Fear of Polio in the 1950s
© 1997, Beth Sokol
Paralytic poliomyelitis, "polio", held a reign of terror over this nation for
decades. But unless you were born before 1955, polio may seem to be just
another ephemeral disease that has been nonexistent for years. Those born
before 1955 remember having a great fear of this horrible disease which
crippled thousands of once active, healthy children. This disease had no cure
and no identified causes, which made it all the more terrifying. People did
everything that they had done in the past to prevent the spread of disease,
such as quarantining areas, but these tactics never seemed to work. Polio could
not be contained. Many people did not have the money to care for a family
member with polio. This was one of the reasons the National Foundation for
Infantile Paralysis was organized. The March of Dimes, the fund raiser headed
by the National Foundation for Infantile Paralysis, raised thousands and
thousands of dollars to help people care for their polio stricken family
members and to aid in the cost of research for a vaccine that would put an end
to this misery that affected the lives of so many people.
Poliomyelitis was the term used by doctors to describe the condition in which
the gray (polios) anterior matter of the spinal chord (myelos) was inflamed
(-itis). Until a cure was discovered, no one had the slightest idea where
"polio" had come from or why it paralyzed so many children. People learned
later that, oddly enough, it was the improved sanitary conditions which caused
children to be attacked by the virus. Since people were no longer in contact
with open sewers and other unsanitary conditions which had exposed them to
small amounts of the polio virus as infants, when paralysis is rare, the
disease grew from a very mild, uncommon occurrence to a terrifying epidemic.
This was now the second generation to deal with the fear of this crippling
disease. In an attempt to control the disease, bewildered health officials
reinstituted the usual rules of sanitation which they would later learn had
worsened the threat of polio. They advised against open drains and unscreened
windows. Parents were instructed to keep their children well bathed, well
rested, well fed, and away from crowds. Bathing suits were locked away in
closets, and nobody went to the public pools. When polio struck, movie theaters
were shut, camps and schools were closed, drinking fountains were abandoned,
draft inductions suspended, and nonessential meetings were canceled until the
epidemic appeared to be over for the time being.
These precautions were harmless, but not particularly helpful. In the past,
these precautions proved very effective in stopping the spread of diseases such
as influenza and plague. For three decades now, people still did not know why
they were getting their disease. And for three decades now, doctors,
epidemiologists, and laboratory researchers were trying to figure out how the
disease was spread.
Nobody has ever discovered completely how it is that polio is spread. The best
evidence suggests that the virus is excreted in the stool and passed through
hand to hand or hand to mouth contact by people who do not wash their hands
properly or often enough. It was during the first few years of the fifties and
many years before then, that health department officials continued to
quarantine households, take in-depth histories of everywhere and everyone the
patient had come in contact, inspect drains and garbage cans, and in general
make it seem as though it was the patient's own fault that he had the virus.
Although keeping track of this contagious disease continued to be of great
concern throughout this time, the many health inspectors and visiting nurses
could not help but admit that they really did not know exactly what they were
looking for or where they might find it.
Many doctors resented the amount of fuss made about polio, and complained that
all of this exaggerated fear diverted attention from more serious health
threats. The majority of people who had polio never even knew it. Of those who
were diagnosed, most recovered with little or no disability. In 1952, the worst
epidemic year, three thousand people died from polio, while in 1950,
thirty-four thousand died of tuberculosis. In 1957,
62,000 people died from influenza during a notorious epidemic.
Although by this time a cure for polio had been discovered, the chances of
contracting and dying from influenza were much greater than the chances of
contracting and dying from polio even in years prior to this epidemic. But this
line of thinking misses the mark. Epidemic diseases which strike a community at
one time are far more alarming than chronic diseases that kill individuals over
a number of years. Diseases whose causes are 5 understood are much less
frightening than diseases whose origins are unknown. Diseases which attack the
young and active are more horrible than ones which strike the weak and old. To
many people, there was only one thing worse than dying of paralytic
poliomyelitis. One could get the disease and live.
People who recovered from influenza did so completely in three to ten days.
They had no paralysis or respiratory difficulty once they had recovered.
Regarding tuberculosis, recovery took much longer than with influenza. In fact,
treatment with medication lasted up to a year. But with proper care and
effective drug therapy, a person did fully recover. Interestingly enough, it
was in 1952 that a drug called Isoniazid was used in treatment of tuberculosis.
These people contracted the disease, recovered, and continued on with their
lives unchanged. Some survivors of polio contracted this disease, recovered
from the actual illness itself, and continued on with their lives. Only, in
contrast to the survivors of influenza and tuberculosis, these polio victims
lives' were forever changed due to their paralysis -- a remnant of their battle
against polio. This puts people's terror of polio into perspective and makes it
more understandable. It was not the disease itself that horrified people; it
was what the disease left behind for its victims to cope with in their lives
that was so terrifying.
"What was it like to have polio?" one may ask. Well, many cases have told a
story of feeling a little badly for a day or two, but not so badly that they
could not participate in their normal everyday activities. But then, a few days
later, they would lose all control of their limbs and under a doctor's care
were placed in casts or draped in hot packs of wet wool in order to keep their
muscles from going into spasm.
Hospital treatment was still hard to come by in some areas, because not all
hospitals would accept polio patients. So, many of the infected had to make do
with whatever care and equipment that they could find at home. Although many
people who won their battle against polio had no after-effects, there were
plenty of people who were left paralyzed with little to help them deal with
their new lot in life. The sparse range of braces and crutches that existed
were expensive, heavy, and quite often painful to use. Even the wheelchairs at
this time were difficult in which to get around. Elevators were rare and ramps
did not exist nor did the idea of rights for the handicapped.
Charity drives were started to raise money to care for the numbers of polio
survivors which continued to grow. These fund-raisers
liked to show a patient smiling inside an iron lung, a machine which cleared
the patient's lungs of mucus, helped him to breathe, and fed him through a
tube. If a patient remained in the iron lung for several days, often he began
to have hallucinations that, ironically, they were moving in a car, a train, or
an airplane. Even after they recovered and realized that these were only
hallucinations, they often remembered their "travels" quite vividly. It was
these dreams that they grasped onto tightly in a time that they feared they
might never be able to leave the iron lung.
Once they were able to breathe outside of the iron lung, the patients were
moved to a device called a rocking bed. This tilted a patient up and down so
that gravity would help force air in and out of the weakened lungs. If they
were able to breathe for themselves, the nurses had to 'wean' them away from
their iron lung. After all, this machine presented these people with a sense of
security, an assurance that they would continue to breathe and remain alive.
The lucky majority survived with little or no residual damage. Those who were
not as fortunate remained in the hospital, struggling to breathe in the iron
lung, trying to wiggle a finger or toe, learning therapy routines, and being
fitted for orthopedic devices. Regardless of whether they survived and became
"lame or limber", they were always going to be "polios."
By 1954, when the people of the U.S. were pushing for the field trial of a new
vaccine developed by a man named Jonas Salk, the National Foundation for
Infantile Paralysis arose. The NFIP could be found everywhere from the mothers
who went from house to house collecting money to the White House introduction
of the new poster child for the year. Many people gave this organization their
complete approval and saw the NFIP as a public institution. This organization
raised enough money each year to pay for hospital and rehabilitation costs of
any polio patient in need of help, while at the same time sponsoring training
programs for nurses and physical therapists and supporting the laboratory
research that led to both the Salk and Sabin vaccines. But, as with every issue
involving money, there were a few who condemned the National Foundation as an
instrument used by powerful men and women to establish ongoing, elaborate, and
expensive publicity campaigns to incite fear into the hearts of the American
people. Hence, the people would be terrified into contributing money. One thing
was certain, and that was the fact that the National Foundation and its efforts
were a very visible part of American life in the 1950s.
With regard to the specialized community of people who collected the money and
gave it way, the NFIP was famous for other reasons. For example, the NFIP was
the first nationwide charitable organization to successfully operate only
asking for a small amount of money -- dimes, not dollars. This seemed so little
to give that people could not help but donate to this cause. In the early
1950s, the privately supported NFIP spent ten times as much money on polio
research as the National Institutes of Health, which were tax supported.
Another aspect that NFIP was famous for was that it collected the money from
people who had never been a part of groups such as the Junior League or the
American Red Cross. It was in groups like these that one's social standing
rather than their devotion or interest more often determined one's role within
the organization. The NFIP was the first national charity in that it went
directly to the "middle" of the middle class to recruit its volunteer workers.
The NFIP appealed to small business men and young parents, to local citizens
who had yet to become leaders, and to the great number of people the NFIP
wanted to fight for its cause and not so much the politicians and other
prominent political figures who were already too much involved in other
affairs. The structure of the NFIP was straightforward and unlike many other
organizations of the era. Where most organizations were commandeered by
financially and socially powerful volunteers directing the activities of
subordinate professional staff, the NFIP had all of its power located in its
National Headquarters, a suite of offices in one building. There were three
thousand local chapters, which were staffed by about ninety thousand year-round
volunteers. These people were supervised by only five paid regional directors
who reported directly to National Headquarters, where a man named Basil
O'Connor basically acted as president of the NFIP.
Whether it was breeding laboratory animals or the purchasing of orthopedic
devices, the executive committee of the National Foundation asked the advice of
scientific and medical experts and paid them well for their opinions. But at
all times, the major decisions made regarding each field that the NFIP granted
money to were made by National Headquarters. Apparently, everybody knew that
this meant that Basil O'Connor was making the decisions. O'Connor once
explained his philosophy, making no effort to tone down his feeling that
"Committees are to help you do what you want to do, and if the committee
doesn't do it, fire them and get a new one!" O'Connor's view outraged a great
many people, but no one could deny the overall good that the NFIP was doing in
providing needed funds for the research to find a cure for polio and for the
communities stricken with the polio epidemic. Despite people's accusations that
the NFIP used scare tactics or misused funds, the fact remained that this
system ran by O'Connor was extremely successful.
The NFIP brought the people crippled by this disease out of their "sickrooms"
and into the spotlight, but the publicity techniques that they chose to use
made numerous people uneasy. They were accused of overstating the perils of
polio and the progress the sufferers could possibly make, for the sole purpose
of increasing their funds. Many of the accusations were veritable. Whether the
fund-raiser was a citizen who had been transformed into a promoter by his
position as chapter chairman or a famous entertainer auctioning off his shirt
off to the highest bidder, it was common knowledge that dignity had very little
to do with the matter at hand. After all, dignity couldn't pay the bill for
training a physical therapist or buy crutches.
The National Foundation for Infantile Paralysis provided not only help, but
hope to a nation of terrified people. The project that it spawned, "The March
of Dimes", held many banquets and had many women collecting money to contribute
to its cause. The March of Dimes was not just about solemn research. It was
about money and sick little children. Some accused the NFIP of being
manipulative, "money-grubbing", and exploitative of the poor diseased children.
In response to this, the members of this organization would simply state that
it was the scientists' job to be "all pure and intellectual", but that somebody
needed to raise the money to pay for their work. Professional training and
research were not the kinds of things that got people to donate. It was the
cute little children on crutches and children from your home town that
convinced people to give money to this cause.
In the decade from 1945 to 1955, the years in which most of the research took
place that made the Salk vaccine possible, two unconnected movements came
together to increase the importance of the NFIP. First, there was a steady,
visible rise in the number of polio cases. The second was the "baby boom",
during which the population increased more than it had in three decades from
1917 to 1947. The goals of the NFIP seemed more worthwhile and urgent than ever
to a group of people who were having more babies. And after all, there is
nothing like the entering into parenthood to make one focus their attention on
The use of the media by the NFIP was an integral part of the war on polio.
Whether it was a child with a new pair of crutches or a hospital with another
iron lung, a photograph was sure to be in the local newspaper along with a
story reminding people that these purchases were possible because of their
donations to the March of Dimes. Whenever a polio scientist found something
promising, the NFIP publicists made sure that it was printed not only in the
scientific journals but also in the popular press. Even more notable was the
first sentence of every article which stated that the research had been paid
for by the NFIP.
A new era of scientific publicity began during this time with regard to
television. Today when famous doctors appear on the evening news, it seems
ordinary to hold a special press conference to report results of a nationwide
medical experiment that had already been greatly focused on by the media. The
1954 polio vaccine trial set the precedent for this. In order to develop a
vaccine that protected against polio, Jonas Salk had combined existing theories
and techniques like those developed by a man named Thomas Francis. Francis had
developed a new standard for the size, speed, and rigor of field trials
combining basic principles of epidemiology with unique public interest. Jonas
Salk was interviewed by Edward Murrow on "See It Now". This interview in which
Salk described his discovery of the polio vaccine was broadcast by CBS. The
NFIP planned to print ten thousand copies of the report and a pharmaceutical
company, Eli Lilly and Company, had offered to produce a closed-circuit
telecast shown in hotels and movie theaters in sixty-one cities on the night of
the announcement, to an invited audience of fifty-four thousand doctors, in
hopes that the broadcast would be centered on introducing the new product that
they would all be buying and using soon. Further contributing to publicizing
the new vaccine, the NFIP began printing their informational pamphlets to
parents, this time with the reminder that the free vaccination program plans
for the schoolchildren who had not already been vaccinated in the field trial
would only take place if the vaccine was licensed.
The most important aspect in the study of this disease was that the
investigation was taken off of the list of duties of clinicians and placed back
into the realm of the experimental laboratory. It became a time of
standardization of criteria and methods. The experimental disease was studied
intensively in one particular manner. One strain of poliomyelitis was studied
in one species of monkey, the rhesus. One (or at the most, two) route of
inoculation, the intercerebral route, was the standard procedure to be
Two men's findings contributed the most to the development of a vaccine
against polio. Dr. John Enders and Dr. Thomas Weller, with their assistants,
began carrying out an experiment in 1949 that won them the Nobel Prize in 1954.
In this experiment, Enders succeeded in growing poliovirus outside the body in
laboratory cultures of non-nervous-system human tissue.
These men knew from the results of earlier studies that they had conducted on
diseases such as mumps that poliomyelitis viruses would multiply in cells other
than those of the nervous system. Before their discovery, this was thought to
be impossible. This discovery was enhanced by the observation that the viral
multiplication was followed by not only injury, but death of the cells. This
explains why it took only a fraction of the time and used only a small
percentage of monkeys that were required in an earlier method in order to
attain adequate amounts of virus for the vaccine.
One thing that concerned the scientists was the possibility that their
research would turn up innumerable individual strains of poliomyelitis. This
would have squelched any hope of developing a vaccine. Luckily enough, only
three specific types of polio emerged. This was a tremendous step in the
direction of developing a vaccine. The second obstruction to the development of
a vaccine was the nervous tissue from infected monkeys was the only source of
the three types of virus. This was an unacceptable inoculum in humans. When
Enders, Weller, and their assistants reported that they had succeeded in
growing the virus in tissue cultures of human embryonic muscle and skin cells
and could identify its presence by characteristic structured changes in 1949,
the potential to develop a vaccine against paralytic poliomyelitis became a
Jonas Salk, who had also been working on a cure for polio, began to equip a
lab for the newest production techniques. In 1950, Salk was certain that he had
developed a cure and asked to begin testing his vaccine on children. His
request was met with some opposition until after another two years of research
which convinced the foundation officers that his vaccines were safe. The
vaccinations were given to children in 1954. An oral polio vaccine was
developed in 1956 by a man named Albert Sabin. The safety and effectiveness of
the vaccines were monitored by clinical observation. The results were
encouraging, and it was discovered that the vaccine strains readily spread to
susceptible contacts. This had never been previously observed and turned out to
be a great advantage in immunization programs.
In conclusion, few realize how greatly polio affected people in society in the
early 1950s. Everyone was affected when there was epidemic outbreak. Public
places were closed, and people were cut off from contact with one another.
People lived in constant fear that they would be next to catch the disease, or
worse, one of their children would contract polio. The lives of polio victims
and those who cared for them were changed forever by the impairments that
victims of polio suffered. The thought of being paralyzed was what made polio
so terrifying. Although other diseases of the era had much higher mortality
rates, none had the permanent ramifications that polio did. No one could
understand where this disease came from or why it could not be controlled.
Polio was the first high profile disease to be fully covered by the media, and
the National Foundation for Infantile Paralysis had a hand in providing polio
related information to the media. The National Foundation for Infantile
Paralysis was instrumental in helping to pay for the expensive treatment and
equipment needed to rehabilitate polio victims. It also funded the research for
the development of a cure for polio. These funds paved the way for the improved
research techniques and methods of the era carried out by scientists such as
Enders, Wellers, Salk, and Sabin to isolate and develop a vaccine against
polio. It was not until the development and distribution of the vaccine against
polio that people could have a secure sense of hope that they would not fall
victim to this paralyzing disease. Once this vaccine proved to be an effective
cure, polio was basically wiped out in our nation. Those of us lucky enough to
live in a time when vaccination is readily available will never know the terror
that permeated the lives of so many just a few decades ago.
1. Jane Smith, Patenting the Sun: Polio and the Salk
Vaccine (New York: William Morrow and Co., Inc, 1990), p. 34.
2. Smith, p. 35.
3. Smith, p. 36.
4. William Atkinson, Epidemiology and the Prevention of
Vaccine-Preventable Diseases (Washington Centers for Disease Control,
1996), pp. 168-69.
5. Abram Beneson, Control of Communicable Diseases in
Man (New York: American Public Health Association, 1970), p. 119.
6. Smith, p. 37.
7. Beneson, pp. 265-68.
8. Smith, p. 37.
9. Smith, p. 38.
10. Smith, pp. 39-41.
11. Smith, p. 41.
12. Smith, pp. 39-41.
13. Smith, p. 43.
14. Smith, pp. 63-64.
15. Smith, p. 64.
16. Smith, p. 65-66.
17. Smith, p. 66.
18. Smith, pp. 82-83.
19. Smith, p. 83.
20. Smith, p. 302.
21. Smith, p. 305.
22. John Enders, "Some Recent Advances in the Study of
Poliomyelitis, 1954" Medicine (September 1992): 316-320, at p. 317.
23. Smith, pp. 126-27.
24. Enders, pp. 317-18.
25. Dorothy Horstmann, "Three Landmark Articles about
Poliomyelitis," Medicine (September 1992): 320-25, at p. 322.
26. Horstmann, p. 322.
Atkinson, William. Epidemiology and Prevention of Vaccine-Preventable
Diseases. Washington: Centers for Disease Control and Prevention, 1996.
Beneson, Abram. Control of Communicable Diseases in Man. New York:
The American Public Health Association, 1970.
Enders, John. "Some Recent Advances in the Study of Poliomyelitis, 1954". Medicine.
Sept. 1992: 316-20. (reprinted)
Horstmann, Dorothy. "Three Landmark Articles about Poliomyelitis". Medicine.
Sept. 1992: 320-25.
Smith, Jane S. Patenting the Sun: Polio and the Salk Vaccine. New
York: William Morrow and Company, Inc., 1990.