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Enormous time, energy and money have been wasted in many fields of medical science by the perpetuation of use of various erroneous remedies and alleged preventives not subjected to critical scrutiny of other workers. In short, it pays to find out what is not so as well as what is so. This, in the instance of the Park-Brodie vaccine, was done inside a year by various of the Commission's grantees. Brodie claimed that his formalinized vaccine protected monkeys against small but fatal doses of infantile paralysis virus.

This claim was definitely not substantiated by grantee Schultz, of Stanford University, and grantee Kramer, of Long Island Medical College.

Brodie claimed, further, that immunity could be shown to appear in monkey's blood as the result of the injection of this infantile paralysis vaccine but this claim was found to be exaggerated by check experiments by grantee Kramer.

It is not certain that the power of human blood against infantile paralysis virus is important in the protection of the human owner of that blood; but Brodie made the claim that the majority of not-immune children did acquire such power in their blood, after they had been injected with his vaccine.

But even this dubiously beneficial effect of the vaccine was not confirmed, when grantees Aycock of Harvard University, Schultz of Stanford, and Kramer of Long Island Medical College put it to test. Studying blood of children, vaccinated and not vaccinated in the 1935 North Carolina epidemic, Aycock found that, during the epidemic, virus-neutralizing substances appeared in about the same proportion of not vaccinated or vaccinated children.

Another vaccine, widely heralded in the summer of 1935, but not supported in its field trial by the Commission's funds, was apparently the cause of a number of tragic deaths of children who were supposed to be made immune with it. At the same time at least one fatal human case of infantile paralysis occurred in southern California at a suspicious interval after the injection of the Park-Brodie vaccine; and competent Public Health authority suggested that the vaccine may have been responsible.

Does this failure of the formaldehyde vaccine to protect children mean that all hope for infantile paralysis vaccination must be forever abandoned?

Not necessarily. Today, as this report is being written, word has been received from Dr. Kramer, of an entirely novel way of making monkeys immune. In brief, he has sprayed a harmless solution of Pituitran "S" mixed with adrephine, day after day, into the insides of monkeys' noses. This causes a notable mobilization of white blood cells to take place just under the mucous membrane, and around the endings of the nerves of smell of the monkeys. Now if, immediately after this spraying, Kramer sprays a fatal dose of infantile paralysis into such monkeys, these animals, a majority of them, resist this instillation! Then, when later tested, a majority of them are found actually to have become immune to the disease. This is, then, a sort of intranasal vaccination. It is not to be confused with the zinc sulphate or picric sprayings, because such sprays leave no permanent immunity. Kramer believes this experiment begins to explain, maybe, how in nature, the majority of children catch immunity, instead of infantile paralysis. For by this new method, immunity has been conferred upon a number of monkeys by way of their noses.

But that brings us to the heart of another one of the Commission's important projects. May it not be possible to discover a skin test, or a simple blood test, that would actually pick out the few susceptible children, out of a large population? If that could be done, then any effective vaccine, however expensive, would be at once a practical possibility. In short, will some test, like the Schick test, ever become available?

Grantee Dr. Joseph Stokes, Jr., of the University of Pennsylvania, is hard at work at the chemical "purification" of the infantile paralysis virus. That is to say, he is engaged in freeing this virus from the nerve tissue of the monkey, which is, at present, the one source from which experimenters can obtain it. The presence of this monkey nerve tissue would certainly "mask" and obscure any skin test that might be attempted on children. But if Stokes succeeds in his purification, some sort of test for the susceptible child might be hoped for.

Is there more than one virus of infantile paralysis? Grantee Dr. John F. Kessel, of the University of Southern California Medical School, has had an excellent opportunity to study this question during the epidemics of 1934-5-6 in southern California. At the very beginning of these outbreaks, it was plain that they were peculiar ones, and not typical infantile paralysis as it has for long been known in the East and in Europe. In southern California the disease was much milder. It did not paralyze people so severely, and their paralysis, when it did occur, was often not so severe, and the death rate in the epidemic was markedly lower.