Epidemiology at Yale, 1930s-1960

The second component of Epidemiology and Public Health at Yale was the research program in epidemiology under the leadership of John Paul. Paul was one of the organizers of the Poliomyelitis Study Group in 1931 and in 1940 became head of the new Section of Epidemiology and Preventive Medicine, formed within the Department of Internal Medicine.

John Rodman Paul (1893-1971), Chairman of the Section of Epidemiology and Preventive Medicine, 1940-1961

John Rodman Paul represented a different approach to public health at Yale from Winslow and Hiscock. After receiving his M.D. from Johns Hopkins in 1919, Paul served as director of the Ayer Clinical Laboratories of the Pennsylvania Hospital. In 1928, Francis Blake invited him to become an assistant professor of medicine at Yale in 1928. Paul was appointed in 1940 to head of the new Section of Preventive Medicine, later the Section of Epidemiology and Preventive Medicine. Its members developed an approach that Paul called "clinical epidemiology," the study of diseases in small communities. Paul made significant contributions to the study of rheumatic fever, infectious mononucleosis, and hepatitis, but he is especially noted for his work on poliomyelitis. He established the Yale Poliomyelitis Study Unit in 1931 with his close friend and collaborator James Trask. Paul and his colleagues made many of the fundamental contributions to our understanding of poliomyelitis on which the subsequent immunization programs were based. He was one of 15 persons named to the Polio Hall of Fame established in Warm Springs in 1958. Paul was a member of the National Academy of Sciences.

Yale Poliomyelitis Study Unit, 1931

The Yale Poliomyelitis Study Unit was organized in 1931 by John Paul and James Trask, a member of the Department of Pediatrics. Paul and Trask began investigating poliomyelitis when epidemics broke out in Middletown, Connecticut, in 1930 and in New Haven in 1931. Paul and Trask went into the homes and neighborhoods of polio patients seeking to isolate the virus and understand how it spread. They did histories, took physical examinations, and collected throat washings, which they tested by inoculating monkeys. In the papers listed here, they demonstrated that the virus was present in the intestinal tract, in sewage, and in flies that feed on feces. In 1936, they received the first research grant given by the President's Birthday Ball which became the National Foundation for Infantile Paralysis. The reprints of the Study Unit fill six volumes from 1931 through 1957.

Paul on rheumatic fever in New Haven, 1941

John R. Paul had begun work on rheumatic fever at the Ayer Laboratory. In 1928, when Francis Blake invited him to join the Department of Medicine, rheumatic fever was a common disease at New Haven Hospital. Paul's early work on unraveling the disease's epidemiology focused on families of patients with rheumatic fever and control families. He verified the role of the hemolytic streptococcus. This later books contains a number of studies in other local groups. One might contrast the table of contents of this volume to Winslow's Health Survey of New Haven to appreciate the differences between Paul's and Winslow's approaches to public health.

James Dowling Trask (1890-1942) and polio research

James Trask, one of Yale's pioneer epidemiologists, graduated from Sheffield Scientific School in 1913 and received his M.D. from Cornell Medical School 1917. At the Rockefeller Institute of Medical Research he worked with Francis G. Blake to demonstrate that measles is a viral disease. Blake brought Trask with him to Yale in 1921. Trask became a member of the Department of Pediatrics and with Paul, formed the Poliomyelitis Study Unit (see above). James D. Trask carried out eleven years of valuable research on the epidemiology of poliomyelitis, much of it in collaboration with John Paul, from 1931 until his untimely death at age 51 in 1942.

Dorothy M. Horstmann (1911-2001)
John Rodman Paul Professor of Epidemiology and Professor of Pediatrics

Dorothy Horstmann, who joined the Section of Preventive Medicine in 1942 as a Commonwealth Fellow, received her M.D. in 1940 from the University of California. She joined the Yale Poliomyelitis Unit in 1943. Among her many notable scientific achievements, she demonstrated that the polio virus reached the nervous system by way of the blood, a discovery that made polio vaccines possible. Later, Horstmann evaluated the oral vaccine program in Russia and studied the effectiveness of a rubella vaccine. In 1961, Horstmann became the first female full professor at the Yale School of Medicine and in 1961 she became the first woman at Yale to hold an endowed chair, the newly established John Rodman Paul Professorship. She was a member of the National Academy of Sciences.

Section of Preventive Medicine, 1946

Though formally a part of the Department of Internal Medicine, the Section of Preventive Medicine (later the Section of Epidemiology and Preventive Medicine) formed in 1940 under the leadership of John R. Paul, functioned independently with its own budget and appointments. It was small to begin with, but soon attracted postdoctoral fellows and international researchers. Its faculty taught epidemiology and preventive medicine to medical students and epidemiology to graduate students in public health, but a major function of the section was epidemiological research, or to use John Paul's term, "clinical epidemiology," in the areas of virology, immunology in poliomyelitis, hepatitis, arbovirus infections, and serologic epidemiology.

Standing, left to right: Dr. B.A. Wenner, Instructor; Dr. J.L. Melnick, Asst. Professor, Dr. R. Lawson, National Research Council Fellow; Major W.P. Havens, Jr., Asst. Professor.
Seated, left to right: Dr. D.M. Horstmann, Instructor in Preventive Medicine; Dr. J.R. Paul, Dr. M.J. Sa-Fleitas, Fellow, Argentina.

Section of Epidemiology and Preventive Medicine, 1959

First row: J.T. Riordan. Dr. F.L. Black, Dr. Dorothy M. Horstmann, Dr. Robert M. Taylor, Dr. John R. Paul (Chairman), Dr. R.H. Green, Dr. C.-D. Hsiung.
Second row: Dr. B.H. Wilmer, Dr. James C. Niederman, Dr. Robert W. McCollum, Dr. J.R. Henderson, Dr. I Yoshioka, Dr. M.G. Gudnadottir.
Third row: Dr. S.R. Sheriden, Dr. W.H. Gaylord, Dr. E.P. Isacson, Dr. H. Sunaga. Dr. Edward M. Opton.

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