How the NIH Came to Be
For anyone living with a condition, like diabetes, advancement in medicine and technology is a lifeline to hope. Without medical and management advances, some of our friends with diabetes wouldn’t be with us, which is what makes the NIH an official ambassador of hope.
When I am looking to broaden my knowledge on a particular subject, I usually use PubMed or NIH.gov as trusted resources. If I’m going to write about research, shouldn’t I start with the biggest receptor of clinical data?
Based in Bethesda, MD, the NIH seems like a governmental edifice that rambles on for miles; but, for my friends and some of my physicians who work there, they speak of the NIH with the utmost respect for its brilliant collaborations between science, chemistry, technology and medicine.
The roots of NIH go back to the Marine Hospital Service (MHS), which was responsible for providing the medical care of Merchant Seamen. In 1798, the service was paid for by .20 cents per month tax on sailors' wages to cover the cost of contract hospitals.
In the 1880s, Congress increased the responsibility of MHS by having them examine passengers arriving by ship for clinical signs of infectious disease. Epidemic outbreaks, like cholera and yellow fever, were common and it was believed that inspecting passengers would contain outbreaks.
At the same time the U.S. was inspecting passengers, European pathologists discovered that comma-shaped bacterium were linked to several infectious diseases, which set the microbiology field on fire. By 1887, officials of MHS decided to authorize a young physician, Joseph J. Kinyoun, to study bacteria and infectious diseases. He called his one room lab “the Laboratory of Hygiene” to clarify that the lab’s purpose was to serve the public good. It was in this lab that Kinyoun identified the cholera bacillus and proved that if found in the body, a physician could prove a positive diagnosis for cholera.
During the 1900s, Congress passed the biologics control act that changed the way the Laboratory of Hygiene operated. Up to that point, vaccines and antitoxins had little to no oversight, and had often caused harm to patients. The diphtheria antitoxin, which killed 13 children, was a prime example of the damage that could happen without oversight.
In 1906, a new fledging agency on oversight and regulation called the Pure Food and Drug Act came into exisitence. The Pure Food and Drug ACt designed standards and established licenses for pharmaceutical companies making vaccines and antitoxins.
As medicine continued to explore and expand, the MHS began to require more categories and facility expansion. In 1912, the MHS was renamed the Public Health Service (PHS) and expanded into non-contagious diseases. Its first landmark effect on public health was the epidemiological study of Pellagra, a condition that affected the poor in southern states. Pellagra caused people to be sensitive to light, have mental confusion, aggression and skin lesions, to name a few of the signs. What the PHS study showed was that Pellagra was a deficiency of niacin (vitamin B) and by adding Brewer's yeast to the diet of someone suffering with pellagra, the scourge of the poor ended. (In 1972, regulation of biologics was transferred to the FDA.)
In WWI, the Public Health Service primarily focused on sanitation around military bases. With destruction of war, basic running water was often problematic. Troops were exposed not only to typical illnesses of the day, but also an unexpected outbreak of anthrax and tetanus. The PHS traced the cause of the anthrax back to contaminated shaving brushes and the tetanus was traced back to bunion pads used to cover smallpox vaccinations.
In 1918, Spanish influenza claimed more than 100 million lives globally. Spanish flu was a particularly virulent and lethal pandemic that was spread by the broadening use of global transportation and troop movement of WWI. This particular strain of virus activated immune cells and increased the amount of immune cells circulating in the blood and overwhelming the lungs with fluid. Healthy young adults essentially drowned from within. No one was immune from the virus, and, as a result, physicians also became deathly ill, as well. In Washington, DC, PHS physicians were pressed into service to help treat patients and back up those who could no longer work.
In 1930, the Randell Act changed the name of the Hygienic Laboratory to National Institute of Health (NIH) and tasked NIH with developing fellowships in research on basic biological and medical problems. The roots of this act came from pressure from chemists, who, during WWI, sought to establish and institute the private sector to help apply fundamental knowledge of chemistry to problems of medicine.
Next up: NIH and the Birth of NIDDK