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14 In the closing days of World War II, the rural Catholic orphanage of Saint Vincent ’s near Freeport, Illinois, was mobilized for a medical experiment. A polio outbreak had taken hold in the facility, and there were many cases of paralysis. On the morning of August 26, 1945, a team of public health officers and scientific consultants arrived at Saint Vincent’s, seeking to control the outbreak by injecting a human blood fraction as part of a clinical trial.1 That afternoon, Saint Vincent’s staff divided the young residents along age and gender lines in preparation for injections. An efficient, assembly-­ line approach characterized the experiment, as a team of two nurses prepared syringes while two physicians administered the injections. That day, Saint Vincent’s charges became among the first humans to systematically receive gamma globulin (GG) in the battle against polio.2 Why did researchers believe that the blood fraction might be effective against the disease? What factors complicated the testing of GG in humans? This chapter explores the discovery of the blood fraction and how medical researchers attempted to assess its value for polio control. Gamma Globulin in the Fight against Disease The entry of GG into the lexicon of clinical interventions was a not radical departure , but was freighted on a long-­ standing fascination with human blood. Since the early twentieth century, doctors had believed that blood harbored protective properties that could be conveyed to others through injection. Some physicians experimented with blood to treat measles and scarlet fever with some success. As a result, the idea that the curative qualities in blood could be passed on to vulnerable individuals lingered, awaiting new studies and technology.3 Forging Momentum Chapter 1 Forging Momentum 15 Laboratory breakthroughs during the late 1930s and early 1940s rekindled interest in human blood to fight disease. Dr. Charles Armstrong’s development of an animal model for polio provided researchers an inexpensive means to evaluate new medical interventions.4 In addition, the 1936 discovery of human blood fractions connected prior optimism with a clinical reality. Dr. Arne Tiselius , a chemist at Uppsala University, Sweden, designated ƴ (gamma) globulin to a group of unique blood proteins.5 Tiselius found that protective proteins, called antibodies, permeated this fraction, but it was difficult to extract and concentrate them for clinical application.6 American researchers, funded through federal government initiatives ahead of World War II, turned Tiselius’s breakthrough into a practical solution. In 1940, the surgeon general of the U.S. Army solicited the National Research Council (NRC) to assist in meeting the military’s medical needs for chemotherapy and blood transfusions.7 The NRC established a series of committees that concerned themselves with the development of blood products, which could be stockpiled for use in distant theaters.8 Research funding combined with the impetus of impending conflict initiated a program to unlock the secrets of blood. To investigate methods for processing and stabilizing blood products, the NRC turned to Harvard physical chemistry professor Dr. Edwin J. Cohn.9 Born to a family of wealthy New York City tobacco merchants in 1893, Cohn was educated at Amherst College, earned a degree from the University of Chicago, and pursued graduate research at Yale and Harvard.10 By 1940, he was director of the Department of Physical Chemistry at the Harvard Medical School, where he and his team worked on proteins and blood albumin.11 Applying this collective knowledge of proteins, peptides, and amino acids to blood, Cohn’s team devised a novel ethanol and centrifugation technique that separated blood into its five constituent parts—­ or fractions. Not until Cohn’s fractionation process was wedded to the American National Red Cross (ARC) blood donor program, however, were clinical possibilities brought to fruition.12 The result was a range of new blood products, including fibrogen (a clotting agent), gamma globulin (an antibody solution), and serum albumin (the purified liquid component of blood). When serum albumin was successfully administered in December 1941 to treat shock among Allied personnel at Pearl Harbor, the blood fractionation program was elevated to a pillar of the war effort. The U.S. Navy, enthralled with the potential medical value of blood fractions, encouraged their clinical application and contracted American pharmaceutical suppliers, such as Sharp & Dohme and Squibb & Son Co., to provide a steady supply.13 Health professionals and researchers clamored to assess the efficacy of gamma globulin in preventing illness. Although GG, as a derivative of blood, was not homogeneous 16 Selling Science and could vary...


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