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Biographical Memoirs: V.47 (1975)

Chapter: 9 John Rodman Paul

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Suggested Citation:"9 John Rodman Paul." National Academy of Sciences. 1975. Biographical Memoirs: V.47. Washington, DC: The National Academies Press. doi: 10.17226/570.
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JOHN RODMAN PAUL April 18,1893-May 6,1971 BY DOROTHY M. HORSTMANN AND PAUL B. BEESON JOHN PAUL was born in Philadelphia, Pennsylvania, the third child in a family of eight. His father was Henry Neill Paul, and his mother had been Margaret Crosby Butler of Yonkers, New York. The Pauls trace their ancestry to Joseph Paull of Illminster, England, who emigrated to this country in 1685, settling with William Penn's Quakers in Philadelphia. On his mother's side, John was a descendant of Theophilus Eaton, the first governor of Connecticut, and of Benjamin F. Butler, Andrew Jackson's attorney general. His maternal t,randfather was William Allen Butler, an eminent lawyer and poet. John's father was also a lawyer and a man of broad scholarly interests. He loved Shakespeare and Elizabethan drama, was Dean of the Philadelphia Shakespeare Society for many years, and published a number of Shakespeare commentaries as well as The Royal Play of Macbeth, a scholarly analysis of the origins of the play. His interests were also in natural history. In the 1880s, while at Princeton, he had taken part in expeditions to Montana for geological and paleontological explorations. His accounts of these trips fascinated John, who later counted them as a major factor in awakening his interest in science at a very early age. This interest was further encouraged when the Paul family settled in Chestnut Hill, then an open suburb of Philadelphia, 323

324 BIOGRAPHICAL MEMOIRS with woods, streams, and fields where the Paul children could roam and bring home to their family museum minerals, butter- flies, birds eggs, and even Indian arrowheads. Summers were spent at Beach Haven on the New Jersey shore, and shells and sea specimens were also added to their collections. A love of the out-of-doors was a deep and sustaining influence throughout John Paul's life, as well as the source of many of his hobbies— bird watching, archeology, wood carving, building stone walls, watercoloring, and photography, etc. It was also responsible for his being an active and articulate conservationist as early as the 1930s, long before the need for preservation of the environ- ment became a popular cause. As a child, John is said to have been reserved, rather shy, but with a strong humorous streak. He had stamina and energy but was not robust, so to improve his health he was sent to New Hampshire at age eleven, where he was tutored and spent much time out-of-doors during the winter before entering St. George's School, in Newport, Rhode Island. The six years at St. George's were important and happy ones: he was an outstanding student and won many scholastic prizes in Latin, Greek, and history. He became editor of the school magazine, manager of the foot- ball team, and coxswain of the school crew. In 1911 John entered Princeton. At first he led a relaxed and carefree life there without any particular scholarly focus— until he came under the influence of Edwin Grant Conklin, professor of biology. Conklin was the kind of professor who lit fires under his students; from then on John took off scientifically and spent as much time as possible in the laboratory. Still he lived a full life at Princeton: he was very popular in his class, was an editor of the Princeton Tiger, a member of the Ivy Club, and manager of the crew and sometimes its coxswain. The decision to study medicine came about through associa- tion with Cecil Drinker, one of John's heroes at the time and subsequently Dean of the Harvard School of Public Health.

JOHN 1tODMAN PAUL 325 The Paul and Drinker families had been neighbors and close friends during summers at Beach Haven, where Cecil had taught John to sail the Drinker's yawl. Cecil's younger brother, Philip, and John were the same age and became fast friends. Later they roomed together all through St. George's School and Princeton. During the Princeton years, Cecil, Philip, and John sailed together in the summers and it was on these pleasant cruises that Cecil persuaded John that he should go to medical school. The advice was accepted, and after graduation from Princeton in 1915, he enrolled at the Johns Hopkins Univer- sity School of Medicine. His goal, he said in later years, was "to be a medical scientist just like Cecil," rather than a prac- ticing physician, the role his family had in mind for him. He never swerved from his commitment to a career as an investi- gator. In 1917, when he was in his second year of medical school, the United States entered World War I. In June, along with thirty-one other medical students, Paul joined the Hopkins unit as an enlisted man and sailed from New York in the first U.S. convoy of World War I to head directly for France, carrying combat and other troops—the vanguard of Pershing's army. The major part of the army transport on which he found himself was occupied by seasoned soldiers, and (as he wrote later) the medical contingent "consisting of the Johns Hopkins Hospital Unit, a hastily assembled and motley group of raw recruits, occupied a place befitting their military experience—far astern and deep in the bowels of the ship." After eighteen long days at sea, often in submarine-infested waters, the overcrowded ships finally reached St. Nazaire, where the men received a warm wel- come from the French. The Hopkins unit went on by train to Bazoille sur Meuse, where Base Hospital #18 was set up, well back of the front line. John's assignments were as bacteriolog- ical technician and substitute ambulance driver. The bac- teriology laboratory was a valuable experience that apparently

326 BIOGRAPHICAL MEMOIRS had considerable influence in shaping his subsequent career. His first duty was to determine the effectiveness of a new method of treating wound infections by continuous irrigation with a sodium hypochlorite solution devised by Dakin, an English chemist. The mountainous task of doing daily smears and bac- terial counts on swabs from the wounds of the many patients who had infections with gas-forming bacilli eventually proved dull work; and since the results did not prove to be helpful as indicators of the course of infection, the study was finally aban- doned. Driving an ambulance turned out to have greater re- wards, which involved a month at St. Nazaire assembling Ford ambulances (they arrived two in a box) and proudly driving the finished products back to Bazoille. After a year in France, Paul, his great friend John M. T. Finney, Jr., and others of the students at Base Hospital-#18 were persuaded that they should return to Hopkins to complete their medical education. By a fortunate stroke of fate, Paul missed the ship on which he was scheduled to return—one that was torpedoed and lost—and came through on another, which sailed successfully from Brest to New York. Shortly after his arrival in Baltimore, the 1918 influenza epidemic erupted and the wards of the Johns Hopkins Hospital were filled with desperately ill patients, many of them professors and staff mem- bers. Apparently the wave of relatively mild respiratory illness that had swept France in 1917 was the forerunner of the more severe 1918 epidemic, and infection with the agent in France conferred immunity on those who had had experience with it, including John Paul. At that time he had had no clinical train- ing but in the desperate situation was put to work on the wards as a substitute intern, to care for the patients as best he could. It was a harrowing ordeal, since the mortality rate was extremely high. The helplessness of the physicians made a deep impres- sion on the young Paul. As he wrote years later: "Many were the nights I passed, making do with a few hours

J OHN RODMAN PAUL 327 of uneasy sleep grabbed as best I could from a 20-hour day, tossing and twisting and deciding that it would have been better if the influenza patients had never come to the hospital. The lessons we learned in those days were not how to treat patients who had postinfluenza pneumonia with drugs, but rather how to save their lives by preventing exposure on the isolation wards by mixing them up with cases of tonsillitis and scarlet fever. If the patients with influenza were kept by themselves they had a far better chance of avoiding cross-infection with pathogenic bacteria, especially the hemolytic streptococcus. This was an epidemiological principle reminiscent of the days of Semmelweis and puerperal fever." ~ Although his military experience caused him to miss his third year of medical school, Paul graduated with the class of 1919. He immediately joined W. G. McCallum, professor of pathology at Hopkins on a trip to Lima, Peru, where the sum- mer was spent working on bartonellosis. The routine consisted of doing autopsies at the hospital in the mornings and exploring the city and its archeologic treasures in the afternoons. On his return to Baltimore, John joined McCallum at Hop- kins as an assistant in pathology. Two of his classmates, Arnold Rich and Leslie Webster, did the same, and the three had a lively and productive year in the laboratory. Paul's first con- tribution to medicine was made during that year—a paper on the histopathology of measles conjunctivitis. Thus his first work dealt with a virus infection—a prophetic note since he devoted most of the rest of his professional life to investigations in that held. The next two years were spent as an intern at the Pennsyl- vania Hospital in Philadelphia. In 1922 he was appointed Director of the Ayer Clinical Laboratory of the Pennsylvania ~ J. R. Paul, "A Clinician's Place in Academic Preventive Medicine: My Favorite Hobby," Bulletin of the New York Academy of Medicine 47(1971): 1264 (hereafter cited as "Clinician's Place").

328 BIOGRAPHICAL MEMOIRS Hospital, a post that had previously been held by Dr. Warfield T. Longcope. Activities during the six-year period at the Ayer Laboratory resulted in papers on a variety of subjects dealing with bacteriology and pathology, including the fir.c~ ones on 1 · ~ ~ · . rheumatic fever, a disease that was to engage much of his at- tention in the ensuing years. In fact, it was when he presented a paper on the pleural and pulmonary lesions in rheumatic fever at the clinical meetings in Atlantic City in the spring of 1928 that he was invited by Francis Blake, professor of medicine at Yale, to join his department as an assistant professor. Thus began Paul's long association with Yale—one that continued until his death forty-three years later. In the 1920s, the Yale Medical School was in the midst of a renaissance under the dynamic leadership of Dean Milton C. Winternitz. Winternitz had gathered together for the recently created full-time faculty a stellar group of young clinician- scientists, including among others Francis Blake, John P. Peters, Grover Powers, and James Trask. According to Dr. Paul, they were all "young, eager, and well trained men, imbued with the idea of making the fulltime system work." He himself fitted into this setting perfectly and within several years of his arrival in New Haven had launched into several major pieces of work that proved to be important landmarks in clinical investigation. Among these were the studies of rheumatic families, the dis- covery of the heterophile antibody (Paul-Bunnell) test for in- fectious mononucleosis, and the demonstration that the com- monest clinical expression of infection with polioviruses is not paralysis, but the "minor illness" or "abortive" form of the disease that is often so mild as to go unrecognized. The seeds of the scientific philosophy that characterized his later work at Yale, and in fact ran throughout his entire pro- fessional life, were planted early in John Paul's mind—when he was a second-year medical student. At that time he attended a meeting of the Federation of Biological Sciences in New York

JOHN RODMAN PAUL 329 City at which there was a lively discussion of the disastrous epidemic of poliomyelitis that had raged in New York and New England during the summer of 1916. In looking back on that occasion, he wrote: "I must have been a singularly impressionable young man at the time, and I was certainly engrossed in watching and hear- ing the words of these great men, who were engaged in recount- ing their efforts to attempt to solve the problem of epidemic poliomyelitis, applying the very weapons which we had been taught to use in our first years at medical school. Dr. Simon Flexner was in the chair; Dr. Peyton Rous was at his side as secretary; and Hideyo Noguchi, who was there as a speaker, was introduced as a man of mystery, one who could almost turn lead into pure gold, or at least turn the virus of poliomy- elitis into 'globoid bodies.' "As a rapt listener, the idea first dawned on me that the religion of the true physician was incomplete without having the concepts of prevention thoroughly ingrained in him. This was particularly true when it came to the prevention of such a colossal tragedy as the 1916 epidemic. My immature reasoning, which I never lost, was that, together with attempts to cure this pestilence, there should be attempts to control it, and this should be done by clinicians who knew the disease best. In other words, this concept should radiate from the top physicians and pediatricians." ~ Once these ideas had taken root, they were nourished by Paul's experience during the 1918 influenza epidemic and grad- ually flowered in the 1920s and 1930s as his concept of "Clinical Epidemiology" developed and took form. In his presidential address to the American Society for Clinical Investigation in 1938, he said: "The term, Clinical Investigation in Preventive Medicine, ~ Paul, "Clinician's Place," p. 1263.

330 BIOGRAPHICAL MEMOIRS is cumbersome and so I will not use it.... It presupposes the existence of a so-called sister science, Curative Medicine.... Clinical Investigation in Epidemiology is better for the pur- poses at hand; Clinical Epidemiology is best, and really what I mean.... It is a science concerned with circumstances, whether they are 'functional' or 'organic' under which human disease is prone to develop. It is a science concerned with the ecology of human disease. It must face the question of 'why' as well as 'how'. Clinical Epidemiology differs, therefore, from the orthodox science of Epidemiology, both in its aim, and its locale, as it were. The orthodox epidemiologist must of neces- sity deal dispassionately with large groups of people. It is the multiplication of observations which give him his results. The clinical epidemiologist, on the other hand, must of necessity deal with small groups of people; people whom he knows well and groups no larger than a family, or small community. The restriction of the size of the group rests on the fact that clinical judgment cannot be applied wholesale, without the risk of its being spread too thinly to be effective.... The clinical epi- demiologist, . . . starts with a sick individual and cautiously branches out into the setting where that individual became sick, the home, the family, and the workshop. He is anxious to analyze the intimate details under which his patient became ill. He is also anxious to search for other members of the patient's family, or community group who are actually, or potentially, ill. It is his aim to thus place his patients in the pat- tern in which he belongs, rather than to regard him as a lone sick man who was suddenly popped out of a health setting; and it is also his aim to bring his judgment to bear upon the situa- tion, as well as on the patient. "Obviously there is nothing new to the family doctor about this concept of Medicine. It is the heart and soul of family practice and probably has been as long as family practice has existed. But now that the emphasis has shifted away from the

JOHN ELODMAN PAUL 331 home and into the Hospital or Dispensary, clinical epidemiology will be practiced only if we take thought about it." ~ Dr. Paul never cared for the term "Preventive Medicine," although eventually his professorship and his section at Yale used this terminology. He regarded it as "too boastful, too suggestive that great things might be just around the corner." His belief was that the focus should be on the teaching of the underlying principles of prevention, i.e., epidemiology. In championing these concepts he was perhaps ahead of his time, but in the past decade his pioneering efforts have begun to bear fruit. The best possible support is provided by his own achieve- ments in which he combined so successfully the study of certain diseases: at the bedside, in the laboratory, and in the natural setting in which they developed. In the New Haven Hospital in 1928 rheumatic fever was a common disease. Paul took advantage of the opportunities this situation provided and turned his attention to unraveling the epidemiology of the disease. His focus was on rheumatic fever in families and the factors involved in its spread. Many of the social and environmental aspects were explored through in- timate, long-term studies over an eight-year period of all mem- bers of 122 rheumatic families and suitable control families. When he began his studies, the role of the hemolytic strepto- coccus was not yet appreciated, but based on his observations Paul concluded that respiratory infection of some kind pre- cipitated the acute attack. While not the first to suggest a relationship between the hemolytic streptococcus and rheumatic fever, it is fair to say that the book he published in 1930, The Epidemiology of Rheumatic Fetter, and particularly the second edition in 1943, set forth the evidence for a causal relationship in such a way that there was never any further question about it. it J. R. Paul, "Clinical Epidemiology," Journal of Clinical Investigation 17(1938) :539~1. t Paul, "Clinician's Place," p. 1267.

332 BIOGRAPHICAL MEMOIRS It was in the course of serologic investigations of patients with rheumatic fever that the heterophile antibody test for in- fectious mononucleosis was discovered. This came about when, having confirmed the observation made by Davidson in 1929 that agglutinins to sheep cells are present in the sera of patients with serum sickness, Paul raised the question whether such heterophile antibodies might not also be present in rheumatic fever since there were similarities between the symptoms of the two diseases. The results with sera of rheumatic patients were negative, but quite by accident, among the control specimens from patients with serum sickness and various other acute ill- nesses, there was one with an extraordinarily high titer higher than had ever been described in serum sickness or any other clinical condition. The patient from whom the specimen came was a medical student with infectious mononucleosis. Gradually over the ensuing months several other patients with this disease were also found to have high heterophile antibody titers, while tests on some 275 controls gave consistently negative results. In 1932 Paul and Bunnell, a medical resident who col- laborated on the project, published their findings. The test, which is still sometimes referred to as the Paul-Bunnell test, re- mains today as the chief laboratory method in the diagnosis of infectious mononucleosis. The first investigations of poliomyelitis, the disease on which Paul's main work was subsequently concentrated, also began early in the 1930s. In Middletown, Connecticut, twenty- six miles from New Haven, a small epidemic occurred in 1930. Paul and his colleague lames Trask were struck by the wide range in severity of the disease. Some suspected cases not only did not have paralysis, but had little or no neck stiffness. Were these also infections with the virus of poliomyelitis? The fol- lowing year, New Haven experienced a sharp epidemic and the opportunity to answer this question by attempting to isolate the virus presented itself. Characteristically, Paul and Trask

JOHN RODMAN PAUL 333 went into the homes of patients hospitalized with paralysis and visited others in the neighborhoods where the cases were coming from. They took histories, did physical examinations, and col- lected throat washings from siblings and contacts who had minor illnesses—brief episodes of headache, vomiting, and sore throat, commonly labelled "summer grippe." Family after family, through which waves of such illnesses passed, were studied. The throat washings were duly tested by intracerebral inoculation of monkeys, and from two children, polioviruses were recovered. These were the first isolations of the virus from living patients in over thirteen years, and they added significantly to the hand- ful of such successful isolations reported in the world literature up to that time. In describing these important results, Dr. Paul later pointed out that the work had been undertaken against the advice of several well-known senior investigators in the field who considered the approach "one which was expensive and would not yield valuable results.... Monkeys cost from 6 to 8 dollars each. This was regarded as an expensive laboratory animal, and it was deemed unwise for amateurs to spend so much money on this type of research, particularly when it was their initial piece of work in this field and there were many more orthodox things to be done." ~ The successful outcome in the face of such discouraging pronouncements bolstered the confidence of the two young investigators, and Paul and Trask continued their "unorthodox" studies. Using recently isolated human strains of the virus, they soon made another major contribution by demonstrating that polioviruses exist in at least two and possibly three serologic types. A preliminary report of similar findings by Burnet and McNamara in Australia had appeared in 1931, but it had been greeted with incredulity by most U.S. workers. ~ J. R. Paul, "From the Notebook of John Rodman Paul," Yale Journal of Biology and Medicine 34(1961-62):164.

334 BIOGRAPHICAL MEMOIRS These early and highly productive investigations by the Yale Poliomyelitis Study Unit, founded in 1931 and led for many years by Paul and Trask, were supported by small grants of several thousand dollars from various sources; but in 1936, the unit received the first research grant ever given by the Presi- dent's Birthday Ball Commission, which eventually became the National Foundation for Infantile Paralysis and finally the National Foundation. The Foundation continued its support of the unit through Grant #1 until 1968. In the mid-1930s, Paul's work was interrupted by illness. He developed severe pulmonary tuberculosis, and after a brief hospitalization in New Haven went to The Desert Sanitorium in Tucson, Arizona, where he remained for two years. The time spent there, far from being a fallow period, was full of activity of quite a different sort. Leita Paul accompanied her husband and took advantage of the opportunity to study the archeology of the Indians of the Southwest at the University of Arizona. She reported to John on lectures and seminars, and he took an equal interest in the subject. The experience was a source of lasting fascination with Indian culture for the Pauls. As he improved, John joined Leita in digging expeditions that yielded many fine pieces of pottery. During the summers—when Tucson was unbearably hot—they stayed in Tyrone, New Mexico. There they became particularly interested in the Mimbreno tribe, whose pottery designs were unusual in that they were zoomor- phic. Paul collected and photographed many rare specimens; his interest culminated in a fine exhibition of Mimbreno pot- tery, which he displayed in 1956 at the Yale Art Gallery, work- ing with art students in gathering materials and preparing and illustrating the catalogue with his own drawings. Several other major hobbies also flourished in Arizona: - photography, ornithology, and painting. During the first year, largely spent in bed on an open-air porch, a camera rigged to the foot of the bed allowed photography of western birds—a

JOHN RODMAN PAUL 335 whole world of new species to learn about. Later, many of these were portrayed in delicate watercolors of great precision and charm. Throughout the Arizona period there was regular com- munication with the laboratory in New Haven. In fact, a letter went out to Dr. Paul from Dr. Trask every single day during the two years. Plans for experiments were discussed, results were reported and analyzed, and at one point Dr. Trask came out for a visit. As convalescence progressed, Paul was able to undertake some work in the laboratory at The Desert Sani- torium and also to serve as a consultant on rheumatic fever cases. His interest in this disease was as lively as ever, so he decided to take advantage of his situation by investigating the effects of climate on its occurrence by determining the prevalence of rheumatic heart disease among Indian children living in reser- vations from the edge of Mexico to the Canadian border. Since the social and environmental aspects of life on the various reser- vations were similar, any differences in rates might be attributed to climate. With Dr. George Dixon, Dr. Paul started off in the family Ford and systematically examined approximately 1000 Indian school children in Montana. Wyoming, New Mexico, and Arizona, representing latitudes of 45°, 43°, 37°, and 33°. The results indicated that rheumatic heart disease was ten times more prevalent in those living close to Canada than in children living on the Mexican border. Back in New Haven in 1937, work on poliomyelitis went forward rapidly. The thrust was still toward exploring the clinical epidemiology of the infection as a clue to how the virus was spread and how the disease might be prevented. Having previously demonstrated the presence of the agent in the throats of individuals with the minor illness, or the "abortive" form of poliomyelitis, Paul and Trask again went into the homes, this time to collect fecal material from siblings of paralytic cases. Previous tests of such specimens had been unsuccessful, largely

336 BIOGRAPHICAL MEMOIRS because of the problem of bacterial contamination and resulting brain abscesses in intracerebrally inoculated animals. From a fecal specimen collected in 1937, however, poliovirus was iso- lated, by switching to intraperitoneal inoculation of the mon- keys. The recovery of virus from feces had actually been re- ported some twenty years earlier by Swedish workers, but their results had been challenged by Dr. Flexner of the Rockefeller Institute and that was enough to cause the subject to be dropped. Paul and Trask's confirmation of the presence of virus in the intestinal tract opened a whole new era in research on polio- myelitis: it turned investigators away from the unfruitful ex- periments with laboratory-adapted strains that had led to false conclusions and an incorrect characterization of poliovirus as a strictly neurotropic agent. The swine of the norm heck ~ ~ rig to clinical investigation and field epidemiology led rapidly to the demonstration by the Yale group that during epidemics the virus is shed not only from the throat and intestinal tract, but is also present in sewage and in flies that feed on feces. During the 1930s, every summer brought large epidemics of poliomyelitis somewhere in the United States, and Paul and Trask were called upon as consultants to aid the harassed and frustrated health officers who were helpless in the face of mount- ing numbers of cases. At least the presence of "experts" gave the appearance that something was being done. Thus opportunities were provided to engage in a series of clinical epidemiological studies. Investigations were carried out in Philadelphia; Los Angeles; Charleston, South Carolina; Detroit; Buffalo, New York; Florida; Toronto, Ontario; and Winnipeg, Manitoba; to name but a few. In the early 1940s, with the outbreak of World War II, new problems and new responsibilities arose. Dr. Paul was ap- pointed Director of the Commission on Neurotropic Virus Diseases of the Army Epidemiological Board. The Commission

JOHN RODMAN PAUL 337 was set up to study arthropod-borne virus diseases and polio- myelitis in members of the U.S. Armed Forces. In 1943, Dr. Paul headed a small group known as the Virus Commission, which included besides himself, Maj. Albert Sabin and Lt. Col. Cornelius Philip. The team was dispatched to North Africa to study hepatitis, sandily fever, and poliomyelitis. Dr. Paul's diaries vividly describe Cairo at the time as unbelievably crowded, teeming with British and American military personnel and allied and axis civilians. The laboratory was finally set up ~ . . . . it. ~ .. ~ . Outside the city in the desert, close to the 38th General Hospital, which was staffed by the Jefferson Medical College Unit. One of the first problems to be dealt with was the occurrence of in- creasing numbers of cases of suspected poliomyelitis among U.S. troops. The British army had reported cases of myelitis and encephalitis some months earlier, and a strain of poliovirus had been recovered at the Rockefeller Institute in New York from nervous tissue of a fatal case. But the U.S. medical officers, particularly the neurologists, were very skeptical about the di- agnosis of poliomyelitis in U.S. troops in Egypt and accepted it only after the virus was repeatedly isolated from various patients. Obtaining monkeys to carry out the tests was a prob- lem, and Paul had to visit Ethiopia to trap his own animals and bring them back to Cairo. These results confirming the occurrence of poliomyelitis among adult "immigrants" to the area were of particular im- portance to Paul because of their implications concerning the epidemiology of the infection. Paralytic poliomyelitis was con- sidered a rare disease in Egypt—not more than five or six cases were reported yearly in a population of 16 million, and all were in young children, none in adults. Paul concluded that the paucity of cases among the local inhabitants did not denote absence of the virus, but quite the opposite. The presence of infantile paralysis denoted probable wide dissemination of the agent in a population living in a poor sanitary environment:

338 BIOGRAPHICAL MEMOIRS circulation of the virus was con~ned to susceptible young chil- dren who acquired their infections in the first few years of life and subsequently remained immune for the rest of their lives. However, when susceptible adults, such as soldiers from Eng- land and the United States who had never met the virus before, were introduced into such an area of high endemicity, they were exposed, infected, and contracted paralytic poliomyelitis at a surprising rate. Several years later Paul provided further con- firmation of this hypothesis in studies that he conducted among U.S. troops in other parts of the world, including the Pacific and the Far East. Shortly after the war he obtained the final proof in the course of serologic investigations conducted in Egypt. By means of these he showed that a high percent of children in the area had experienced poliovirus infections and had acquired specific antibodies by two years of age, and by four virtually all were immune. It was in connection with these efforts that he coined the term "serological epidemiology" to describe an approach that in his hands had yielded discoveries of fundamental importance. The other two diseases that the Virus Commission was as- signed to investigate, hepatitis and sandily fever, were both continuous sources of enormous morbidity in the U.S. Army, seriously interfering with the conduct of military operations. An amicable arrangement was worked out in which Sabin and Philip took on sandily fever, and Paul chose to study hepatitis. In these studies he was joined by Maj. W. P. Havens of the 38th General (Jefferson) Hospital Unit. Epidemiologic features of cases in British and American troops in North Africa and in Sicily during the epidemic of 1943 were investigated, and sera and stool specimens were obtained from patients in the aerate phase of the infection. These materials were kept frozen until some months later, when, having recovered from a severe bout of hepatitis, Paul returned to New Haven, where he was joined by Major Havens. Together they set about testing the speci-

J OHN RODMAN PAUL 339 mens collected in Egypt in volunteers in order to identify virus positive pools that might be used in attempts to transmit the infection to some experimental animal. These studies in volun- teers constituted the first demonstration in the United States of the enteric-oral transmission of infectious hepatitis; similar results were obtained simultaneously in England by MacCallum and Bradley. Paul and Havens later went on to define the times at which hepatitis virus was present in blood and feces both before and after the appearance of jaundice. They also con- ducted cross-protection studies in volunteers and showed a lack of cross immunity between serum and infectious hepatitis. This work, along with studies by others, formed the basis of the differentiation of the two hepatitis viruses and the diseases they cause, a classification that still holds today. After World War II, with the return to peacetime activities, Paul turned his attention to building the Section of Preventive Medicine into an active teaching, training, and research unit. The Section had been established in the Department of Internal Medicine at Yale in 1941, with Dr. Paul as professor and chair- man. He preferred this arrangement to having a separate de- partment because he viewed his territory as an integral part of medicine and pediatrics rather than a separate discipline allies! to public health. The focus was to be on "the epidemiology of disease in families, in the local community, . . . clinical and environmental virology, including the role of insects and ani- mals as vectors of human disease, etc." ~ Paul struggled in the not too favorable climate of the 1940s and 1950s to bring his concepts of clinical epidemiology to medical students, house staff, fellows, and faculty. He cham- pioned the home visit as a teaching exercise in which a student, accompanied by a faculty member, could gain some idea of the role played by family and environmental and social deter- # Paul, "Clinician's Place," p. 1268.

340 BIOGRAPHICAL MEMOIRS minants in influencing the patient's disease, whether it was an acute infection or a chronic or recurrent malady. He strongly supported J. N. Morris's contention that "epidemiology . . . helps to complete the clinical picture and to clarify the natural history of disease." ~ His efforts to bring his philosophy to stu- dents and colleagues also took form in his book, Clinical Epi- demiology, published in 1958 "to introduce this subject to doctors or students of medicine, biology, or sociology in non- technical language and with examples they might use." ~ The book went through several editions and has been the text for students in courses given in many departments of preventive medicine in the United States. To the Section of Preventive Medicine—later Epidemiology and Preventive Medicine—over the years came a stream of post- doctoral fellows from the United States and other parts of the world. Many of them subsequently went on to distinguish careers in virology and epidemiology in Europe, South America, and the United States. At Yale they absorbed the philosophy of clinical epidemiology that permeated Paul's laboratory, while participating in ongoing studies on rheumatic fever, arthritis, streptococcal infections, measles, infectious mononucleosis, hepatitis, and particularly poliomyelitis. Work on poliomyelitis was in full swing in the Yale lab- oratory in the 1940s and 1950s, and some of Dr. Paul's most telling contributions were made during this period. One came about in the course of a serological survey of poliovirus anti- bodies among north Alaskan Eskimos that he conducted in 1949. There was no evidence that poliomyelitis had occurred in the Point Barrow area since 1930, when illnesses suggestive of the paralytic form of the disease had been recorded. In those ~ J. N. Morris, Uses of Epidemiology, Ed ed. (Baltimore: Williams & Wilkins, 1964), p. 277. ~ J. R. Paul, Clinical Epidemiology (Chicago: Univ. of Chicago Press, 1958; rev. ea., 1966), p. xiii.

JOHN RODMAN PAUL 34 pre-tissue-culture days the only feasible technique for large-scale serum surveys was the mouse neutralization test, which could be used to detect only Type II poliovirus antibodies. Remark- ably, Paul and his colleagues found that virtually none of the Eskimos under the age of twenty years had Type II antibodies, whereas these were almost universally present in persons over that age, i.e., those who had been alive in 1930 when polio- myelitis was known to have visited the area. Clearly the 1930 epidemic had been due to Type II—an extraordinary piece of lULK 'Ul- tIlC ~nvesugarors. Some of the Eskimo sera were also tested for antibodies to Types I and III polioviruses by the more cumbersome and restricted technique of neutralization tests in monkeys. The results were unexpected and extremely provoca- tive: antibodies to these two types were present only in persons over thirty-five and forty-five years, respectively, indicating that Types I and III had been absent for very long periods. The import of these findings, the "moment of truth" as Paul put it, was that a single exposure to a poliovirus tone could convey 1 :11_1 ~ . . ~ . . . 1 __ ~1. ~ ~ ~ , ~ . , 1 1lrelong Immunity. prom that time on, he held the belief that the way to provide permanent immunity against poliomyelitis was to induce inapparent infection with attenuated virus strains. He therefore aligned himself early with the approach championed by Sabin, and by Koprowski, which eventually led to the development of the currently used oral poliovirus vac- c~nes. In the l950s Paul and his colleagues conducted small and large field trials of the Sabin strains in the United States and in Central America, with special emphasis on the unique op- portunity that the live virus vaccine afforded to do experimental epidemiology in humans. These studies contributed not only to establishing the safety and effectiveness of the vaccines, but they also provided precise information about the incubation period of the infection, the capacity of polioviruses to spread among susceptible contacts, the prevalence and interfering ef-

342 BIOGRAPHICAL MEMOIRS feet of infection with other enteroviruses on oral vaccine "takes," and the dissemination of vaccine strains in the environ- ment—in flies and in sewage. By the 1950s, Paul had become a recognized international figure in virology and epidemiology. Inevitably, with his great knowledge and almost unique perspective, he was constantly being asked to serve on committees for the United States Armed Forces, the National Institutes of Health, the World Health Organization (WHO), and others. For fifteen years he was Di- rector of the Commission on Viral and Rickettsial Infections of the Armed Forces Epidemiologic Board, and for twenty years, a member of several of the WHO Expert Committees on Viral Diseases. In 1956 he also served as the leader of the first medical mission under governmental auspices to visit the Soviet Union. As a member of numerous U.S. Public Health Service Commit- tees during the years 1955-1962, he was in the thick of contro- versies over the licensing of the Salk and Sabin-type poliovirus vaccines and the subsequent problems associated with them. In this period he served as a senior statesman, helping to guide a national policy. Many honors came to Paul over the years. Among these were the Medal of Freedom of the U.S. Government (1946), the Howard T. Ricketts Award of the University of Chicago (1954), and an Honorary D.Sc. from the same university (1956~. He was elected to the National Academy of Sciences in 1945. In 1950 he was elected an honorary member of the Royal So- ciety of Medicine, London, and was also a Fellow of the Royal College of Physicians and of the Royal Society of Health of Great Britain. The list of professional societies in which he was active is a long one, and he served as president of several: the American Society for Clinical Investigation (1938), the Amer- ican Epidemiological Society ( 1950), and the Association of American Physicians (1956~. In 1963 he was awarded the Kober Medal of the latter—an honor that he particularly cherished.

JOHN RODMAN PAUL 343 He was also a member of the Society of American Archeologists, the American Geographical Society, the American Academy of Arts and Sciences, and the Century Association of New York. Dr. Paul retired from the chair of Epidemiology and Preven- tive Medicine in 1961. His research activities continued un- diminished, however, for he immediately became the first Director of the World Health Organization Reference Serum Bank at Yale, one of three established by WHO in different countries. He led this laboratory through its early development and undertook among other projects a nationwide serologic survey of U.S. military recruits, measuring their immune status with respect to a variety of viral and bacterial diseases. Infectious mononucleosis had been one of Paul's continuing interests since the chance discovery of the heterophile antibody test in 1931. Over the years unsuccessful attempts were made in his laboratory to isolate the etiologic agent, using materials collected from students at Yale, Smith, and the University of Connecticut. While the search was a frustrating one, the pro- spective serological study of the disease at Yale, which was undertaken by Niederman and Paul beginning in the late 1950s, eventually paid off handsomely. Thus when a technician in the laboratories of Werner and Gertrude Henle in Philadelphia developed infectious mononucleosis and was found to have ac- quired antibodies to the recently discovered Epstein-Barr virus (EBV) in the course of her illness, the Henles and their col- leagues were quick to explore a possible etiologic role for EBV in infectious mononucleosis. They turned to the Yale Labora- tory, and serologic tests on the collection of sera obtained from Yale students on entry to college, together with serial specimens from those who developed the disease during the ensuing four years, provided strong confirmatory evidence of the role of EBV in infectious mononucleosis. Although at this time he was not immediately involved in the work, Dr. Paul took great satisfac- tion in seeing his foresight rewarded and the potential of sero-

344 BIOGRAPHICAL MEMOIRS logical epidemiology as a research tool so productively exploited by his younger colleagues. An episode in connection with the first publication of sero- logical studies on the Yale students, which represented a col- laboration between Niederman and McCollum at Yale and the Henles at the University of Pennsylvania, illustrates one strong aspect of John Paul's character—his uncompromising honesty. A reporter for the New York Times had published an article in the Sunday science section hailing the Yale authors and the Henles for the remarkable discovery that EBV is probably the etiologic agent of infectious mononucleosis. Dr. Paul was aghast at this misstatement and immediately sent a letter to the editor (published the following Sunday) pointing out that it was the Henles and their colleague Diehl who were responsible for the discovery, not the Yale group, whose contribution was merely confirmatory. The editor was so astonished that he telephoned Dr. Paul to tell him that never before in his long experience had he received such a letter denying credit for an accomplish- ment. Chronic heart disease imposed the necessity for less and less physical activity, and in 1966 Dr. Paul retired from the director- ship of the WHO Serum Bank. The increasing discomfort and restrictions due to his cardiac problems never elicited a com- plaint from him, however. He suffered no decline in intel- lectual vigor, and with typical determination and fortitude he spent the last five years of his life in a concentrated period of writing. He accepted an appointment of the Department of History of Science and Medicine and set about preparing three books and a number of papers on historical subjects. His most important contribution during this period was his magnificent book, A History of Poliomyelitis, published by the Yale Uni- versity Press in 1971—a few months before his death. This has been widely acclaimed as a classic in medical history: it not only tells the story of a dramatic disease, but also reveals the way

JOHN RODMAN PAUL 345 scientific discoveries are actually made—how backward steps as well as forward ones are part of the slow process and how the personalities and foibles of scientists inevitably affect the course of events. Published after his death was "An Account of The American Epidemiological Society" and Serological Epidemiology, which he edited with Dr. Colin White. He also wrote histories of several Commissions for the Archives of the Armed Forces Epi- demiologic Board (AFEB). These included A History of the Virus and Rickettsial (V e? R) Commission, A History of the Early Years of the Virus Inf ections Commission, and A d- dendum to the History of the Neurotropic Virus Commission, which completed his earlier account written shortly after World War II, when military censorship was still in effect. In addition he left several incomplete manuscripts, including one on in- fluenza in World War I. Throughout his seventy-eight years, Paul was a person of enormous energy, imagination, and inner strength. These traits were concealed in a gentle exterior that often belied the tough- ness beneath. He had the essential qualities of a leader: all who came in contact with him respected him and recognized his integrity, judgment, and wisdom. Despite his eminence and many honors, he retained a certain shyness; modesty and hu- mility were strong in his character. His professional manner was rather formal and reserved, and it was not easy to get to know him well. But with friends he was a wonderful com- panion—lively, warm hearted, and possessed of a delightful sense of humor, understated humor. He was a stimulating conver- sationalist and took immense pleasure in good talk in the company of friends over dinner and a bottle of his favorite Mosel wine, of which he was a connoisseur. He had a particular gift for friendship and kept up with a host of devoted friends around the world who had entered his life beginning in his school days.

346 and always the birdlife—led him to devote as much time as possible to exploring these aspects. He kept a diary during most of his life, and his war journals and various travel journals are filled with perceptive and witty observations on people and places. Not surprisingly, descriptions of birds and many skillful sketches of them dot the pages. John Paul's life has been described by John Enders as a "splendid edifice." ~ It was indeed rich in all of its facets—in family, friends, career, and by no means least in the devoted companionship of his wife, Leita, during their forty-nine years of marriage. In summing up, one of his Yale colleagues has said: "Armed with a quiet zest and a pocketful of hobbies that stretched from Aves to Zunis, he was courteous and reserved on the surface, delightful and gracious beneath and with a generosity of spirit and adventurousness of mind few have com- manded. There is an old pre-Socratic saying that 'Character is Man's Destiny.' Dr. Paul richly fulfilled that vision—as a phy- sician and teacher, as a scientist, and most of all, as a person." BIOGRAPHICAL MEMOIRS Paul travelled widely over the years; an unquenchable wanderlust was one of his main characteristics. His foreign travels began early, when as a medical student he spent a sum- mer working at the Grenfell Mission in Labrador. Curiosity about the behavior of disease in different geographic areas, cultures, macr - , and microclimates took him to many parts of the globe. Besides his early expedition to Peru with W. G. McCallum and assignment during World War II in North Africa and the Middle East, his later research activities involved fieldwork in Costa Rica, Cuba, Puerto Rico, Iceland, Germany, Czechoslovakia, Morocco, Israel, Korea, and Japan. Whatever the country, his interest in the culture and art of the people— ~i J. 17. Enders, "Book Reviews: A History of Poliomyelitis: Yale Studies in the History of Science and Medicine 6. By John R. Paul," New England Journal of Medicine 285(1971):359. ~ E. Atkins, "John Rodman Paul, M.D.," Yale Medicine (Fall/Winter 1971), p. 9.

J OHN RODMAN PAUL BIBLIOGRAPHY KEY TO ABBREVIATIONS 347 Am. J. Hyg.—American Journal of Hygiene Am. I. Med. _ American journal of Medicine Am. .T- Med. Sci. American Journal of the Medical Sciences Am. l. Public Health _.\merican journal of Public Health Ann. Intern. Med. - Annals of Internal Medicine Arch. Pathol. Archives of Pathology Bull. Ayer Clin. Lab.—Bulletin of the Dyer Clinical Laboratory of the Pennsylvania Hospital Bull. N.Y. Acad. Med. Bulletin of the New York Academy of Medicine Bull. U.S. Army Med. Dep. Bulletin of the United States Army Medical Department Bull. WHO Bulletin of the World Health Organization Conn. Med. Connecticut Medicine Conn. State Med. I.—Connecticut State Medical {ournal Int. .\ssoc. Med. Mus. Bull. International Association of Medical Museums Bulletin Johns Hopkins Hosp. Bull. Johns Hopkins Hospital Bulletin I. Am. Med. .Assoc. Journal of the American Medical Association I. Bacteriol. {ournal of Bacteriology i. Biol. Chem.— Journal of Biological Chemistry I. Clin. Invest. journal of Clinical Investigation I. Exp. Med. Journal of Experimental Medicine Med. Clin. North Am. Medical Clinics of North America Milbank Mem. Fund Q.—Milbank Memorial Fund Quarterly Newsl. Assoc. Teach. Prev. Med. = Newsletter of the Association of Teachers of Preventive Medicine Pan Am. Health Organ. Sci. Publ. - Pan American Health Organization Scientific Publication Proc. Pathol. Soc. Phila. Proceedings of the Pathological Society of Philadelphia Proc. Soc. Exp. Biol. Med. - Proceedings of the Society for Experimental Biology and Medicine R.I. Med. i. - Rhode Island Medical journal Trans. Am. Clin. Climatol. .Assoc.—Transactions of the American Clinical and Climatological Association Trans. Assoc. Am. Physicians—Transactions of the Association of Amer- ican Physicians Yale l. Biol. Med. - Yale Journal of Biology and Medicine 1920 The histological pathology of a case of measles conjunctivitis. Johns Hopkins Hosp. Bull., 31:455-58.

348 BIOGRAPHICAL MEMOIRS 1921 The relation of histamin to leukocytosis. Bull., 32: 20-21. 1923 Johns Hopkins Hosp. Echinococcus disease. Proc. Pathol. Soc. Phila., 15:26-28. With G. W. Norris. Aneurysm of the aorta, simualting a neoplasm of the mediastinum. Proc. Pathol. Soc. Phila., 16:22-23. Portal thrombosis with liver abscess. Proc. Pathol. Soc. Phila., 16: 30-33. Case of periosteal fibroma followed by progressive myositis ossificans. Proc. Pathol. Soc. Phila., 16:89. 1924 An account of the Pennsylvania Hospital Museum. Bull. Ayer Clin. Lab., 8:5-22. With W. E. Chapin. Nitrituria in infections of the urinary tract. Bull. Ayer Clin. Lab., 8:23-24. 1925 A study of an unusual case of myositis ossificans. gery, 10:185-95. Archives of Sur- The optical activity of glucose as influenced by normal and diabetic urine. J. Clin. Invest., 1: 317-31. With A. E. Billings. Tumors of lateral aberrant thyroids. Bull. Ayer Clin. Lab., 9:27-44. Post mortem blood chemical determinations. Bull. Ayer Clin. Lab. 9:51-62. The study of a microscopic section from a museum specimen which has been preserved for 118 years. Int. Assoc. Med. Mus. Bull., 11:9-12. 1926 Rotary and reducing values of glucose as influenced by the addition of muscle tissue and insulin in vitro. l. Biol. Chem., 68:425-38. Aberrant thyroids. Atlantic Medical Journal, 24:684-86. Post mortem blood sugar determinations. Bull. Ayer Clin. Lab., 10: 34-43. With R. S. Graham. Studies in rheumatic fever. A brief review of

JOHN RODMAN PAUL 349 clinical and gross pathological findings in eighteen fatal cases. Bull. Ayer Clin. Lab., 10:44-67. 1927 Lesions in the pulmonary artery in rheumatism. Arch. Pathol., 3:352. A comparative study of the rotatory and reducing properties of ultra- filtrates from blood plasma. l. Clin. Invest., 3:631-52. A comparative study of smooth and rough pneumococcus J. Exp. Med., 46:793-805. colonies. The occurrence of rough pneumococci in viva. l. Exp. Med., 46: 807-17. 1928 A comparative study of the rotatory and reducing properties of plasma ultrafiltrates from diabetic and nephritic patients. l. Clin. Invest., b: 303-17. With S. L. Wright, Jr., and E. F. Herr. The relationship of lactic acid to the optical activity of normal and diabetic blood before and after glycolysis. I. Biol. Chem., 80:571-87. Pleural and pulmonary lesions in rheumatic fever. Medicine, 7: 383~10. 1929 With W. U. McClenahan. A review of the pleural and pulmonary lesions in twenty-eight fatal cases of active rheumatic fever. Arch. Pathol., 8:595-610. The pathological museum of the Pennsylvania Hospital. Int. Assoc. Med. Mus. Bull., 12: 19-24. 1930 Nathan Smith and typhoid fever. Yale I. Biol. Med., 2:169-81. Localized peritonitis in rheumatic fever. A case report. Bull. Ayer Clin. Lab., 12:9-16. With W. U. McClenahan. A review of the pleural and pulmonary lesions in twenty-eight fatal cases of active rheumatic fever. Bull. Ayer Clin. Lab., 12: 17-18. The Epidemiology of Rheumatic Fever. A Preliminary Report with Special Reference to Environmental Factors in Rheumatic Heart

350 BIOGRAPHICAL MEMOIRS Disease and Recommendations for Future Investigations. New York: Metropolitan Life Insurance Co. Press. With C. H. Weis. Type I pneumococcus otitis media. Yale l. Biol. Med., 2:437~2. With S. L. Wright, fir., and E. F. Herr. The optical activity and cerebrospinal fluid in suppurative meningitis, and its lactic acid. sugar and chloride content. I. Clin. Invest., 9:443-61. 1931 With R. Salinger. The spread of rheumatic fever through families. I. Clin. Invest., 10:33-51. Age susceptibility to familial infection in rheumatic fever. l. Clin. Invest., 10:53-70. 1932 With W. W. Bunnell. The presence of heterophile antibodies in infectious mononucleosis. Am. l. Med. Sci., 183:90-104. With R. Salinger and l. D. Trask. "Abortive" poliomyelitis. l. Am. Med. Assoc., 98: 2262-68. With l. D. Trask. The detection of poliomyelitis virus in so-called abortive types of the disease. J. Exp. Med., 56:319-43. With J. D. Trask. Observations on the epidemiology of poliomy- elitis with particular reference to so-called abortive poliomyelitis. Trans. Assoc. Am. Physicians, 47: 116-22. With l. D. Trask. Observations of the epidemiology of poliomy- elitis. Transactions of the College of Physicians of Philadelphia, 54: 158-63. Epidemiology of Rheumatic Fever. In: The Cyclopedia of Medicine, pp. 136~2. Philadelphia: F. A. Davis Co. With l. D. Trask and R. Salinger. Comparative statistical analyses of the 1916 and 1931 epidemics of poliomyelitis in and about the city of New Haven. Yale i. Biol. Med., 5:39-54. 1933 Rheumatic fever. In: Practitioner's Library of Medicine and Sur- gery, ed. by George Blumer, vol. 3, chap. 33, pp. 357-73. New York: D. Appleton-Century Company, Inc. Infectious mononucleosis. In: Practitioner's Library of Medicine and Surgery, ed. by George Blumer, vol. 3, chap. 34, pp. 375-77. New York: D. Appleton-Century Company, Inc.

J OHN RODMAN PAUL 351 Smallpox, vaccinia, chickenpox, measles, rubella, fourth disease, erythema infectiosum, erythema nodosum, mumps, epidemic pleurodynia. In: Practitioner's Library of Medicine and Sur- gery, ed. by George Blumer, vol. 3, chaps. 35~4, pp. 379~28. New York: D. Appleton-Century Company, Inc. With P. A. Leddy. The social incidence of rheumatic heart disease. A statistical study in Yale University students. Am. l. Med. Sci., 184:597-610. With l. D. Trask. A comparative study of recently isolated human strains and a passage strain of poliomyelitis virus. T. Exp. Med., 58:513-28. Hydrophobia, psittacosis, foot and mouth disease. In: Practitioner's Library of Medicine and Surgery, ed. by George Blumer, vol. 3, chaps. 47-49, pp. 443-56. New York: D. Appleton-Century Company, Inc. With l. D. Trask. Neutralizing antibodies in abortive poliomyelitis. J. Exp. Med., 58:531-44. Witn I. D. Trask. Immunity in abortive poliomyelitis. Trans. Assoc. Am. Physicians, 48:23-30. Incidence of abortive types of poliomyelitis. Am. l. Hyg., 17: 601-12. 1934 With R. Salinger and B. Zuger. The relation of rheumatic fever to post-scarlatinal arthritis and post-scarlatinal heart disease a familial study. l. Clin. Invest., 13:503-16. Pneumococcus variants. I. Intermediate forms and the influence of environment in their production during in vitro S to R and R to S transitions. J. Bacterial., 28:45-67. Pneumococcus variants. II. Dissociants of R pneumococci and their relation to streptococcus viridans. l. Bacteriol., 28:69-93. With E. R. Harrison, R. Salinger, and G. K. de Forest. The social incidence of rheumatic heart disease. A statistical study in New Haven school children. Am. i. Med. Sci., 188:301-9. 1935 Methods of determining the prevalence of rheumatic fever in cities and small communities. Milbank Mem. Fund Q., 13:52-67. Predisposing factors in rheumatic fever. Modern Concepts of Car- diovascular Disease, 4~3~. 2 pp. With J. D. Trask. The neutralization test in poliomyelitis. Com-

352 BIOGRAPHICAL MEMOIRS parative results with four strains of the virus. J. Exp. Med., 61 :447-64. With I. D. Trask and L. T. Webster. Isolation of poliomyelitis virus from the nasopharynx. J. Exp. Med., 62:245-57. 1936 With J. D. Trask. Experimental poliomyelitis induced by intra- cutaneous inoculation. l. Bacterial., 3 1: 527-30. A note on the early history of infantile paralysis in the United States. Yale l. Biol. Med., 8: 643-48. 1937 Rheumatic heart disease among American Indian school children in different climates. Milbank Mem. Fund Q., 15: 135-38. With G. L. Dixon. Climate and rheumatic heart disease. A survey among American Indian school children in northern and south- ern localities. l. Am. Med. Assoc., 108:2096-2100. With i. D. Trask, W. l. German, and A. R. Beebe. Viruses of polio- myelitis. Trans. Assoc. Am. Physicians, 52:306-10. With T. D. Trask. Viruses of poliomyelitis. An immunological com- parison of six strains. J. Exp. Med., 65:687-704. 1938 With I. D. Trask. The skin infectivity of poliomyelitis virus. Science, 87:44~5. A method for the concentration of poliomyelitis virus in naso- pharyngeal washings. I. Bacteriol., 35:493-500. With l. D. Trask and A. l. Vignec. Poliomyelitis virus in human stools. l. Am. Med. Assoc., 111 :6-11. A review of recent studies on the epidemiology of poliomyelitis in the United States. Yale J. Biol. Med., 10:577-90. With A. J. Vignec and J. D. Trask. The recovery of the virus of poliomyelitis from extra-neural sources in man, with a survey of the literature. Yale.~. Biol. Med., 11:15-31. Dber neuere Studien Epidemiologic der Poliomyelitis in den Vereinigten Staaten. Muenchener medizinische Wochenschrift, 85:430-34. With l. D. Trask and A. i. Vignec. Isolation of poliomyelitis virus from human stools. Proc. Soc. Exp. Biol. Med., 38:147-49.

JOHN RODMAN PAUL 353 Clinical epidemiology. (President's address, American Society for Clinical Investigation) l. Clin. Invest., 17:539~1. 1939 Infectious mononucleosis. Bull. N.Y. Acad. Med., 15:43-55. With M. A. Kennard, C. R. Schroeder, and i. D. Trask. A cutaneous test for tuberculosis in primates. Science, 89:442-43. With i. D. Trask and C. S. Culotta. Poliomyelitic virus in sewage. Science, 90:258-59. With l. D. Trask and A. [. Vignec. New aspects of the clinical epi- demiology of poliomyelitis. Trans. Assoc. Am. Physicians, 54: 119-22. Epidemiology of rheumatic fever. In: Cyclopedia of Medicine, 2d ea., pp. 629-34. Philadelphia: F. A. Davis Co. With l. D. Trask. Recent developments in the epidemiology of poliomyelitis. International Clinics, 3:59-63. With A. [. Vignec and I. D. Trask. Identification of a strain of poliomyelitis virus from feces in non-paralytic poliomyelitis. I. Immunologic tests. Proc. Soc. Exp. Biol. Med., 41:241-45. With A. i. Vignec and I. D. Trask. Poliomyelitis virus from feces in non-paralytic poliomyelitis. II. Infectivity by various routes. Proc. Soc. Exp. Biol. Med., 41:246-50. With G. Klatskin and M. E. Howard. The virus diseases. In: Thera- peutics of Internal Diseases, ed. by G. Blumer and A. I. Sullivan, pp. 503-62. New York: D. Appleton-Century Company, Inc. 1940 Rheumatic fever. Factors in its occurrence. Milbank Mem. Fund Q., 18: 156-60. Focal infection. Conn. State Med. l., 4:198-99. With J. D. Trask and A. J. Vignec. I. Poliomyelitic virus in human stools. J. Exp. Med., 71:751-63. With l. D. Trask and S. Gard. II. Poliomyelitic virus in urban sewage. l. Exp. Med., 7 1: 765-77. Preventive medicine at the Yale University School of Medicine. Yale J. Biol. Med., 13:253-58; also in Journal of the Association of American Medical Colleges, 16:312-16, 1941. Environmental factors in rheumatic fever. Trans. Assoc. Am. Phy- sicians, 55:290.

354 BIOGRAPHICAL MEMOIRS The epidemiology of rheumatic fever. In: Diagnosis and Treatment of Cardiovascular Diseases, ed. by W. D. Stroud, chap. 4. Phila- delphia: F. A. Davis Co. With L. R. Farquhar. Rheumatic fever in New Haven, Connecticut. A survey of recent hospital admissions. Public Health Reports, 55: 1903-13. 1941 With J. D. Trask. The virus of poliomyelitis in stools and sewage. J. Am. Med. Assoc., 116 :493-97. Withy. D. Trask. Observations on fecal examinations in poliomy- elitis. Am. l. Public Health, 31:239-44. Poliomyelitis. Bull. N.Y. Acad. Med., 17:259-67. The epidemiology of poliomyelitis. (Delivered at Vanderbilt Uni- versity, April 1941) In: Infantile Paralysis, pp. 129-228. New York: National Foundation for Infantile Paralysis, Inc. With J. D. Trask. Experimental poliomyelitis in Cerco pithecus aethio~ps sabaeus (the green African monkey) by oral and other routes. J. Exp. Med., 73:453-59. With J. V. Deutsch. Rheumatic Fever in Connecticut. A General Survey. Hartford: Connecticut State Department of Health. The clinical epidemiology of poliomyelitis. (The John WyckoR Lectures for 1941, Baltimore) Medicine, 20:495-520. The epidemiology of rheumatic fever. Am. [. Public Health, 31: 611-18. With J. D. Trask, M. B. Bishop, and J. L. Melnick. The detection of poliomyelitis virus in flies. Science, 94:395-96. Macro-climate and micro-clin~ate in rheumatic fever. Trans. Am. Clin. Climatol. Assoc., 57:172-78. Editor. Rheumatic Fever in New Haven. Lancaster, Pa.: Science Press. ~ . . 1942 With J. I). Trask. Periodic examinations of sewage for the virus of poliomyelitis. J. Exp. Med., 75: 1-6. With J. D. Trask. Occurrence and recovery of the virus of infantile paralysis from sewage. Am. l. Public Health, 32:235-39. James Dowling Trask (1890-1924~. Yale J. Biol. Med., 14:567-71. What and who is an epidemiologist? Am. l. Public Health, 32: 867-69.

JOHN RODMAN PAUL 355 With J. D. Trask. Intracutaneous inoculation of poliomyelitis virus in monkeys and its detection in their stools. Ann. Intern. Med., 17:975-78. Poliomyelitis. Harvey Lecture Series, 38:104-22. 1943 With l. D. Trask and J. L. Melnick. The detection of poliomyelitis virus in flies collected during epidemics of poliomyelitis. I. Methods, results, and types of flies involved. l. Exp. Med., 77: 531~4. With l. D. Trask. The detection of poliomyelitis virus in flies col- lected during epidemics of poliomyelitis. II. Clinical circum- stances under which flies were collected. l. Exp. Med., 77:545- 56. With l. L. Melnick. Susceptibility of Cebus capucina (the South American ringtail monkey) and Cerco~pithecus cephus (the African mustached monkey) to poliomyelitis virus. J. Exp. Med., 78: 273-83. Poliomyelitis (infantile paralysis). In: Textbook of Medicine, 6th ea., ed. by R. Cecil and R. F. Loeb, pp. 56-62. Philadelphia: W. B. Saunders Co. The Epidemiology of Rheumatic Fever and Some of Its Public Health Aspects, 2d ed. Printed for the Metropolitan Life In- surance Co., New York. 1944 Susceptibility of East African monkeys to experimental poliomy- elitis. Yale l. Biol. Med., 16:461-66. The clinical epidemiology of poliomyelitis. (The John Wyckoff Lectures) Phi Delta Epsilon News, 35:57-80. With W. P. Havens and C. E. van Rooyen. Poliomyelitis in British and American troops in the Middle East. British Medical Journal, I :841~3. With A. B. Sabin and C. B. Philip. Phlebotomus (pappataci or sandfly) fever. A disease of military importance. l. Am. Med. Assoc., 125:603-6, 693-99. With C. B. Philip and A. B. Sabin. Dimethyl phthalate as a repel- lant in control of phlebotomus (pappataci or sandfly) fever. War Medicine, 6:27-33. The filtrable viruses. In: Laboratory Methods for the U.S. Army,

356 BIOGRAPHICAL MEMOIRS bth ea., ed. by J. S. Simmons and C. J. Bentzkow, p. 579. Phila- delphia: Lea & Febiger. Medicina Preventiva en la Escuela de Medicina de la Universidad de Yale . Facu l tad de Medicina Ins ti tu to de Higiene ExPeri- mental, pp. 6-16. With W. P. Havens, R. Ward, and V. A. Drill. Experimental pro- duction of hepatitis by feeding icterogenic materials. Proc. Soc. Exp. Biol. Med., 57:206-8. 1945 Public health aspects of rheumatic fever. R.I. Med. J., 28:15-20. With W. P. Havens and C. E. van Rooyen. Human transmission of infective hepatitis by the oral route. Lancet, 1:202-3. With W. P. Havens, A. B. Sabin, and C. B. Philip. Transmission experiments in serum jaundice and infectious hepatitis. J. Am. Med. Assoc., 128:911-15. With W. P. Havens. Prevention of infectious hepatitis with gamma globulin. J. Am. Med. Assoc., 129:270-72. The etiology of infectious hepatitis. Bull. U.S. Army Med. Dep., 4:498-99. The virus of poliomyelitis. Bull. U.S. Army Med. Dep., 4:630-31. A brief account of Dr. James D. Trask. Connecticut Teacher, 13:3. Infectious hepatitis. In: Nelson's Loose-Leaf Medicine, chap. 46, pp. 213-18. New York: Thomas Nelson & Sons. 1946 Infectious hepatitis. Bull. N.Y. Acad. Med., 22:204-16. With W. P. Havens. Recent advances in the study of infectious hepatitis and serum jaundice. Trans. Assoc. Am. Physicians, 69: 133-41. The New Haven industrial medical service. A summary of three and one-half years experience. Conn. State Med. J., 10: 193-96. 1947 Epidemiology of rheumatic fever. Am. J. Med., 2:66-75. With H. A. Wenner. Fatal infection with poliomyelitis in a labora- tory technican. Isolation of virus from lymph nodes. Am. J. Med. Sci., 213:9-18. Poliomyelitis in Japan. Am. J. Hyg., 45: 206-18. The peripheral spread of poliomyelitis through rural and urban

J OHN RODMAN PAUL 357 areas: observations from a recent epidemic. Yale l. Biol. Med., 19:521-36. With H. T. Gardner. Infectious mononucleosis at the New Haven Hospital, 1921-1946. Yale l. Biol. Med., 19:839-53. With D. M. Horstmann. The incubation period in human polio- myelitis and its implications. I. Am. Med. Assoc., 135:11-14. 1948 With l. R. Melnick. Experimental Fort Bragg Fever (pretibial fever) in chimpanzees. Proc. Soc. Exp. Biol. Med., 67:263-68. With l. L. Melnick and A. B. Sabin. Experimental attempts to transmit phlebotomus (sandfly, pappataci) and dengue fevers to chimpanzees. Proc. Soc. Exp. Biol. Med., 68:193-98. Poliomyelitis. In: Diagnostic Procedures for Virus and Rickettsial Diseases, 1st ea.; also in Am. l. Public Health, 38: 165-86. Changing aspects of poliomyelitis. Trans. Assoc. Am. Physicians, 61 :301-7. With C. Armstrong, D. Bodian, T. Francis, Jr., and A. B. Sabin. A proposed provisional definition of poliomyelitis virus. Science, 108:701-5. With W. P. Havens, in Infectious hepatitis and serum hepatitis. In: Viral and Rickettsial Infections of Man, 1st ea., ed. by T. M. Rivers, pp. 269-83. Philadelphia: J. B. Lippincott Co. 1949 Poliomyelitis: early diagnosis and early management of acute cases. Ann. Intern. Med., 30:1126-33. With F. R. Corria and D. M. Horstmann. Analyses from a tropical epidemic of poliomyelitis which occurred in Florida and Cuba in 1946. American Journal of Tropical Medicine, 29:543-54. Poliomyelitis attack rates in American troops. Am. l. Hyg., 50:57- 62. The poliomyelitis research unit at Yale. 13:8-9. Yale Alumni Magazine, Infectious mononucleosis. In: Current Therapy, ed. by H. F. Conn, p. 10. Philadelphia: W. B. Saunders Co. Poliomyelitis, acute anterior. In: Current Therapy, ed. by H. F. Conn, pp. 22-25. Philadelphia: W. B. Saunders Co. Encephalitis (virus types). In: Current Therapy, ed. by H. F. Conn, p. 494. Philadelphia: W. B. Saunders Co.

358 BIOGRAPHICAL MEMOIRS A review of recent researches on some of the common viruses. Pro- ceedings of the New York State Association of Public Health Laboratories, 28: 70-76. The diagnosis of infectious mononucleosis. In: Diagnosis of Viral and Rickettsial Infections, ed. by F. H. Horsfall. Tr.. nn 1()-11 New York: Columbia Univ. Press. Foreword for symposium on poliomyelitis. Am. I. Med., 5:535-36. -Geographical aspects of the epidemiology of poliomyelitis. In: Pro- ceedings of the 4th International Congress for Microbiology, p. 274. Copenhagen: Rosenkilde and Bagger. Immunologic types of poliomyelitis viruses. In: Poliomyelitis. Papers and Discussions Presented at the First International Poliomyelitis Conference, pp. 271-75. Philadelphia: J. B. Lid pincott Co. ~ ~--~ rr~ ~~ ~~ 1950 Preventive medicine at the Yale University School of Medicine, 1940-49. Yale l. Biol. Med., 22: 199-211. With F'. T. Gardner. Endemiologic aspects of hepatitis in U.S. troops in Germany 1946-1950. Am. l. Med., 8: 565-80. Endemic hepatitis among U.S. troops in postwar Germany. Proceed- ings of the Royal Society of Medicine, 43:438-40. Social and geographical pathology. Yale l. Biol. Med., 22:709-13. Controlling poliomyelitis. Yale Review, 39:647-55. With l. T. Riordan. Observations on serological epidemiology. Antibodies to the Lansing strain of poliomyelitis virus in sera from Alaskan Eskimos. Am. I. Hyg., 52: 202-12. "Clinical" observations on American archeology. Trans. Assoc. Am. Physicians, 63: 29-34. Epidemiology of rheumatic fever. In: Cyclopedia of Medicine, Sur- gery and Specialties, vol. 2, pp. 985-93. Philadelphia: F. A. Davis Co. Epidemiology of rheumatic fever. In: The Diagnosis and Treatment of Cardiovascular Diseases, Ed ea., ed. by W. D. Stroud, pp. 194- 205. Philadelphia: F. A. Davis Co. Infectious mononucleosis. In: Current Therapy, ed. by H. F. Conn, pp. 15-16. Philadelphia: W. B. Saunders Co. Encephalitis (virus types). In: Current Therapy, ed. by H. F. Conn, pp. 552-53. Philadelphia: W. B. Saunders Co. Epidemiology. In: Research in Medical Science, ed. by D. E. Green

J OHN RODMAN PAUL 359 and W. E. Knox, p. 52. New York: Macmillan Publishing Co., Inc. 1951 Infectious mononucleosis. In: Current Therapy, ed. by H. F. Conn, pp. 23-24. Philadelphia: W. B. Saunders Co. Encephalitis (virus types). In: Current Therapy, ed. by H. F. Conn, pp. 511-12. Philadelphia: W. B.-Saunders Co. Observations on the history of poliomyelitis. Bull. Ayer Clin. Lab., 4:21-33. With l. 17. Riordan and L. M. Kraft Serological epidemiology: antibody patterns in North Alaskan Eskimos. journal of Im- munology, 66: 695-713. With i. T. Riordan and l. L. Melnick. Antibodies to three different a~tigenic types of poliomyelitis virus in sera from North Alaskan Eskimos. Am. J. Hyg., 54: 275-85. Recent trends in poliomyelitis research. Am. l. Med., 11:577-80. Poliomyelitis and poliomyelitis following inoculation. In: Modern Practice in Infectious Fevers, ed. by H. S. Banks, pp. 659-79. London: Butterworth & Co., Ltd. Poliomyelitis~infantile paralysis). In: Textbook of Medicine, 8th ea., by R. L. Cecil and R. F. Loeb, pp. 55-64. Philadelphia: - -r - W. B. Saunders Co. With l. L. Melnick, l. T. Riordan, V. H. Barnett, N. Goldblum, and E. Zabin. Isolation from human sera in Egypt of a virus apparently identical to West Nile Virus. Proc. Soc. Exp. Biol. Med., 77:661-65. 1952 Current knowledge and trends in poliomyelitis. The Merck Report, pp. 3-8. Rahway, N.J.: Merck & Company, Inc. Recent advances in poliomyelitis research. Chicago Medical Society Bulletin, 34:837-40. With l. L. Melnick, V. H. Barnett, and N. Goldblum. A survey of neutralizing antibodies to poliomyelitis virus in Cairo, Egypt. Am. l. Hyg., b5:402-13. Francis Gilman Blake, 1887-1952. Yale J. Biol. Med., 24:435-49. Poliomyelitis: mysterious, paralyzing disease. Link, pp. 6-8. Present concepts and recent advances in acute poliomyelitis. Ar- chives of Internal Merlicine, 90:271-79.

360 BIOGRAPHICAL MEMOIRS Viral hepatitis in U.S. troops in Germany. United States Armed Forces Medical journal, 3: 1457-63. With l. L. Melnick and i. T. Riordan. Comparative neutralizing antibody patterns to Lansing (Type 2) poliomyelitis virus in different populations. Am. J. Hyg., 56:232-51. Geography and antibodies. Trans. Assoc. Am. Physicians, 65:184- 90. Knowledge and trends in poliomyelitis: a summary. In: Poliomy- elitis: Papers and Discussions Presented at the Second Interna- tional Poliomyelitis Conference, pp. 376-81. Philadelphia: J. B. Lippincott Co. With W. P. Havens, Jr. Infectious hepatitis and serum hepatitis. In: Viral and Rickettsial Infections of Man, Ed ea., ed. by T. M. Rivers, pp. 359-77. Philadelphia: J. B. Lippincott Co. 1953 The neurotropic viruses. Recent advances in poliomyelitis and the virus encephalitides. Acta Medica Scandinavia, 146:56-58. Climate and antibodies. Trans. Am. Clin. Climatol. Assoc., 4: 163-68. Expert committee on hepatitis. First report. World Health Organi- zation Technical Report Series no. 62. Geneva. 1954 Immunization against poliomyelitis: its present status. Conn. State Med. J., 18:140-44. Warfield T. Longcope (1877-1953~. Pennsylvania Hospital Bulletin, 11:9-10. With J. L. Melnick and D. M. Horstmann. The Yale poliomyelitis study unit. Yale School of Medicine Alumni Bulletin, 2:2. Practical and theoretical considerations with regard to vaccination in poliomyelitis. I. Am. Med. Assoc., 156: 18-20. Epidemiology and its teaching in medical schools. Yale l. Biol. Med., 27:35-45. Historical and geographical aspects of the epidemiology of polio- myelitis. Yale J. Biol. Med., 27: 101-13. The patient and his environment. In: The Principles of Internal Medicine, 2d ea., ed. by T. R. Harrison et al., pp. 7-10. New York: Blakiston. Francis Gilman Blake, 1887-1952. In: National Academy of Sci-

JOHN RODMAN PAUL 361 ences, Biographical Memoirs, 28:1-29. Washington, D.C.: Na- tional Academy of Sciences. 1955 Second A.A.M.C. teaching institutes. Med., 4:~-10. Newsl. Assoc. Teach. Prev. With I. L. Melnick and M. Walton. Serologic epidemiology of poliomyelitis. Am. i. Public Health, 45:429-37. Symposium on poliomyelitis. Epidemiology. Modern Medicine, 23~10~: 160-61. With D. M. Horstmann. A survey of poliomyelitis virus antibodies in French Morocco. American Journal of Tropical Medicine and Hygiene, 4:512-24. With H. van Magnus and J. H. S. Gear. A recent definition of polio- myelitis viruses. Virology, 1:185-89. Poliomyelitis (infantile paralysis). In: Textbook of Medicine, 9th ea., ed. by R. L. Cecil and R. F. Loeb. no. 59-~g Phil~rir~lnhi~ W. B. Saunders Co. ~ ~ <~_- v ~ ~ _ - ~ ^~ ~ ~~111C4~. With l. L. Melnick. Viruses. In: Medical and Public Health Lab- oratory Methods, 6th ea., by i. S. Simmons and C. l. Gentzkow. chap. 37, pp. 836-48. Philadelphia: Lea & Febiger. Epidemiology of poliomyelitis. World Health Or=nniz~tinn Mann graph Series, 26:9-29. ~ ~ it, ~ ~ , ~ _. ~ an, ~ ,, ~ ,, ~ Future prospects. In: Poliomyelitis: Papers and Discussions Pre- sented at the 3d International Poliomyelitis Conference, pp. 420-23. Philadelphia: l. B. Lippincott Co. 1956 Properties of an "ideal" poliomyelitis vaccine. Bull. N.Y. Acad. Med., 32:747-52. With C. M. MacLeod, K. F. Meyer, J. B. Shimkin, and R. E. Shope. The United States medical mission on microbiology and epide- miology to the Soviet Union. USDHEW, Public Health Service. J. Am. Med. Assoc., 162: 656-58. Indications for vaccination against poliomyelitis. i. Am. Med. Assoc., 162:1585-88. With I. L. Melnick. Poliomyelitis. In: Diagnostic Procedures for Virus and Rickettsial Disease, Cd ea., pp. 53-90. New York: American Public Health Association. With D. M. Horstmann. Etude des anticorps antipoliomyelitiques

362 BI OGRAPHICAL MEM OIRS chez les habitants du Maroc Franc~ais. Maroc-Medical, 368: 35-36. The epidemiology of rheumatic fever. In: Diagnosis and Treat- ment of Cardiovascular Diseases, 3d ea., ed. by W. D. Stroud, pp. 985-94. Philadelphia: F. A. Davis Co. Worldwide public health progress. Conn. State Med. .T-, 20:650-51. The advancement of scientific and practical medicine. (Presidential Address) Trans. Assoc. Am. Physicians, 69:1-6. Epidemiologia de la poliomyelitis. Boletin de la Oficina Sanitaria Panamericana, 40~6~ :521-36. Infectious mononucleosis. In: Practice of Medicine, 6th ea., ed. by I. C. Meakins, pp. 339-47. St. Louis: C. V. Mosby Co. 1957 Encephalitis (virus type). In: Current Therapy, ed. by H. F. Conn, pp. 500-501. Philadelphia: W. B. Saunders Co. The Soviet program for medical research, 1956-1960. A brief and critical review of "The Research Plan of the Academy of Medical Sciences U.S.S.R., 1956-1960." Yale l. Biol. Med., 29:377-88. Poliomyelitis immunization in 1957. (Editorial) Ann. Intern. Med., 46: 1214-18. With D. M. Horstmann, l. L. Melnick, and l. V. Deutsch. Infection induced by oral administration of attenuated poliovirus to per- sons possessing homotypic antibody. l. Exp. Med., 106: 159-77. American medical mission to the Soviet Union. Scientific Monthly, 85: 150-56. With D. M. Horstmann, l. L. Melnick, I. C. Niederman, and l. V. Deutsch. Immunization against poliomyelitis: killed vaccine followed by induced infection with live virus. New York Acad- emy of Sciences Special Publication, vol. 5, pp. 141-47. Poliomyelitis in the tropics. Industry and Tropical Health, 3:81- 86. With D. M. Horstmann, l. C. Niederman, and l. L. Melnick. Polio- myelitis: comparison of responses of vaccinated and naturally immune humans to ingestion of attenuated poliovirus. Trans. Assoc. Am. Physicians, 70:91-101. Epidemiology of infectious hepatitis. In: Hepatitis Frontiers, pp. 183-93. Boston: Little, Brown & Co. Epidemiology of rheumatic fever. In: Diagnosis and Treatment of

J OHN RODMAN PAUL 363 Cardiovascular Diseases, ed. by W. D. Stroud, chap. 6, pp. 141- 49. Philadelphia: F. A. Davis Co. 1958 With J. C. Niederman. The home visit as a teaching exercise: a clinical concept. journal of Medical Education, 33:29-35. Infant mortality rates and poliomyelitis: an epidemiological study. Science, 127: 1062. With W. W. McClure. Epidemic hemorrhagic fever attack rates among United Nations boons during the Korean War Am Hyg., 68: 126-39. With C. N. H. Long. John Punnett Peters, 1887-1955. In: National Academy of Sciences, Biographical Memoirs, 31: 347-75. New York: Columbia Univ. Press. Encephalitis (virus type). In: Current Therapy, ed. by H. F. Conn, pp. bb9-60. Philadelphia: W. B. Saunders Co. Haven Emerson, 1874-1957. Trans. Assoc. Am. Physicians, 71: 23-24. 'TV ~ ~^ , ~,^~ .~^ ~4, ~ v ~4 . ~ .,,,. J . Endemic and epidemic trends of poliomyelitis in Central and South America. Bull. WHO, 19:747-58. With W. P. Havens, in Infectious hepatitis and serum hepatitis. In: Viral and Rickettsial Infections of Man, 3d ea., ed. by T. M. Rivers and F. L. Horsfall, pp. 570-91. Philadelphia: J. B. Lip- pincott Co. Infectious mononucleosis. In: Viral and Rickettsial Infections of Man, ad ea., ed. by T. M. Rivers and F. L. Horsfall, pp. 790-98. Philadelphia: J. B. Lippincott Co. Clinical Epidemiology. Chicago: Univ. of Chicago Press. Vaccination against poliomyelitis. (Discussion of paper by A. M.- M. Payne) In: Poliomyelitis: Papers and Discussions Presented at the Fourth International Poliomyelitis Conference, pp. 179- 80. Philadelphia: l. B. Lippincott Co. 1959 Poliomyelitis (infantile paralysis). In: Textbook of Medicine, 10th ea., ed. by R. L. Cecil and R. F. Loeb, pp. 60-70. Philadelphia: W. B. Saunders Co. Commentaries on medical education and medical research in Latin America, 1958. Yale J. Biol. Med., 31 :284-93.

364 BIOGRAPHICAL MEMOIRS The Eighteenth Charles Value Chapin Oration: Chapin and mod- ern epidemiology. R.I. Med. i., 42: 375-79. With D. M. Horstmann, l. C. Niederman, and I. T. Riordan. The trial use of Sabin's attenuated Type I poliovirus vaccine in a village in southern Arizona. Am. I. Hyg., 70:169-84. With D. M. Horstmann and J. C. Niederman. Attenuated Type I poliovirus vaccine. Its capacity to infect and to spread from "vaccinees" within an institutional population. J. Am. Med. Assoc., 170: 1-8. Perspectives in epidemiology. (Foreword to papers presented at symposium at Yale University School of Medicine) Yale .T- Biol. Med., 32:1-3. Poliomyelitis. Its epidemiology and prophylaxis. Med. Clin. North Am., 43: 1441-49. With D. M. Horstmann and I. C. Niederman. Immunity in polio- myelitis infection: observations in experimental epidemiology. In: Immunity and Virus Infection, ed. by V. A. Najjar, pp. 233- 45. New York: John Wiley & Sons, Inc. Poliomyelitis. In: American Peoples Encyclopedia. Chicago: Spencer Press, Inc. With D. M. Horstmann, l. T. Riordan, {. C. Niederman, and I. Yoshioka. The use of Sabin's attenuated Type I poliovirus vac- cine in different environments, and newer techniques for testing the virulence of recovered strains. In: Live Poliovirus Vaccines. Papers Presented and Discussions Held at the First International Conference on Live Poliovirus Vaccines, pp. 218-26. Pan Amer- ican Sanitary Bureau Scientific Publication no. 44. Washington, D.C. 1960 Poliovirus vaccines killed and live. American Journal of Nursing, 60:60-62. The case for live poliovirus vaccination. Yale I. Biol. Med., 32: 241~9. With D. M. Horstmann, J. T. Riordan, E. M. Opton, and R. H. Green. The capacity of live attenuated polioviruses to cause human infection and to spread within families. In: Live Polio- virus Vaccines. Papers Presented and Discussions Held at the Second International Conference on Live Poliovirus Vaccines,

JOHN RODMAN PAUL 365 pp. 174-84. Pan Am. Health Organ. Sci. Publ. no. 50. Washing- ton, D.C. With D. H. Horstmann, E. P. Isacson, and i. C. Niederman. Effec- tiveness of trivalent vaccine in immunizing young children. Studies on the stability of the vaccine strains after human pas- sage. In: Live Poliovirus Vaccines. Papers Presented and Dis- cussions Held at the Second International Conference on Live Poliovirus Vaccines, pp. 113-23. Pan Am. Health Organ. Sci. Publ. no. 50. Washington, D.C. The spread of attenuated polioviruses among household contacts. In: Poliomyelitis: Papers and Discussions Presented at the Fifth International Poliomyelitis Conference (Copenhagen, Denmark, July 26-28, 1960), pp. 23-24. Philadelphia: J. B. Lippincott Co. Recent advances in research on the etiology of trachoma. Conn. Med., 24: 104-~. With A. S. Evans. Infectious mononucleosis. In: Preventive Medz- cine in World War 11, Communicable Diseases, vol. 5, chap. 13, pp. 355-61. Once of the Surgeon General. Washington, D.C. With H. T. Gardner. Viral hepatitis. In: Preventive Medicine in World War II, Communicable Diseases, vol. 5, chap. 17, pp. 411-62. Office of the Surgeon General. Washington, D.C. Poliomyelitis vaccines. (Editorial) Conn. Med., 24:177-78. 1961 Epidemiology and modern medicine. Conn. Med., 25:79. With I- C. Niederman. Infectious mononucleosis. In: Current Therapy, ed. by H. F. Conn, pp. 27-28. Philadelphia: W. B. Saunders Co. Status of vaccination against poliomyelitis, with particular refer- ence to oral vaccination. New England Journal of Medicine, 264:65 1-58. The story to be learned from blood samples. Its value to the epi- demiologist. I. Am. Med. Assoc., 175: 601-5. With i. T. Riordan, I. Yoshioka, and D. M. Horstmann. The de- tection of poliovirus and other enteric viruses in flies. Am. l. Hyg., 74: 123-36. With D. M. Horstmann, M. Godenne-McCrea, R. H. Green, E. M. Opton, A. I. Holtz, and J. C. Niederman. Immunization of pre-

366 BIOGRAPHICAL MEMOIRS school children with oral poliovirus vaccine (Sabin). I. Am. Med. Assoc., 178: 693-701. Estado actual de la vacunacion contra la poliomyelitis. America Clinica, pp. 239-44. A message from the President. Newsl. Assoc. Teach. Prev. Med., 8:1-3. Poliomyelitis. In: Britannica Book of the Year, p. 564. Chicago: En- cyclopaedia Britannica, Inc. Present day opportunities for research based on known geographic variations in disease. In: Proceedings of the Conference on Genetic Polymorphisms and Geographic Variations in Disease, ed. by B. S. Blumberg, pp. 50-58. New York: Grune 8c Stratton. 1962 Measles vaccine future in developing areas of the world. American Journal of Diseases of Children, 103: 523-24. The Middletown oral poliovirus vaccine program. I. Foreword, with a review of the past experiences of the Yale Poliomyelitis Study Unit with oral poliovirus vaccines. Yale I. Biol. Med., 34:439-46. With R. l. C. Pearson, D. G. Miller, M. L. Palmieri, A.M.-M. Payne, and D. M. Horstmann. The Middletown oral poliovirus vaccine program. II. Scope planning and initial steps. Yale J. Biol. Med., 34:447-54. Considerations regarding vaccination with live attenuated polio- viruses. Bull. Ayer Clin. Lab., 4:3-8. With D. M. Horst~nann, l. T. Riordan, E. M. Opton, I. C. Nieder- man, E. P. Isacson, and R. FI. Green. An oral poliovirus vaccine trial in Costa Rica. Bull. WHO, 26: 311-29. 1963 Acceptance of the Kober Medal for 1963. Trans. Assoc. Am. Phy- sicians, 76:29-33. (Presentation of the Kober Medal for 1963 to John Rodman Paul, by P. B. Beeson, pp. 23-28) New concepts regarding viruses. Conn. Med., 27:256. Aims, purposes and methods of World Health Organization serum banks. Yale J. Biol. Med., 36:2-4. Poliomyelitis immunization 1963. Med. Clin. North Am., 47~: 1219-30. Neurotropic virus diseases. In: Internal Medicine in World War II,

JOHN RODMAN PAUL 367 Infectious Diseases, vol. 2, chap. 4, pp. 79-102. OSG, Department of the Army. Washington: U.S. Government Printing Once. 1964 With i. C. Niederman, R. l. C. Pearson, and C. du Ve Florey. A nationwide serum survey of United States military recruits, 1962. I. General considerations. Am. i. Hyg., 80:286-92. 1965 A nationwide serum survey of U.S. recruits in the three armed services. Military Medicine, 130:1-12. Worldwide public health progress. (Editorial) Conn. State Med. J., 20:650-51. Serological epidemiology and the function of serum banks. Archiv fur die gesamte Virusforschung, Band XVII, Heft 3-4, 465-71. With W. P. Havens, Jr. Infectious hepatitis and serum hepatitis. In: Viral and Rickettsial Infections of Man, 4th ea., ed. by F. L. Horsfall, Jr., and I. Tamm, pp. 965-93. Philadelphia: J. B. Lippincott Co. With A. S. Evans. Infectious mononucleosis. In: Viral and Rickett- sial Infections of Man, 4th ea., ed. by F. L. Horsfall, fir., and I. Tamm, pp. 994-1005. Philadelphia: J. B. Lippincott Co. 1966 Academic preventive medicine. Newsl. Assoc. Teach. Prev. Med., 12:1-8. Poliomyelitis. In: Encyclopaedia Britannica, pp. 156-58. Chicago: Encyclopaedia Britannica, Inc. 1968 With l. C. Niedermann and R. W. McCollum. A new lead in in- fectious mononucleosis. (Editorial) l. Am. Med. Assoc., 203: 219-20. 1970 Dean Winternitz and the rebirth of the Yale Medical School in the 1920s. Yale I. Biol. Med., 43:111-19. Thomas Francis, Jr., M.D., as a clinician. Archives of Environ- mental Health, 21: 247-51.

368 BIOGRAPHICAL MEMOIRS Poliomyelitis (infantile paralysis). In: Infectious Agents and Host Reactions, ed. by Stuart Mudd, chap. 22, pp. 5 19-37. Phila- delphia: W. B. Saunders Co. 1971 A clinician's place in academic preventive medicine: my favorite hobby. Bull. N.Y. Acad. Med., 47:1262-71. A History of Poliomyelitis. New Haven and London: Yale Univ. Press. 1972 Stanhope Bayne-Jones (1888-1970~. Educator, military hero, micro- biologist and historian. Yale J. Biol. died., 45:22-32. 1973 An account of the American Epidemiological Society. A retrospect of some fifty years. Yale i. Biol. Med., 46:3-84. Serological Epidemiology, ed. by J. R. Paul and C. White. New York: Academic Press, Inc. 1974 Thomas Francis, fir., 1900-1969. In: National Academy of Sciences, Biographical Memoirs, 44:57-110. Washington, D.C.: Nationa Academy of Sciences.

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Biographic Memoirs Volume 47 contains the biographies of deceased members of the National Academy of Sciences and bibliographies of their published works. Each biographical essay was written by a member of the Academy familiar with the professional career of the deceased. For historical and bibliographical purposes, these volumes are worth returning to time and again.

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