Transcript Margaret Pittman, Ph.D.

Short History of NIH
Victoria A. Harden, Ph.D.
Historian, NIH
Federal Government
and Medical Research

No support at all before late 19th
century

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Medical system based on “humoral” theory
U.S. Constitution made no mention of
health or medicine
Marine Hospital Service

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Marine Hospital,
New Orleans, Louisiana
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
Political Philosophy

Americans were suspicious of government
funding because they believed:

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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

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“The First Operation with Ether”
by Robert Hinckley
Only major U.S.
contribution to
medicine before the
U.S. Civil War
Wholly in the private
sector
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
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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
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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
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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

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
25th & E Sts, Washington, DC,
1904-1939/41 home of NIH
Buried in a
supplemental
appropriations act
Authorized
$35,000 to build
one building
Authority to
investigate
“infectious and
contagious
diseases”
1902
Research Program Begins

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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

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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
1916
First professional woman hired
Dr. Ida Bengtson,
Bacteriologist
Worked in Biologics
Control
Ransdell Act, 1930
Hygienic Laboratory renamed
National Institute of Health
Charles H. Herty
(Georgia and N.C.)
Senator Joseph Ransdell
(Louisiana)
1930s
Change in Political Philosophy

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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
NIH Campus under construction, ca. 1939
1939-41--move from
DC to Bethesda
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
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June 1940

Sept. 1940
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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

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NIH Division of Public Health Methods
worked with the Selective Service
43 percent unfit for
military service
28 percent not fit for
any military service
15 percent fit for
limited service only
Research for the home front:
Workers protected

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Working conditions of >300,000
defense workers improved
Dangers of
specific
munitions
Diagnostic
tests for toxic
materials
Research for the battlefield

Exotic diseases

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Malaria
Yellow fever
Epidemic
typhus
Tsutsugamushi
(scrub typhus)
schistosomiasis

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Battlefield
trauma
Shock
Burns
Blood & blood
products
High altitude
physiology
Architects of today’s NIH
World
War II
leaders
Surgeon General
Thomas Parran
NIH Director
Rolla E. Dyer
1944 PHS Act


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Authorized NIH
grants program
Authorized clinical
research
Mandated materials
prepared for public
Rapid growth, 1945-2001
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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
Protection for
Human Subjects
•
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, DHHS
established June 2000
Major lines of research, 1945-2003:
Human Genetics

http://history.nih.gov/exhibits/genetics/
NIH and Genetics Research

1961—Nirenberg broke genetic code

1973—rDNA safety issues

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Guidelines written
RAC established

1988—Human Genome Project launched

2003—Human Genome Project completed
Major lines of research, 1945-2003:
Basic Research

http://history.nih.gov/exhibits/bowman/
NIH and Basic Research

>100 Nobel prizes, 5 intramural

Biochemical instrumentation, 1945-1968
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Molecular biology, 1970s-present

Neuroscience: emphasis on “brain” rather
than “mind”
Major lines of research, 1945-2003:
Chronic Diseases

http://history.nih.gov/exhibits/opiates/
NIH and Chronic Diseases

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Drug addiction: search for
“nonaddicting opiate”
Heart disease, stroke, sickle cell anemia
Cancer
Diabetes, types I and II
Arthritis
Major lines of research, 1945-2003:
infectious diseases

http://aidshistory.nih.gov/home.html
NIH and infectious diseases

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Surprising reappearance in 1981: AIDS
Emerging diseases: SARS, Ebola, hanta virus,
etc.
Bioterror agents: anthrax, plague, smallpox,
botulism, tularemia
Major world killers: malaria, rotavirus, polio
NIH worldview: absorbing but dangerous.
How do we deal with the brave new world?