Post on 15-Dec-2015
transcript
Short History of the U.S. National Institutes of Health
Victoria A. Harden, Ph.D.Historian, NIH
U.S. Federal Government and Medical Research
No support at all before late 19th century Medical system based on “humoral”
theory U.S. Constitution made no mention of
health or medicine
Marine Hospital Service
Established in 1798 under the commerce clause of the Constitution
Series of hospitals for merchant seamen
Placed in Treasury Department to collect 20 cents per month from each sailor
Marine Hospital,
New Orleans, Louisiana
Political Philosophy
Americans were suspicious of government funding because they believed:
If government funds research, government can control what research gets done.
People who accept funds from the government are not self-reliant.
Discovery of Anesthesia
Only major U.S. contribution to medicine before the U.S. Civil War
Wholly in the private sector
“The First Operation with Ether”
by Robert Hinckley
Intellectual Revolution, 1870s-1890s
The Germ Theory
Louis Pasteur
Robert Koch
The Power of the Germ Theory
National Board of Health
First grants for medical research to university scientists
Bitter political disagreements
1878-1883/93
Laboratory of Hygiene Marine Hospital Service
Marine Hospital, Staten Island, NY
Joseph J. Kinyoun, M.D.
Kinyoun’s laboratory
Kinyoun’s microscope & first publication
Growth of laboratory
1891--moved to Washington, DC
1894--production of diphtheria antitoxin begun
rabies vaccine, smallpox vaccine made available
Diphtheria antitoxin made by Hygienic Laboratory, 1895
1902 Biologics Control Act
1901: 13 children in St. Louis died from contaminated diphtheria antitoxin
1902: Congress acted
Hygienic Laboratory given regulatory responsibility
Mulford rabies vaccine outfit
1901 NIH’s organic legislation
Buried in a supplemental appropriations act
Authorized $35,000 to build one building
Authority to investigate “infectious and contagious diseases”25th & E Sts, NW, Washington,
DC,
1904-1939/41 home of NIH
1902 Research Program Begins
New Name: Public Health and Marine Hospital Service
Hygienic Laboratory organized into 4 divisions Pathology and Bacteriology (original work) Zoology Chemistry Pharmacology
Ph.D.s hired to head new divisions
1912 Non-infectious disease
research
New Name: Public Health Service
Hygienic Laboratory authorized to investigate noncontagious diseases and the pollution of waterways
Pellagra: niacin deficiency
Who got pellagra? Dr. Joseph Goldberger
Hookworm: parasitic helminth
Who got hookworm?Dr. Charles Wardell Stiles
1916First professional woman
hired
Dr. Ida Bengtson, Bacteriologist
Worked in Biologics Control
Ransdell Act, 1930Hygienic Laboratory
renamedNational Institute of Health
Charles H. Herty, Ph.D.(Georgia and N.C.)
Senator Joseph Ransdell (Louisiana)
1930sChange in Political
Philosophy
Government “control” can be used to rectify injustices
Government “control” can provide oversight of ethics of research
Scientists can remain self-reliant if they decide which projects to undertake
NCI created, NIH moved to Bethesda
1937--National Cancer Act foreshadowed
categorical structure
authorized to give grants
and fellowships
1939-41--move from DC to BethesdaNIH’s Bethesda campus under
construction, ca. 1939
1938-41 70 Acres for Science
Some opposition to construction from Bethesda Chamber of Commerce and Montgomery County Commission
October 31, 1940: FDR dedicated campus
Steps Toward War
Sept. 1, 1939
June 1940
Sept. 1940
Germany invaded Poland
Battle of Britain U.S. National Defense Council
established
Japan signed mutual assistance pact with Germany and Italy: global war
Congress enacted first peacetime draft in US history
Health of Recruits
43 percent unfit for military service
28 percent not fit for any military service
15 percent fit for limited service only
NIH Division of Public Health Methods worked with the Selective Service
Research for the home front:Workers protected
Dangers of specific munitions
Diagnostic tests for toxic materials
Working conditions of >300,000 defense workers improved
Research for the battlefield
Exotic diseases
Malaria Yellow fever Epidemic
typhus Tsutsugamus
hi (scrub typhus)
schistosomiasis
Battlefield trauma
Shock Burns Blood & blood
products High altitude
physiology
Architects of today’s NIH
Surgeon General Thomas Parran
NIH Director Rolla E. Dyer
World War II leader
s
1944 PHS Act
Authorized NIH grants program
Authorized clinical research
Mandated materials prepared for public
Rapid growth, 1945-2001
1945: NIH and NCI 1949: 6 institutes 1969: 15 institutes, centers &
divisions 1999: 25 institutes & centers 2001: 27 institutes & centers
NIH Clinical Center
NIH Clinical Center, 1953
“Pool of Bethesda”
Lorraine cross design philosophy
Goal: transfer new biomedical knowledge as rapidly as possible from the laboratory to the patient’s bedside
• Hippocratic Oath: First, do no harm
• Nazi medical experiments– Nuremberg Code (1946): Informed consent must be
obtained
• Clinical Center review of protocols, 1953
• Tuskegee syphilis study (begun 1932, recognized as public scandal 1972)– Protection for Human Subjects Act (1974):– Institutional Review Boards established– NIH Office of Protection from Research Risks
established
• Office of Human Research Protections, DHHSestablished June 2000
Protection for Human Subjects
Major lines of research, 1945-2003: Human Genetics
http://history.nih.gov/exhibits/genetics/
Major lines of research, 1945-2003:
Basic Research
http://history.nih.gov/exhibits/bowman/
Major lines of research, 1945-2003:
Chronic Diseases
http://history.nih.gov/exhibits/opiates/
Major lines of research, 1945-2003:
Transitional Research
http://history.nih.gov/exhibits/thinblueline/
Major lines of research, 1945-2003:
infectious diseases
http://aidshistory.nih.gov/home.html
Training junior scientists
http://history.nih.gov/exhibits/stadtman
NIH worldview: absorbing but dangerous.How do we deal with the brave new world?
NIH poster, with apologies to Steinberg