progress down the ages; when the balance sheets show our losses and gains, our aims and our accomplishments, our investments and our dividends; when we think of the state of the world and the despair that exists everywhere, and of our descending spiral of achievement in a moral sense: when we examine what science has brought us to. and where it might have—it is then that the spirit saddens and man is left to face the disquieting fact that he has never truly learned to distinguish between the milestone and the millstone.
The above articles are quoted from Dr. Shelton Hygienic Review Box 27 San Antonio, Texas by special permission.