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Short History of the U.S. National Institutes of Health: 

Short History of the U.S. National Institutes of Health Victoria A. Harden, Ph.D. Historian, NIH

U.S. Federal Government and Medical Research: 

U.S. Federal Government and Medical Research No support at all before late 19th century Medical system based on “humoral” theory U.S. Constitution made no mention of health or medicine

Marine Hospital Service : 

Marine Hospital Service Established in 1798 under the commerce clause of the Constitution Series of hospitals for merchant seamen Placed in Treasury Department to collect 20 cents per month from each sailor Marine Hospital, New Orleans, Louisiana

Political Philosophy: 

Political Philosophy Americans were suspicious of government funding because they believed: If government funds research, government can control what research gets done. People who accept funds from the government are not self-reliant.

Discovery of Anesthesia: 

Discovery of Anesthesia Only major U.S. contribution to medicine before the U.S. Civil War Wholly in the private sector “The First Operation with Ether” by Robert Hinckley

Intellectual Revolution, 1870s-1890s The Germ Theory: 

Intellectual Revolution, 1870s-1890s The Germ Theory Louis Pasteur Robert Koch

The Power of the Germ Theory: 

The Power of the Germ Theory

National Board of Health: 

National Board of Health First grants for medical research to university scientists Bitter political disagreements 1878-1883/93

Laboratory of Hygiene Marine Hospital Service: 

Laboratory of Hygiene Marine Hospital Service Marine Hospital, Staten Island, NY Joseph J. Kinyoun, M.D.

Kinyoun’s laboratory: 

Kinyoun’s laboratory Kinyoun’s microscope & first publication

Growth of laboratory: 

Growth of laboratory 1891--moved to Washington, DC 1894--production of diphtheria antitoxin begun rabies vaccine, smallpox vaccine made available Diphtheria antitoxin made by Hygienic Laboratory, 1895

1902 Biologics Control Act: 

1902 Biologics Control Act 1901: 13 children in St. Louis died from contaminated diphtheria antitoxin 1902: Congress acted Hygienic Laboratory given regulatory responsibility Mulford rabies vaccine outfit

1901 NIH’s organic legislation: 

1901 NIH’s organic legislation Buried in a supplemental appropriations act Authorized $35,000 to build one building Authority to investigate “infectious and contagious diseases” 25th & E Sts, NW, Washington, DC, 1904-1939/41 home of NIH

1902 Research Program Begins: 

1902 Research Program Begins New Name: Public Health and Marine Hospital Service Hygienic Laboratory organized into 4 divisions Pathology and Bacteriology (original work) Zoology Chemistry Pharmacology Ph.D.s hired to head new divisions

1912 Non-infectious disease research: 

1912 Non-infectious disease research New Name: Public Health Service Hygienic Laboratory authorized to investigate noncontagious diseases and the pollution of waterways

Pellagra: niacin deficiency: 

Pellagra: niacin deficiency Who got pellagra? Dr. Joseph Goldberger

Hookworm: parasitic helminth: 

Hookworm: parasitic helminth Who got hookworm? Dr. Charles Wardell Stiles

1916First professional woman hired: 

1916 First professional woman hired Dr. Ida Bengtson, Bacteriologist Worked in Biologics Control

Ransdell Act, 1930Hygienic Laboratory renamedNational Institute of Health: 

Ransdell Act, 1930 Hygienic Laboratory renamed National Institute of Health Charles H. Herty, Ph.D. (Georgia and N.C.) Senator Joseph Ransdell (Louisiana)

1930sChange in Political Philosophy: 

1930s Change in Political Philosophy Government “control” can be used to rectify injustices Government “control” can provide oversight of ethics of research Scientists can remain self-reliant if they decide which projects to undertake

NCI created, NIH moved to Bethesda: 

NCI created, NIH moved to Bethesda 1937--National Cancer Act foreshadowed categorical structure authorized to give grants and fellowships 1939-41--move from DC to Bethesda NIH’s Bethesda campus under construction, ca. 1939

1938-41 70 Acres for Science: 

1938-41 70 Acres for Science Some opposition to construction from Bethesda Chamber of Commerce and Montgomery County Commission October 31, 1940: FDR dedicated campus

Steps Toward War: 

Steps Toward War Sept. 1, 1939 June 1940 Sept. 1940 Germany invaded Poland Battle of Britain U.S. National Defense Council established Japan signed mutual assistance pact with Germany and Italy: global war Congress enacted first peacetime draft in US history

Health of Recruits: 

Health of Recruits 43 percent unfit for military service 28 percent not fit for any military service 15 percent fit for limited service only NIH Division of Public Health Methods worked with the Selective Service

Research for the home front:Workers protected: 

Research for the home front: Workers protected Dangers of specific munitions Diagnostic tests for toxic materials Working conditions of >300,000 defense workers improved

Research for the battlefield: 

Research for the battlefield Exotic diseases Malaria Yellow fever Epidemic typhus Tsutsugamushi (scrub typhus) schistosomiasis Battlefield trauma Shock Burns Blood & blood products High altitude physiology

Architects of today’s NIH: 

Architects of today’s NIH Surgeon General Thomas Parran NIH Director Rolla E. Dyer World War II leaders

1944 PHS Act: 

1944 PHS Act Authorized NIH grants program Authorized clinical research Mandated materials prepared for public

Rapid growth, 1945-2001: 

Rapid growth, 1945-2001 1945: NIH and NCI 1949: 6 institutes 1969: 15 institutes, centers & divisions 1999: 25 institutes & centers 2001: 27 institutes & centers

NIH Clinical Center: 

NIH Clinical Center NIH Clinical Center, 1953 “Pool of Bethesda”

Lorraine cross design philosophy: 

Lorraine cross design philosophy Goal: transfer new biomedical knowledge as rapidly as possible from the laboratory to the patient’s bedside

Protection for Human Subjects: 

Hippocratic Oath: First, do no harm Nazi medical experiments Nuremberg Code (1946): Informed consent must be obtained Clinical Center review of protocols, 1953 Tuskegee syphilis study (begun 1932, recognized as public scandal 1972) Protection for Human Subjects Act (1974): Institutional Review Boards established NIH Office of Protection from Research Risks established Office of Human Research Protections, DHHS established June 2000 Protection for Human Subjects

Major lines of research, 1945-2003: Human Genetics: 

Major lines of research, 1945-2003: Human Genetics http://history.nih.gov/exhibits/genetics/

Major lines of research, 1945-2003:Basic Research: 

Major lines of research, 1945-2003: Basic Research http://history.nih.gov/exhibits/bowman/

Major lines of research, 1945-2003:Chronic Diseases: 

Major lines of research, 1945-2003: Chronic Diseases http://history.nih.gov/exhibits/opiates/

Major lines of research, 1945-2003:Transitional Research: 

Major lines of research, 1945-2003: Transitional Research http://history.nih.gov/exhibits/thinblueline/

Major lines of research, 1945-2003:infectious diseases: 

Major lines of research, 1945-2003: infectious diseases http://aidshistory.nih.gov/home.html

Training junior scientists: 

Training junior scientists http://history.nih.gov/exhibits/stadtman

NIH worldview: absorbing but dangerous.How do we deal with the brave new world?: 

NIH worldview: absorbing but dangerous. How do we deal with the brave new world? NIH poster, with apologies to Steinberg