Talk:History of poliomyelitis

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Poliomyelitis section split?[edit]

(Refactored from User_talk:MarcoTolo. -- MarcoTolo 03:26, 9 May 2007 (UTC))

Have you seen the polio peer review? What do you think about a history section split? I am having some trouble with this, it seems difficult to move much of anything out of the current article without sacrificing "the story". I might be too close to the article though, I would love to hear any thoughts you might have.--DO11.10 18:18, 6 May 2007 (UTC)

I'm torn on this one, too - will think about it and get back to you shortly. -- MarcoTolo 07:48, 7 May 2007 (UTC)
Okay, my gut reaction was to keep the entry together -- keep the story complete, as you mentioned in the peer review. After all, the historical aspects of polio are unique as a human disease entity. After thinking about Colin's comments in the PR, however, I've decided to try and look at the main Poliomyelitis article as a "current status" page like most other ID articles and construct a separate "History of...." page to accommodate the bulk of the historical and societal info. Its a bit crude, but I've made a prototype Poliomyelitis test page in my userspace with an accompanying History of poliomyelitis article. I am not explicitly advocating for this division - the pages are there for getting a handle on what such a division might look like. Take a peek when you get a chance and let me know what you think. -- MarcoTolo 00:18, 8 May 2007 (UTC)
Actually that does look pretty good! It doesn't really seem like the main article suffered at all, and it might enable some expansion of the History part. It looks like it might work after all?? What do you think? I will drop Colin a line, see what he thinks. Thanks for giving me some perspective here!--DO11.10 02:34, 8 May 2007 (UTC)
Somewhat to my surprise, it works reasonably well.... The "History" article needs some copyediting in the intro and the main article history section probably could be tightened somewhat, but otherwise it looks workable. Let's see what Colin's "outside perspective" viewpoint is and work from there. -- MarcoTolo 02:47, 8 May 2007 (UTC)

Colin's suggestions

The history article needs a proper lead that summarises the article. You need more sections. this web site has got a good history and timeline of key events that could be covered. However, as a reference I'd prefer if you used the book rather than the author's homepage, which probably doesn't meet WP:RS.
I hope the new page gives the History room to expand. I'm sure there's enough material for a well structured article several times this size.

Colin°Talk 13:17, 8 May 2007 (UTC)

I see you've been bold...[edit]

This history article is looking good so far, but still needs a proper lead that summarises the article. The current "lead" is actually a section (pre 20th Century — not sure what name it should have).Colin°Talk 13:00, 9 May 2007 (UTC)

Yes, the page needs an appropriate lead, I will try to work on one. Dunno what to call the pre-20th century section either??
Some areas I think could be expanded:
  1. The historical treatment section: lots of (rather frightening) stuff out there, could potentially have a section for each treatment.
  2. Should we include anything about the vaccine development? I am currently thinking a small pointedly historical section.
  3. The epidemics could be described in more detail, a graph of case numbers could be made.
  4. More "world view" type information, the US info is just easier to come by (I love the CDC), but epidemics occurred everywhere.

This is just an off the top of my head type list, it may not work, and I am sure that the article could be expanded in many more areas.--DO11.10 21:12, 9 May 2007 (UTC)

Yes, the vaccine story must be mentioned (briefly since it has its own article) from a historical POV and mentioned briefly in the main polio article from a current-day POV. Your point 4 is vital. Even documentaries in the UK focus on the American story but WP should attempt to be international. I'm really surprised there isn't more to say about the pre-20C stuff. There's really two sections but they are currently very brief: The ancient history and the first modern clinical descriptions. Colin°Talk 21:29, 9 May 2007 (UTC)
The lack of pre-20th century info is less surprising than one might originally expect - epidemic polio is really a recent phenomenon (see Trevelyan et al 2005. Some general non-US epidemic info can be found in the same article. While not universal, some have suggested that a variation of the hygiene hypothesis (better public health -> reduced antigenic exposure -> increased susceptibility to epidemic diseases) is responsible for the shift in the natural history of polio events. -- MarcoTolo 21:59, 9 May 2007 (UTC)

Possible sources for the "Early history" section[edit]

A fantastic resource but some of the most important pages are restricted :( nonetheless it should offer some fine details.
An oldie but goodie, digitized full text available.

I'll add more to this list as I stumble across them :) Fvasconcellos (t·c) 13:10, 29 August 2008 (UTC)

Vitamin C therapy[edit]

A bit of research has prompted me to remove the following addition to the article:

Interestingly, even Sabin, the later inventor of live virus vaccine, formerly also tested the antibiotic usage of vitamin C against polio,[1] however he failed to follow Jungeblut's[2] important clinical observations, especially the dosage, thus failing to finally confirm effectiveness of the antibiotic vitamin C therapy.[3]

The reasons for removal are several-fold:

  • Sabin's paper available as full text here states the following:
"The results recorded both in Chart 1 and Table I show that vitamin C neither modified the course of the disease nor prevented paralysis: 80 per cent of the untreated monkeys and 90 per cent of the treated ones developed paralysis. With these data at hand, Dr. Jungeblut's advice was sought and a similar experiment was carried out jointly in his laboratory. In a group of forty monkeys, among which ten were controls and thirty were treated with varying amounts of vitamin C, only one monkey, a treated one, escaped paralysis."
This roundly discredits the statement that "[Sabin] failed to follow Jungeblut's important clinical observations, especially the dosage..."
  • It also demonstrates that this is not the reason that Sabin "[ed] to finally confirm effectiveness of the antibiotic vitamin C therapy". Besides, this statement is pure speculation. It is impossible to predict that he would have confirmed any effectiveness. That is not how science works, we don't test hypotheses with experiments to confirm our ideas; it is with the opposite goal in mind.
  • Finally in later paper, Jungeblut himself admits that:
"it has not been possible to duplicate the seemingly startling results obtained in two preliminary experimental series with nasal infection."

Quite interesting nonetheless.--DO11.10 (talk) 18:32, 8 January 2009 (UTC)

Hi. I'll dispute some of the statements, in friendly way I hope :-)
As of the vitamin C effectivity, this is quite a theme itself, however Fred R. Klenner evolved the clinical use of antibiotic C later. I have read several his papers and he did valuable scientific work, full of curiousity and searching answers for the sake of his patients. He puts valuable clinical experience on paper, not a distant theory. I don't know anyone that went so far in real work, and he brings up successfull treatment of thousands of patients. If You're curious, I strongly suggest You to read at least this "earlydays" paper to judge yourselve, whether it has been worthy or not: The Use of Vitamin C as an Antibiotic. Journal of Applied Nutrition, Volume 6, 1953, pp. 274-278.
Later he much enhanced the methodology, the dosage etc, and published it all, I can give You few links. However, these former papers are more interesting, because they show, how he got involved, and reading with open mind, one can hardly imagine any fraud behind that.
As of Sabin's failure I'll cite statement from aforementioned paper: One of the most unfortunate mistakes in all of the research on poliomyelitis was Sabin’s UN-SCIENTIFIC attempt to confirm Jungeblut’s work with vitamin C against the Polio virus in monkeys. Jungeblut in infecting his rhesus monkeys used the mild “droplet method” and then administered vitamin C by needle in varying amounts up 400 mgm/day. Even this method did not give him absolute control over the degree of infection that would result. However, his antibiotic (vitamin C) remained relatively constant. With almost infinitesimal amounts, as we at present recognize, he was able to demonstrate in one series that the non-paralytic survivors was six times as great as in the controls. On the other hand, Sabin, in infecting his monkeys did not follow the procedure given by Jungeblut whose experiments he was attempting to repeat, but instead employed a more forceful method of inoculation which obviously resulted in sickness of maximum severity. Sabin further refused to follow Jungeblut’s suggestion as to the dose of vitamin C to be used. By Sabin’s actual report the amount given was rarely more than 35 per cent of that used by his associate. Sabin makes this significant statement (1939 7), “One monkey was given 400 mgm of vitamin C for one day at the suggestion of Jungeblut who felt that large doses was necessary to effect a change in the course of the disease.” Yet on the basis of Sabin’s work the negative value of vitamin C in the treatment of virus diseases has been for years accepted as final.
As of Jungeblut, I will again cite Klenner in his "most known" paper The Treatment of Poliomyelitis and Other Virus Diseases with Vitamin C, Southern Medicine and Surgery, july 1949, p209, In all fairness it must be said that Jungeblut noted on several occasions that he attributed his failure of results to the possibility that the strength of his injectable "C" was inadequate. It was he who unequivocally said that "vitamin C can truthfully be designated as the antitoxic and antiviral vitamin."
As of price, even with relatively low price of the vaccine, obviously it's much more stable and profitable business to vaccinate EVERY child, million after million, repeatedly, than it is to wait until a few come ill and give them vitamin C with total cost of, say, $3.
As of safety, taking a few precautions (1g calcium gluconate daily, drink a lot and eat during IV), intravenous vitamin C itself has virtually none confirmed negative sideeffects, and none lethal known, although Klenner notes some commercial batches of intravenous C with such additives inside, that their IV usage could kill the patient. On the other hand, vaccine can cause encephalopathy, paralysis, even death, and after the live vaccine, the recipient spreads the live virus to his close relatives for several weeks. Also, I assume You know of 112 million doses of the polio vaccine, contamined with cancer-causing simian virus SV-40. So I assume we can agree, that should the vitamin C have been an effective cure, THEN vaccine should be disregarded being unsafe and dirty treatment in any fair comparison. That's why I say, that the Sabin's failure changed course of medicine significantly, and maybe even not for good...
As of vaccine effectivity, the case is not as clear as would seem. The decline of incidence was at least partially achieved by merely diagnostic criteria changes. AFAIK, polio was declining before the vaccine was tested; after the vaccine introduction, the definition of polio changed from 'paralysis for 24 hours' to 'paralysis occurring for 2 months', the definition of epidemic changed from 20 cases to 35 cases, and polio as a disease name was given mostly to the unvaccinated and polio in the vaccinated became meningitis, etc. Moreover, Salk, the inactivated vaccine inventor claimed under oath, that the Sabin vaccine generated far more polio cases than the natural epidemics. Hearings before CIFC, 87th Congress, 2nd Session on H.R. 10541, May 1962, at 94.
I appreciate the great work You have done editing the Polio page, and I hope You'll take these statements as friendly dispute, not as an offend. -- (talk) 14:02, 13 January 2009 (UTC)

I apologize for the delay in response. I have no problem expanding the historical treatment section to include more details about early treatments. However, please remember, Wikipedia asserts facts, it is not here to "right the wrongs". All information must be presented accurately and be accompanied by reliable sources, without undue weight, and with a neutral point of view. The above addition was not accurate, and decidedly POV. As for Klenner, I had read his paper. There is very little hard data presented there regarding polio specifically, additionally there are some serious problems with the research itself (the largest being that he did not confirm that 45 of the 60 patients actually had polio, the sample size is far too small given that most people who develop paralytic polio recover anyway, and the lack of reproducibility). If you'd like to suggest an alternative addition, please do so. --DO11.10 (talk) 19:11, 19 January 2009 (UTC)
Hi, as of Sabin's failure, I thought that Klenner was the only who recognized that, but I was wrong. I cite from Bourne GH. Vitamin C and Immunity. British Journal of Nutrition, Volume 2, Issue 04, Dec 1949, p 345 doi: 10.1079/BJN19480063. He used very similar, although more neutral formulation than me: Klein (1945) has claimed this (inactivation of virus) for influenza virus and Jungeblut (1939) for poliomyelitis virus. In experiments in vivo they found that in rhesus monkeys vitamin C had a protective effect if the animals were treated with minimum infective doses of the virus. Post-mortem investigation showed fewer pathological changes in animals that had received vitamin C than in those without the vitamin. Sabin (1939), however, was not able to confirm this work. So, I can try to reformulate the paragraph.-- (talk) 07:48, 23 February 2009 (UTC)
Well, I did it. I hope the new formulation is factographically exact and neutral.-- (talk) 10:10, 23 February 2009 (UTC)

I've removed the following two sentences:

Later, Fred Klenner published his own clinical experience with vitamin C in the treatment of polio,[1][2] however his work was not well received and no large clinical trials were ever performed. The methodology was post mortem summarised by Smith.[3][4]
  1. Klenner FR (July 1949). "The treatment of poliomyelitis and other virus diseases with vitamin C". South Med Surg 111 (7): 209–14. PMID 18147027. 
  2. Klenner, F.R. (1953). "The Use of Vitamin C as an Antibiotic". J. Appl. Nutr. 6: 274–278. 
  3. Smith, L.H. (1988). Vitamin C as a Fundamental Medicine: Abstracts of Dr. Frederick R. Klenner, M.D.’s Published and Unpublished Work. Tacoma, WA: Life Sciences Press. ISBN 0-943685-01-X. 
  4. Smith, L.H. (1991). Clinical Guide to the Use of Vitamin C. Adapted from: Vitamin C as a Fundamental Medicine: Abstracts of Dr. Frederick R. Klenner, M.D.’s Published and Unpublished Work. Tacoma, WA: Life Sciences Press. ISBN 0-943685-13-3. 

This doesn't seem to contain any relevant information on the history of polio and, other than in Orthmed circles, Klenner doesn't appear to be notable in the history of polio. The two remaining sentences seem sufficient WP:WEIGHT for something that was briefly considered and then discarded. Even then, we are citing the primary literature here, not a review or academic study of the history of polio. The convenience links in the above four sources point to unreliable non-professional web sites that are almost certainly copyright violations. We simply can't include them (see WP:COPYLINK) as convenience links. See also WP:CITE#SAYWHEREYOUGOTIT. Colin°Talk 21:20, 24 February 2009 (UTC)

I can agree with the convenience links.

However, This doesn't seem to contain any relevant information on the history of polio -You cant't be serious! This is section on HISTORICAL TREATMENT, and the vitamin C was the most notable treatment available, if not the single notable one ever, althought disregarded and forgotten on the basis of plain ignorance. Nobody ever attempted to challenge the methodology on clinical basis. It was never refuted, but simply ignored instead, "just like that". Even on AMA annual meeting, when brought up publically, nobody was willing to care about the possibility of even TRYING this. So, I'm removing the convenience links, and I'm adding other well-sourced publications on the topic.-- (talk) 10:32, 25 February 2009 (UTC)

BTW, just try to use keywords polio vitamin C in the PubMed, and You'll be surprised, that the topic is quite relevant. Greer, Reshetnikova, Lavegas, Colobert, Peloux, Biones, Gsell, Baur. That's just on the "nothing more than orthomed circles" sentence.-- (talk) 10:55, 25 February 2009 (UTC)
I've just searched PubMed as you describe and only a handful of relevant articles (not all are papers) are found, all very old. If "vitamin C was the most notable treatment available" then there would be a secondary source (such as a book on the history of polio) that we could cite to indicate the importance of vitamin C. Doing a search of the primary research literature, in order to prove a point, is very much discourage on WP. Points must be proven by our sources (is vitamin C notable in the history of polio), not by editors. Please can you find a reliable source to show why we should spare more than the two sentences I left. Also, my comment about "doesn't seem to contain any relevant information" still holds. All you say is some other guy studied it too, and someone summarized his work later. And the reader says "so what?" Colin°Talk 17:42, 25 February 2009 (UTC)
Well, in comparison with other historical treatments, the vitamin C therapy results seem most notable out of all of them. Even in comparison with current therapies (are there any relevant either?) The therapy that worked, and that was even studied by independent authors, You characterize by "dosen't seem to contain any relevant information"? And yes, there are books that cite importance of vitamin C in treatment of polio, and even importance of Klenner's discoveries:
Thomas E.Levy: Curing the Incurable: Vitamin C, Infectious Diseases, and Toxins. Library of Congress Number: 2002093697; 451 pages; ISBN 1-4010-6964-9 (Hardcover); 1-4010-6963-0 (Softcover). Xlibris Corporation 1-888-795-4274.
Irwin Stone. The Healing Factor: Vitamin C Against Disease. Grosset and Dunlap, New York, 1972. ISBN 0-399-50764-7.
Hickey S and Roberts H. Ascorbate: The science of vitamin C. 2004. ISBN 1-4116-0724-4. Morrisville, NC: (talk) 09:52, 2 March 2009 (UTC)
Those sources may indicate polio is notable in this history of pushing Vitamin C as a cure for anything. They do not indicate vitamin C is notable in the history of polio. For that you need an impartial history of polio, not a partial history of vitamin C. Colin°Talk 13:32, 2 March 2009 (UTC)
There is an indication of Your disrespect and bias in Your statement. You're perverting the means and consequences. Fred Klenner was not interested in "pushing Vitamin C as a cure for anything". He even didn't consider vitamin C any way more significant than other doctors of his age. He, and his colleagues at hospital, (semi-accidentally) discovered real antiviral properties of vitamin C on viral pneumonia case, and after realizing the possibilities, they immediately turned the research to a clear target - treatment of "polio, the crippler". This is what he published in his papers, and what he publicly suggested on AMA annual meeting, where his suggestion was grossly ignored. This ignorance is also the reason, why it is so hard to find these things in polio history books. The Sabin's poorly performed experiments were "show-stoppers" for the mainstream, however they were not the end of the cure itself. I agree, that during subsequent decades, Klenner discovered much more diagnoses that improved using vitamin C, and that other doctors published even more, but clearly the things didn't happen the way You propose.-- (talk) 13:47, 5 March 2009 (UTC)
I was commenting on your sources. The first book (Levy) most certainly pushes vitamin C as a cure for just about anything. See the introduction, for wild claims of a cure for nearly all infectious diseases plus cancer and heart disease. These are not reliable sources by any stretch of the imagination. It doesn't matter if Klenner was on to something or not. History has ignored him and only the ortho fringe regard the work on polio as important. Colin°Talk 16:56, 5 March 2009 (UTC)
    • ^ Sabin, A.B. (1939). "Vitamin C in Relation to Experimental Poliomyelitis". J. Exper. Med. 69 (4): 507. doi:10.1084/jem.69.4.507. 
    • ^ Jungeblut, C.W. (1939). "Further Observations on Vitamin C. Therapy in Experimental Poliomyelitis". J. Exper. Med. 66: 459. 
    • ^ Klenner, F.R. (1953). "The Use of Vitamin C as an Antibiotic". J. Appl. Nutr. 6: 274–278.