harvard public health review, 75th anniversary issue, vol. i

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Evolution of a Global Leader

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  • 7H A N N i V t . H A P Y ISSUE V O L . !

    Harvard Public Health Review ")f science and education are the

    brain and nervous system

    of civitization, heaith is the heart."

    F r e J g r / c ^ 71 G ^ ^ e s ,

    i^^MgMf^/ w a g i n g o/^

    Evolution of a Global Leader

  • ALUMNI COUNCIL OFFICERS

    Myron Allukian, Jr., M.p.H'67 Preside?!? Joel F. Finlay, M.F.H'pz

    Joan M. Altekruse, M.P.H'6^ .Secretary

    COUNCILORS

    1994-97 Dileep G. Bat, M.p.H'71 Julie B. Akabogu-George, s.M.'p^ Janet L. Mitchell, M.p.H'87

    1995-98 George E. Hardy, Jr., M.p.H'70 Steve U. McKane, M.p.H'7$ Susan L. Warren, M.p.H'

  • Harvard Public Health Review 75TH A N N I V E R S A R Y !SSUE VOL. t

    Departments

    From the Dean

    1922-1938: Exptoration and innovation

    4

    i z

    1 5

    18

    24

    3 i

    35

    Richard Pearson Strong and the Age of the Explorer-Scientist

    Cecil Kent Drinker: Dean, 1 9 3 5 - 1 9 4 2 .

    Gordon Fair: Across the River

    Alice Hamilton: Adversary of the Poisonous Trades

    Breathing Easy: The Invention of the Iron Lung

    A Partner, Not a Patron: The Rockefeller Foundation

    Women and Children First: Harold Coe Stuart, Martha May Eliot,

    and the Development of the Department of Maternal and Child Health

    1939-1953: War and independence

    4 1 In the Trenches

    The Harvard-Red Cross Field Hospital Unit

    55 James Stevens Simmons: Dean, 1 9 4 6 - 1 9 5 4

    58 First in Food: Fredrick J . Stare and the Department of Nutrition

    65 Hugh Rodman Leavell

    67 Flying High: Ross McFarland and the Birth of Aerospace Medicine

    1954-1971: Expansion and Giobaiization

    Taming the Summer Scourge

    John Crayton Snyder: Dean, 1 9 5 4 - 1 9 7 1

    Jane Worcester

    Home Away from Home: Henry Lee Shattuck International House

    Shifting Gears: Epidemiology's Mid-Century Renaissance

    M y Year at the Harvard School of Public Health

  • From the Dean

    ^ T GIVES ME GREAT PLEASURE to present the first of

    ] two special issues of the H ^ r t w J H M ^

    ) Rg^ew published in conjunction with the School's

    75th Anniversary. This issue covers the years 192.Z to

    1 9 7 1 , a period in which public health in the United States

    emerged as a mature enterprise drawing on the full range

    of analytic, scientific, and policy disciplines. In these pages

    you will read about some of the remarkable people, events,

    and discoveries that shaped the development of the School

    and, indeed, the field of public health.

    Public health research and training at Harvard

    actually dates to the last decade of the nineteenth century,

    when University President Charles William Eliot allocated space at the now-

    defunct Bussey Institution to house the Commonwealth's vaccine production

    laboratories. In 1909, the nation's first Department of Preventive Medicine and

    Hygiene was established at Harvard Medical School under the direction of

    Milton J . Rosenau, and two years later, Harvard established a Department of

    Sanitary Engineering led by George Chandler Whipple. Rosenau and Whipple

    subsequently joined forces with Massachusetts Institute of Technology's

    renowned sanitary engineer William T. Sedgwick to launch the Harvard-MIT

    School for Health Officers, the nation's first professional public health training

    program and the forerunner to the Harvard School of Public Health.

    It is impossible in so few pages to tell the full story of an institution as

    broad in scope, rich in history, and diverse in talent as the School of Public

    Health. For every faculty member or graduate mentioned here, there are many

    more who have made critical contributions to the field and whose achievements

    bring added luster to the School. As dean, I extend congratulations and my

    profound respect to all who have been a part of the success of this institution over

    the yearsalumni, faculty, staff, and benefactors. I also wish to acknowledge

    the support of the five university presidents who have presided during the School's

    first 75 years: Abbott Lawrence Lowell, James Bryant Conant, Nathan Pusey,

    Derek Bok, and Neil L. Rudenstine.

    Most importantly, I salute my six predecessors as dean of the School of

    Public HealthDavid Linn Edsall; Cecil Kent Drinker; Edward Godfrey Huber,

    D.P.H.'n; James Stevens Simmons, s.D.'^c); John Crayton Snyder; and Howard

    H. Hiatt. They nurtured the School's success, imprinted it with their vision,

    and guided its evolution into a global leader.

    /V^wcy V fwc&dvg, De

  • Exp!oration and tnnovation

    HE YEAR is 192.2. Warren G. Harding is in the White House, Prohibition reigns, and on Broadway, T^p Zz'cg/eM FoH^s starring Wiil Rogers sets the tone for the "Roaring Twenties."

    Although heart disease has recently overtaken tuberculosis as America's ieading cause of death, infectious diseases are stiH the world's killers eiite. Vaccines for polio, measles, diphtheria, and rubella are still decades away, and the memory of the 1 9 1 8 influenza pandemic that claimed some 22 million lives is still fresh in the public's mind.

    In the fall of 1 9 2 2 in Boston, the first class of men and women begin classes at the newly launched Harvard School of Public Health. The succes-sor to the eight-year-old Harvard-MiT School for Health Officers, the School shares a dean, administrative structure, and, for the first year, classroom and laboratory space with Harvard Medical School. Over the next decade and a half, the School will emerge as a leading research and training center in the fields of sanitary engineering, tropical medicine, and industrial hygiene, laying the groundwork for three quarters of a century of achievements in public health at home and abroad.

  • ng and the EFORE THE JET PLANE m a d e it

    possible to traverse continents overnight, explorer-scientists such as Richard Pearson Strong covered

    ^ -OHm****^ thousands of miles by boat, train, and even foot to study tropical diseases that few Westerners would recognize. Between 1 9 1 3 and 1938 , Strong led five overseas scientific expedi-tions to Africa and Central and South America, including the 192.6-192.7 Harvard African Expedition that crisscrossed the remote interior of Liberia then cut 3,500 miles across central Africa to end at Mombasa, Kenya.

    The expeditions formed the backbone of Strong's impressive 2.5-year career at Harvard. When he was named the university's first profes-

    1922 The Harvard School of Public Health is founded. David Linn Edsall is dean. With a budget of $162,800, the new School boasts 13 departments and 16 students. Women are admitted, but not eligible for degrees. Tuition and expenses for the year are $300.

    U.S. mortality rate from tuberculosis falls to 97 per 100,000, down from 202 in 1900, while the death rate from heart disease reaches 155 per 100,000, up from 123 in 1900.

  • sor of tropica] medicine in 1 9 1 3 , he initially hoped to establish a Harvard-affiliated school devoted entirely to tropical medicine, along the lines of those that had recently been established in Europe and Great Britain. Instead, he settled in to lead a department in the newly founded School of Public Health, throwing his considerable energy behind building up an area of research that remains strong to this day. In 192.6, Strong joined forces with renowned tick-borne disease researcher Ernest Tyzzer to form the Depart-ment of Comparative Pathology and Tropical Medicine. The department's members included Lemuel R. Cleveland, an expert on insect-borne protozoa; Jack Sandground, a round-worm expert who would accompany Strong on several of his expeditions; A. Watson Sellards, a yellow fever expert; and Clinical Professor of Tropical Medicine George Cheever Shattuck.

    Traveling, researching, and publishing at a preter-natural pace, Strong packed several lifetimes worth of achievements into a single career, accumulating an encyclo-

    too long, no trouble too great to take and watch over a patient," according to an anonymous biographical sketch written in 1933 . Even in retirement, Strong was relentless, teaching classes in tropical medicine at the U.S. Army Medical College during World War II and revising to the point of rewriting Edward R. Stitt's 1,747-page DMgwosM, Pre^eMf/ow

  • Mo^ froM^/e w g ^^ 7 we^ ^ r o M g ^ / r o w

    ^^OM^gfS C O W W g Richard Pearson Strong, diary of the 1926-1927 Harvard African Expedition

    the same time, Louis Pasteur's discoveries had launched the germ theory of disease and the bacteriological era in medical research. European and American scientists were eager to go out into the world with their microscopes and discover new disease-causing microorganisms. Where better to go than to the tropics, with its exotic diseases (at least to Westerners) and alarming epidemics?

    When Strong was a teenager, Patrick Manson, sometimes called the father of Western tropical medicine, was developing his theory that mosquitoes spread malaria. When Strong was in prep school, Theobald Smith (who would ^ become an influential figure in the early years of tropical medicine at Harvard) and Fred Kilborne discovered that a tick spread Texas cattle fever. The year that Strong graduated from medical school, Ronald Ross dissected dapple-winged Anopheles mosquitoes and identified the parasite that causes malaria. ^

    Strong, already specializing in tropical medicine, clearly fell under the spell of expeditionary research. In his first year at Harvard he led an expedition through Colombia, Ecuador,