Frederick Novy and the Development of Bacteriology in Medicine 9780813585116

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Frederick Novy and the Development of Bacteriology in Medicine

Critical Issues in Health and Medicine Edited by Rima D. Apple, University of Wisconsin–­M adison, and Janet Golden, Rutgers University, Camden Growing criticism of the U.S. health care system is coming from consumers, politicians, the media, activists, and healthcare professionals. Critical Issues in Health and Medicine is a collection of books that explores these contemporary dilemmas from a variety of perspectives, among them political, legal, historical, sociological, and comparative, with attention to crucial dimensions such as race, gender, ethnicity, sexuality, and culture.

For a list of titles in the series, see the last page of this book.

Frederick Novy and the Development of Bacteriology in Medicine Powel H. Kazanjian

Rutgers University Press New Brunswick, Camden, and Newark, New Jersey, and London

Library of Congress Cataloging-­in-­Publication Data Names: Kazanjian, Powel H., 1953–­author. Title: Frederick Novy and the development of bacteriology in medicine / Powel H. Kazanjian. Other titles: Critical issues in health and medicine. Description: New Brunswick, New Jersey : Rutgers University Press, [2017] | Series: Critical issues in health and medicine | Includes bibliographical references and index. Identifiers: LCCN 2016032167| ISBN 9780813585093 (hardcover : alk. paper) | ISBN 9780813585109 (e-­book (ePub)) | ISBN 9780813585116 (e-­book (Web PDF)) Subjects: | MESH: Novy, Frederick G. (Frederick George), 1864–­1957. | Bacteriology—­ history | History, 19th Century | History, 20th Century | United States | Biography Classification: LCC QR74.8 | NLM WZ 100 | DDC 616.9/201—­dc23 LC record available at https://​lccn​.loc​.gov/​2016032167 A British Cataloging-­in-­Publication record for this book is available from the British Library. Copyright © 2017 by Powel Kazanjian All rights reserved No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, or by any information storage and retrieval system, without written permission from the publisher. Please contact Rutgers University Press, 106 Somerset Street, New Brunswick, NJ 08901. The only exception to this prohibition is “fair use” as defined by U.S. copyright law. The paper used in this publication meets the requirements of the American National Standard for Information Sciences—­Permanence of Paper for Printed Library Materials, ANSI Z39.48–­1992. www​.rutgersuniversitypress​.org Manufactured in the United States of America

For Sahira, Sarine, Powel III, and Louisa

Contents



Introduction 1

Chapter 1

Frederick Novy and the Origins of the Michigan Hygienic Laboratory 17

Chapter 2

What Novy Did in His Medical School Laboratory 47

Chapter 3

Making Medical Education Scientific 86

Chapter 4

Defining Bacteriology as a Discipline in Its Early Years 128

Chapter 5

Significance for American Culture: Arrowsmith 143

Chapter 6

Making a Scientific Career in Medicine 164



Conclusion 182

Acknowledgments 191 Notes 193 Index 231

vii

Frederick Novy and the Development of Bacteriology in Medicine

Introduction

This is a book about Frederick Novy (1864–­1957) and his scientific contributions to medicine. Novy was a leader among a new breed of full-­time bacteriologists at American medical schools in the 1890s. He was atypical for his time, as he was a scientist who had earned a doctorate in chemistry before he entered medical school. As a medical student, Novy traveled to Europe to learn the new science of bacteriology with the preeminent scientists of the day: Robert Koch in Berlin and Louis Pasteur in Paris. Upon returning to America, he obtained a newly established position at the University of Michigan Medical School as a laboratory-­based researcher-­educator. He was not required to directly practice medicine. The scientific work Novy carried out in this position was different from the work of his American peers and helped form the historic roots of biomedicine as we know it today. This book examines what was exceptional about Novy and his scientific activities. Novy’s research program sought fundamental truths about microbial behavior. This quest to elucidate basic microbial truths stood in stark contrast to the mainstream focus of American bacteriology at the time—­namely, practical applications. Novy designed novel equipment to seek what he and his circle of colleagues and students at the time called fundamental knowledge about microbes, how they survive in nature, spread in their environment, and cause disease in humans. He strove for this ideal of of what he and his peers called “pure science”—­to seek basic biological truths about microbes—­as the principal endeavor of his laboratory and sought to impart this ideal to the students in his bacteriology course, the first full-­semester course of its kind offered in America. To his students, Novy strove to instill what he called “a spirit of

1

2 Introduction

science in medicine”—­a duty to search for fundamental biological truths solely for the sake of adding to the sum of knowledge. His mastery of technological innovation as a means to, as he said, “solve nature’s puzzles” earned him a reputation as a preeminent figure whose own brand of laboratory science led to a greater understanding about basic microbial biology. The activities of this first-­ generation American bacteriologist who was devoted to what his peers called the “truth-­seeking science ideal” had an enduring legacy for medicine, bacteriology, and American society. His colleagues and students viewed his devotion to producing new knowledge as adding legitimacy to a medical profession in need of certainty. His medical instruction was considered instrumental in establishing a foundation for the reforms in American medical education and the establishment of the basic science departments that would follow. His scientific activities demonstrated a role for a new breed of physician, the physician scientist, in American medicine. As a founding member of the Society of American Bacteriologists in 1899, he insisted on the development of basic microbiology, which helped to establish bacteriology as an independent discipline with a special scientific knowledge. Evidence of the infiltration of Novy’s science into American culture can be found in the widely read novel Arrowsmith. Author Sinclair Lewis used an account of Novy’s activities to construct and popularize a heroic image of a truth-­ seeking medical researcher, an image that had widespread and lasting appeal in American society. Novy’s scientific activities helped to form the historical roots of several key elements that comprise today’s biomedical world. His bacteriological investigations and instruction helped to integrate basic scientific courses in medical instruction, establish a new role of the physician scientist in the medical profession, and popularize the scientific activities of physician scientists whose discoveries are prominently highlighted by the press and media in American society today. Historians have not explored the foundation of these important facets of modern biomedicine. This is a story of Frederick Novy—­a leader among the first generation of researcher-­educators in bacteriology in the 1890s whose scientific activities helped to shape the contours of our contemporary biomedical world in America. Who Was Frederick Novy?

Frederick George Novy was a leader among a new breed of full-­time researcher-­ educators who began working in laboratories that were newly constructed at a handful of American medical schools in late nineteenth-­century America—­ Harvard, the University of Pennsylvania, Michigan, and Johns Hopkins.1

Introduction 3

Unlike most American physicians at that time, Novy worked exclusively in a university-­affiliated laboratory and did not practice medicine. His role as a researcher-­educator at the hygienic bacteriology laboratory was established and directed by Victor Vaughan, Novy’s professor of physiological chemistry and hygiene at the University of Michigan Medical School.2 This position involved no clinical work or private patients, and Novy devoted his entire effort to research and teaching. In the context of his duties as an assistant to Vaughan at the Hygienic Laboratory, Novy developed an independent research program and introduced a comprehensive lecture-­laboratory course to instruct students about the new science of bacteriology. Until Novy’s time, physicians taught medical students through lecture only, with a complete absence of laboratory work in the curriculum. Physician teachers earned their living primarily by collecting fees from their private practices, but they also received supplemental payment for teaching courses. The researcher-­educators like Novy who had emerged at Harvard, Pennsylvania, and Michigan by the 1880s, however, began to provide new laboratory-­lecture courses (later referred to as basic science courses) that provided students hands­on training in subjects including bacteriology that would become standard for American medical schools following Abraham Flexner’s report on American medical education in 1910. To date, historians have not systematically examined the work that first-­ generation, full-­time bacteriological researchers conducted in their medical school laboratories and what those researchers taught their students. Likewise, the meanings of their educational and research activities for American medicine, bacteriology, and American society have not been fully explored.3 This book examines the research and educational activities of one such American bacteriologist from 1889 to 1933. To understand the activities and events in Novy’s life as they unfolded, I have used his published papers, laboratory notebooks, and private correspondence with students, scientists, and family members, materials archived at the Bentley Library and the Taubman Medical Library at the University of Michigan.4 I have used these sources to examine the ideas that drove Novy’s laboratory work, what he taught his students, and how they viewed this instruction. Novy used his chemistry training together with his newly acquired bacteriological skills to seek a greater understanding of fundamental microbial behavior. Novy’s circle of colleagues and students referred to his scientific investigations and instruction as fundamental or pure science that generated what they called “pure truths” about basic microbial biology, as opposed to providing a practical means to kill or prevent germs. They regarded him as a preeminent figure

4 Introduction

and leader among a new breed of full-­time bacteriologists based in medical schools in late nineteenth-­century America. Despite Novy’s one-­time renown, no scholarly work has been written about him. His distinct contributions to science had important implications for medical education, bacteriology, and American society. Novy’s Scientific Activities and Their Significance for Medicine, Bacteriology, and Society

Novy stated that his major goal was to carry out original investigations in search of new knowledge about microbes and their behavior.5 He insisted on having the freedom to pursue his goal of original investigation without the restraints of practicality—­developing therapies to eradicate microbes or means to prevent them.6 What may have predisposed Novy to value most highly what he called his “spirit of scientific medicine”—­a rigorous search for new knowledge about fundamental microbial biology above practical considerations? In what ways did Novy’s research focus and activities differ from the mainstream focus of American bacteriologists during this time period? How did it differ from that of his colleagues with whom he studied in Europe? How did his peers characterize the emphasis, quality, and scope of what they called his pure scientific research? Novy promoted the ideal of pure scientific investigation of nature’s fundamental truths, which in turn inspired his educational activities. He used his research investigations as a springboard for his instruction of medical students. This book will address what he was trying to accomplish in his full-­semester lecture-­laboratory course first taught in 1889. What was his rationale for insisting that having a laboratory component was essential in medical education? Why did he feel that teaching the logic and methods of the laboratory would be valuable for all medical students, even those who would become practitioners as well as researchers? What specifically did he try to teach these students? In trying to instill in his students the same spirit of research in medicine that guided his experimental research, was he seeking to do something more than teaching critical thinking and training their minds? How does an exploration of Novy’s educational goals add to what historians have previously described for late nineteenth-­century American medical educators? How would he try to teach scientific methods to the majority of medical students in the late nineteenth century who had no prior training in the principles or methods of science? What did his students think of his intentions to teach bacteriology and expand the instruction of laboratory science in medical education, a course of instruction that would later be referred to as the basic science curriculum?

Introduction 5

Novy’s pedagogical efforts to establish his full-­ semester lecture-­ laboratory bacteriology course were a key step toward integrating basic science departments into American medical schools in the 1890s.7 Before this time, laboratory-­based research was almost nonexistent in either for-­profit proprietary schools or university-­affiliated medical schools.8 Small groups of medical practitioners taught part-­time in both types of schools, and the typical medical faculty in 1880s consisted of instructors who taught students in lecture halls in didactic settings.9 It took three years to earn a medical degree at university-­affiliated schools like Michigan; there were no formal admission criteria for any medical schools.10 The introduction of intensive basic science lecture-­laboratory courses like Novy’s bacteriology course in 1889 was a key factor that lengthened the curriculum to four years at the University of Michigan in 1891, led to higher admission criteria (e.g., mandatory high school graduation and prerequisites in math and science), and reshaped the medical school into a center of advanced teaching and research.11 By 1893, Johns Hopkins exposed a more select group of students to scientific medicine, a trend established by Harvard, Pennsylvania, and Michigan that was an important facet of the overall medical education reform that took place in the 1890s in America and then expanded to other American medical schools following the Flexner Report, Medical Education in the United States and Canada, published in 1910.12 The creation of what were later called basic science courses at Michigan and a handful of other university-­affiliated medical schools in the 1890s helped to build an important foundational component of the biomedical system as it remains today. Novy’s fundamental research operation also had significance for the developing field of bacteriology in the 1890s. Bacteriology was a nascent field when Novy and other officers of the newly formed Society of American Bacteriologists were striving to turn their field into a distinct specialty. Bacteriologists crafted arguments to justify the creation of their new area into an independent, distinct field. They rallied around the theme of basic biological research as a way to unify an area that they believed was becoming fragmented by practical applications in diverse realms. They asserted that a unifying pursuit, such as investigating the fundamental science of microbes as had been carried out by Novy, rather than a focus on the practical applications of bacteriology, would distinguish their field from others and free it from what they viewed as subservience to the field of pathology.13 This enabled bacteriologists like Novy to create independent departments of bacteriology in their respective institutions in which they could pursue basic research in microbial biology and physiology. Their ideas dictated that a distinct and growing body of knowledge not

6 Introduction

only justified fashioning their field into a separate science—­it compelled them to do so. Novy’s activities and pure science ideal had implications in a broader sense by forming the basis for the construction of the noble image of a medical researcher in American society. The author Sinclair Lewis’s popular, accessible novel Arrowsmith is used as a vehicle to explore the meanings of Novy’s activities for early twentieth-­century American society. Lewis based the characters and major themes of his novel on firsthand information about Novy’s scientific attitude and research ideals supplied by Novy’s former student, Paul de Kruif. Arrowsmith was the result of a 1925 collaboration between Lewis and de Kruif. Lewis took de Kruif’s worship of Novy as the revered medical researcher who occupied the highest strata in the medical world and applied it to American society at large. Lewis’s novel was a portal through which the public could view Novy’s specialized academic activities and ideals, which had previously been known to his scientific colleagues and students like de Kruif. In Arrowsmith, Lewis demystified the unfamiliar work done by Novy and made that work accessible to the public, providing large-­scale recognition of the ideals of pure science that Novy symbolized. The pure science ideal that characterized Novy’s research and educational activities had broad-­reaching implications in the realms of medical education, bacteriology, and American society. Novy’s scientific activities were at the roots of today’s biomedical world—­the central space for the basic sciences in medical education, the durable role of the physician scientist, and the popular interest in their activities. The work done by Novy—­a first-­generation American bacteriologist based at a medical school rather than a public health department—­ differs from traditional characterizations of early bacteriology in America. Novy’s ambitions to discover the basic aspects of microbial behavior without practicality or competing interests entering into his experimental motives is distinctly different from the conventional characterization of American bacteriologists at that time. To best appreciate how Novy’s work differed from that of other bacteriologists, the conventional portrayal of American bacteriology during this period is now provided. Early Bacteriology in America

Histories written about the beginnings of bacteriology in America have focused on the activities of European-­ trained American physicians who worked in public health department laboratories.14 According to these histories, these well-­established physicians gradually defined the field.15 The role of the public

Introduction 7

health bacteriology laboratory was to control disease processes through the application of the germ theory of medicine, which had originated in Europe. Their activities led to the development of specific methods to control the spread of disease among populations (cleaning drinking water of feculent material, vaccinating the uninfected, and controlling other vectors) or therapies for individual patients (antisera and later chemotherapy).16 Historians have depicted the practical activities of American bacteriologists working in public health departments. Consequently, bacteriology in America during the late nineteenth century has been characterized predominantly as a period of germ theory practice—­the application of theories and practices developed in Europe. Bacteriology laboratories were first introduced in the American public health setting during the early germ era in the late 1880s. Prior to this period, public health departments in nineteenth-­century America focused on rectifying unclean public environments, chiefly urban ones.17 Public health measures were based on the belief that filthy environments were responsible for contagious diseases. Sanitation interventions to rectify susceptible environments had been the focus of public health campaigns targeting the spread of contagion.18 But the public health doctrine identifying sanitation and the removal of filth as a sufficient barrier against contagion was challenged soon after the germ theory was postulated. Historians Barbara Rosenkrantz, John Duffy, and Judith Walzer Leavitt have noted that during the 1890s the emphasis of public health began to shift away from sanitation programs and was directed instead toward interventions based on pathogen identification and eradication.19 These interventions were derived from the germ theory of medicine that had flourished in Europe in the mid-­to late nineteenth century. The theories informing these interventions were then imported to American public health departments by American-­schooled physicians who had traveled to Europe to study the new European science of bacteriology. What practices in Europe so compelled American physicians to travel abroad in the 1880s to learn about the new germ theories? The excitement had begun earlier, when the German pathologist Joseph Henle in 1840 postulated the germ theory of disease—­a premise that microbes correspond with specific disease entities.20 Henle acknowledged that he did not have the technology at hand to unveil what he called “the secretive lives of invisible organisms.”21 The technology Henle desired—­tools that would allow him to separate a specific microorganism from a specific disease process and culture it in pure form—­ did not exist in his day.22 In the 1840s, individual characteristics of microbes remained difficult to decipher because technology that allowed bacteria to be

8 Introduction

seen with sharp borders was not available. Stains were not available to contrast bacteria with their background. Henle could not identify distinct bacteria because he could not differentiate them according to morphology. By 1870, the invention of these technologies enabled experimenters to test Henle’s germ theory.23 The Abbe condenser, for example, allowed bacteria to be seen with greater clarity; aniline dyes first used in the clothing industry allowed different forms of bacteria to be distinguished according to the stain they incorporated, thereby allowing bacteria to be differentiated according to their size, shape, and color; and the development of solid media by Robert Koch in 1876 allowed bacteria to be isolated in pure culture.24 By 1884, researchers possessed instruments capable of achieving what Henle in 1840 desired. Using these instruments and techniques, in 1884 Koch developed systematic methods to formulate his criteria for proof that a specific bacterium is the cause of a specific disease.25 Organisms could now be isolated in pure culture and then reinjected into healthy animals to induce the same disease as observed in humans. After demonstrating the presence of these same bacteria in the diseased animals, he posited the bacterial nature of a particular disease, tuberculosis, in 1884. The prospect of learning the methodology that Koch utilized for his postulates compelled enterprising physicians throughout the world to search for a bacterial cause of an array of human diseases besides tuberculosis.26 The isolation of anthrax and tuberculosis encouraged physicians to take up a search for the specific microbial causes of more diseases: streptococcus (1883), diphtheria (1884), typhoid fever (1884), tetanus (1884), pneumococcus (1886), plague (1894), and botulism (1896). The American neurosurgeon Harvey Cushing likened the excitement of the possibility of identifying causal bacteria for numerous common infections to “new discoveries . . . being announced like corn popping in a can.”27 Physicians excited by the possibility of making new discoveries came from America and elsewhere to Europe in search of expanding the repertoire of disease-­producing bacteria. By the 1880s, European germ researchers had already expanded their efforts beyond microbe hunting toward the practical applications of preventing or remedying human diseases. Their goal became discovering the means to kill disease-­ causing germs or inactivate their toxins. Louis Pasteur, for example, began a series of investigations to show that immunity could be produced through inoculation of attenuated live germs.28 He induced immunity in animals by injecting bacterial cultures that he rendered nonvirulent by laboratory manipulation. Later, Koch attempted to treat tuberculosis, albeit unsuccessfully, by using immunization with tuberculin.29 Emil von Behring, Koch’s

Introduction 9

student, successfully produced immunity to tetanus in rabbits, which resulted in the discovery of the diphtheria and tetanus antitoxins by Pasteur’s student Emile Roux.30 These discoveries allowed physicians to treat previously lethal infections by injecting the ailing person with an antitoxic serum prepared by earlier immunization of an animal. Adherents of bacteriology heralded diphtheria antisera as tangible evidence that dramatic cures for infectious disease could be attained through the application of the principles of the germ theory of medicine.31 Historian William Bulloch noted that American physicians who traveled to Europe were captivated by the European scientists who were using germ theories to devise practices to control human diseases.32 Upon returning to the States, American physicians translated their newly acquired knowledge into the creation of public health departments to control communicable diseases.33 They imported their European methodology to newly constructed public health department laboratories in New York City (1887); Providence, Rhode Island (1888); and the state of Massachusetts (1888).34 In the realm of public health, they applied European bacteriological techniques to treat disease causing bacteria, nullify their toxins, or prevent infection.35 William Park, bacteriological diagnostician at the New York City Health Department, for example, began to mass-­produce diphtheria antitoxin for the protection of the community.36 The New York City Health Department laboratory later sought to mass-­produce sera and vaccines to combat tetanus and other lethal diseases.37 Directed by physicians educated about European germ techniques, the focus of American public health laboratories at their inception was the practical application of bacteriological methods to identify and control epidemic diseases. Physicians and public health officials began to write about how bacteriology laboratories improved the capacity of public health departments to control epidemics. Stephen Smith, surgeon and officer in the New York City Metropolitan Board of Health, posited in 1921 that the use of bacteriological testing enabled the department to establish a more precise diagnosis, permit specific targeted therapy, and better control epidemics than had previously been possible.38 At the time Smith was writing in 1921, his department had been using standard culture methods along with a new immunologic Schick test to identify cases of diphtheria and target who should receive a vaccine with greater certainty. About these new diagnostic tests and practices, Smith said that the “brilliant research and discoveries abroad were accepted and extended in this country.”39 Because of bacteriology laboratories, Smith said, “Knowledge has replaced guess work; experiment has superseded empiricism.”40 Like Smith, Charles Chapin, superintendent of the Department of Public Health in Rhode Island, maintained that bacteriological testing eliminated

10 Introduction

guesswork and permitted the targeted use of biological products in a discriminating fashion.41 Chapin claimed the bacteriology laboratory targeted public health measures by keeping human feces out of food to fight dysentery, destroying mosquitoes to combat yellow fever, and vaccinating against smallpox. Chapin argued that laboratories enabled health departments to pinpoint “the mode of transmission of each infection and discover its most vulnerable point of attack.”42 Chapin argued that the advent of vaccines and antitoxins, together with diagnostic testing to direct their proper use, provided health workers with a targeted method for both preventing and curing contagious disorders. The positive stories that physicians like Chapin and Smith told about early bacteriology in the realm of public health resonated with the optimism about the promise of science and a faith in the reality of progress that characterized the Progressive period in which they wrote.43 Later in the twentieth century, medical historians continued the positive theme of the practical applications of early American bacteriology. George Rosen, physician and medical historian at Yale University Medical School, argued in 1958 that bacteriologists opened a path for the control of infectious diseases on a “more rational, accurate and specific basis.”44 He wrote that epidemics could be handled more efficiently because the “empirical shotgun methods of an earlier day could now be made more precise and definite.”45 Likewise, Howard Kramer, medical historian at the University of Iowa, wrote in 1948 that bacteriology replaced older “fallacious ideas” and provided “certainty as to diagnosis and knowledge of the method of disease transmission.”46 Kramer noted that twentieth-­century epidemics were “giving ground as they were faced with man’s increasing scientific knowledge.”47 In 1992, John Duffy, medical historian at the University of Maryland, also argued that the bacteriology laboratory yielded more precise methods of diagnosing disease than had been possible in previous times and saved lives by the targeted use of vaccines, antisera, and antitoxins.48 These historians maintained that bacteriology improved and reformed public health departments.49 Their positive themes resonated with a widespread confidence during the postwar period in mid-­twentieth-­century America that the nation’s success in the war had to a degree been a product of its scientific and technological prowess.50 Scholars have also portrayed a pragmatic phase of early American bacteriology devoted to destroying disease-­ producing germs at the expense of pursuing original knowledge. Esmond Long, pathologist at the University of Pennsylvania, noted in 1959 that “little original work in the field of bacteriology had been done in this country.”51 Similarly, Rosen argued that American physicians were behind the Europeans in the development of basic

Introduction 11

bacteriological science, as they focused their attention on the practical application of bacteriological principles.52 Rosen stated, “while Americans contributed only in a limited degree to the growth of microbiological knowledge, they were more alert than their European confreres to its practical applications.”53 Duffy said in 1990, “Americans contributed little to the development of bacteriology.”54 Barnett Cohen, a chemist from Johns Hopkins University, wrote in 1950 that “the practical applications of bacteriology carried out in America followed the germ theories of Europe.”55 Kramer said in 1948, “European germ theory as applied in public health departments in America [met its] awesome possibilities.”56 Sociologist Paul Starr said in the 1980s, “While Europeans made the major theoretical advances in bacteriology, Americans made some of the practical applications.”57 Scholars have consistently upheld that the foremost contribution of early American bacteriology had been its practical applications—­not its originality. One can speculate why the dominant view of early bacteriology in America veered away from emphasizing originality and instead came to highlight the practical application of existing theories. One explanation could be the locations where these studies were done—­in public health departments where the focus of bacteriology has been its application to controlling disease. Secondly, it may be due to the power of the narrative that encompasses the excitement surrounding the discovery of bacteria and the drama of vanquishing killer diseases. It was a story told first by early twentieth-­century physicians and public health officials who were attracted to the compelling narrative of how previously lethal diseases were controlled by the application of germ theories in the bacteriology laboratories located within public health departments. C.E.A. Winslow, chairman of the department of public health at Yale Medical School, captured the compelling drama of this story. In 1950, he said, “This was a thrilling period in the history of our science—­the revelation as ‘the science of the infinitely little’—­the sudden opening of a whole new world of organic life, fraught with the widest implications for the future welfare of mankind.”58 Winslow’s comment epitomizes the element of adventure and discovery associated with the conquest of epidemics that has been so momentous to physicians, medical historians, and general society.59 Perhaps this powerful story of control and decline has obscured the less dramatic investigations such as those done by Novy. Basic investigations like Novy’s were discussed primarily among experts using highly technical, arcane language within the field of bacteriology. Furthermore, the consequences of these studies were perhaps not as recognizable to general physicians who wrote about medical history, or later to medical historians. Or perhaps the rewards

12 Introduction

of their outcomes were not as captivating as the control of previously lethal diseases—­the story told by examining the work done in public health department bacteriology laboratories. Regardless of the reasons, systematic accounts of the work of bacteriologists like Novy who worked in university laboratories during the late nineteenth and early twentieth centuries have been largely left out of historical narratives about early bacteriology in America. Some studies, nevertheless, have addressed bacteriological work done outside of American public health laboratories during this time period. This work, however, has largely focused on the pragmatic search for organisms that caused agricultural, animal, or human disease.60 In 1880, for example, Thomas Burrill, professor of botany at the University of Illinois, investigated a bacterial etiology of a plant disease called “pear blight.”61 Also, George Sternberg of the US Army Medical Center discovered a bacterial cause of pneumonia in humans.62 Further, pathologists William Welch and Mitchell Prudden at the Bellevue Medical College and the College of Physicians and Surgeons in New York identified a bacterial cause of a human bloodstream infection.63 And Theobald Smith of the Bureau of Animal Industry of the US Department of Agriculture in Washington carried out field studies of a disease among cattle called Texas fever to show that the disease was caused by protozoa, Pyrosoma bigemmum, and spread by cattle ticks.64 The work done by these investigators at their respective American institutions in the 1890s has focused largely on searches for a microbial cause of a particular disease and the insect carriers that were responsible for its transmission. To date, however, historians have not systematically explored the work of bacteriologists who began to work in university-­affiliated medical school laboratories in the 1880s and 1890s: Novy (Michigan); William Trelease, Harry Lyman Russell (Wisconsin); Joseph McFarland, Alexander Abbott, Henry Formad (Pennsylvania); and Veranus Moore (Cornell). I explore the research and educational activities of Frederick Novy, whose focus on fundamental biology as opposed to practical applications was distinctly different from that of other bacteriologists of his time. Chapters

Chapter 1 traces how Frederick Novy became a full researcher-­educator in a medical school setting. Novy became an amateur scientist while in high school, examining specimens he obtained from the natural environment. In college and graduate school, he chose to study chemistry, where he learned to devise equipment to test hypotheses and carry out experiments. During medical school, Novy learned the new science of bacteriology firsthand in Europe. He was

Introduction 13

drawn to the instrumental side of European bacteriology, which he approached with a predilection he had already embraced as a chemist. The Hygienic Laboratory at the University of Michigan was the structure that permitted Novy to pursue his research. At this time in America, most bacteriology laboratories were located in public health departments in urban settings for the pragmatic purpose of controlling epidemics then raging in crowded, unsanitary cities. But the key interest of Victor Vaughan, founder of the university’s Hygienic Laboratory, was to carry out independent research along with fulfilling its practical obligations. Vaughan hired his striving student in physiological chemistry, Novy, as an assistant in the laboratory and full-­time faculty member. This newly created position, together with the location of the laboratory within the medical school, enabled Novy to set an agenda for original investigation in the context of public health duties. Chapter 2 describes the broad scope of Novy’s original laboratory experiments. Throughout his career, he explored a number of fundamental questions about microbes—­including the machinery of microbial life and their basic biological behavior in nature. Novy investigated the chemical processes of metabolism and respiration, devised equipment to culture a wide array of microbes in situations where others had been unable to, and invented novel methods to understand the behavior of protozoa in nature. He also attempted to use his methods to resolve disagreements among bacteriologists about microbial speciation and to settle controversies among physicians about the cause of a 1901 epidemic in San Francisco whose cause was hotly disputed. Novy carried over his childhood interest of using instruments to uncover nature’s secrets to his adult career. Historians’ common view of this time as a period of great germ hunting—­American scientists applying European germ practices to public health departments—­did not actually apply to the work done by Novy. He instead meticulously performed basic scientific investigations in his distinctive medical school setting. Chapter 3 shows how Novy used his fundamental scientific research operation as a platform to teach bacteriology to all medical students at his university. He familiarized students with hypotheses about microbes, and then he helped them become acquainted with the latest scientific instruments and laboratory techniques of the day. To accommodate intensive courses like Novy’s full-­ semester lecture-­laboratory bacteriology course, the medical school expanded the course of study from three to four years and raised admission standards to ensure that students were capable of grasping rigorous scientific coursework. Novy’s vision of integrating basic laboratory science into the medical

14 Introduction

curriculum was a key portion of the medical reform that was taking place at the University of Michigan in the early 1890s and the formation of medical education in America up to the present. Novy sought to foster in students a spirit of research in medicine—­an ideal that valued searching for occult truths in nature and a commitment to discipline, work, and independence in choosing experiments without the constraint of practicality. He intended to instruct the mind and mold the moral character of all students. Novy’s students valued his brand of instruction and the ideals he espoused. In turn, he viewed his instruction as providing legitimacy to a profession that could now behold verifiable truths. Novy was thus able to create a group of adherents who valued the pursuit of knowledge for its own sake and, in the process, to establish the viability of the physician scientist and a long-­lasting space for lecture and laboratory basic science courses in medical education. Chapter 4 explores how Novy’s fundamental science activities were an important component in the construction of bacteriology as an independent discipline. A cadre of scientists, including Novy, who were the founders of the Society of American Bacteriologists in the 1890s argued that because of the unique ideas, tools, and methods used by a bacteriologist like Novy to understand natural phenomena that had previously been unaccounted for, bacteriology deserved the status of a separate scientific field. Other fields of science, such as astronomy and geology, they maintained, had done the same, and this was what conferred independent status on these sciences.65 By providing his students a unifying purpose of accessing nature’s truths, Novy was able to cultivate a group of adherents in bacteriology, including his student Paul de Kruif. The possession of distinct knowledge, techniques, and identity legitimated the creation of bacteriology as its own field and the establishment of bacteriology as its own basic science department in medical schools such as the University of Michigan in 1902 and other American medical schools to follow. Chapter 5 uses Sinclair Lewis’s novel Arrowsmith and its film adaptation to explore the meanings of Novy’s activities for early twentieth-­century American society. The novel follows the education of Martin Arrowsmith, a medical student who is attracted to the ideal of medical research as embodied by his bacteriology professor Max Gottlieb. Lewis bases Gottlieb on information about Novy supplied by Paul de Kruif.66 Though de Kruif stated that Jacques Loeb, a scientist de Kruif admired when he worked at the Rockefeller Institute, also influenced his writings, the truth-­searching characteristics of Gottlieb were specifically patterned after Novy.67 Likewise, Lewis acknowledged that

Introduction 15

he relied on de Kruif’s firsthand knowledge about his experience with Novy to construct the image of Gottlieb as the medical researcher.68 Gottlieb, Lewis’s fictional Novy, was Martin’s greatest mentor in the novel.69 Lewis’s novel depicted the independent, truth-­seeking medical researcher as possessing an ideal that was lacking in other professions in American society. The film Arrowsmith, released in 1931, echoed the novel’s portrayal of the medical scientist as a disinterested and relentless seeker not of profit but of truth. The movie, like the book, was popular and became a box office success.70 The novel and movie had widespread and long-­lasting appeal in twentieth-­ century American society. Chapter 6 shows how Novy succeeded in his efforts to achieve his goal of becoming a full-­time researcher who contributed to the sum of scientific medical knowledge. Novy made active choices to remain in the setting that permitted his unique laboratory focus throughout his career. With the exception of a two-­month investigation of an outbreak of plague in San Francisco in 1901, Novy avoided involvement in public health department activities that might derail his focus on original research.71 He also declined offers from competing institutions, including one to head bacteriological research at the Rockefeller Institute, which would have given him a higher salary and greater laboratory support than what he had available at Michigan.72 Novy chose to retain the intellectual independence that allowed him to select research topics and carry out experiments without the constraints of practicality. By making a career in medicine outside of simply caring for patients, Novy became an important figure in establishing experimental investigations in the laboratory as a foundation for a medical career in America. Novy, in summary, was an early American bacteriologist whose work was distinctly different from that of other bacteriologists of his day and whose activities had an enduring legacy for medical education, bacteriology, and American society. The lecture-­laboratory course that Novy pioneered was instrumental in establishing a permanent space for the basic sciences in medical education. He helped to establish the viability of a new type of physician in the medical profession—­the physician scientist who works full-­time as a researcher and educator at a medical school base. His basic research activity and his scientific ideals were instrumental in establishing bacteriology as an independent discipline with its own basic science department in medical schools today. Today, the prominent coverage of discoveries by medical researchers in the lay media and press is an indicator of the American public’s curiosity about the activities of the medical researcher. Novy’s activities provide insight into the historic

16 Introduction

roots of these cornerstones of biomedicine. Moreover, his bacteriological activities helped to shape the contours of our biomedical profession in America that endure today. Despite his preeminence at the time and the importance of his activities in helping to establish the scientific underpinnings of American medicine and medical education today, Novy’s name is unfamiliar to many medical historians. One can speculate why in histories of microbiology and medicine Novy is given polite but cursory mention, unlike the names of Koch or Pasteur.73 Texts on the history of bacteriology, for example, reference Novy only once, whereas they have full chapters devoted to Pasteur and Koch.74 Perhaps historians have focused on these well-­known researchers who professed to have founded a new science. In addition, Novy’s orientation toward basic research may have lacked the sensation that surrounded more well-­known endeavors of his day. I do not intend to portray Novy’s work as a triumph over traditional medical ideas and practices. Rather, I intend to credit him for his unique vision of medical research and the ideals of the brand of scientific medicine that he espoused. My intention is to use Novy’s self-­derived and influential activities to provide a more complete narrative of early bacteriology in America than can be found in the literature and to explore the significance of his scientific contributions for medicine, bacteriology, and society.

Chapter 1

Frederick Novy and the Origins of the Michigan Hygienic Laboratory

Frederick Novy’s relationship to his workplace was distinctive—­it served as a base that enabled him to combine laboratory investigation and instruction on a full-­time basis. The Hygienic Laboratory at the University of Michigan was the institutional structure that permitted Novy’s original research investigations and educational activities. To understand how the laboratory and its mission arose, the beginnings of the Michigan Public Health Department and the University of Michigan Medical School will be explored. These two institutions became connected through the vision of Victor Vaughan, the laboratory’s founder. While acknowledging the practical mission of the Hygienic Laboratory, Vaughan’s major interest was to carry out fundamental, independent research. Vaughan successfully obtained funding from the state legislature to build and equip the Hygienic Laboratory for these purposes at the University of Michigan. Vaughan hired his most promising student in chemistry, Novy, as the assistant in the new laboratory. Shortly thereafter, Novy and Vaughan decided to travel abroad to study bacteriology, first at Koch’s Hygienic Institute of Berlin and then at the Pasteur Institute in Paris. But why travel to Europe in pursuit of an idea they had already developed? Both men recognized the need to learn bacteriology in the two laboratories of the world where advanced training in the new science was offered by master scientists. They learned exacting experimental techniques in well-­equipped laboratories from leading European scientists. Novy, upon return to America, used his European training in his Hygienic Laboratory to perform original research into basic aspects of microbes and their behavior. At this time, though, his position also entailed practical duties in the

17

18

Chapter 1

public health service. Novy believed his “original” research intentions would complement the practical responsibilities that were expected of him. In order to best understand what may have attracted Novy to a full-­time laboratory-­ based research position at a medical school, this chapter explores his early background as an amateur scientist and his inclination toward laboratory investigation, which he developed during his study of chemistry as an undergraduate. It also describes his German training and the aspects of his European experience that he sought to replicate after he returned to America. The Michigan Department of Health

The Michigan Board of Health was created in 1873 with a progressive goal to provide a rational, systematic means for the prevention of diseases that threatened the public well-­being.1 The founder of the Michigan board, Dr. Henry Baker, had become convinced of the need for a state board of health to track the vital statistics of these diseases. At this time, the state health agency was gaining public support because of the frequency with which illuminating oil, used in homes and the workplace, was exploding and resulting in fire, property damage, injury, and death. This was compounded by a scare about the use of arsenic in wallpaper.2 Baker had been involved in army hygiene and sanitation during the Civil War and subsequently served on the Michigan State Board of Agriculture.3 After reading the first report of the Massachusetts Board of Health, Baker persuaded the Michigan State Medical Society to promote a similar agency for Michigan. His medical partner, Dr. Ira Bartholomew, was president of the state medical society and was elected to the state legislature.4 With Bartholomew advocating in the legislature, the Michigan State Board of Health was established in 1873.5 The first members appointed to the Michigan board, four physicians and two ministers, set an ambitious program. Baker, who was chosen secretary, sought to compile statistics on sicknesses among people, including diarrheal illnesses and circumstances and conditions that influenced public health, such as hazardous illuminating oil and the hygiene of school buildings.6 Baker also laid out an educational mission of teaching citizens about how to avoid potentially harmful environmental exposures to products like poisonous wallpaper. The board conducted sanitary investigations and drafted regulations in regard to water supply, disposal of excreta, and the heating and ventilation of any public institution or building.7 The Michigan board worked with the legislature to enact a law in 1877 that required each township to appoint a health officer to report on health and sanitary conditions.8 The law created a need for qualified health officers and led the board to conduct sanitary science examinations in 1878 to certify the officers



Origins of the Michigan Hygienic Lab 19

in biology, diseases, physical science, sanitary engineering, and sanitary inspection. The first Michigan Health Department created a progressive agenda and recruited professionals on its staff as well as its board. The Michigan board began to carry out an expansive array of projects ranging from investigations on the adulteration of foods to the publications of pamphlets and yearly activity reports of its activities.9 Sanitary conventions were designed to educate local health officials and the public.10 The Michigan board developed standing committees dealing with health and sanitation topics, including how to test various foods for adulteration—­milk, ice cream, and maple syrup. Samples were collected throughout the state and sent to a central physiological chemistry laboratory at the University of Michigan for analysis by Albert Prescott, professor of physiological chemistry.11 During 1882, a newly appointed member of the Board of Health, Victor Vaughan, assistant professor of hygiene and public health at the University of Michigan, lectured the public on how to eat a nutritious diet.12 Victor Vaughan (1851–­1929) was a physician and a leading proponent of hygienic science in the late nineteenth century. He graduated from Mount Pleasant College in Fayette, Missouri, in 1872 and entered the University of Michigan in 1874 to study chemistry. He received a doctorate in chemistry in 1876 and a medical degree in 1878. For twenty years following his graduation, Vaughan was engaged in active medical practice.13 But his interests focused on laboratory work, particularly the relationship between chemistry and hygienic science. Through his association with the Michigan Department of Health, he was to investigate poisonings and adulterations of foods. In recognition of his contributions on preventive medicine, epidemiology, and food poisonings, Vaughan became an assistant professor of chemistry in 1880 and then professor of hygiene and physiological chemistry at the University of Michigan in 1887.14 In the mid-­1880s, the statistical studies done by the Department of Public Health led Vaughan to speculate that outbreaks of poisonous foods were potentially caused by infectious diseases. In 1883, an outbreak of cheese poisoning affected hundreds of persons in widely scattered parts of Michigan, and it was followed by an epidemic of poisoning from ice cream.15 In 1884, Vaughan traveled to various townships to inspect local markets and then returned to his laboratory to analyze food samples that had been purchased in grocery stores.16 Vaughan found evidence of fishmongers’ hiding signs of decomposition by removing a fish’s eyes and coloring its gills with blood.17 He also went to a cheese factory in southeastern Michigan, Lenawee County, that had been identified as one of the sources of poisonous cheese. Vaughan speculated that the tainted cheese was the result of bacterial contamination. He postulated

20

Chapter 1

that “[poisonous] changes in milk occurred due to growth of minute organisms.”18 Vaughan, however, was performing his public health activities in the mid-­1880s when bacteriology was in its infancy and, despite his suspicions, he did not have a bacteriology laboratory or the necessary techniques to test his hypothesis. The Hygienic Laboratory at the University of Michigan

The speculation about infectious outbreaks prompted Vaughan to call for a hygienic laboratory that could perform bacteriological testing of suspected specimens.19 Vaughan, who headed a special committee of the Michigan board members, conferred with the regents of the University of Michigan about establishing a state hygienic laboratory at the university.20 To the regents, Vaughan argued that the location of the laboratory within the university would be mutually beneficial: the presence of the laboratory would strengthen the science department at the university by providing specimens for analysis, and the hygienic laboratory would be enriched by scientific research being done in departments at the university.21 Vaughan said that the laboratory should “naturally belong to the university and have all the advantages of the association with the other departments. . . . In union there is strength, and . . . there will be felt an influence in the direction of scientific thought and investigation which will [redound] to the interest of the University and the state at large.”22 To Vaughan, locating the Hygienic Laboratory at the university would strengthen the scientific analyses of the laboratory, improve public health, and drive the school in a more practical direction. Although this seems like a natural source of collaboration today, academia in the late 1880s tended to be closed to practical studies. Vaughan maintained that the university had traditionally focused on purely scholarly subjects (e.g., the literature and language of ancient Greece), but it ought to pay more attention to pragmatic issues—­the health of its own citizens. He stated, “Would it not be well to give a little attention to the prevention of disease? Shall it leave from its curriculum altogether the study of the prevention of diseases which afflict human life? Are the lives of citizens of so little value?”23 In his justification of a university location for the Hygienic Laboratory, Vaughan made an argument that the university’s academic mission contains a fundamental duty to public service. Vaughan’s argument that both universities and government science agencies were duty bound to public service was not totally new, as the Library of Congress (created in 1800, it provided scientific investigators access to primary sources to map mineral resources in the United States); the Geologic Survey (funded in 1879 by the



Origins of the Michigan Hygienic Lab 21

federal government to advance understanding of the natural environment); and the Morill Acts (created in 1862 to establish extension programs in how to use resources more efficiently for citizens and farmers) represented a call to public service by the government or universities.24 Nonetheless, hygienic laboratories in America were being developed separately from universities until Vaughan made his arguments to link them. In arguing that the Hygienic Laboratory would make the university more useful in promoting the welfare of the people, and that training in sanitary science was as worthy as training in any other science or in art or literature, Vaughan became an advocate for change. Educational reform was already underway at the University of Michigan. As Vaughan made his arguments about the potential for a mutually beneficial relationship between laboratory and educational institution, the university’s president James Angell was also becoming a primary instigator of change toward a modern university.25 President from 1871 until 1909, Angell involved himself in the development of the university’s activities and pressed for the growth of practical subjects, particularly the natural sciences. He felt these subjects, unlike the focus on the antiquities, were of use to mankind, and he initiated advanced instruction at the graduate level.26 In recent years, American universities have not changed as dramatically as the University of Michigan did in the 1880s. During that period, Angell expanded the topics of courses offered to undergraduates, including modern languages, science, engineering, and laboratory-­based courses.27 He also promoted original research in laboratories and the introduction of the elective system.28 Angell insisted that the university promote education and research in all areas of learning, new and old.29 He also sought to invigorate the university’s professional schools—­medicine and law—­which he felt had been functioning autonomously and should be fully integrated with the spirit of university life.30 At Michigan, two professors exemplified Angell’s idea of a unified modern university as they taught courses—­Victor Vaughan, who taught “Sanitary Science,” and Albert Prescott, who taught “Organic Chemistry”—­and had dual appointments in the Chemistry Department in the Literature, Arts and Sciences Department, and also at the medical school.31 As a symbol of the integration of the university’s medical school with the sciences on campus, Angell occasionally attended the biweekly faculty meetings held by the medical school.32 Angell and Vaughan advocated for educational reform and a closer relationship between the professional schools and the basic science departments at Michigan, which coincided with the rise of the modern universities in America. Angell reasoned that a closer relationship would enhance the quality of the science at the medical school, as well as provide opportunity for

22

Chapter 1

practical applications of the basic sciences. Angell’s stance had been advocated earlier—­in the 1870s—­by President Charles Eliot at Harvard, and was also promoted in the 1880s by Daniel Gilman at Johns Hopkins and Andrew White at Cornell.33 Vaughan himself acknowledged that universities older than Michigan, including Oxford and Harvard, had begun to construct new departments and courses to meet what he called “the wants of the time.”34 Thus, Angell’s idea of educational reform, with the new sciences being offered in addition to older courses and the integration of the professional schools with laboratory-­ based sciences on campus, was consistent with the vision of a modern university that had been previously promoted by a handful of other American college presidents.35 Vaughan’s argument to locate the laboratory within the university resonated with the regents, who were eager to strengthen the sciences through linkages between the university and the state. Hermann Kiefer, a scientifically trained German physician who practiced in Detroit, was the chairman of the Medical Committee of the Board of Regents, who approved Vaughan’s request on December 7, 1886.36 After gaining the approval of the regents, Vaughan requested funding from the state legislature to organize and equip a suitable hygienic laboratory, which he argued was “absolutely essential to the best interests of the people of this state for their preservation and well-­being.”37 To the legislature, Vaughan argued that it is the duty and responsibility of the state to provide support to protect its citizens from disease, as had been done in other countries but not yet in other states in America. Vaughan said, “Nearly every civilized country is now manifesting great interest in the protection of the health and the prolongation of the lives of its citizens. Germany has established a number of hygienic institutes in connection with its universities. . . . The municipal laboratory in Paris is maintained by the city [resulting in] the wisest enactments against food adulterations.”38 Vaughan reminded the legislature that precedents had been set in other countries regarding the duty of the state to fund well-­equipped hygienic laboratories, and he argued that Michigan could lead in making the changes needed and America should follow its lead. Vaughan’s arguments proved successful. On January 17, 1887, the state legislature received a request from Vaughan and Baker of the State Department of Health to construct a hygienic laboratory at the University of Michigan, with the regents’ approval, for the dual purposes of “preservation of life and . . . perfection of . . . physical health . . . [and the] teaching of knowledge of most worth” at the university.39 In a joint petition with a group of regents of the university, the Michigan Senate convened on June 24, 1888, and the state legislature granted $30,000 to the university to build and equip a laboratory for



Origins of the Michigan Hygienic Lab 23

hygiene in the building that also housed the Physics Department.40 Construction began in October 1887, and the facility was ready for use by late autumn 1888.41 This time period coincided with the opening of hygienic laboratories at the US Marine Hospital Service (1887) that were moved to Washington, DC in 1892, and the health departments of other states—­Rhode Island (1888) and New York (1892). But the Michigan Hygienic Laboratory was the first in America to be linked with a university, thereby enabling what Vaughan described to the regents and legislature as the advancement of “hygienic science . . . on a plane not inferior to any subject taught at the university.”42 To achieve his goal, Vaughan appointed his favorite student in chemistry, Frederick Novy, as assistant in the laboratory and instructor of hygiene.43 Shortly after his appointment, Novy expressed his pleasure with the amount of funding granted by the state for their laboratory, stating, “Success eventually crowned the efforts of the board and a generous appropriation by the legislature.”44 Furthermore, because the building cost $29,000 to construct, Novy and Vaughan used a portion of the $30,000 state grant left over to pay for additional equipment and reagents.45 Novy credited the state legislature for providing what he judged to be a “well-­constructed and well-­equipped laboratory” that he considered “suitable for [his] . . . purposes.”46 As early as October 1887, Vaughan laid out his goals and agenda for the laboratory.47 Vaughan and Novy considered practical services to protect the well-­being of citizens—­bacterial analyses of specimens from ill patients (e.g., sputum and other substances) and also analyses of milk, water, meats, and other substances to search for pathogenic bacteria—­as their duty to the state.48 But they prioritized their goals and identified original research in bacteriology and biology as the primary calling of the facility and staff.49 Thus, Vaughan’s goals of the Hygienic Laboratory were aligned with Angell’s overall vision of a modern university. In addition, Vaughan’s primary mission for the Hygienic Laboratory differed from the primarily practical duties and responsibilities of hygienic laboratories being constructed in state and municipal public health departments. About the mission of his Hygienic Laboratory, Vaughan said, “Research work constitutes the real raison d’être of a laboratory.”50 Vaughan constructed an argument that linked original research with a public health mission to preserve life. Vaughan’s insistence on original research and instruction also must be understood within the context of the overarching effort to make medicine more scientific at the University of Michigan Medical School. Opened in 1850, the medical school differed from proprietary schools in having its building on the campus of a university and employing professors who were paid

24

Chapter 1

salaries.51 Many proprietary medical schools located outside of academia had two three-­month semesters, and teachers were paid with fees received through their private practices. The original two-­year curriculum at Michigan was composed of two four-­month semesters and was principally composed of didactic lectures. With the 1881 hiring of Henry Sewell, research had begun in one laboratory-­based scientific discipline, physiology.52 Sewell extended the physiology lectures from thirty to eighty lectures and from one to two terms to illustrate his lectures to medical students with laboratory demonstrations, although the course did not have a dedicated laboratory component for student participation. To accommodate the extended time in physiology, as well as the extended number of courses Vaughan offered in sanitary science, in 1884 the total course of study was extended from two to three years.53 As an instructor of hygiene, Novy’s duty was to serve as an assistant researcher in the Hygienic Laboratory and to teach a course in bacteriology.54 When Vaughan became the dean of the medical school in 1891, a position he held until his retirement in 1921, he became intent on reshaping the entire medical school into a center of advanced teaching and research. By gathering expert faculty, Vaughan enabled the medical school to be considered by its peers as the strongest scientific school in the country.55 In accomplishing this, Vaughan sought to foster a culture of scientific medicine by assembling a cadre of expert faculty in an array of fields that included physiology (Henry Sewell and Warren Lombard), pharmacology (John Jacob Abel and Arthur Cushney), anatomy (Franklin Mall), internal medicine (George Dock), pathology (Aldred Warthin) and, in 1891, physiological chemistry and hygiene (Frederick Novy).56 Who Was Frederick Novy?

Novy was born in Chicago on December 9, 1864, two years after his parents emigrated in 1862 from Bohemia, in what is now the Czech Republic, seeking greater security than may have seemed possible amid the political turmoil in their homeland.57 In the 1860s, Bohemia was ruled by the Austrian Empire, as the Czech nationalists who called for autonomy for Bohemia had been defeated during the Revolution of 1848. Following their defeat, many Czech nationalists were constitutional monarchists and remained loyal to the central Hapsburg emperor. But by 1861, an opposing political faction emerged consisting of the Bohemian aristocracy who favored the renewal of the old Bohemian Crown. By 1864, tensions were mounting between the Austrian Empire and the Kingdom of Prussia over the unification of the German states that anteceded the 1866 Austro-­Prussian War fought in Bohemia. It is possible that Novy’s father, Joseph, who was conscripted as a sergeant in the Austrian army for seven years



Origins of the Michigan Hygienic Lab 25

from 1851 to 1858 and had been a master tailor in Bohemia, was in favor in 1848 of the nationalist and labor movements.58 Novy’s father may have felt conflicted by a dual loyalty to Austria and to Bohemia during this time of conflict. As Joseph did not want his sons to be required to serve seven or more years in the Austrian army, especially during a time of conflict, he decided to move to the United States to make a better living than he was able to do in Bohemia.59 Joseph moved to Chicago, where there was a large Bohemian settlement in the regions of South Canal and South Halsted Streets.60 They built a two-­story multifamily frame house, where Joseph’s living quarters were on the first floor, and the upper floors were rented out. Both of Novy’s parents worked jobs, his mother as a milliner in their tailor shop in the basement, where a major part of their business was making uniforms for policemen. The young Frederick Novy’s academic interests were evident as early as elementary school but continued to evolve through high school.61 In elementary school, his major interest was history.62 He maintained this focus as a teenager, but by high school, he also had begun to explore science, including archeology.63 Novy particularly enjoyed classical Greek and Roman history and archeology.64 During his senior high school year in Chicago, Novy’s interests ranged from ancient Egyptian, to Greek, ancient Roman, and medieval history.65 Although his primary academic focus would continue to veer toward science, his early interest in history would carry over into his professional life as he emphasized the historical aspects of a particular scientific topic he was studying (e.g., the germ theory of medicine, trypanosomes, etc.) in his scientific articles and lectures.66 Outside of his studies, Novy sold newspapers and served as an altar boy at the First Bohemian Catholic church on Dekoven Street in Chicago, where both of his parents were parishioners.67 By his junior year of high school, Novy’s interest in science had been refined to chemistry and involved laboratory experimentation and research.68 He was influenced by a chemistry teacher, Marc Delafontaine, who lectured and then performed laboratory demonstrations.69 Novy was particularly intrigued by Delafontaine’s experiments.70 Under Delafontaine’s guidance, Novy soon began to perform chemistry experiments of his own in a laboratory that Novy constructed beneath the back wooden stairs of his home (see figure 1.1). On one occasion, Novy noted he had succeeded in making an unstable gas—­phosgene—­which exploded and blew up part of the stairs, nearly setting fire to his family’s house.71 Acknowledging Novy’s efforts at experimentation, Delafontaine invited Novy to his home and showed Novy his microscope and spectroscopes. Influenced by this visit, Novy resolved to earn enough money to buy a microscope of his own. In September 1880, he was hired for a job in

Figure 1.1   Novy at age fifteen in 1880. Novy was an amateur scientist and attended West Division High School in Chicago. (Courtesy of the Novy family)



Origins of the Michigan Hygienic Lab 27

the stacks of the Chicago Public Library. For the next two years, he worked evenings and weekends in the library.72 With part of his earnings, he purchased his own microscope—­a high-­quality R and J Beck variety that was expensive, sixty dollars, for its day.73 Novy turned to the natural environment and began to seek ways to use his newly purchased instrument to unveil microscopic inhabitants in nature. He began to search ponds and fields for life invisible to the naked eye.74 In the late nineteenth century, this sort of behavior—­searching the outdoors for specimens to observe organisms with microscopes—­was practiced by other amateur scientists, too.75 Novy collected specimens from ponds and swamplands on the outskirts of Chicago, particularly Lincoln Park and Chicago’s South Side, to search for and view various forms of microscopic life, including algae.76 In Chicago, a group of amateur scientists formed a club, the Chicago Microscopical Club, that Novy was prompted to join by the person who sold the microscope to him.77 A dozen amateur microscopists of various backgrounds (e.g., lawyers, ministers, doctors), with their microscopes and specimens, organized periodic meetings.78 At these meeting, Novy developed his microscopic skills by observing specimens that other microscopists had collected around the Chicago surroundings and presenting specimens he had collected to them.79 One of the specimens Novy collected was in a form of Volvox, a free-­ swimming freshwater single-­celled alga found in ponds, ditches, and shallow puddles. He had read that Volvox was an exclusively European organism.80 But with the help of the amateur microscopists, Novy found that this alga, propelled by whip-­like structures called flagella that allowed it to dart under his view, could also be found in America. After finding Volvox, he looked up in the literature what he had seen in nature, to see if what he was observing had been described before.81 It was in one of the books on free-­living protozoa that Novy first read about trypanosomes—­ other unicellular, motile, flagella-­ propelled organisms that would later appear prominently in his work as a medical investigator. As an amateur scientist, Novy was stirred by a spirit of mastering techniques to explore unknowns in his environment—­a spirit that he would uphold throughout his professional career. Delafontaine wanted to continue to assist Novy in his explorations, and he viewed Albert Prescott, professor of physiological chemistry at the University of Michigan, as an authority in his field. Like Vaughan, Prescott taught both at the medical school and in the Chemistry Department of the university. In 1881, Novy wrote to Prescott asking for a list of the chemistry books used in the courses he taught at Michigan. With the assistance of the buyer for the library,

28

Chapter 1

who ordered the books for him at a discount, Novy purchased a set of three volumes and began to acquire a library about the principles and methods of chemistry.82 As an amateur scientist, Novy was drawn toward the use of instruments to search for nature’s hidden mysteries. But he also became interested in the empirical methods of chemistry. At age seventeen, Novy decided to follow his chief interest and become a scientist in general and a chemist in particular. It was then that he entered the University of Michigan. Novy’s decision was perhaps influenced by the correspondence he had already established with Prescott and Delafontaine’s recommendation of Prescott as a prominent organic chemist. Novy’s father Joseph, however, was not fond of Novy’s desire to become a chemist, as the career choices available to those majoring in chemistry at that time remained uncertain. Joseph wanted young Frederick to become a tailor, as did Theodore, one of Novy’s two brothers.83 Nevertheless, Novy remained steadfast and told his parents that he would enter and pay for college on his own if they could not help him.84 His considerate parents Joseph and Frances enabled his wish by themselves leaving Chicago on September 17, 1882, and moving to Ann Arbor along with Novy in order to help him financially.85 Joseph Novy worked as a tailor with his son Theodore for Wagner’s Clothing Store in Ann Arbor. Meanwhile, Frederick would pursue his college courses while living at home—­first a wooden house and then a larger brick house Novy purchased in 1900 that remained his primary residence until his death in 1957.86 Novy entered Michigan in 1882 under Angell’s presidency when the school was becoming modern. Novy was exposed to practical subjects, including the natural sciences and modern languages, as well as advanced lecture-­laboratory courses in several areas of chemistry—­analytic, quantitative, and organic—­and mineralogy.87 As a freshman undergraduate, Novy took advantage of the growing variety of subjects that were available, including the study of French and German.88 He also studied one course in logic. Novy was intellectually engaged by the subject of logic as a means to generate hypotheses and arrive at truths as evident by his meticulous notes outlining proofs on the immortality of the soul.89 Novy nevertheless gravitated toward chemistry courses, demonstrating his preference for empirical analysis rather than a strictly intellectual process as a means to apprehend truths. As a freshman, Novy was intrigued by his geology course, particularly with the focus on observation and classification of inorganic nature.90 Eventually, he was drawn toward chemistry as a subject that would provide him an opportunity to empirically test hypotheses through the use of specialized methods in the laboratory, which specialties like logic or geology couldn’t afford him.



Origins of the Michigan Hygienic Lab 29

Throughout college, Novy settled on taking laboratory-­based courses in chemistry that had been newly created at the university. In a variety of lecture-­ laboratory courses taught by Albert Prescott, John Langley, and others, Novy relished the opportunity to learn about, master, and devise equipment that enabled him to test hypotheses through experimentation.91 The precise notes of his methods and meticulous drawings of his experimental apparatus indicate that he took pleasure in the opportunity to manipulate instruments and develop confidence in designing and mastering the methods of experimentation.92 In one course in analytic chemistry taught by Langley, Novy learned about equipment used and techniques employed to test various chemical reactions and the gaseous elements that were emitted.93 In his laboratory notebook, Novy detailed his experimental methods and illustrated the apparatus he devised to analyze gases that were emitted from a chemical reaction of two inorganic compounds (see figure 1.2).94 In these courses, Novy was given the opportunity and latitude to design equipment and develop methods to analyze and quantitate products of chemical reactions.95 Novy thrived in courses where his professors encouraged instrumental design and stressed technical precision—­a scientific method he first embraced during his training in chemistry and would later transfer to his career as a medical researcher in bacteriology. Novy’s increasing proficiency in mastering scientific techniques, his skills in solving scientific problems, and his ability to perform experiments independently became evident to his professors, who were seeking students with scientific talent. In a letter of recommendation for Novy, Prescott stated, “I regard Mr. F. G. Novy as a student of unusual ability and a young man who gives excellent promise of success both as a teacher and as a worker in science. He is a man of sterling qualities.”96 Novy’s abilities led his teachers to rely on him to assist with their instruction while he was a student in their classes.97 While in college, Novy was likely exposed to issues of public health through courses in physiological chemistry taught by Albert Prescott. Prescott figured prominently in Angell’s educational reform; he had built his career by applying physiological chemistry investigations to the realm of public health.98 Prescott performed chemical analyses of adulterated foods that were sent to his laboratory by the State Department of Health. He railed against the unscrupulous practices of food adulteration and its vitiating influence on the public, including, among others, the mixture of paraffin and sugar that was deceitfully sold as honey, or colored beef tallow sold as butter.99 Prescott also exposed practices of adulterating butter and sugar sold as pure cane; he found the latter contained corn starch—­added to increase bulk.100 He said, “The dangers of

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Figure 1.2   Notebook from Novy’s 1883 analytic chemistry course. Novy’s

drawings convey meticulous attention to the details of instruments and methods that he devised to measure the gas ethylene bromide that was produced by a reaction between ethylene (heated to the left), and bromide (contained in sequential bottles moving to the right). (Courtesy of Bentley Library)

adulteration are underrated when it is supposed that falsified food can be tolerated without depraving the public purpose and impairing the sacred safeguards of human life.”101 By equating commercial fraud with health risks, Prescott exposed the exploitation of unsuspecting consumers by dishonest manufacturers and adopted a moral rather than a strictly scientific view of adulteration. Prescott’s commitment to protecting the public from injury and profiteering



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through the application of science in the realm of public health was a subject that Novy would embrace in his later professional years. The educational reforms of the 1880s provided Novy the opportunity to take advanced courses with professors like Prescott and Langley throughout his college years. In 1886, Novy was one of three Michigan undergraduate students who received a degree in a newly created program—­the bachelor of science degree.102 By the time of his graduation, Novy had flourished in an environment where he was encouraged to design and build instruments and develop methods that enabled him to empirically test hypotheses and analyze and quantify chemical reactions.103 His college education had reaffirmed his first love for chemistry and the scientific method, both of which had been kindled when he was an amateur scientist. After graduating in 1886, Novy returned to Chicago, where he sought a job as an analytic chemist. His reference letters from college professors endorsed his suitability for this position.104 In Chicago, only three men were working as analytic chemists, and all three depended upon work other than chemistry for their livelihood.105 Novy inquired about jobs at several places, including the stockyards of the meatpacking and preserving company, Armour Packing Company. Novy undoubtedly felt qualified for a position at Armour’s because he had studied about the use of preservatives in meats (e.g., borax and borates) in Prescott’s organic chemistry class in college.106 Novy explained to Philip D. Armour, the president of the company, the potential importance of the work he could do for the packing industry.107 Armour said he would hire him only if Novy would agree that the equivalent of his salary would be returned to the company in earnings collected directly from his work. Looking back on this episode after his retirement, Novy considered Armour’s response a turning point in his career. It was then he realized that he would not be able to obtain a job in industry, as he believed that industrialists like Armour did not yet adequately value chemists.108 While seeking work in Chicago, Novy received a letter from Prescott inviting him to return to Ann Arbor in 1886 as an assistant in organic chemistry at a salary of two hundred dollars per year.109 Novy accepted Prescott’s offer. During the next year, Novy taught classes in organic chemistry and toxicology at the University of Michigan and studied toward a master of science degree, a newly offered course of graduate study ushered in along with Angell’s reforms. Upon graduation, Novy presented a thesis on “Cocaine and Its Derivatives,” in which he described the chemical structural formulas of several alkaloid derivatives of cocaine that he had identified and quantified.110 Novy was one of two students at Michigan to receive a master of science degree in June 1887.111

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While a student in graduate school, Novy took courses in physiological chemistry with Victor Vaughan. He continued his teaching duties as an assistant in organic chemistry; in the fall of 1887, he embarked on further study and began working toward a doctor of science (ScD) degree in physiological chemistry, which he completed in June 1890.112 In September 1888, while still enrolled as a doctoral student, he also opted to enter medical school without specific knowledge of whether the type of experimental research he had come to know in chemistry might be feasible in the medical profession. Thus, from September 1888 to June 1890, Novy was simultaneously carrying out three tasks—­completing his doctorate degree in chemistry, teaching courses in chemistry, and earning a medical degree. In all of Novy’s notes, he never explicitly stated why he decided to enter medical school and increase what must have been an already grueling workload. One can speculate that his interest in the medical field was sparked by at least one of his three professors in the Chemistry Department who also taught at the medical school—­Prescott, Langley, and Vaughan.113 Novy entered medical school studying for a doctorate in chemistry when most of his classmates had graduated from high school only. The course of study for medical school at the time was three years: two years of lecture courses and the third year in the clinics. In 1888, Michigan’s program, like most medical school programs, consisted of lectures that covered a period of six months each for years one and two.114 Subjects that Novy took during these years included descriptive anatomy, histology, practice of medicine, systematic surgery, physiology, organic chemistry, and materia medica and therapeutics.115 These courses were taught in classroom halls by didactic lecture, with the exception of anatomy, in which students dissected cadavers in a room used for that purpose, and the occasional demonstration, such as in physiology.116 Subjects in year three taught in clinic settings included clinical medicine, clinical surgery, clinical gynecology, diseases of children, diseases of the skin, and ophthalmology and otology.117 Novy’s student notes in medical school show that, unlike his study in chemistry, the medical school curriculum did not provide a forum to critically evaluate the information received in lecture halls. Novy’s professor in his 1890 course “Theory and Practice of Medicine,” Walter Christopher, for example, focused on fixed descriptions of disease. Christopher described and categorized diseases, but, unlike in Novy’s chemistry courses, did not provide a laboratory component to empirically investigate the cause of disease or evaluate therapies that were recommended.118 Novy’s notes show how the study of medicine at that time was being presented as a defined body of knowledge and a student’s task was to



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master that knowledge rather than question, verify, or falsify it. Novy’s medicine professors provided didactic lectures that covered information about disease causality, prevention, and treatment that was derived from their experience as practicing physicians.119 Novy had become accustomed to the empirical method of testing hypotheses as a scientist, and so it must have seemed as if the didacticism of his lecture courses belied the tentativeness of medical knowledge. Novy’s student notes from an 1890 medical school lecture about diphtheria illustrate his views about the need for new methods to advance knowledge in medicine. Novy recorded detailed clinical features of the disease—­its pseudomembrane that covered the larynx, and the paralysis.120 He then wrote about how a bacterium “and its product” was responsible for the symptoms. Some therapeutics he recorded—­lime water or carbolic acid applied by a spray—­were antiseptics used at the time, but no agents to counteract the “product of the bacterium” were available. Other therapeutics advocated as being useful, including gentle bloodletting, clysters (e.g., enemas), and cupping, may have seemed counterintuitive or even contradictory to Novy, as they were based on older humoral ideas of disease resulting from internal imbalances of injurious humors and not on specific external causes (e.g., germs) (see figure 1.3). The rationale behind other diphtheria therapies such as whiskey and turpentine may not have been intuitively obvious to Novy, especially as his notes indicate that many patients died despite these therapies.121 Novy, in fact, began teaching his own bacteriology course, which had an intensive laboratory component, in 1889 (see chapter 3). In his own lectures to medical students in this course, Novy insisted that students must question their professor’s teachings rather than accept them uncritically. In these lectures, Novy pointed out the crucial need in medical education to verify the information received in lecture halls, to reconcile conflicting information, and to develop new knowledge about diseases.122 Novy’s lecture notes for his course in 1891 revealed how he believed one could resolve disparate information and arrive at new knowledge—­through skepticism about information and empirical scientific testing. In a lecture entitled “the trend of modern medicine,” Novy said, “scientific medicine of today aims to unravel the cause of disease, to foster methods and agents for cure.”123 Novy stated that one must start with skepticism about received wisdom from teachers in lecture halls; he said, “Medicine has outgrown dogma.”124 He cautioned students against being misled into passively believing the “popular notion that all about disease is known.”125 On the contrary, he believed medical wisdom that was transmitted had to be actively tested in the laboratory to arrive at truths; he said, “Medicine is a biological science . . . experimental inquiry is the only road to follow to foster methods.”126

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Figure 1.3   Novy’s notebook for his “Theory and Practice of Medicine”

course, October 15, 1890. Professor Walter Christopher lectured on the treatment of inflammation associated with infections like diphtheria. Novy was taught that bloodletting remained an effective treatment, whereas the use of poultices, cupping, and leeches went in and out of popularity. (Courtesy of Bentley Library)

Novy believed that medicine was in need of a “scientific” methodology beginning with skepticism in the received work and followed by laboratory testing, with which he had become familiar in chemistry, that could yield new knowledge that was more certain and verifiable than the didactic information he received in lecture halls.127 Novy’s objection to learning by what he called “blind faith”—­an uncritical reception of lectures given by his professors—­is a theme that remained a mainstay of his teaching throughout his career. He would tell medical students in



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1902 that “blind faith should be put to the test”—­he encouraged being skeptical of received knowledge and finding a forum to validate it in an empirical setting.128 Novy repeatedly insisted upon a faith in doubt as a route to true knowledge rather than blind faith in the teaching of one’s professor (see chapter 3). He asserted that there was a need to supplement lectures with laboratory courses so as to foster critical thought and actively test hypotheses empirically.129 Without a laboratory component to a lecture course, Novy argued, students would be denied the only route to test hypotheses, resolve discrepant information, and investigate new knowledge.130 For Novy, truth could not be apprehended by passive learning of a lecture; it required skepticism first, followed by active participation in a laboratory setting. But how could medicine become scientific in the manner that Novy delineated? He had certainly mastered laboratory-­based scientific methodologies as an undergraduate student in chemistry. But how could he incorporate his inclination for laboratory science into the field of medicine? He became interested in the demonstrations that his professor Henry Sewell used in his physiology course, but even this course lacked its own separate laboratory section where students could learn themselves.131 Likewise, his other medical school courses lacked a dedicated laboratory section. Novy found a new European laboratory-­ based science he felt had potential relevance in medicine—­bacteriology. He was, as outlined below, introduced to that science in Europe the summer before he entered medical school. While in medical school, he grew to regard bacteriology as a unique sphere where the scientific methodology he learned in chemistry could be applied to medicine in a laboratory setting. He felt that his self-­acquired skill in microscopy could be combined with his knowledge of physiological chemistry and put to use in this new science.132 Novy, while studying medicine, taught his lecture-­laboratory course in bacteriology and carried out scientific investigations in that field in his capacity as assistant to Vaughan in the Hygienic Laboratory. As a source for his experiments, he would use specimens sent to the laboratory for bacteriological testing. One of Novy’s early responsibilities in the Hygienic Laboratory was to analyze the bacterial contents of the community’s potentially contaminated water supply.133 Samples of drinking water from communities where there had been diarrheal outbreaks were submitted to the laboratory to test for suspected bacteriological contamination. But Novy acknowledged there were no bacteriologists at the university with whom he could learn the techniques of the new science.134 Novy first resorted to using his knowledge of German to read one of the very few handbooks written in 1887 by Ferdinand Hueppe in Germany.135 Novy, however, recognized there was a lack of proper bacteriological equipment and resources at

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Michigan, and he realized that he did not have the necessary training in bacteriological techniques to carry out his duties. In 1887, Novy stated that “it was evident that first-­hand knowledge of bacteriological technique could only be obtained by going abroad for a course of instruction in the ‘new science.’”136 When he learned that Hueppe was to give a bacteriology course in Wiesbaden, Novy asked Vaughan if he could travel to Germany to take Hueppe’s course. Vaughan agreed and decided to travel with Novy.137 They were among several others in his generation who opted to cross the Atlantic to meet European investigators in their laboratories. Novy traveled to Berlin to learn Koch’s thorough techniques of the new science that would be the cornerstone of the lasting contributions to the field that Novy would soon make.138 In the summer of 1888, at the Institute of Koch in Berlin, Novy took a laboratory course in bacteriology taught by Koch’s assistant, Karl Fraenkel.139 Novy wrote an account of the facets of his experience at the institute that had most influenced him. He thrived in the rigorous daily routine of Fraenkel’s student laboratory, admiring its rigorous laboratory methodology, the precise use of advanced instrumentation as a means to gain new knowledge, and the intensive instruction.140 He delighted in the disciplined habits that his expert teachers cultivated in and expected of their students. He marveled at the spacious and well-­equipped German laboratories and the dedicated time German researchers had to carry out their work. He idealized the enthusiasm the leading German scientists exhibited for their research, and treasured the freedom and encouragement they gave to their pupils to choose their projects, design their own experiments, and work out their solutions. While he was abroad, Novy wished to return to America to translate the precise bacteriological methodology and skills he had acquired in Berlin as a foundation for his career in medical research and education.141 Novy said that he would use the “unsurpassed, spacious and properly-­equipped facilities” he saw at the Berlin Institute as a model for the Hygienic Laboratory in Michigan.142 Novy believed that it was essential to re-­create these conditions in America for the rigorous scientific techniques that characterized German bacteriological research to flourish domestically.143 Upon returning to America, Novy used the exacting experimental methodology, including the autonomy the German professors gave their students, as a standard for his research and educational activities at Michigan.144 In designing his own research and educational activities, Novy acknowledged that he owed much to the example of his German experience—­the uniformly high expectations, the excitement of doing original research, and the superbly equipped laboratories that were led by men on the frontiers of medical research.145 Novy



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acknowledged the German assumption about the harmony of research and teaching—­that teaching at the university level had to be based on original research, and that serious research only existed in the disciplines of fundamental laboratory science. Novy reiterated that the facility at the institute was “unsurpassed,” and it was the only one of its kind where such rigorous instruction was imparted. Patterning his course in Michigan after Koch and Fraenkel’s, Novy would teach his students about the excitement of doing original work, the methods of bacteriology and research in a laboratory setting, and the autonomy to work out problems on their own.146 Novy’s impressions about his experience in Germany bear resemblance to those of other American students who studied in Germany during that period. Historian Thomas Bonner, for example, maintained that American students also admired the uniformly high standards of the German system.147 Bonner noted that students were inspired by the scientific ideology they experienced in Germany that swept away all doubts they may have had about the value of science in medicine.148 Historians Joseph Ben-­David and William Rothstein also stressed how many Americans learned from the creative investigations of eminent German scientists.149 Charles McClelland claimed that students were inspired by the German idea that serious research was carried out in the basic sciences.150 In this sense, Novy was like other Americans who were inspired by their German experience of studying in well-­equipped laboratories led by researchers on the frontier of medical research. Novy differed from his American student cohort in how he translated his German experience upon return to America. Unlike other Americans, Novy adapted his German experience to a full-­time medical setting and devoted his career to original bacteriology research without practicing medicine. When other physicians returned from Europe to America, the majority discovered that most American medical schools did not have full-­time faculty appointments available in their disciplines.151 At that time, most American medical schools continued to regard basic sciences as of secondary importance. Consequently, most American physicians who studied in Germany resorted to practicing medicine in order to make a living because they were unable to obtain full-­time positions in medical science.152 Others who studied bacteriology in Europe worked in public health department laboratories upon their return to America, focusing on the practical applications of European-­derived germ theories.153 Novy set his sights on securing a position that enabled him to pursue his university-­ based research and teaching interests.154 This type of position—­ and university-­ funded, without clinical practice duties—­ had been newly

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established at the University of Michigan in the late 1880s following the introduction of physiology to the medical curriculum.155 By the early 1890s, this type of position was beginning to include other disciplines such as bacteriology and pathology; Novy’s new appointment at the University of Michigan in 1891 was at the vanguard of a trend that other American medical schools would soon follow, most notably Johns Hopkins when it was established in 1893.156 Given the limited number of these full-­time research positions available in the 1890s, most Americans who went to Europe to study bacteriology in the late 1880s and 1890s returned to America to practice medicine or work in laboratories in public health departments that emphasized developing practical applications of bacteriology.157 But Novy remained convinced that a university setting in America would provide him with the elements he would need to succeed in his scientific research—­freedom to pursue the experiments of his choice and designated time to perform his work.158 These elements would be absent in private practice or in public health service, each of which would be too time-­ consuming to permit intensive laboratory research.159 In all of Novy’s notes, in fact, there is no indication that he ever considered practicing medicine.160 Similarly, Novy would avoid full-­time work in health departments mainly because it would entail duties and responsibilities that would encumber his focus on laboratory research endeavors. In 1896, Novy resigned from his two-­year position as a member of the Michigan Board of Health because of his full-­time involvement in scientific research.161 Novy’s emphasis from the start, given the opportunities that were available to him, was on developing his scientific investigations on fundamental microbial mechanisms in a full-­time medical school position. He made active decisions to maintain this position throughout his career (see chapter 6). How was Novy’s interest in translating his European bacteriological training to a full-­time medical school position distinctly different from the interests of his peers? One reason was different ideological orientations—­many American physicians were captivated by the promise of the practical applications of bacteriology, with its therapeutic antisera or vaccines, to control lethal epidemics. Some of these physicians, including the better-­known scientist William Welch, spent a considerable amount of their investigative effort on the control of infectious disease through the practical application of bacteriology.162 Novy, on the other hand, was specifically attracted by the instrumental side of bacteriology that was best illustrated, as Novy mentioned, when Henle identified the need for new technologies to test theories about microbes and their ability to cause disease. In his lecture on the history of the germ theory in his bacteriology course, Novy, in fact, acknowledged that Henle postulated the germ theory



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but did not possess the means to demonstrate it.163 This brand of bacteriology—­ the design of instruments to search for unknown aspects of microbes and their behavior—­most attracted Novy. It was this uninterrupted lifelong focus that distinguished Novy from the better-­recognized medical scientists of his day, such as Theobald Smith and William Welch. Novy’s adaptation of his European training also differed from that of his peers in practical ways. There simply were not enough medical school slots available to accommodate the American researchers who returned from studying abroad. Novy’s ability to obtain a full-­time position in research without a clinical practice was atypical for the time, as many physicians who were aspiring medical researchers, including Vaughan, worked in a private practice in order to make a living since full-­time positions that combined research and instruction were not available to them.164 The final reason was financial—­a university position was less lucrative than other options and may have been an incentive for some to enter practice.165 Notwithstanding these reasons for choosing his full-­time medical school position, the challenge for Novy would be how he could carry out original research investigation as an assistant in the Hygienic Laboratory while also carrying out his duty to perform laboratory services for the state. Public Health Service at the Michigan Hygienic Laboratory: Foundation for Research

Novy and Vaughan’s initial work at the Hygienic Laboratory involved performing chemical analysis to search for adulterations of milk and other substances.166 They found that dairy operators skimmed cream from milk, added an adulterant to restore bulk, and mixed in sodium bicarbonate to neutralize lactic acid as it formed.167 Novy tested samples of milk and discovered that enterprising but unscrupulous dairymen were able to turn swill milk—­a thin bluish liquid, nearly devoid of nutrients and fat, taken from cows who were fed a residue of alcohol—­into a rich creamy mixture by adding generous quantities of magnesia, chalk, and plaster of paris. Samples purporting to contain nutritious milk had in fact been adulterated with these potentially poisonous and non-­nutritious substances.168 Tainted milk, as exposed by Novy and Vaughan, became such a public issue that state laws were passed in 1891 to regulate the quality of milk and the prohibition of any form of adulteration of it.169 Novy also detected cases of the adulteration of ice cream.170 Later, Novy’s investigations revealed another type of fraud through the promotion of a so-­called local anesthetic, stenocarpine.171 Novy argued that the substance had no anesthetic benefit, and having been exposed, the mixture was withdrawn from the market.172

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The exposure of fraud by Novy and Vaughan in the Hygienic Laboratory underscores the prominent role played by the medical and public health profession in responding to the problems of the unregulated market in the late nineteenth century. Novy wrote, “the examination of milk [that] purports to contain all the nutrients of milk, . . . [shows that] such a claim is entirely preposterous and shows . . . its fraudulent nature and harm to the public.”173 Novy, like his chemistry teacher Prescott, argued that it was the duty of the state to regulate unsafe products of unscrupulous manufacturers who were profiting by deceiving and misleading the unsuspecting public. Like Prescott, he adopted a moral outrage about commercial corruption rather than a strictly scientific view of adulteration. By performing their chemical analyses, Novy and Vaughan worked to make reforms to protect consumers from fraudulent, misleading, and unsafe practices and to institute regulations to safeguard public health in the late nineteenth century. Novy and Vaughan also conducted bacteriological testing of water specimens sent to them from throughout the state in order to ensure that pure drinking water was free of pathogenic microbes.174 Testing the water with a high degree of scrutiny, they revealed a broad prevalence of impure drinking water.175 Vaughan noted that the germ of typhoid fever had been found in the water supply in 85 of the 400 samples submitted to the laboratory during its first ten years of operation.176 These analyses led to a variety of public health measures to attempt sterilization of the supply of drinking water, including the installation of resins and filters. Vaughan said, “[typhoid fever] can be greatly reduced if people will cease polluting the soil about their homes with slops, garbage, cesspools and privy vaults, and will see to it that their drinking water is pure beyond question.”177 Novy believed that the comprehensive aspect of the Michigan laboratory in combining chemical analysis with bacteriological analysis was unique for its time.178 He argued that it was only through such scrutiny that the drinking water supply had been properly tested for pathogenic bacteria and the public was protected against harm. Novy referred to the Hygienic Laboratory as “the pioneer of its kind in this country” because of its ability to detect unsafe water through comprehensive analyses.179 Novy recognized that other states had “followed in the footsteps of Michigan” but none, he claimed, had laid a “broader and more thorough foundation for work in hygiene.”180 Novy argued that hygienic laboratories that did not have bacteriological capabilities were unable to adequately perform investigations of epidemic diseases.181 Novy, in fact, attributed his ability to find pathogenic bacilli in milk, ice cream, cheese, and also water to the comprehensive capabilities of his laboratory.182 Novy’s original research investigations arose in the context of his public health duties. He used specimens sent to him from throughout the state not



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only for chemical and bacteriological testing but also for original research purposes. According to Vaughan, in 1891 Novy discovered poisons in filtrates from cultures of the bacillus of hog cholera in water specimens and attempted to obtain immunity in rats against the active germs of the disease—­all in the name of carrying out his public health duties.183 In addition, in his investigations of sampling water for surveillance purposes from a town in Michigan’s Upper Peninsula, Iron Mountain, Novy began to perform experiments on the products of metabolism of the typhoid bacillus that had been isolated.184 After the laboratory had been in operation for ten years, Vaughan assessed its performance according to Novy and Vaughan’s original goals put forth in 1887 of performing practical service in the realm of public health while also stressing original investigation into the cause of disease.185 They documented the laboratory’s purifying contaminated water and withdrawing adulteraccomplishments—­ ated milk and ice cream from the market, and the resulting decline in deaths in the state due to the activities of the laboratory—­to justify the public health value of the laboratory and show that it was worthy of the state’s investment.186 In 1897, Vaughan at the same time noted the results of the laboratory’s “original investigations”—­including the isolation of new bacterial poisons found in drinking water, and other poisons in the stool of children with summer diarrhea, and still more from poisonous cheese—­which had been published in nearly fifty articles.187 In his ten-­year assessment, Vaughan said, “Scientific facts bearing upon the causation and prevention of disease are to be discovered and verified.”188 From the start, Novy and Vaughan set their goals of performing original research by using specimens sent to them for public health purposes. Novy distinguished between what he termed research of an “original” or “fundamental” nature and “practical” investigations.189 He was not opposed to his experimental findings, as derived from his original or fundamental work, eventually having a practical application. Indeed, when that was the case, he highlighted those circumstances. He simply felt that the purest science in bacteriology was motivated by a desire to understand the basic behavior of microbes, and he did not wish to restrict his future investigations solely to how to prevent, attenuate, or kill pathogenic organisms. In Novy’s words, the laboratory was “called into existence by the fundamental desire or demand for knowledge of the hidden facts which bore upon microbes as well as for the causation of disease. The first object therefore of such an institute is to carry on original investigations whereby the bounds of knowledge will be materially widened.”190 Novy maintained that the consideration of therapeutic relevance would impair the quality of his science by restricting his selection of research topics and limiting his choice of experiments. He insisted that the motives for

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original research should be to search for hidden truths rather than be guided by practical relevance. Novy did acknowledge, however, that his fundamental research might provide the foundation for practical studies to be carried out at some future time. Throughout the first decade of their Hygienic Laboratory, Novy and Vaughan acknowledged a service component of the laboratory—­testing samples of milk, water, and specimens from humans to identify contagion and protect the welfare of the state. But in their arguments, they linked the service activity with original research because public health advances (antisera, vaccines) had been preceded by basic scientific investigations. Basic scientific work, in their narrative, was essential to the advancement of public health. Both Novy and Vaughan justified the existence of their Hygienic Laboratory—­for service, investigation, and teaching—­being located in a medical school setting from the start in 1887 (see chapter 6). Novy emphasized original medical investigation while simultaneously acknowledging his public health responsibilities. He stated, “The practical application of known facts in elucidating health problems and in preventing disease constitutes another aim of the lab. The sanitary analysis of water, milk, butter and foods in general; the identification of disease producing organisms in suspected: tuberculosis, diphtheria, typhoid fever and in other afflictions render such a laboratory directly useful to the community.”191 Novy’s research aim was compatible with his public health goal. In the late nineteenth century, as Terrie Romano has pointed out, scientific medicine was seen as an array of medical activities based in the physical and chemical sciences, and in medical practices rooted in these sciences.192 At the time, chemical analysis of food and water and sanitary measures based on such testing were considered scientific. Thus, the various duties that Novy performed in the public health laboratory, including what he himself termed public health service as well as original investigation, were connected to a common theme in the nineteenth century—­by standards of the day, Novy operated scientifically in all of these arenas. To satisfy his multiple scientific obligations, Novy, along with Vaughan, stressed the vital importance of an adequate laboratory facility, one that was properly equipped with sufficient space. He considered Koch’s laboratory as the standard for a properly equipped laboratory in an adequate space. While in Berlin in 1888, Vaughan and Novy purchased the necessary equipment for the new laboratory in Ann Arbor so that it could become a suitable research facility to carry out Novy’s scientific obligations.193 During the 1880s, the well-­equipped Michigan Hygienic Laboratory occupied an anomalous position in America.194 Noting the scarcity of well-­equipped US research laboratories located in university settings, Novy said, “There are



Origins of the Michigan Hygienic Lab 43

not many universities here where laboratories well equipped for research work are maintained.”195 The inclusion of a research component as a major aim of the Hygienic Laboratory underscores the pivotal role of both the state and of the growing modern university in enabling medical research in nineteenth-­century America. With the support of the Michigan legislature for the Hygienic Laboratory, Novy had an adequate facility in which to carry out the fundamental investigations that he had been trained to perform. Combined with the income he received from the medical school, Novy was able to devote his entire efforts to medical research in a properly equipped laboratory. These two elements—­ full salary support from the medical school and a state-­supported laboratory—­ furnished Novy with the ingredients he needed to establish his institutional base and to pursue full-­time medical research. Novy was in an unprecedented setup in America to carry out his desire to perform fundamental, original research: he had the ultimate training in the latest sciences of the day, a well-­ equipped facility, and a full-­time position to carry out his work without clinical responsibilities. Novy’s success in establishing himself must be credited to the medical school dean Victor Vaughan, who shared Novy’s desire to develop medical laboratory science, and to President Angell, who broadly encouraged the growth of medical science within the scope of the university. As will be developed in forthcoming chapters, Vaughan also played a role in advancing Novy’s position in his early years as a faculty member. While Novy recognized the importance of having a laboratory in a university setting for purposes of research, he also felt this setting provided a springboard for instructing medical students. Medical education was a priority from the inception of the laboratory, and he felt that educational opportunities were inexorably linked to research. Novy said, “The third and by no means the least important object of a hygienic lab is that of instruction. That department is really useful which combines teaching with original research and in a university it is difficult to conceive how one can be fostered without the other.”196 Novy felt that the need for research and education justified the location of the Hygienic Laboratory within a university setting. In the late nineteenth century, the Michigan Hygienic Laboratory was the first but not the only one to be affiliated with an American university. At this historic moment, scientists and health officials began to advocate for the construction of a number of health-­related hygienic laboratories to be located first at the University of Michigan (1887), and then at the University of Pennsylvania (1889) and Johns Hopkins (1893).197 While historians have noted these university-­related laboratories, no study has systematically examined what individual research was conducted. Were they exclusively investigating

44

Chapter 1

practical issues that had applications in the realm of public health only? Were they doing something other than extending the searches for microbes that caused disease or searching for improved means of preventing or controlling disease? If so, what were these research agendas and what types of ideas did these bacteriologists explore in their laboratory? The following chapters address these questions by exploring the research and educational activities carried out by Frederick Novy, a leader among these early bacteriologists. In conclusion, Novy’s passion was to explore nature’s truths—­the pure science ideal—­throughout his long professional career. Novy was stirred by his own views on the strengths of the German system—­the disciplined work, the emphasis on innovating instruments to explore nature’s unknowns, the excitement of carrying out original fundamental work, and the autonomy enjoyed by the scientists in well-­equipped laboratories. The German ideal of medical science melded seamlessly with Novy’s inclination toward doing independent research and designing novel instruments to search for unknowns in his laboratory, a passion he had first developed as an amateur scientist and later nurtured while studying chemistry before he entered medicine. Novy and Vaughan opted to learn bacteriological methods and research techniques in Germany and import them to the United States with the idea of then making their own original investigations. With Vaughan, Novy tried to recast the unity of research and teaching he witnessed firsthand in Germany at the Hygienic Laboratory of the University of Michigan Medical School. It was this aspect of their European experience—­the investigation of basic facts about microbes and their behavior in the environment—­that he sought to replicate after he returned to America. Novy’s predisposing inclination toward independent laboratory research and an education program made him an ideal fit for the newly created full-­time position in the laboratory at Michigan. Novy possessed the quality he in fact had exhibited since his childhood days as an amateur scientist—­the zeal and dedication required for independent scientific experimentation. His orientation toward research carried over to his instruction, and he was committed to the belief that students should have the opportunity to demonstrate truths for themselves in the setting of a lecture-­laboratory course. Having amassed the highest credentials of the day in chemistry and bacteriology, he had positioned himself to achieve his goals to combine laboratory investigation and instruction on a full-­time basis. Notwithstanding his expert qualifications, establishing himself as a full-­ time researcher and educator was not a straightforward task. For example, how would he justify his career goal to perform basic biological research in microbiology when his duty as a state employee was to provide practical service?



Origins of the Michigan Hygienic Lab 45

Furthermore, how would he legitimate his basic research interests in a medical profession whose mission to heal was inherently practical? In chapter 6, I will explore the arguments Novy made to justify his basic research activities. In this chapter, I have shown how he forthrightly argued to the state legislature, which funded his Hygienic Laboratory, that his primary interest was fundamental research. In creating an environment to do this work, Novy had the help and encouragement of Vaughan, his enabling, like-­minded mentor who ensured that Novy had no clinical responsibilities that would compete with his research work. It was from this specially crafted position that the fledgling Novy embarked on his independent research program. With Vaughan’s backing, Novy situated his professional obligations in such a fashion that they provided minimal diversions from the activity from which he derived the greatest satisfaction—­laboratory research. Novy was different from most American physicians who studied abroad in the 1880s in that he set laboratory science, not medical practice or practical applications of public health, as his primary aspiration. Novy was in an unusual position as he had the highest scientific credentials of his day, was situated in a well-­ equipped laboratory, and had a full-­time appointment in his institution without clinical responsibilities when he embarked on his first faculty position as junior professor of hygiene and physiological chemistry upon graduation from medical school in 1891 (see figure 1.4). In this year, he also married Grace Garwood. When Novy was in medical school, he had met Grace, who studied homeopathic medicine at Michigan from 1888 to 1889. In the ensuing years, Grace remained his devoted wife and confidante, provided loving care for the five children they were to have, and enabled him to pursue his professional aspirations. It was within the context of this unique professional and personal position that Novy was able to accomplish his goal of carrying out basic microbiological research. The forthcoming chapters will address the specific research agenda and educational activities carried out by this employee of a state university, stirred by his scientific training in chemistry and the scientific ideology he witnessed firsthand in Europe.

Figure 1.4   Novy, 1891. Novy had obtained training in bacteriology with Robert Koch, earned his doctorate degree in chemistry, graduated from medical school, been appointed junior professor of physiological chemistry, and married Grace Garwood. As assistant to Vaughan in the Hygienic Laboratory at the University of Michigan, he was poised to embark on his own independent research career. (Courtesy of Bentley Library)

Chapter 2

What Novy Did in His Medical School Laboratory

This is a chapter about Novy’s laboratory investigations. What type of questions did Novy explore about microbes in his laboratory, how did he try to answer them, and what did he discover? What ideas drove his research—­what was he trying to accomplish and from what premises did his research work originate? How did he use his public health duties in the hygienic laboratory as a springboard for independent research? What methods did Novy use in his laboratory, and to what extent did his initial training in science and his European training in bacteriology influence his research orientation? How did his early orientation toward instrumental design manifest itself throughout his work? How did the emphasis on creativity and independence he learned in Germany show itself in his projects? By exploring these questions, this chapter will reveal how the focus of Novy’s laboratory goals and activities was distinctly different from that of his contemporary bacteriologists. Historians have viewed this time as a period of germ hunters applying principles that originated in Europe to public health strategies in America.1 Novy’s focus on the use of instrumental design to uncover truths in nature and resolve disputes in medical science was different from what historians’ characterization of bacteriologists in late nineteenth-­ century America has emphasized. Novy’s Laboratory Space and Equipment

Novy’s initial space was located on the second floor of the Hygienic Laboratory building at the University of Michigan campus (figure 2.1). Figure 2.2 shows that Novy had two adjacent rooms of approximately 500 combined square feet in size designated for his original research purposes.2 Novy’s laboratory had up to two

47

Figure 2.1   Building that housed the Hygienic Laboratory located on the main campus

of the University of Michigan in 1888. The Hygienic Laboratory was located on the second floor and attic; the first floor and basement were earmarked for physics laboratories. (Courtesy of Bentley Library)

Figure 2.2   Schematic of the Hygienic Laboratory. The space designated for Novy’s independent research included two adjacent rooms marked “assistant’s private laboratory” and “private room” for advanced work (approximately 500 square feet). Rooms marked “general hygienic laboratory” and “bacteriology” were shared spaces for routine bacteriological work for public health purposes. (Courtesy of Bentley Library)



What Novy Did in His Medical School Lab

49

rows of benches that displayed his core equipment.3 Figure 2.3 shows Novy as a twenty-­eight-­year-­old man performing an experiment in his laboratory in 1892. Table 2.1 outlines some of the core equipment that Novy used on a day-­to-­ day basis for the experiments described in this chapter. Novy used this equipment to prepare culture media, sterilize agar, inoculate microbes, incubate plates for culture, stain organisms, and view them with his microscope.4 He also used the equipment for his experiments using laboratory animals—­rats, guinea pigs, and rabbits.5 Novy’s laboratory equipment was more complex than can be shown by a simple image of a laboratory containing a microscope, culture media, and slides (see table 2.1 and figure 2.4). In addition to the core equipment listed in table 2.1, Novy designed specialized equipment for the purposes of his experiments on the mechanisms of microbial life, expanding the scope of microbes, and the determination of microbial behavior. Mechanisms of Microbial Life: Combining Chemistry with Bacteriology

Novy performed a variety of experiments designed to discover the mechanics of microbial life. He relied upon his background as a scientist to explore the chemical mechanisms of how germs survive in their environment. As a

Figure 2.3   Novy performing experiments in 1892 to analyze and quantify the chemi-

cals produced by anaerobic bacteria. The large diagonal arm device is Hesse’s gas producer used to analyze gas produced by bacteria. The dome-­shaped glass instruments were used to culture anaerobic bacteria. (Courtesy of Bentley Library)

To inoculate bacteria onto media

Spatula and wire loop

Wire loop used to streak bacteria onto various media

(continued)

A flame-­sterilized wire loop was used to transfer bacteria from a specimen into culture media or to streak a specimen onto solid gelatin agar. The spatula was used to perform a stab inoculation into solid media.

For solid media, gelatin was added to bouillon broth; the globe with gelatin media was carried to individual Petri dishes. A glass pipette was used to transfer media from one to another dish.

To prepare solid media

Petri dish with pipette

Pipettes used to transfer media from a test tube to solid media in Petri dish

To prepare Used as a final sterilization, by steam The tubes with liquid media were placed into an autoclave for final liquid bouillon under pressure; used for media or sterilization. This resulted in a higher temperature than that using media glassware regular steam sterilization—­up to 120°C (eliminating spores as well as vegetative bacteria).

Steam-­sterilized liquid media was poured into a globe which was then placed on a metal platform with tubes carrying media into test tubes. The tubes were placed in a wire basket.

Metal platform To prepare Used to pour steam-­sterilized media and wire basket liquid bouillon into test tubes media

Autoclave

The glass container containing filtered liquid media was placed in a steam sterilizer. The temperature reached 58°C, high enough to destroy vegetating forms of bacteria when used for one hour, but not the spores.

Novy placed beef in a flask with water and then boiled the water in a glass container. To filter out impurities, he poured the boiled bouillon liquid through a funnel or globe with cotton in the neck of the funnel. The funnel or globe was inserted into a vacuum flask with a sidearm. The liquid media was then suctioned through an air pump into a container.

Procedure

Large (about 30 cm in diameter), heavy (made of cast iron), sterilizers heated with a burner placed in a door in the bottom cylinder

Steam sterilTo prepare izers (Koch and liquid bouillon Novy) media free of bacteria

To prepare Used to filter liquid media from liquid bouillon impurities media

Glass flask, globe, with funnel

Description

Purpose

Apparatus

Table 2.1  C ore Laboratory Equipment with Routine Procedures That Novy Used

To determine pathogenicity of a particular microbe

To determine pathogenicity of microbe

Animal apparatus

Compound microscope

Stained glass slides were placed on stage under a high-­power objective.

Cages were used to house the animals prior to inoculation, a holder kept the animal still during moments of animal transfer, and containers housed the animals in the laboratory after they had been inoculated.

The Gram’s method (gentian violet, then decolorizing with alcohol, and then counterstain with the aniline dye safranin) was used to stain bacteria smeared onto slides.

The incubator was a large piece of equipment that included a thermoregulator to keep the temperature constant and optimize cell growth.

Procedure

Source: Apparatus and descriptions in table taken from: F. G. Novy, “Bacteriological technique,” Reference Handbook of Medical Sciences 8 (1904): 370–­404.

To view bacteria prepared on slide with gram stain technique

Apparatus for rabbits, guinea pigs, rats, mice, and birds: an animal holder; cage; holder to take temperature and inject animals

Stand for dye solutions (crystal violet, Gram’s iodine, alcohol, safranin, fuscin, and methylene blue); forceps for holding slides

To identify bacteria by staining

Staining solutions, slides, and forceps

Description

Koch’s incubator with a Novy thermoregulator used to keep the temperature at 38°C.

Purpose

Incubator and To incubate thermoregulator bacteria

Apparatus

Table 2.1  C ore Laboratory Equipment with Routine Procedures That Novy Used (continued)

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Figure 2.4   An array of instruments (steam sterilizer, autoclave, funnel with sidearm,

glass globe, Petri dishes, stand, and scale) that Novy used. See tables 2.1 and 2.2 for details. (Courtesy of Bentley Library)

foundation for these experiments, he used specimens (e.g., water and milk) sent to his Hygienic Laboratory for public health purposes. Novy devised new instruments to determine and measure chemical structures that were consumed and produced during the processes of microbial metabolism and respiration—­ processes that are vital for their life.6 Novy also explored whether there was a relationship between these processes and the diseases that the microbes and their chemical products caused in their hosts. Novy’s interests in exploring the mechanisms of microbial survival had precedents in the work of early nineteenth-­century European germ theorists. Novy wrote about Joseph Henle, for example. As a pathologist, Henle’s main interest was to understand the relationship between microbes and disease.7 Henle believed that it was not the presence of the germ itself that caused disease, but what the germ did to cause disease. He postulated that the “so far unseen bodies” produce disease by a process similar to putrifications and fermentations.8 To Henle, the trope of visibility was not limited to literally seeing an organism through the use of optic aids; it also applied to devising new methods to understand how organisms behaved to cause disease, or as he described it, “life’s manifestations.”9 But Henle could only speculate on these questions because at that time, he lacked the tools and methods



What Novy Did in His Medical School Lab

53

to determine what he termed “the power of each one of these” microbes to cause disease. Novy, like Henle, was interested in instrumental innovation as a means to explore what microbes do. But Novy’s primary interest in using these tools was more expansive than Henle’s interest in the relationship between germs and disease processes. Novy was interested in basic microbial science—­to investigate what microbes did in order to live and survive in nature. Novy realized that he would need to develop new techniques other than optical aids to explore the basic mechanisms of microbial survival. To do this, he would employ the use of instruments and techniques from scientific fields other than bacteriology. As Novy said in 1902, “To cross the threshold of the cell, to unravel the changes which take place in the normal and in the diseased cell, is the next task. In that work the microscope will no longer be of value since the changes will involve alterations of molecules and not of cells. It is to the chemist and the physicist that medicine and the broader biology must look for the solution of the ever recurring puzzle of life.”10 For Novy, a study of microbial life entailed more than cultures, stains, and microscopes—­it involved using the instruments of a field with which he was familiar, chemistry. This reliance on chemistry to explain basic mechanisms of digestion and metabolism—­factors accounting for what he called the “thrill of life”—­had precedents in the work of Pasteur, also first trained as a chemist before studying fermentation.11 Novy’s experiments on metabolism and respiration, outlined below, can be seen as extending the premises of the earlier germ workers, Pasteur and Henle. In the late 1880s, Novy began to investigate the chemical products of a hog cholera bacillus that he isolated from specimens of water sent to his laboratory for testing for bacterial contamination. Novy used the specimens to analyze the metabolic products of bacteria resulting from the breakdown of carbohydrates, fats, or proteins. To discover these products, he filtered the liquid media from which the bacteria grew and performed a chemical analysis of the filtrated substances (see table 2.2). Novy isolated and identified a nitrogen-­containing base in this filtrate, C16H26N2, which he termed a diamine.12 He concluded that the nitrogenous diamine was an active product of metabolism from complex organic proteid molecules. Novy then investigated whether it was toxic to its host.13 He first showed that small amounts (0.25 cc) of bacterial filtrate injected into rats caused markedly toxic properties—­intestinal hemorrhages and death. He injected the purified nitrogenous diamine product into rats and observed harmful effects only when he administered much larger quantities (15 cc).14 He concluded that

Table 2.2  S pecial Equipment, with Procedure Apparatus

Purpose

Description

Procedure

A. Filtration devices*

To analyze products of bacteria (e.g., ptomaines, toxins) or to search for “ultramicroscopic” forms of infection

Devices used to filter out bacteria from media. The porcelain of the Pasteur-­ Chamberland filter absorbed bacteria, and the filter paper of Martin or Berkefeld removed bacteria according to size.

Filters were used to separate soluble products of bacteria from solid cells. Toxins of pathogenic bacteria and ptomaines passed through the filter, but bacteria themselves did not. The filtration process demonstrated the existence of ultra-­ microscopic organisms that could not grow on any culture media.

B. Microbic respiration apparatus and gas analyzer

To analyze gas produced by microbes

Apparatus to analyze and measure gas consumed and produced by microbes. Novy sought to measure the slow respiration of bacterial cultures over sixty days. He used Hesse’s apparatus to analyze gas produced by bacteria.

The differential manometer had one arm connected with a closed vessel in which mycobacteria grew on a slant. There were T tubes and stopcocks on the culture side. Novy sampled gas for analysis, measuring O2 and CO2 over the culture.†

C. Novy anaerobe jar‡

To culture anaerobes

In instruments to culture anaerobes, oxygen was pumped out of the air in the jar. The equipment completely excluded oxygen and allowed the culture of anaerobic bacteria.

Bacteria were streaked onto Petri dishes vertically stacked in an atmosphere where oxygen was displaced by a vacuum pump. Modifications to improve the amount of oxygen displaced from the inner jar: improved seal by the using vices surrounding a side lip; jar with a stopcock for vacuum culture. (continued)



What Novy Did in His Medical School Lab

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Table 2.2  S pecial Equipment, with Procedure ( continued ) Apparatus

D. Collodium sac

§

Purpose

Description

Procedure

To culture spirochetes

Apparatus to grow organisms in the peritoneal cavity of an animal where nutrients are supplied and where the organisms are protected against phagocytic white blood cells. This was accomplished by enclosing bacteria in a sac, the walls of which were permeable to the waste products of germs and the “nutrients” of peritoneal fluid.

A sac holding 3 ml of blood was made to “trap” organisms in large concentrations. Tubes, 15 cm long and 2 cm wide, were inoculated with specimens and then placed in a peritoneal cavity of a guinea pig or a rabbit. Novy then removed the sac and stained the contents (figure 2.7).

*See figure 2.5. Novy was able to determine “microbic respiration” by calculating the respiratory quotient (RQ), defined as carbon dioxide (CO2) production divided by oxygen (O2) consumption. Information in table taken from: Frederick G. Novy, H. R. Roehm, and M. H. Soule, “Microbic Respiration: I. The Compensation Manometer and Other Means for Study of Microbic Respiration,” Journal of Infectious Diseases 36 (1925): 109–­167. †Filtration Devises in table taken from F. G. Novy, “Bacteriological Technique,” Reference Handbook of Medical Sciences 8 (1904): 370–­404. ‡Anaerobic culture devices in table taken from Frederick G. Novy, “New Apparatus for the Culture of Anaerobic Bacteria,” Transactions of the 8th International Congress of Hygiene and Demography, Budapest 2 (1894): 437–­441. §Collodium sac techniques in table taken from R. E. Knapp and Frederick G. Novy, “Studies on Spirillum obermeieri and Related Organisms,” Journal of Infectious Diseases 3 (1906): 291–­393.

bacteria produce nitrogenous metabolite products while living in nature, and that not all of these products exhibit very strong toxic or poisonous properties in their hosts. Novy subsequently elaborated on the tangential relationship between products of bacterial metabolism and disease. Novy reasoned that microbes require food—­organic compounds found in dead plants and animals. He saw no reason to believe that all breakdown products of this metabolism should be poisonous. He distinguished poisonous, disease-­causing “synthetic products made by the germ within itself” (e.g., toxins) from “analytic products formed by the splitting up of complex . . . molecules,” most of which had no discernable effects on their host (e.g., ptomaines).15 Ptomaines, he said, are an “array

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of intermediate products [formed when] bacteria metabolize highly complex organic molecules to relatively simpler ones.”16 Included among the ptomaines were the breakdown products of complex starches to carbon and oxygen molecules, and the breakdown of complex proteids to nitrogen molecules.17 Novy referred to nitrous and nitric acids and other amine derivatives as “putrid” fermentations of non-­starch substances because of their “disagreeable odor.” Novy claimed that most of these carbon, oxygen, and nitrogen breakdown products “cannot account for the intensely poisonous [toxins produced] by certain bacteria”; rather, most are harmless transition products of the metabolism of an array of complex organic molecules.18 Novy maintained that the importance of fermentation and putrefication in nature lay not in causing the death of the host but in perpetuating life. These processes, he claimed, not only sustained microbial existence through a mechanism of metabolism, they also supported the life of new animals and plants that require simple substances such as nitrogen, carbon, and oxygen. Through this process of decay of dying animal and vegetable matter, he concluded, bacteria play an important role in nature by supporting the life of new plants. Novy said the following: As soon as death claims its own, these minute organisms set to work to tear down the complex organic matter . . . until the resultant products are those of the inorganic world. In this way carbon is returned to the air as carbonic acid, nitrogen of the proteid molecule becomes ammonia, and new vegetation . . . arises from the products of that which preceded. [This] law governs the conservation of life. Putrefaction and fermentation are correlative phenomena, not of death but of life.19

Novy then went on to make a key distinction: that the process of metabolism is of interest to the “enquiring physician . . . insofar as [it has a] relation to intoxication and disease,” whereas chemists and bacteriologists are interested in this topic “insofar as the study of life and nature of the organism is concerned.”20 Novy’s primary interest in studying the chemical mechanisms of metabolism was the latter: to gain new knowledge about basic microbial biology and about the “exceedingly important role” organisms played in nature.21 Novy explored the chemical structure of the products that microbes consume and produce during their lifetime. Novy, like Pasteur, who was first a chemist before studying microbial metabolism, directed his inquiry toward the mechanisms of organic decomposition in general and the production of alkaline nitrogenous amines specifically.22 To Novy, these products were not poisonous toxins to be nullified by antisera; most were harmless by-­products of nutrition manufactured during microbial life.23



What Novy Did in His Medical School Lab

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Novy eventually turned his interest toward another mechanism of microbial survival—­respiration. Microbes, he said, not only metabolize chemicals to sustain life, they must also exchange gases. He stated that “respiration is a fundamental characteristic of life” for any organism, and from this premise, he reasoned that microorganisms must produce gas during respiration in order to live.24 Changes caused by oxidation, which provide energy to a unicellular microbe, he reasoned, are no different from those that make up a multicellular higher animal or plant.25 According to Novy, bacteriologists had not studied this essential subject, in part for technical reasons. Novy said, “Little or no attention is given to the gaseous product of cell activity [because of] the high complexity of apparatus that would be required to measure gasses produced by microbes.”26 Novy sought to overcome this technical hurdle by devising an instrument to measure gas exchange of microbes and assess whether respiration was a vital source of energy and a requirement for optimal growth.27 Novy designed an instrument to correlate the consumption of oxygen (O2) and elimination of carbon dioxide (CO2) with microbial growth (see table 2.2). He initially chose to study the tubercle bacillus because he reasoned that this microbe might be more likely to depend on oxygen for growth. To test this hypothesis, Novy altered the content, or tensions, of O2 and CO2 in the microbe’s environment to determine the effect on the growth of the tubercle bacillus.28 By doing this, he could gain insight into whether variations in oxygen content could affect the growth of the organism.29 He devised new equipment to determine respiration by measuring the CO2 and O2 tension of the gas produced by mycobacteria growing in an incubator in relation to the O2 tension of the growth environment (see table 2.2 and figures 2.5 and 2.6).30 His instrument contained a differential manometer with one arm connected with a closed vessel in which the organisms grew in a medium while the other arm measured the respiration of the tubercle bacillus.31 Novy found that mycobacteria grew best in tubes that contained higher O2 content and when they produced greater amounts of CO2.32 Respiration, he concluded, occurred in the tubercle bacillus, and he later showed the same was true for a variety of other unicellular microbes. Respiration, he claimed, was an essential mechanism for its growth and life, as had been known to be true for multicellular animals or plants.33 His findings had implications for understanding basic microbial biology and physiology. Novy’s experiments on microbial respiration illustrate how he devised innovative equipment to demonstrate and quantitate the gases that microbes produce during respiration—­a process, he argued, that furnished the energy to sustain microbial life.34 Unrestrained by what he viewed as bacteriology’s focus

Figure 2.5  Novy’s differential manometer for microbic respiration experiments,

1923. One arm of a mercury-­containing U tube was attached to a closed vessel. The other arm was connected with a vessel in which the organisms grew in culture. When the level of the mercury in the manometer was read, the volume of O2 and CO2 produced or taken up by the culture was calculated. Note the consistent theme of Novy’s devising apparatus to measure gaseous products of his experiments, in this case forty years after his college chemistry experiments. (Courtesy of Bentley Library)

Figure 2.6  Novy in 1929 with his differential manometer in the background. (Courtesy of Bentley Library)



What Novy Did in His Medical School Lab

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on practical applications, Novy focused his inquiry on basic aspects of microbial biology, metabolism, and respiration simply to gain basic knowledge about the mechanics of microbial life. Novy also addressed whether his results might have implications for understanding disease pathogenesis. His experimental results showed that the slow multiplication of the tubercular bacillus is correlated with low O2 consumption. Consequently, he reasoned, the indolent nature of tuberculosis may be due to diminished oxygen supply that is present within various host tissues that are affected by the organism. He also attempted to correlate his findings with therapies that physicians had been recommending to patients. Novy said, “The slow multiplication of the tubercle bacillus in the body is explainable from the standpoint of growth in diminished O2 tension. The ‘rest cure’ . . . [employed by physicians to] check the progress of disease probably act[s] by reducing to a minimum the available O2 supply in the tissues.”35 His experiments on microbic respiration had implications for variations in disease patterns in the animal host (e.g., reduced growth of mycobacteria in tissues with diminished O2 tension) and mechanisms behind treatments for tuberculosis that doctors had been prescribing. For his novel experiments, Novy received widespread recognition from his peers. For example, C.E.A. Winslow, chairman of Public Health at Yale Medical School, said, “Novy’s work on microbic respiration has been not only original but largely basic in the field. . . . [It has] made a fundamental contribution to bacterial physiology.”36 Developing New Techniques to Help Expand the Scope of Bacteriology

Novy designed novel equipment to culture classes of microbes in situations where this had not previously been attempted. Several classes of microbes, he argued, attracted little attention largely because of the all-­absorbing interest in the study of bacterial disease. Novy adopted the attitude that these other microbes had been neglected by too many early bacteriologists because of technical and methodological difficulties in visualizing and culturing them.37 In the early germ theory era, he said, bacteria had been given an “almost exclusive role in the production of infectious disease.”38 By not studying other classes of organisms, Novy felt, bacteriologists would miss an opportunity to study microbes like anaerobic bacteria and protozoa that were as important in causing human disease and whose behavior in nature was thus as important to understand.39 Novy was keenly interested in devising new equipment to culture these microbes to gain more knowledge about them and their behavior.

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He began his search to culture new microbes, beginning with anaerobes, once again by using specimens sent to him for analysis for public health purposes at the Hygienic Laboratory. Anaerobes

In 1893, Novy developed novel methods to culture anaerobic organisms from samples of milk sent to the Hygienic Laboratory for analysis.40 From the milk samples, Novy was interested in isolating a phosphate-­rich acidic protein called nuclein that was contained in milk.41 Novy’s hypothesis was that nucleins from milk may elicit an antibody response when injected into rabbits, and that he could then have a model where he could study immunity in rabbits against future challenges from bacteria or their toxins.42 After isolating and purifying the nuclein, however, he found that injecting the purified nuclein into rabbits was not immunogenic.43 To his surprise, the injected rabbits died. Novy postulated that a bacterium caused the death of the rabbits because he observed a bacillus by Gram’s stain taken from blood specimens of deceased rabbits.44 But he was unable to culture an organism from this specimen using conventional bacteriological testing of its tissues. Novy did not abandon his theory of a bacterial cause for the rabbits’ death. He postulated that the stained organism was a type of anaerobe called an obligate anaerobe—­one that required complete exclusion of oxygen to be cultivated. During Novy’s time, no method to achieve this condition was available because existing anaerobic culture techniques did not completely deplete the environment of oxygen.45 He said that methods to grow anaerobes that require an absolute oxygen-­free environment had not been attempted because they were “tedious and difficult and require a special apparatus.”46 To create such an oxygen-­excluding culture system, he devised a bottle with a special stopcock for the entrance and exit of gas out of the environment of the culture medium with the use of a special vacuum pump, thereby completely depriving bacteria of oxygen so that obligate anaerobic bacteria could grow on solid gelatin culture plates (see table 2.2).47 Novy used the apparatus, which became known as the “Novy anaerobic jar,” to isolate an obligate anaerobic organism he called Bacillus novyi in culture from specimens from rabbits that died of a skin infection termed “malignant edema” after being injected with nuclein.48 The Novy jar would eventually become used in his own laboratory and others to isolate anaerobic organisms that caused a variety of infections.49



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Spirochetes, Filterable Viruses, and Protozoa

Novy’s growing reputation for devising innovative culture techniques attracted the attention of investigators throughout the world. By the early 1900s, his colleagues began to send Novy specimens by mail, retrieved from symptomatic humans or animals in diverse environmental settings, with hopes that he might be able to devise a system to culture an organism from the specimens. The geographic range of source material expanded well beyond the specimens that had been submitted throughout Michigan to his Hygienic Laboratory. In fact, Novy was able to test in his Michigan laboratory specimens sent to him from areas throughout the world—­New York (1906), Montana (1907), India (1908), Africa (1904), and the Philippines (1904), among others.50 The goals of his experimental inquiry expanded in parallel, as he was able to perform specialized tests in search of microbes from these specimens without himself moving to these distant and sometimes tropical regions. Using specimens from these expanded regions, Novy devised novel techniques to expand the array of microbes known to bacteriologists. In the process, he helped to expand the scope of bacteriology to include spirochetes, filterable viruses, and protozoa, and he sought, in parallel, to explore basic questions about their behavior. Novy began his search for spirochetes—­fastidious organisms that had not been grown in conventional cultures—­from specimens sent to him from New York City. From a colleague at Bellevue Hospital, Charles Morris, Novy obtained specimens derived from a patient who was suffering from a condition known as relapsing fever in which symptoms recur in a cyclic pattern.51 Morris viewed an organism that had the appearance of a spirochete on a stain of the patient’s blood smear but was unable to culture the microbe using conventional techniques.52 In the absence of techniques to cultivate the microbe, the convention was a cumbersome process of perpetuating the spirochetes by successive transfer of blood to rats, the natural habitat for the organisms.53 In 1905, Morris sent Novy a white rat inoculated with the blood of the ill patient so that Novy could attempt to culture the organism.54 Novy began by injecting the blood into his experimental rats to keep the organism alive in another animal’s body. He then proceeded with attempts to culture the spirochete he believed was responsible for the disease. Novy’s initial attempts to cultivate the spirochete on a variety of artificial media were unsuccessful.55 He reasoned that the organism may be present in quantities too small to appear on cultivation by routine methods. To explore this possibility, Novy collaborated with Professor Floyd Bartell in the Chemistry Department to develop an apparatus, called a collodium sac, to batch organisms in a large enough concentration (see table 2.2).56 This semipermeable sac, when

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inoculated with blood from an infected rat, was placed in the peritoneal cavity of an uninfected rat to obtain and secure nutrients from the peritoneal fluid and permit maximal replication of the organisms in vivo. When Novy removed the sac three days later, he reasoned that material from the blood-­filled collodium sac might be able to support the growth of organisms. Using this methodology to concentrate the microbe, Novy was the first to artificially culture a spirochete, which he then termed Spirochaeta novyi (see figure 2.7).57 In recognition of his

Figure 2.7  Stains of the spirochete named Spirochaeta novyi in blood smear from a rat. The organisms taken from Novy’s novel collodium sac culture system had the same appearance as the organisms in these blood smears. (Courtesy of Bentley Library)



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achievement of culturing the spirochete that caused relapsing fever in humans, and perhaps also to acknowledge his craftiness in uncovering nature’s secrets, he acquired the nickname “Spi” Novy from the students in his laboratory.58 Novy’s interest in culturing spirochetes indirectly led to his inquiry into a different type of microbe—­a “filterable virus.”59 In 1909, the stock rats in which his spirochetes were being maintained were dying for unknown reasons. Unable to demonstrate a bacterial cause of death in those rats, Novy postulated that an “ultramicroscopic” or “filterable” virus might be the cause of the rats’ rapid death.60 Novy’s interest in searching for “ultramicroscopic life” had in fact begun a decade earlier. Since 1898, Novy had been interested in visualizing these “infinitely small” organisms as a potential cause for yellow fever at a time when conventional compound microscopes and culture techniques did not reveal a bacterial cause.61 At this time, two other investigators had already postulated a filterable virus as the cause of diverse diseases in both animals (hand, foot, and mouth disease) and in plants (tobacco mosaic virus).62 Novy recognized that these minute organisms, after passing through the walls of filters that retain the larger bacteria, may cause infection similar to the disease in his stock rats when inoculated into a healthy, susceptible animal (see table 2.2).63 Novy believed that filtering these minute organisms offered the best chance to demonstrate their presence as the cause of death in his experimental rats. In the early 1900s, he knew that existing staining techniques and conventional microscopes were unable to visualize what he called the “extraordinarily minute” microbes.64 Novy wondered whether an instrument he recognized did not yet exist—­what he termed an “ultramicroscope” that had sufficient magnifying power to fulfill his desire to “actually demonstrate such small things”—­would ever be devised.65 Novy began his search for these ultramicroscopic germs by causing disease in healthy mice injected with blood that had been extracted from infected rats and then passed through specialized filters. Injecting even a minuscule amount, one hundred-­ billionth of one milliliter of infected rat blood, would cause convulsions and then kill the rats.66 Because there were no cell-­ associated cultures that would allow the virus to be maintained in incubating agar plates, Novy preserved a supply of the virus for his studies by continuously inoculating rats and then taking serum from them to inoculate others. From 1909 to 1918, Novy’s assistants maintained the virus in this manner by taking blood every seven days from an infected rat, inoculating another rat, and keeping enough blood in a tube sealed with glycerin. But all work had to be stopped when the stock material containing the virus was unaccountably lost in 1918 and the whereabouts of the tubes containing blood taken from infected

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rats remained unknown.67 After the loss, Novy lamented that the chance of maintaining his research projects was practically nil.68 Still, records and data of the rat virus experiments were kept in his unpublished laboratory notebooks, which he never discarded.69 Meanwhile, the Bacteriology Department moved to a new building and personnel changed. Novy retired in 1935, and it appeared as if his undeveloped scientific project to search for a filterable virus as a cause of death in his rats was destined not to reach fruition. Many years later, however, it was discovered that the tubes containing the rat virus had not been lost, just misplaced. In the fall of 1951, an old laboratory was being cleaned in preparation for a move when workers found a set of dust-­covered tubes that remained sealed with glycerin.70 Novy, who was alive at the age of eighty-­six and living as a retiree in Ann Arbor, read the labels on the tubes and confirmed that the blood had been drawn from the virus-­infected rats between 1914 and 1918 (see figure 2.8). By matching the labels on the tubes with his old notes, he verified that the tubes had contained virus-­infected blood.71 The virus had been found and Novy, with the help of a new team of investigators, used the newly developed powerful electron microscope to visualize the minute virus and show that it had survived.72 Not only had they found the filterable virus, but they showed that it was still alive and still capable of killing healthy rats after decades of desiccation.73 When he completed his experiments at age eighty-­eight and reentered his retirement in 1954, Novy had lived long enough to use the technology he had pined for since his early career—­a powerful new microscope that was able to view a minute filterable virus that his conventional microscope could not visualize.74 After a lifelong effort, Novy helped to isolate a filterable virus from stored specimens taken from his own laboratory rats, which had died of the virus over forty years earlier in 1911. Earlier in his career in 1903, Novy also sought to devise new methods to culture a different class of microbes that he felt had been completely neglected by bacteriologists—­protozoa.75 At this time, nothing was known about how to cultivate protozoa in artificial media and it had not been attempted.76 Novy began to use gelatin media to cultivate an intracellular protozoan of rabbits, coccidia, but he was unable to do so.77 He reasoned that his inability was due to the fact that the protozoa he was attempting to culture were confined to cells, an environment he was unable to reproduce in the cell-­free culture media he was using.78 Novy reasoned that free-­swimming protozoa could avoid this limitation and might be more amenable to culture on the agar media he had available. Novy thus turned his attention toward selecting an extracellular, motile protozoan that might be suitable for culturing.79 He had previously been



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Figure 2.8  Novy in 1953 after returning to the laboratory from his retirement

to investigate the rat virus. From “Lost and Found (Rat Virus),” in Time magazine 61, no. 6 (February 2, 1953). (Courtesy of Bentley Library)

interested in cell-­free, unicellular organisms when he was studying the Volvox algae swimming freely in the ponds of Chicago. He remembered reading about the trypanosome earlier as an amateur scientist high school student, and he reasoned that this parasitic organism would be suitable for culturing as it had a free stage in the blood of a wide range of animals.80 As trypanosomes were found to be present in the stained blood of rats in India without having caused disease, Novy postulated that trypanosomes could

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also be found in the blood of rats in America.81 He asked his students to catch wild gray rats, and he indeed viewed trypanosomes in the blood of these rats using conventional staining methods.82 Novy then sought to keep the organisms alive by means of transferring blood from the wild gray rat to the white rat that he used in his experiments.83 By creating such an animal model, he was able to maintain a supply of material he could then use for his experiments. Novy tried without success to culture the trypanosomes from the infected white rats by inoculating their blood onto agar supplemented by nutrients and animal blood.84 To his surprise, he found that the organism grew not in the blood agar, but in the water of condensation that formed on the inside portion of the agar plate.85 He reasoned that the trypanosomes preferred to swim in liquid—­much as Volvox had preferred pond water.86 Novy posited that solid media used to culture conventional bacteria restrained protozoan growth.87 He therefore developed a new method for growing pure cultures of the harmless rat trypanosome, Trypanosoma lewisi.88 Having succeeded in culturing a nonpathogenic protozoan, Novy next sought to culture disease-­causing protozoa. In 1904, he received blood specimens from diseased animals from David Bruce, who in 1894 had used conventional staining techniques to show the etiologic role of a trypanosome, Trypanosoma brucei, in causing animal disease, nagana, in South Africa.89 Bruce was working in Entebbe, Uganda, with the African Sleeping Sickness Commission, formed by the Liverpool School of Tropical Medicine in 1902.90 Bruce would later begin work on another trypanosome, Trypanosoma gambiense, which caused sleeping sickness in humans.91 At that time, European imperial nations had a keen interest in controlling parasitic diseases that had erupted in their colonies, affected animals and man, and threatened their economic interests.92 The experimental conditions that Novy used to culture T. brucei were initially unfruitful, but after numerous attempts in modifying the media, Novy was eventually successful in developing methods that permitted the isolation of T. brucei from the specimen.93 Likewise, Novy was successful in developing media to grow T. evansi, obtained from a specimen from a case of surra, a disease of horses and cattle, from colleagues in the Philippines.94 With his culture techniques, Novy was able to describe characteristic morphologic features of each species that enabled him to classify the different trypanosomes with more reliability than was possible by using the conventional staining techniques that Bruce had used.95 Novy next sought to culture disease-­causing protozoa other than trypanosomes. Charles Nicolle from the Pasteur Institute sent Novy a specimen from a human in Tunis with a disease called leishmaniasis that caused prolonged



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fever and enlargement of the spleen.96 Novy attempted to use specialized media to culture the organism but was unable to do so.97 After modifications designed by Nicolle and his student Ward MacNeal, the investigators were able to isolate the protozoan Leishmania infantum by further manipulations of his media, which they called Novy, MacNeal, and Nicolle (N:N:N) media.98 In his publications on trypanosomes and leishmania, Novy methodically detailed the rigorous methods he used to culture each of these parasites so other investigators could use his methods in their own laboratories and expand upon them.99 Novy’s efforts attracted worldwide scientific attention because he discovered the conditions in which protozoa, including those that cause animal disease worldwide, could be grown artificially in a laboratory.100 William Welch noted the significance of Novy’s work, stating, “For the first time it has been possible to obtain strictly pure cultures of animal protozoa.”101 David Bruce credited Novy with “throwing light on the trypanosome.”102 Novy’s discoveries, as his laboratory notebooks reveal, were the result of innumerable trials after what he called “many ineffectual attempts.”103 His diligence in pursuing the attempt to culture protozoa in the face of so many first failed attempts was a sign of what Ward MacNeal was to refer to throughout the years as the “dogged persistence of the chief.”104 Novy would apply his persistence to his next challenge—­to discover the behavior of the protozoan forms that had now become visible through his cultures. Studies on Microbial Behavior

Novy used his culture techniques as a foundation to investigate scientific questions about protozoa, how they behave in nature, and how they cause disease in their animal hosts. He designed methods, he stated, to “imitate the natural condition” of the protozoa.105 His goal, he said, was to “establish the relationship . . . [between an organism and its] life history” in nature.106 Novy stated that his dynamic system of pure cultures was “admirably adapted for the study of the life-­history of the organism inasmuch as the multiplication process can be followed under the microscope.”107 These methods, Novy said, would also provide “positive proof” of the organism as the etiologic agent in disease.108 His culture method enabled him to correlate the forms that appeared in his cultures with their behavior in nature and gain insight into the complex interplay of protozoa, insect carrier, and animal host that permits microbial survival and transmission. Novy noted that the morphology of the trypanosome that appeared in his culture system differed from the free-­swimming adult form he viewed in the blood smear of the affected animal. In his cultures, he observed the forms

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developing, maturing, and dividing over time in the laboratory. He found the trypanosome first assumed a flattened shape and configuration that he termed a crithidial form that subsequently multiplied and developed into an array of eight parasites anchored together by whiplike flagella that he called a “rosette form” (see figures 2.9 and 2.10).109 Neither Bruce nor Koch had seen these forms

Figure 2.9  Novy’s photographs of trypanosomes, T lewisi and T brucei, in

his culture system. Novy made lantern slides for his classroom lectures, and his handwritten descriptions are visible in the margins. The early crithidia forms were spindle-­shaped with a wavy whiplike membrane (flagellum) attached to a small organelle (centrosome) located anterior to the black nucleus at the midpoint of the organism. (Courtesy of Bentley Library)



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Figure 2.10  Rosette pattern. The crithidial forms matured and divided over

twenty-­four hours into a rosette pattern anchored together by flagella. Novy correlated the rosette form in his culture system with that in its natural habitat in the stomach of the tsetse fly. (Courtesy of Bentley Library)

in their stains of blood taken from animals with nagana or humans with sleeping sickness.110 Novy then correlated the culture forms in his experimental system with forms that he found in the stomach of the insect vector, the tsetse fly (glossina sp.) for T. brucei. He said, “Trypanosomes . . . found in the stomach of . . . tsetse flies . . . present the same characteristics of growth as those which have been grown artificially.”111 Novy then said, “they are to be regarded as

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cultural forms which develop in the alimentary tract in a manner analogous to those cultivated in the test tube.”112 But what were the trypanosome forms in the stomach of the fly? On the basis of their morphology, Novy first concluded they were due to harmless species of trypanosomes.113 Together with Bruce’s observation that tsetse flies must bite within hours of their infected feed to cause infection, Novy first hypothesized that the fly was a mechanical or “passive” carrier of pathogenic T. brucei.114 Novy then modified his view when a German investigator, Friedrich Kleine, showed that flies that had fed upon blood infected with T. brucei after a noninfective period of twenty days could still transmit disease.115 Novy concluded, based on his own experimental findings and Kleine’s observation, that “[T. brucei], after being ingested with blood, slowly adapt themselves . . . and therefore, the insect carrier is essentially a culture tube.”116 Likewise, he postulated that T. lewisi multiplies in the gut of the louse as readily as the test tube.117 He reasoned that the adult trypanosomes that form in the blood of an animal were sucked up by the insect and in their gastrointestinal environment gave rise to developmental forms analogous to the crithidial and rosette forms that he identified in test tube cultures (see figure 2.10).118 Thus, the insects, he concluded, were “active carriers [that] become suitable soil for the organism to multiply or pass through a developmental cycle.”119 By correlating the changing forms he observed in the culture system with the morphology that he visualized in the gut of the fly, Novy favored the hypothesis that the carrier was not simply a mechanical passive conduit of the microbe but was an active carrier in which the microbe adapted and evolved.120 Novy, furthermore, sought to determine whether these culture forms were indeed the forms that insects could transmit to infect their animal hosts. In a series of experiments, he injected pure cultures of both T. brucei and T. lewisi into a healthy rat’s peritoneum. In each case, the rats became ill within one week, and he confirmed that the developmental culture forms could transmit infection by documenting adult trypanosome forms in the blood of the rats (see figure 2.11). He confirmed what he termed the “adaptation” of the developing rosette culture forms into the typical mature disease causing adult “trypanosome” form in the blood of the rat injected with T. lewisi and T. brucei.121 Having established that the culture forms were identical to the forms in the stomach of the insect, Novy inferred that the tsetse fly (see figure 2.12) was also the insect vector that transmitted the developmental crithidial and rosette forms of T. brucei and T. gambiense to their animal host.122 Stating that “T. gambiense multiplies in the fly . . . [and] the progeny . . . are capable of causing infection,” Novy was correlating the forms of the trypanosomes in his



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Figure 2.11  The mature trypanosome form as it appeared in a blood smear of a rat following injection of the rosette form. Novy noted that this form differed from the culture forms in that the centrosome is at the posterior end and an undulating membrane of the flagella is attached to it. (Courtesy of Bentley Library)

culture system with their function—­transmission and infection—­in nature.123 Thus, with his culture system, Novy gained insight into the biological behavior of developing protozoa and the envronmental variables required for its transmission in nature and subsequent interaction with its animal host. Novy’s dynamic system introduced something new to bacteriology—­the ability to assess the comprehensive function of microbes as they were in the process of developing. Until this time, bacteriology had been about correlating an organism with a disease after the disease had occurred.124 By correlating the changes that

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Figure 2.12  Glossina morsitans. In the stomach of the fly, Novy noted crithidial forms that corresponded with his culture forms. He correlated the forms seen in the stomach of the fly with his experiments to show that the fly was the vector of transmission and that the crithidial forms were the infective forms. (Courtesy of Bentley Library)

occurred in his experimental system as the organism was living and maturing into different forms, Novy was able to establish an all-­inclusive life history—­a cause-­ and-­effect relationship between the transmissible developing forms in the gut of the fly vector and the disease-­causing adult form in its animal hosts.125 By studying these changes as they were occurring, not after they had happened, Novy was able to experimentally test the function of these different forms. Bruce and Koch were unable to test for these factors by using their static observation of organisms that they saw in their stains of human specimens.126 Novy’s culture system allowed him to view the appearance, maturation, and function of these organisms as they developed under his direct observation.127 Although Novy’s interest in studying trypanosomes overlapped with the work of European investigators, his focus on understanding basic scientific information about the microbe and its vector differed from their intentions. European investigators sought to control the epidemics by using chemotherapy to kill the parasite (e.g., the use of atyoxyl by Koch) or attempting to eliminate the insect vector (e.g., Bruce).128 These investigators had been working in nations whose interest was in combating epidemics that endangered Europe’s dominion over their colonies in distant lands.129 Novy, working in a nation that had no direct colonial interests in Africa, however, was able to focus his efforts



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on the science of the parasite and its carrier. In addition, Novy conducted his studies in an artificial environment that was remote from where the epidemics actually occurred. Unlike Koch and Bruce, who made their observations using conventional staining techniques in the field settings in which the diseases occurred, Novy designed laboratory experiments to scientifically simulate the interactions between parasite, insect, environment, and host.130 In this regard, the focus of Novy’s laboratory investigations of the interactions of the parasite and carrier was more encompassing than that of Bruce, Koch, or Theobald Smith—­who used staining techniques to identify the tick as the carrier of Texas Fever in the field setting.131 The scientific focus of Novy’s laboratory investigations into the interactions between the parasite, carrier, and host was more inclusive than that of his European peers. Novy used his innovative methods to investigate the science of parasites other than trypanosomes. He modified his dynamic culture system to reproduce the life history of the pathogenic protozoan, Leishmania infantum. Novy and his colleagues first cultured the leishmania in artificial media, and, like the trypanosome, observed that the leishmanial form in the culture tube differed from the form that caused disease in animals. As was the case with trypanosomes, Novy suspected that the form in the culture corresponded with the flagellated rosette forms of its yet-­to-­be-­identified insect carrier (subsequently found to be the sand fly, Phlebotomus sp.) (see figures 2.13 and 2.14).132 To correlate the culture form of leishmania with its life history in nature, Novy injected cultures containing developing rosette forms with a whip-­like flagellum at the head into the peritoneum of his experimental animal, the dog.133 Fourteen days later, he sacrificed the animal and made smears of its spleen and saw that his culture forms had developed into the adult flagella-­free disease-­causing form in humans (the amastigote leishmanial form [LD forms]) (see figure 2.15).134 The developing form that appeared in his culture system matured into the pathogenic form in animal tissue when causing disease. By devising the novel culture system, Novy studied the life history of leishmania by simulating in the laboratory how the organism matured, was transmitted, and changed its form as it caused disease in its animal host. Physicians and scientists marveled at how Novy’s innovative real-­time experimental methodology permitted insight into basic, scientific protozoology. William Welch and C.E.A Winslow, for example, understood the novelty of Novy’s work. In a letter to Novy, Welch said, “I congratulate you heartily for your original work demonstrating an experimental model with leishmania—­it adds another laurel to your already splendid record of achievement in this field of investigation, which is a great credit to American medicine. We are all

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Figure 2.13  Appearance of leishmania L infantum in Novy’s culture system.

Novy noted the small oval forms of leishmania, the leptomonad form, which are similar to the crithidial form of trypanosomes. (Courtesy of Bentley Library)

proud of you.”135 Winslow wrote that “Novy’s work on experimental infections with Leishmania and life cycles of trypanosomes represented an original and basic contribution to his field.”136 Winslow, who considered Welch and Novy the two most influential leaders among early bacteriology in America, regarded Novy as “mak[ing] a much greater original contribution to bacteriology than Welch.”137 What was it about Novy’s work on parasites that Welch and Winslow regarded as so basic, original, and distinct? Neither explicitly elaborated. But



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Figure 2.14  Rosette forms in Novy’s culture system. The leptomonad forms divide longitudinally and develop into “rosette” forms with flagella. The flagellated, promastigote forms are similar to crithidia of trypanosomes in that flagella are attached to an anterior basal granule (centrosome). (Courtesy of Bentley Library)

one can speculate that it was Novy’s ability to devise innovative continuous observation culture methods to grow protozoa, reproduce their dynamic changes as they evolved over time in their insect vectors and natural hosts, and then correlate the transformations observed in his laboratory with their life history.138 By simulating the dynamic changes that protozoa underwent as they adapted to their insect vectors and animal hosts, Novy sought to gain a

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Figure 2.15  Leishmania forms seen in an aspirate of the spleen of a dog following injection of the rosette forms show the small, nonflagellated forms (Leishmania donovani forms, or LD forms) inside splenic cells (macrophages). (Courtesy of Bentley Library)

better scientific understanding of the ecological and biological factors responsible for the transmission of protozoa and how they cause disease. In fact, when Theobald Smith asked Novy what he considered his most original work, Novy himself identified that it was re-­creating the dynamics of protozoan development in his laboratory, whereby, as he said, he “placed tropical disease at the disposition of the laboratory worker.”139



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Resolving Disputes: Heterogenesis and Plague in a Population

Novy used his novel techniques of culturing trypanosomes and spirochetes in an attempt to resolve a controversy among bacteriologists about whether the two species could convert from one to another. Fritz Schaudinn, a respected German bacteriologist and the discoverer of the microbial cause of syphilis, believed in the conversion of microbial species. He argued that spirochetes and trypanosomes in the rat were in fact the same organism and they could switch from one form to another.140 Schaudinn observed the blood of rats and owls using staining techniques and postulated that the spirochetes and trypanosomes he viewed were expressions of different forms of the same organism.141 He believed there was an alternation of growth of spirochetes in the blood of his owls, and that spirochetes changed into trypanosomes and vice versa. Schaudinn argued that microbes living inside circulating white blood cells of the owl were blood trypanosomes that, following ingestion by a mosquito, replicated inside the gut of the insect and gave rise to spirochetes.142 Once these spirochetes matured, he said they converted back to trypanosomes, thereby demonstrating the conversion of species.143 Schaudinn believed in an interrelationship of spirochetes and trypanosomes. Although the words treponema and trypanosome are not etymologically related, one cannot discount the possibility that the verbal similarity of the words may have perpetuated Schaudinn’s view. Nevertheless, Schaudinn’s idea that some microbes could convert to one another had in fact been a long-­debated issue in bacteriology and was countered by those who believed that microbial species were fixed and not transformable.144 Schaudinn’s publication spurred Novy to use his trypanosome culture system of both microbes to test Schaudinn’s hypothesis.145 From cultures of blood taken from owls, Novy methodically observed the maturation of trypanosome forms in a sequential fashion over a forty-­eight-­hour period. If species converted, as Schaudinn claimed, Novy should directly observe it in his laboratory cultivation system. He examined the specimens himself and saw no changes of the type to which Schaudinn had referred. Novy concluded that what Schaudinn felt were spirochetes were actually stages in the life history of the trypanosome, as he could observe the exact forms Schaudinn felt were spirochetes in the pure culture system of the trypanosome.146 This finding bolstered his conclusion that one species was not converting into another. Novy felt that Schaudinn failed to appreciate this fact because Schaudinn did not have a culture system to observe the trypanosomes maturing and changing form dynamically over time.147 Based on this observation, Novy noted, “the cultivation method is superior to the

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microscopic exam.”148 The pure culture system was the objective instrument that Novy used to refute Schaudinn’s claim and provide evidence against the theory of conversion of species.149 Novy maintained that Schaudinn’s inability to observe the organisms sequentially as they matured in a culture system led to his “erroneous conclusions.”150 Novy stated that Schaudinn failed to recognize these “simple facts” because his static observations at set time points did not allow him to recognize the trypanosome in its developing form.151 In his papers, Novy concluded that the spirochete and the trypanosome were independent forms of life—­a finding that he believed also disproved the general idea of the interchangeability of species.152 Novy used his culture system to show that trypanosomes could not convert to spirochetes in particular and to resolve a hypothetical issue regarding the behavior of organisms and whether they were capable of alternating species. In his publications on this topic, Novy did not mention having a practical goal in mind; he was performing experiments to understand how microbes develop over time and to discover where they come from. Acknowledging Novy’s evidence, Schaudinn eventually rescinded his claim of the alternation of species.153 Novy also attempted to use his objective instruments to resolve a different type of controversy—­a bitter public dispute among government officials and public health officials about whether plague was present in San Francisco in 1901, a port city with trade routes to Chinese cities where there had been plague. Joseph Kinyoun, a highly respected bacteriologist working for the Marine Hospital Service (MHS), had identified plague in the city after using culture techniques to identify the bacillus in a Chinese man with swollen inguinal glands.154 But politicians and businessmen thought that plague would threaten San Francisco’s prosperity, where the trade and tourism industries were thriving, since outbreaks of plague historically shut down trade and tourism in port cities. In addition, a diagnosis of plague led the Chinese to fear that Chinatown would be burned to the ground.155 In the absence of a massive epidemic, which doctors had been taught was an invariable characteristic of plague, many San Francisco physicians felt Kinyoun must have erred in his diagnosis.156 Consequently, citizens, physicians, and public health officials denied a diagnosis of plague on economic, political, and social grounds.157 Since politicians and citizens of San Francisco refused to implement measures to control the problem of plague as identified by his federal quarantine officer Kinyoun, Surgeon General Walter Wyman decided to opt for an assessment by experts who were not employed by the federal public health service or who did not have ties to local California interests.158 Wyman selected



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three members whom he believed met his criteria: Simon Flexner, professor of pathology at the University of Pennsylvania, as director; Lewellys Barker, professor of pathology at the University of Chicago, as secretary; and Novy as bacteriologist. In his letter inviting Novy to be the commission’s bacteriologist, Wyman was confident that the controversy surrounding Kinyoun’s diagnosis would be resolved if eminent specialists who were independent of the federal or San Francisco health departments would personally visit San Francisco and analyze specimens obtained from deceased bodies for plague.159 Wyman assumed that Novy’s reputation as an expert bacteriologist who had mastered objective bacteriologic instruments and the independent status that his university base afforded him would render his opinion unassailable by those who had rejected Kinyoun’s conclusion.160 As Novy traveled to San Francisco on January 24, 1901, he began a series of daily letters to his wife, Grace, that he would continue until his return to Ann Arbor on March 6, 1901.161 Novy considered Grace a confidante and shared his private impressions of his San Francisco experience with her on a daily basis. Noting the unfavorable San Francisco newspaper coverage that had been dismissing the scientific methods the commissioners used as misguided and irrelevant, Novy became uneasy about whether his scientific findings would be contested if he were to find plague. Novy felt that the objection to Kinyoun involved a repudiation of any scientist whose findings threatened the prosperity of the city. On January 27, he wrote to Grace, “The newspapers maintain that [plague] not only does not exist but even that it has never existed. The moneyed interests are so vast that they will not consent to our scientific findings should it be positive. The newspapers feel that they must not be guided by bacteriological evidence. They will in the end lambaste us just as they have done to Kinyoun should we find plague.”162 On February 5, 1901, the commissioners began their daily rounds of visits to Chinatown, gained access to ill Chinese residents, and secured a suitable laboratory in City Hall in which to carry out their bacteriological studies.163 On February 7, Novy diagnosed his first case of plague in San Francisco. He concurred with Kinyoun’s diagnosis, concluding on February 27 that “plague was present beyond possible doubt” in six of thirteen people who presented symptoms that were suggestive of plague.164 He tracked the deaths in the population, and he noted that the dynamics of the disease in the San Francisco population differed from classic patterns of plague described in medical texts—­it was not devastating the population, did not always have buboes, and sometimes lacked a rapid progression to death.165 Novy had shipped a culture plate of the plague bacillus from San Francisco to his Michigan laboratory, where he began to

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perform animal studies to explore its attenuated virulence.166 But experiments were aborted when his laboratory assistant Charles Hare developed acute pneumonic plague as a result of the accidental introduction of the microbe to Hare’s mouth through the use of a pipette, soiled finger, or cigarette.167 Hare survived the episode, but Novy could neither investigate nor explain the biological basis of plague’s atypical behavior in 1901. Nonetheless, Novy used his bacteriologic evidence to argue that there could be variations to the classic descriptions of plague in medical texts as a frightful ravage. The objective evidence provided by a disinterested and eminent bacteriologist like Novy did not immediately preempt the dissenting voices of politicians and practicing physicians. In the absence of a massive epidemic, some practicing physicians in the city rejected Novy’s bacteriological diagnosis of plague.168 For C. N. Ellinwood, professor of clinical surgery at Cooper Medical College, plague could not have existed because the epidemiologic pattern of the outbreak in San Francisco did not fit his notion of plague as a devastating scourge.169 Others, including a physician practicing in California, Charles Kuhlman, had repudiated the germ theory and dismissed the commissioners’ findings because they were incapable of correlating their scientific findings with actual disease processes.170 At a California Medical Society meeting on February 21, Kuhlman vehemently asserted that bacteriology was bereft of clinical meaning.171 He wrote, “Because the much vaunted bubonic government commission was . . . ignorant of the laws and teachings of clinical medicine, and consequently of the true relation of bacteria to disease processes, the knowledge of its members cannot be sufficient to properly weigh the evidence necessary to form correct conclusions in any matter [pertaining] to disease.”172 Kuhlman called the commissioners “arrogant, artless youngsters” who had not “engaged in the actual practice of medicine” and possessed knowledge “limited to experiments performed in college laboratories.”173 The presence of plague continued to be denied both by physicians who dismissed the commissioners’ findings, and by elected public officials who did not institute adequate sanitary measures or specific plague public health measures that included control of rats and vermin.174 Following the release of the commissioners’ report in April 1901, the local press denied that experts in bacteriology could provide convincing laboratory evidence that plague was present in the city in the absence of a devastating epidemic. The Chronicle said, “Had there been any ground for the assumption that cases pronounced [by the commissioners] to be plague were the real thing, we should long since have had unmistakable evidence of the genuineness of the visitation in the shape of an epidemic. But there has



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been nothing even remotely suggesting such a thing.”175 The press accused the commissioners of lacking the local knowledge of San Francisco that was necessary to judge whether plague was present. The San Francisco Herald, for example, proclaimed the “plague scare propagated by the federal commissioners . . . [was] harmful to the town and had to be gotten rid of.”176 At the time these newspapers’ articles impugning the expertise of the commissioners were being published, Dr. Alonzo Taylor from California informed Novy, who had returned to his laboratory in Ann Arbor, that “the report of the plague commission was being ignored in California.”177 In January 1902, Novy warned of the dangers of denying scientific findings, stating, “the whole country will someday reap the inevitable fruits of the plague culture nourished by the policy of the governor of California, for unless stamped out it will sooner or later suddenly expand over the whole country.”178 When the local health department continued to document ongoing plague in the city, the country threatened economic sanctions against California in October 1902.179 Delegates from a National Conference of State and Provincial Boards of Health of North America, held in New Haven, Connecticut on October 30, 1902, called upon federal health authorities to take decisive action toward stamping out the plague before it spread to other coastal cities, which would happen unless California ceased denying the epidemic and instituted aggressive measures to control it.180 National papers argued that an embargo on California trade be implemented unless decisive, comprehensive, anti-­plague measures including rat control were adopted to halt the spread of the epidemic.181 Only then did California, under the leadership of a newly inaugurated governor, a physician named George Pardee, elect to institute aggressive sanitary and rat control measures in February of 1903 to control plague in the city and to prevent the spread of plague throughout the country.182 Thus, Novy’s bacteriologic findings were accepted and his conclusions were acted upon only when they resonated with the overall financial and political interests of the city. Novy sought to use his instruments as an objective means to settle disagreements about whether microbes could change from one species to another, and resolve a controversy about whether plague could have caused an outbreak in San Francisco in 1901 that lacked the classic devastating behavior of plague epidemics historically. Novy was operating at a time when American scientists believed the use of these instruments could yield objective facts that other scientists could agree upon.183 He championed a conviction that through adherence to rigorous methods and the use of new techniques, scientists could unveil occult truths about microbes that would leave little room for disagreement. But San Francisco’s response to the plague commission

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report shows that Novy’s objective means of diagnosis were not universally considered the most authoritative source of disease interpretation. Novy’s laboratory science, with its rational methodology, could not entirely banish bias or conflict among different sectors within San Francisco during this historic moment. Other than the brief six weeks he spent investigating plague in San Francisco, Novy never returned to study diseases where they were actually occurring. Rather, he spent the bulk of his career in his Michigan laboratory addressing questions about basic microbial biology and serving as a mentor to his students (see chapter 6). Experimental Latitude

The scope of Novy’s experimental inquiry—­spanning from the basic biology of microbes, to microbial behavior, host response, and variant behavior of diseases in a population—­was considered by his peers to be exceedingly broad for his day.184 Perhaps the breadth of his work can be partly attributed to the freedom of experimental choice that Novy granted to his graduate students to pursue areas that most intrigued them. Indeed, several of Novy’s graduate students whom he mentored believed that Novy created an atmosphere that encouraged freedom to pursue topics according to their creative wishes.185 This atmosphere attracted a variety of students with different interests, and Novy did not restrict the topics of their research pursuits. One former student, Max Marshall, who became a professor of bacteriology at the University of California at San Francisco, wrote about how Novy encouraged him to “select and work on problems in basic science of my [Marshall’s] own choice,” and how the “spirit of the environment” was centered around “forcing nature to give up its secret.”186 Consequently, some of Novy’s investigations were free to veer away from the direction in which they were originally intended if they needed to do so in order to pursue an unexpected finding. One of Novy’s experiments can be used to illustrate the consequences of the scope of experimental freedom and flexibility that he encouraged. He began investigations into whether animals could build up protective immunity to repeated injections of trypanosomes.187 He and his graduate student Paul de Kruif unexpectedly noted a sudden decline in temperature, inability to form clotted blood, and circulatory collapse that led to death in some animals.188 It appeared to them that a specific poison, or anaphylatoxin, was being generated by the contact of rat serum with the trypanosome in the bloodstream.189 At this point, Novy and de Kruif decided to completely abandon their original experimental aims and to entirely redirect the focus of their inquiry exclusively onto



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the cause of death in their experimental animals. They began a pursuit of the chemical nature of the anaphylatoxin and what it was about the trypanosome-­ host interaction that resulted in anaphylaxis.190 By injecting filtrated blood into healthy animals, they found that anaphylaxis was due to a change in the normal clotting factors of circulating blood (e.g., its globulin fraction) into poison that was triggered by an interaction with the trypanosomes.191 Despite their continued pursuit, they were unable to define the chemical nature of the anaphylatoxin and how the host produced such a toxic reaction to an external organism.192 Nonetheless, their experiments demonstrate how the encouragement and freedom Novy gave his students to pursue serendipitous findings was in part responsible for the unique scope of Novy’s experimental queries about microbes, their behavior, and the range of host responses to them. In conclusion, the public health context of Novy’s medical school bacteriology laboratory permitted investigations into what were more fundamental research problems, inquiries that remained Novy’s principal interest throughout his career. In his Hygienic Laboratory, Novy devoted his primary mission to investigating new basic knowledge about microbes and their behavior.193 He acknowledged that he had other duties in his Hygienic Laboratory, including the examination of waters and other materials to aid in the diagnosis and control of disease, as well as teaching.194 He fulfilled these obligations with his characteristic excellence. But he was consistent in his priorities, stating that among those duties, “research was given the first prominent position.”195 To accomplish his goal of seeking to discover fundamental aspects of microbial biology, Novy relied on technical expertise, strict adherence to methodology, and instrumental design to access nature’s unknowns. The value that Novy placed on this approach as a means of obtaining basic knowledge had its roots in his initial training in chemistry. Transferring this scientific approach to bacteriology, he discovered basic aspects of the mechanisms of microbial life—­ the chemical elements consumed and produced during metabolism and the gases emitted during respiration. Undaunted by what he believed was bacteriology’s overly narrow focus on bacteria, he broadened its scope to include an array of microbes that could be visualized with the novel techniques he developed. Furthermore, he was able to simulate in the laboratory the life history of protozoa in nature by correlating the forms he saw in his novel culture system with those that appeared in insect vectors and animal host models. Innovation, whether in posing scientific questions or devising the tools with which to answer them, was a defining tenet of Novy’s work. Novy’s basic scientific focus largely differed from that of his American peers, who worked on practical applications of bacteriology in public health

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departments. Novy eschewed having the practical applications of his laboratory work be the principal function and purpose of his research agenda. His focus on the use of instrumental design to uncover truths in nature and resolve disputes in medical science was distinctly different from historians’ characterization of the work of bacteriologists in late nineteenth-­century America. Novy’s consistent focus throughout his long scientific career remained an unwavering search for a greater understanding of basic microbial biology. Unlike European medical scientists studying trypanosomes, his focus was on the science of protozoology and not on the practical aspects such as chemotherapy (e.g., Robert Koch) or vector control (e.g., David Bruce).196 Unlike American medical scientists studying protozoa (e.g., Theobald Smith), Novy studied the disease in a laboratory remote from the site of the epidemic by the use of novel instruments, devising real-­time methods to explore the interaction of the protozoa with their insect carrier and animal host. Moreover, he spent his entire career in a medical school laboratory with minimal diversion into the realm of field studies or practical applications of public health. The better-­known American medical researchers of this era worked in schools of public health (e.g., William Welch) or departments of public health (e.g., Theobald Smith) and were trained as pathologists and not first as scientists.197 From a teenage amateur scientist to an eighty-­nine-­year-­old retiree, Novy’s primary focus from his laboratory was the investigation into the mechanisms of microbial life and the biological behavior of microbes. Novy’s peers recognized his innovative research as pure and fundamental for his time.198 In actuality, however, some of his research might be considered as something other than strictly basic in nature. One could argue that in the process of expanding the scope of bacteriology to include anaerobes, spirochetes, and protozoa, for example, his work had practical implications as he identified disease-­causing organisms. In addition, Novy occasionally performed experiments to test the potency of agents used for purposes of disinfection.199 Furthermore, in studies funded by the Rockefeller Institute he sought to study immunity to trypanosomes in animal models as a basis for a therapeutic vaccine (see chapter 6). Thus, it would be misleading to claim that Novy’s research was exclusively limited to the pursuit of basic scientific information per se. Nonetheless, the overwhelming emphasis of Novy’s research corpus was the use of novel techniques to seek a greater understanding of microbial biology and pathogenesis. Novy’s orientation toward technological innovation to gain insight into fundamental microbial knowledge had historic roots among early European germ theorists. A student of history, Novy wrote about these European roots, and he devoted his career to expanding upon them. The premise of Novy’s



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work on exploring the chemical mechanisms of microbial life, for example, had its origins in Pasteur’s studies on fermentation. Similarly, Novy’s interest in devising new instruments and methods to identify new microbes and how they behave had its premises in Henle’s call for the development of new instruments to determine the role that microbes play in disease processes. Novy was attracted to the early germ theorists who focused on instrumental innovation to answer questions about microbes; it was this aspect of his European experience that he translated to his medical school laboratory. The location of his laboratory at the medical school provided Novy an opportunity to use his research activities as a foundation for medical education. Novy acknowledged that he sought to instill in medical students his spirit of scientific investigation—­to search for nature’s truths—­that guided his own research investigations. In addition, Novy reported to his students, “many of the methods as well as some of the apparatus described have originated in this laboratory.”200 The following chapter outlines the scope of his educational activities and how his research activities served as the basis for his position as a full-­time researcher-­educator.

Chapter 3

Making Medical Education Scientific

Novy used his hygienic duties and his basic research operation as a platform to teach bacteriology to the university’s medical students. What specifically did he teach those students? What was he trying to accomplish by teaching laboratory medicine to students who would spend their careers practicing medicine? Years later, how did he view his early efforts in instruction? When he began his teaching, Novy wrote and lectured about what he intended to accomplish by introducing laboratory instruction into the medical curriculum. In his lectures and texts prepared for his students, he stated that he wanted to instill “the spirit of research in medicine” in all medical students, including those who would enter private practice as well as future researchers. What did he mean by this term, and what was his goal of instilling this spirit in his students? How does a study of Novy’s educational activities add to what medical historians have already recognized for late nineteenth-­ century American medical educators? Many of Novy’s students wrote to him about their experience in his classroom and laboratory course. They elaborated on the ways in which Novy’s ideas and instruction influenced them throughout their careers as practitioners or as medical researchers. How did this group of students receive Novy’s intentions—­both initially while enrolled in medical school and as they reflected back on their education? How did they see Novy’s ideas as having influenced them, and which were most important? What meanings did they attribute to Novy’s work, and how do their perceptions of Novy compare with Novy’s own stated goals? How did those destined to become practitioners view his laboratory instruction?

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There is an inherent selection bias in this method, as the letter-­writing students represent a self-­selecting sample of the total population of students who took Novy’s courses. Because the voices of students who did not write to him cannot be included, this chapter will not claim to portray a complete picture of Novy’s students’ experience as a whole. Nonetheless, one can employ the letters to explore how this group viewed Novy’s instruction overall, and his emphasis on the spirit and principles of basic science in particular. This chapter addresses what Novy represented to these students, then explores why they may have valued him so much. Medical Education at Michigan in the 1880s

Before the decade when Novy entered medical school at the University of Michigan in the 1880s, medical education consisted mainly of didactic lectures that took place in large rooms.1 With the exception of anatomy, there were no laboratory-­based classes, and laboratory-­based research was almost nonexistent.2 Like most other American medical schools, including proprietary schools not affiliated with a university and operated by part-­time medical practitioners for profit, Michigan was a two-­year school.3 In addition, there were no formal admission requirements.4 By the mid-­1880s, Michigan was among a handful of American medical schools that were beginning to expose students to scientific medicine. Scientific medicine in the late nineteenth century was seen as an array of medical practices rooted in experimental physiology, the chemical analysis of food and water, sanitary measures, and other areas.5 On the basis of this definition, medical education at Michigan was becoming scientific in the 1880s. By 1884, Michigan added courses in both physiology and sanitary sciences into the medical curriculum, and to accommodate the new courses it extended the students’ length of study from two to three years to earn a degree. But these scientific medicine courses in the 1880s did not include a separate laboratory component. At that time, for example, Henry Sewell taught a full two-­term course in physiology with demonstrations during his lectures, without a designated laboratory section.6 In addition, Victor Vaughan began to teach about the germ theory of disease by weaving the topic into his course on sanitary science in the 1880s.7 But this course was not devoted exclusively to bacteriology, and again, there was no laboratory component.8 The insertion of an occasional lecture on bacteriology into the medical curriculum at Michigan did not differ from the practice at other American medical schools in the 1880s.9 By the mid-­1880s, in fact, professors in a handful of American medical or veterinary schools did sporadically give lectures on

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bacteriology in courses devoted to hygiene: Dr. H. C. Ernst (Harvard Medical School, 1885); Theobald Smith (George Washington Medical School, 1886); George Homes (Chicago Medical School, 1888); and Harold Pammel (Veterinary School of Iowa State, 1889).10 But the occasional lecture on bacteriology was not accompanied by a laboratory component, and no full course devoted exclusively to bacteriology was offered. Novy’s Microbiology Course

Novy developed a course devoted exclusively to microbiology that included a laboratory component—­the first full-­semester lecture-­laboratory course in bacteriology taught in America. The first year, the course was initially offered as a three-­month elective in the fall semester of 1889—­while Novy himself was a medical student. According to Novy, relatively few students took the course when it was first offered.11 By the next year, however, the lecture-­laboratory course became required for all students.12 Titled “Practical Bacteriology,” the intensive course included a one-­hour daily morning lecture in bacteriology each morning five days a week for twelve weeks each semester to all first-­year students. Each lecture was accompanied every afternoon by a corresponding four-­hour laboratory session.13 By the early 1890s, bacteriology had clearly assumed a dominating position in the first year of the Michigan curriculum—­ students worked in the laboratory every afternoon.14 At this time in 1890, no other course at the university had a dedicated laboratory component and met for a full hour each day for the entire semester.15 By the close of the 1890s, bacteriology occupied the largest portion of the curriculum at Michigan.16 The content of Novy’s course in the 1890s is outlined in the lecture notes that he meticulously kept and also the two textbooks that he used to accompany his laboratory course (see figure 3.1).17 In 1894, he published his first textbook, a 202-­page text entitled Directions for Laboratory Work in Bacteriology (for the use of the medical classes).18 Five years later, Novy expanded his previous text to a 563-­page book called Laboratory Work in Bacteriology (see figure 3.2).19 In his course, Novy lectured about fundamental scientific principles and mechanisms about microbes—­their basic biology and chemistry, metabolism, how they live and spread in nature, their life history, the role they play in nature by decomposing complex organic materials into simple elements, and how they produce disease. His course spanned all classes of microbes, including protozoa as well as bacteria he had discovered, regardless of whether they were disease-­causing or not. As Novy himself acknowledged, he used his own research investigations as a foundation for his instruction about the scientific aspects of microbes and their basic behavior in nature.20

Figure 3.1  Novy’s handwritten lecture notes for his 1891 bacteriology

course. In lectures 1–­3, Novy taught about the history of the germ theory and fundamental aspects of microbes (taxonomy, metabolism, chemistry). In later lectures, he instructed students in how to culture and identify microbes and how to determine whether an organism is responsible for producing human disease. (Courtesy of Bentley Library)

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Figure 3.2  Introduction page to Novy’s 1899 textbook Directions for Labora-

tory Work in Bacteriology. His text included an ample number of blank pages for students to sketch the morphologic characteristics of individual microbes that they had learned to culture. (Courtesy of Taubman Library, University of Michigan)

Novy emphasized both the cognitive and manual components of laboratory investigation. In the laboratory section, he stressed experimental design to test these theories, technical proficiency, and the proper use of laboratory instruments that he had learned firsthand by studying with the European masters.21 Some of what Novy taught his students was derived from his duties in the sanitary laboratory. For example, students were trained in the methods of examination of air,



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soil, water, milk, and foods for bacterial contamination.22 Thus, he taught about methods that were derived from his duties in the Hygienic Laboratory as well as his independent research activities. Novy taught students how to use the laboratory as a means of verifying information they learned in the classroom. When he lectured on theories about germs and their relationship to disease, he would then provide students the opportunity to empirically test the hypothesis that germs cause disease by performing culture and animal inoculation studies.23 Novy was guiding his students to test the authenticity of medical information as it passed on in the classroom—­including the validity of the germ theory itself. This was a time when scientists disputed what germs were and whether they caused disease.24 At Michigan, in fact, students were being taught by a professor of pathology, Henneage Gibbes, who did not adhere to the germ theory of medicine.25 Novy gave his students a then-­rare opportunity in medical education—­to use instruments to test opposing theories empirically as opposed to accepting or rejecting either one blindly.26 In essence, Novy was taking the same equipment and methods that he used in his research setting and making them essential to medical instruction. Prior to introducing laboratory courses in medicine, students had no avenue to question or validate the information they received from their professors during classes in imposing lecture halls.27 These sorts of broad goals made Novy’s laboratory instruction meaningful to all students, including those destined for medical practice. To teach medical students the laboratory techniques necessary to accomplish these goals, Novy laid out an ambitious, methodical agenda for the four-­ hour daily laboratory section. He introduced students to the core instruments of bacteriology outlined in table 2.1—­microscopes, solid culture plates, agar preparation, pipettes, incubators, sterilizers, and the handling of animals. Novy then provided exercises to teach students the methods of preparing and staining specimens, plating bacteria onto gelatin and potato agar plates, incubating plates, and inoculating animals with pure colonies.28 Novy taught how to perform postmortem examinations of guinea pigs in order to detect the presence of bacteria. In his course, Novy familiarized students with the latest scientific ideas and techniques of the day—­including the use of his own innovative apparatus. This was an ambitious task because medical students at that time did not have scientific training before entering medical school; the majority of students in the 1890s had no prior training in science or laboratory methods; indeed, many had not graduated from high school.29 In fact, most students were destined to spend their careers working not in the laboratory, but at the bedside. As the

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course was required for all students, Novy sought to demystify the complex instruments of the laboratory and make the techniques accessible to all students who took his class. Once students demonstrated capability in carrying out these techniques, they were given the opportunity to think critically about the relationship of the microbes cultured in the laboratory to disease. In his laboratory session, Novy encouraged active participation in learning. Students were provided unknown isolates and asked to identify the organism. Novy omitted illustrations of the various microbes and their cultural characteristics and provided blank pages for students to sketch from observation of the organism.30 Once the pathogen was identified, students were asked to determine whether or not the microbe was a disease-­causing pathogen, depending on whether it fulfilled Koch’s postulates.31 He not only introduced students to the rationale for a use of control in their experiments and the logic of experimental design, but he instructed them on how to precisely use the scientific methods and instruments needed to evaluate whether a microbe was a pathogen.32 He taught students to learn to differentiate bacteria by morphological and cultural appearances from similar but harmless organisms.33 Thus, the content of Novy’s course combined the cognitive with the technical aspects of bacteriology and laboratory experimentation. He taught the logic and technique of bacteriology of the day—­the methods students would need to interrogate the disparate and conflicting views they heard about the validity of the germ theory of disease. But in addition to teaching information that was specific to bacteriology, Novy also sought to instill in students a duty to seek new knowledge by a combination of thought and hard, disciplined, time-­consuming work.34 As he stated, his goal was to provide students with “the power to think and do,” meaning experimental inquiry—­creating hypotheses, using scientific methods, and actively, methodically participating in the laboratory to test hypotheses.35 Knowledge of experimental methods gave students power, according to Novy, to cancel or modify knowledge in the laboratory, not merely accept a fixed notion of knowledge transmitted through texts, classrooms, and recitation rooms. Thus, through his own course in 1890, Novy advocated for and demonstrated what he believed to be the value of laboratory training for all doctors in medical education—­to test and verify hypotheses they learned in the classroom through their own empirical observations.36 It was his intention to make medical education more scientific by taking this key step in expanding the instruction of laboratory science, a course of instruction that would later be referred to as the basic science curriculum.37 Novy’s textbook was used by his colleagues who taught bacteriology courses in other university-­affiliated medical schools. His colleagues’ letters, however,



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do not explicitly state how they structured their courses, how they used Novy’s texts in their classes, or how extensive their laboratory sessions were. William Welch, for example, indicated in a letter to Novy in 1899 that he was using the text for his course at Johns Hopkins and that his students “get exceptionally good training in this important subject.”38 Edwin O. Jordan wrote to Novy that he found Novy’s text provided “many suggestions of practical value to students” at the University of Chicago Medical School.39 Similarly, Theobald Smith indicated that he was using Novy’s book in his lectures at Harvard Medical School.40 Novy’s instruction and text had an influence on other elite medical schools, but a comprehensive nature of this influence cannot be provided. To accommodate Novy’s extensive three-­ month-­ long, four-­ hour daily lecture-­laboratory course, as well as other laboratory-­based courses, Vaughan recommended that the duration of medical education at Michigan be extended from three to four years.41 The rationale for lengthening the course of study, provided by the like-­minded Board of Regents who approved the change in 1891, was that “Instruction is no longer in method mainly didactic and descriptive, but experimental, manipulatory, scientific.”42 At medical school faculty meetings, Novy and Vaughan also advocated for higher admission standards to improve the caliber of medical students, who Novy believed were improperly prepared to comprehend the language of basic science contained in the new curriculum.43 Together with Vaughan, Novy advocated for prerequisite courses in the sciences and eventually the attainment of a bachelor’s degree prior to medical school entrance.44 In the 1890s, Novy cited the need to train students’ minds in scientific methodology to justify improving the caliber of medical students to ensure that they possessed the experience and skills needed to comprehend the complexity of the material being taught in basic science courses.45 Two decades after Novy introduced his course, the value of the inclusion of laboratory work in medical education was articulated by Abraham Flexner in his well-­known 1910 report, Medical Education in the United States and Canada. Flexner stressed the importance of hands-­on instruction in medical education—­ teaching all medical students the methods to solve problems and to follow the logic of new medical information as it was reported in medical journals and later in medical texts.46 Flexner credited Michigan as a medical school that had already been succeeding in this initiative and as a “model of medical education” in America.47 Furthermore, the educator and philosopher John Dewey later recognized the importance of the hands-­on teaching of critical thinking to students in a different arena—­elementary education—­as he regarded knowledge not as fixed but as expanding and evolving.48 Thus, Novy’s insistence on the process of embracing empiricism and laboratory experience as an avenue to obtaining new

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knowledge in the 1890s was a precursor of the ideas articulated by Flexner and Dewey. Dewey had been a faculty member at the University of Michigan from 1884 to 1894 and in fact knew Novy as a colleague during that time. Although the exact extent of their interactions was not documented, Dewey indeed had been a supporter of Novy’s research and educational activities at the university.49 Years later, in 1929, while on the faculty at Columbia University, Dewey wrote to Novy, recalling his “vivid recollections” of his “colleague Novy” and acknowledging his “undulled memories of their former companionship” at Michigan.50 Dewey wrote of his “admiration” of Novy’s personal qualities, scientific accomplishments, and educational work.51 Although Dewey did not further elaborate on his approval of Novy’s activities, one can speculate that it was Novy’s views on the provisional nature of knowledge and his emphasis on learning by doing rather than passive learning that resonated with Dewey’s own philosophical ideals about knowledge and education.52 Novy never specifically addressed how understanding laboratory methods per se would help practitioners assess the validity of information they had learned in lecture halls, or how doctors following their graduation could implement Novy’s lessons on a day-­to-­day basis. He had, in actuality, no direct evidence that all doctors should have scientific training. Furthermore, he did not contest the importance of clinical experience to medical education or to the practice of medicine. In fact, he paid considerable attention in his text and lectures to correlating his microbiologic findings with clinical information (e.g., descriptions of disease, organ involvement, and pathologic findings) so that the two were complementary.53 For Novy, it was not simply a matter of being in favor of laboratory medicine or clinical experience. He did not consider experimental design and method as incompatible with clinical medicine. Novy certainly embraced the ideals of laboratory medicine, but he did not excessively or exclusively believe in devotion to the laboratory at the expense of clinical experience. Novy wrote that bacteriology was one of several laboratory-­based scientific fields that were essential to the first year of medical education. He maintained that instruction in other fields—­anatomy, physiology, and pharmacology—­was also crucial to the first-­year curriculum.54 Novy was motivated to advocate for the dominant placement of this group of laboratory-­based courses, including bacteriology, in first-­year medical education. By the 1930s, Novy would refer to this group of laboratory-­based science courses as the basic sciences.55 In the 1890s and early 1900s before he adopted this terminology, Novy reported that by teaching this group of courses, instructors could instill a spirit of research



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in medicine or foster a spirit of science in all medical students.56 Below, I will explore the broad meanings included in Novy’s use of the term and how it went beyond teaching students critical thinking and the logic of scientific method that historians have addressed.57 Spirit of Research in Medicine

In a speech delivered at the opening session of the Department of Medicine and Surgery in September 1902, Novy outlined the meaning of the term spirit of research in medicine.58 He had used a similar term previously, including in the preface to his 1899 textbook, where he referred to the spirit of science in medicine.59 Novy stated, “The spirit of scientific investigation, and not mere book reading, must be fostered in the student from the start, since it is this that leads to progress in medicine and serves to distinguish the true physician from those bound down through blind faith, commercialism, or ignorance.”60 Novy wanted to impart a spirit of scientific inquiry that involved more than didactic instruction, encompassing active empirical testing of hypotheses in the laboratory. Novy taught the incoming first-­year students that in order to possess the spirit of science one must first reject what he termed “blind faith” learning, which was fostered solely by book reading and lecture courses. Next, students must be motivated to search independently for hidden truths in nature by performing disciplined, precise laboratory work. This act required more than adopting a rational scientific method. The work was to be carried out diligently, and with persistence and plodding. He warned students they must be able to endure criticism from traditionalists who resented questioning of authority. Finally, motivation by commercialism—­a term Novy never precisely defined—­ was discouraged as counterproductive. By incorporating a code of ethical conduct and disciplined habits, Novy’s spirit of science was more inclusive than training the mind alone. Novy espoused the idea that through laboratory-­based science courses, students would first learn the necessary facets of critical thinking—­to doubt notions of fixed medical truths passed down in lecture halls, to free themselves from blind faith in what their professors claimed were universal truths, and to think independently. Novy said that students must become involved in a “struggle for independence, . . . [for] emancipation from servile obedience to the writings of medical teachers.”61 Laboratory courses demanded that students actively participate in experimental inquiry in a laboratory setting—­an “active process of searching for truths as they exist.”62 Through this process, Novy believed, a student would reside in what he said was a “republic of medicine . . . unfettered by dogma . . . by be[ing] bold to work with his own

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hands, the power to do work, and describe ‘facts’ as he found them through his experimentation.”63 All students who incorporated the spirit of research could become citizens in Novy’s republic—­a democratic regime that bestowed to all members the “power to work independently and to assess new scientific theories . . . [and] to retain some and discard others.”64 Thus, through a process of doubt, critical thought and experimental inquiry, students would become worthy citizens of a new, rational culture of scientific medicine. Novy inspired students to believe in what they discovered through their own critical, rigorous assessment process, instead of uncritically accepting what was told to them by their professor. With this charge, Novy deflated the idea of a medical professor as infallible. Furthermore, by noting a “common bond that unite[d] teacher and student . . . the search for truth,” Novy envisioned a shared sense of purpose among like-­ minded but hierarchically dissimilar people.65 Novy described the common purpose not dispassionately, but emotively—­as a “desire . . . a thirst, love, yearning . . . or zeal to seek the cause of things . . . [that] will expand the boundaries of knowledge.”66 Learned and intensely felt values about the usefulness of science in understanding nature and the harnessing of science for practical reasons structured the attitudes of Novy’s students and teachers alike, and helped to deliver students from an older order—­characterized by things that had been accepted without enough scrutiny—­to a new order where students had latitude to think independently and had the power to modify or cancel knowledge. Novy intended to have an ennobling, elevating influence on his republic of students by providing them with the tools to find nature’s truths, verify information, or reconcile conflicting theories they had been taught. For Novy, instilling the spirit of science in students involved more than training the mind, it also involved disciplining daily habits. He believed that a cognitive component of critical thought was one portion of the spirit; also comprising this spirit was a code of behavior that encouraged disciplined work that involved the manipulation of complex laboratory instruments as the means to access nature’s truths.67 Novy taught students they have a “duty to doubt . . . a high purpose to think critically, work hard and describe things as you find them, not as they are supposed to be . . . [and] . . . courage to endure criticism.”68 Novy taught his students they have an obligation “to work hard [and with] high purpose” toward one goal—­the “search for the solutions of the ever recurring puzzles of life.”69 He sought to instill in his students an ethos or spirit—­a “duty to seek the cause of things [and] . . . produce some addition to the common stock of knowledge.”70 Novy did more than discipline his students’ minds with an intellectual regimen: he provided rules for moral conduct and insisted on disciplined daily habits of diligent work.



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Novy placed the highest value on the discovery of “hard facts” about basic microbial behavior that promised no return except the satisfaction of adding to the sum of human knowledge. Through his scientific conduct and instruction, Novy embodied this code of ethics—­a moral commitment to a disinterested search for truths in nature above other commitments, including the development of practical interventions for therapy or prevention. In turn, he asked all students to commit themselves to the cause he outlined and to eschew self-­ interested courses of action (e.g., commercialism or the development of practical interventions for therapy or prevention) or blind faith in didactic lectures. Novy insisted on the acquisition of disciplined habits—­hard work, accurate recording—­together with the cultivation of behaviors of determination, perseverance, and plodding. Doing so would garner what he termed a “true” or “intelligent” physician.71 Novy intended to harness the work of laboratory science to mold the character of his students rather than merely to educate them. Though their minds were disciplined with an intellectual regimen, Novy also provided rules for moral conduct and insisted on disciplined daily habits of hard work. By regulating the behavior of students, Novy worked to create noble men of science in a rational culture of medical science. Novy’s goals of teaching laboratory science were more expansive than historians have previously described for late nineteenth-­century American medical educators. Historian Kenneth Ludmerer has comprehensively examined how researcher-­educators taught students critical thinking and the logic of scientific method in laboratory courses that stressed learning by doing.72 educators teaching critical thinking Ludmerer concentrated on researcher-­ and scientific methodology that was associated with learning by doing. But historians have not addressed the intentions of medical educators to instill morals, habits, and an ethical conduct in students. Tracing the activities of an individual physician scientist such as Novy provides an additional dimension to the picture of the late nineteenth-­century researcher-­educators that historians have portrayed—­to mold their characters as well as training their minds. Novy legitimated pure laboratory science, with its disciplined work, search for truths, and moral code, by establishing its noble spirit of science in medicine as a norm of behavior for all medical students, researchers, and practitioners alike. Novy insisted that his lecture-­laboratory course was “essential to the proper education of the medical student of the present day.”73 By asserting that his course was indispensable for all medical students, Novy’s medical instruction paralleled the democratic ideals of America and differed from the teaching of medicine in Germany, where the same bacteriology that Novy had learned

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firsthand was taught only to those destined to become researchers. Novy’s educational goal was to provide methodical habits and a code of ethics based on shared duties and responsibilities for all medical students, rather than focusing exclusively on the few who were destined for a research career. Although new for medicine, Novy’s goal of molding the character of his students according to an ideal of science had precedents in nonmedical American sciences. The goal of Ira Remsen, who taught chemistry at Johns Hopkins University in the 1870s and 1880s, for example, was to instill ethical values of an honest search for truth in nature, of the virtue of hard, thorough work, and of discipline in his students.74 In addition, the president of Johns Hopkins University, Daniel Gilman, viewed the teaching of laboratory science at Johns Hopkins in the 1870s as a means to build students’ character.75 Furthermore, H. A. Rowland, a late nineteenth-­century physics teacher at Johns Hopkins University, argued that American scientists ought to be motivated not by profit but by pure science to uncover truths in nature, and must have regulated habits in the laboratory.76 Thus, during the 1880s American physicists and chemists were devoted to a pure science ideal.77 These scientists urged their students to be motivated to perform science for the pure love of truth because searching for truth was the highest and most noble order of human pursuit.78 They insisted that a selfless search for truths in nature for the benefit of science—­to study science for the sake of science—­ennobled the scientist.79 By disciplining students’ minds, and instilling a code of ethics and disciplined habits, Novy, much like the chemist Remsen and the physicist Rowland, built the character of his students. The pure science ideal that Novy upheld, therefore, had precedents in scientific disciplines that he had exposure to before he studied medicine and bacteriology. During the 1880s when Novy was enrolled in both chemistry and physics courses in college, professors teaching these subjects at American universities strove to uphold a pure science spirit and establish this method of study as a standard. Novy’s adherence to pure science, therefore, would not have been unusual for late nineteenth-­century American scientists who contended that nature called them to study its mysteries through disciplined work in the laboratory.80 It was Novy’s exposure to these scientific courses before he entered medicine that may have predisposed him to believe in the pure science spirit so devoutly. Novy’s faith that a spirit of science would provide a path to reveal nature’s mysteries had parallels with classic religion. Novy taught students a system of belief—­in the existence of truths in nature that could be apprehended through doubt coupled with the use of the scientific method.81 Novy objected to “faith in words, blindness to reason and subservience to dogma” and rejected the idea of



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medical teachers as “high priests who hold keys to everything worth knowing” written in texts that contain “knowledge to perfection . . . [and] truth itself.”82 He called for teachers to cease using “written words as a product of truth” and replace those words with “looking into the phenomenon of nature.” He said, historically, “spiritual truths . . . were learned by study of the revealed word and medical truths were sought for by studying what had been revealed in the writing of Hippocrates and Galen. Scriptures became Bible for all men, and works of Greek and Latin writers became the Bible for doctors.”83 Novy entreated students to have courage to oppose the infallible teachers and to “question authority or throw [it] aside unless it [is] supported by demonstrable fact.”84 But Novy warned students that they must couple skepticism of blind faith with the use of the scientific method and independent investigation; otherwise they were at risk of replacing one dogma with another.85 Novy drew on strains of religion in his faith that laboratory science would uncover hidden truths in nature that would benefit society by widening the existing boundaries of knowledge. A son of worshiping Catholic Czech immigrants and an altar boy as a youth, he turned to the scientific world and devoted his life to scientific endeavors as an adult. No longer able to seek reflection solely in religion, he turned to a faith in scientific progress and a belief that nature’s mysteries would be discovered through a rational scientific method. His major interest was in exploring a world of purely natural laws rather than one in which there was divine intervention.86 His faith in a progressive science became a theology of its own, and he had faith that eventual salvation would be attained through a rational process of discovery of hidden truths. Novy told students that they should enter the medical profession led by a spirit composed of ideals and ethical codes of searching for the truth, not by commercialism. Novy did not explicitly elaborate on what he meant by commercialism in his lectures on the spirit of science in medicine. But he did write about his views on the corrupting influence of commercialism in other venues. Novy, for example, disapproved of medical graduates, mainly of proprietary schools, whom he viewed as misguided because of their interest in seeking profit rather than truths in nature. Novy had written that the quality of medical education in America in the 1880s was poor, and he regarded proprietary colleges in the late nineteenth century in particular as “deplorable.”87 He objected to the commercial nature of “worthless proprietary medical schools and medical sects . . . [that produced] . . . ignorant, immoral, and dangerous doctors . . . [who were] swindlers, . . . [prescribing] unverified nostrums . . . [to] the unfortunate afflicted.”88 Novy not only admonished improperly trained doctors but implicitly condemned manufacturers as well for harming unsuspecting

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consumers. He was writing at a time when medical products had been commercialized before they were adequately studied and were fraudulently advertised so as to exaggerate the merits and repress knowledge of failures of the product.89 During this time, for example, boiled microbes were manufactured as vaccines and advertised to treat an array of infectious conditions against which they had never been tested.90 Novy believed that scientific testing in an adequately equipped laboratory offered the sole means of protecting the public against harm. Indeed, he himself had previously exposed the adulteration by unscrupulous manufacturers of one anesthetic compound, stenocarpine, and milk by performing chemical analysis.91 In addition, after investigation of two other compounds advertised as germicidals, Chinosol and Afridiol, for treatment of a variety of infections, he concluded that they had been placed on the market before they had been properly scientifically tested.92 Novy believed that the part-­time faculty members at proprietary schools were unable to keep pace with the new scientific medical approaches that would be needed to safeguard against these fraudulent products and that these schools did not have proper facilities to support laboratory research necessary to expose these dishonest practices.93 By the time he was writing about the spirit of scientific medicine in 1902, the number of medical schools had increased dramatically (from 100 in 1882 to 161 in 1902); the majority of these schools, according to Novy, were run as a business rather than a scientific medical school.94 He lamented that the majority of proprietary schools and the sectarian schools “were graduating illiterate and incompetent men . . . without proper training.”95 In addition to the substandard quality of the medical graduates of these schools, Novy also criticized the mercenary motivation of physicians who served as professors at proprietary or sectarian schools. For example, Novy stated that “proprietary medical schools were run by a group of doctors who cared as much about profits as medical education.”96 Throughout the years, Novy maintained that incorporating science into medical education was a potent factor in what would lead to the needed “uplifting” of medicine.97 With the incorporation of the laboratory sciences—­physiology, anatomy, pharmacology, physiological chemistry, and bacteriology—­ into the first-­year curriculum of university-­affiliated regular schools, Novy said medical education would now be poised to eliminate the “ignorance” of physicians and replace “superstitions” previously held by students who had “blind faith” in the words of their professors, with “absolute facts” that could be verified through laboratory investigation and facility with the scientific method.98 Novy believed that the once “disgraceful status of medical education” improved because of the “development of the medical sciences” in university-­affiliated medical schools



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in the 1890s, where full-­time scientific-­educator investigators could provide all students with a “rational and orderly method of understanding documentable realities within nature, accurate assessment of new medical knowledge, and legitimate therapies.”99 The rational, verifiable, special knowledge of laboratory science, Novy argued, would provide physicians with a new skill that would provide status and prestige to their profession, which was in need of improvement. Novy later noted that the proliferation of the sciences in university-­affiliated schools led to the “extinction of undesirable medical colleges” including “proprietary schools and sectarian schools” where the “enterprising physician” and nonscientific teacher had perpetuated “ignorance” in medicine.100 Novy said that “two forces that stemmed the tide of deterioration in medical education”—­the introduction of basic sciences into the curriculum and the introduction of licensing laws for physicians—­led to the “practical disappearance of worthless schools and old medical sects . . . [and the] improvement in medical education.”101 According to Novy, the elimination of these sectarian schools could only benefit the profession, as they were of inferior quality and had produced inept physicians unqualified to practice medicine. Novy’s declarative and outspoken views on the vitiating influence of proprietary and sectarian schools on the quality of medicine were not subdued even though his wife, Grace, had been a student in the School of Homeopathic Medicine at Michigan when they met.102 To Novy, it was the incorporation of basic sciences into the curriculum that led to the elimination of these sectarian schools and the upgrading of American education. The basic sciences, according to Novy, “stemmed the tide of deterioration in medical education.”103 It was the incorporation of basic science into the medical curriculum, in Novy’s view, that would improve medical education by elevating the caliber of university-­based medical schools and eliminating the proprietary and sectarian schools he deemed inferior. Furthermore, Novy claimed, “Proprietary schools began to realize their inability to meet the increasing demands for better instruction in the basic sciences. They had to yield to the inexorable demands of progress and pass into oblivion.”104 By unifying medical education around science, Novy removed the duty to instruct students about diseases from nonregular (e.g., homeopathic and eclectic) physicians and regular physicians at proprietary medical schools. In its place, he located that responsibility in the sphere of physician scientists working at university-­based medical schools. Novy argued that by situating basic sciences in a dominant position in the first two years of the curriculum, American medical schools would reach a new dimension of credibility that would parallel the rank of the European institutes where he had trained. He said, “The basic medical sciences were born

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in Europe, brought to this country and became the leaven which transformed medical education.”105 He continued, “To provide instruction in these subjects meant the discard of the old didactic system . . . and the affiliation of the better schools by universities. The transplantation of medical sciences from Europe became complete, not only as regards to teaching, but also as regards productiveness through original research. It is no longer necessary to go abroad for fundamental medical training.”106 Referring to the incorporation of science into the medical curriculum, Novy said, “When America wakes up let Europe look to her laurels.”107 His comments suggested that because bacteriology and basic laboratory science had been included in the American medical curriculum, the gap in science between America and Europe had dissipated and American students no longer needed to travel to Europe to study science. The changes in medical education curricula that Novy and a cadre of other American physician educators introduced as first-­generation, basic physician scientists facilitated the transformation that had been taking place in American medical education. Michigan, for example, was a university-­based medical school when Novy arrived in 1889. Together with Vaughan’s, Novy’s efforts bolstered the basic science facilities of the medical school, added substantial laboratory scientific instruction of students, and established an extended, two-­year, basic-­science curriculum in the medical school. In the late nineteenth century, Michigan was at the forefront of scientifically oriented institutions that began to extend their basic science curriculums. As these institutions were strengthening basic science as a foundation of medical education, smaller, proprietary medical institutions concomitantly began to decline in number.108 In the process, American medical education largely relocated from proprietary institutions to university-­based centers with extensive basic-­science facilities.109 The incorporation of science into university-­based medical schools that was driven by physicians like Novy through the introduction of lecture-­laboratory courses changed the character of American medical education during the late nineteenth century. During the first year of what Novy would call the basic sciences, active, hands-­on learning in a laboratory setting was added to traditional didactic teaching that took place in the lecture hall. Underlying these changes was the emerging ideal of medical education based upon experimental science. This was an ideal taken up by physicians such as Novy and Vaughan who returned from laboratories in Germany with a conviction that genuine research and learning took place only when students were active participants in the learning process.110 This account of Novy’s educational pursuits underscores how one academic leader in medicine embraced the ideal of learning by doing, critical



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thinking, and problem-­solving, methods that John Dewey later advocated for use in elementary education, too.111 Novy’s endeavors to make medical education scientific offered the promise of providing solid truths to a profession that was thought to be lacking in certainty and in need of reliable remedies. Prior to the introduction of laboratory science, allopathic medicine had occupied a lowly status in American culture in the mid-­to late nineteenth century, allowing alternative systems of healing to flourish, including home therapies and eclectic practices.112 The curriculum reform that resulted from strengthening the basic sciences, together with efforts to educate postgraduate practitioners, offered the promise of lending a degree of respectability to a medical profession that was then lacking prestige and authority.113 Furthermore, the infusion of laboratory science into medicine would provide the special knowledge that was needed to transform the profession from its weak, heterogeneous, eclectic status to a strong, cohesive profession that possessed verifiable truths. The reform offered the broader opportunity of improving the quality of students and elevating medical education. At a time when medicine had not attracted the nation’s most promising students, Vaughan and Novy were reshaping the medical school into a center of advanced teaching and research.114 The introduction of Novy’s intensive laboratory-­ based bacteriology course was a key component in Vaughan’s overall educational reform strategy, meant to establish medicine as a branch of higher learning in the late 1880s, well before Flexner’s Report on medical education in 1910.115 There is, of course, an alternative way of looking at Novy’s elevation of allopathic doctors to men of science. Laboratory science could be seen as a vehicle by which allopathic medicine achieved domination over its competitors—­ eclecticism, homeopathy, and the smaller, proprietary allopathic medical schools. The latter had proliferated and competed with the regular physicians, who in the mid-­nineteenth century could not claim to have any uniquely effective methods. But a special body of knowledge—­laboratory science—­became available in the late nineteenth century thanks to the influx of doctors who had trained in Europe. Smaller, poorer proprietary schools or sectarian schools did not have professors who possessed this unique sphere of knowledge. Nor did they have the facilities needed to support laboratory research. These schools could no longer compete with the larger, university-­affiliated, scientifically based schools, especially after they were unable to obtain Rockefeller Corporation grants following the release of the Flexner Ratings.116 One casualty of effectively eliminating smaller programs was that those schools had once accommodated the training of doctors from a more diverse background than the white, middle-­class men capable of affording the tuition of college and medical

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education, which the working class and poor could not. This perspective is not inconsequential when examining Novy’s educational activities. The end goal of Novy’s educational efforts differed from that of his European colleagues. By offering his course to all medical students and attempting to make bacteriology relevant to clinical practice, Novy made his science more inclusive than had his German professors, who restricted training in their laboratories to the most skilled students who were interested in becoming medical researchers themselves. Novy also wrote articles to instruct postgraduate practitioners who may not have had sufficient scientific training in the basic methodology of bacteriology and in critical thinking.117 In contrast, bacteriology courses were not taught in German medical schools or to postgraduates in the late nineteenth century.118 At that time, bacteriology was taught at a separate institute devoted to the discipline, to which one need apply while expressing a desire to perform medical research in order to enroll.119 In contrast, the vast majority of the students who enrolled in Novy’s class did not aspire to academic research but were to enter private practice. It could be argued that Novy’s course, by targeting a complete range of medical students, was more egalitarian than that of his European colleagues. Novy’s intentions to teach medical students bacteriology and its techniques remained medically controversial at the university. Not every Michigan faculty member was supportive of Novy’s efforts to introduce bacteriology into the research agenda and medical school curricula. Dr. Henneage Gibbes, professor of pathology, was one faculty member who was troubled by the thought of Novy’s returning to Ann Arbor after studying in Koch’s laboratory. Gibbes was an opponent of the germ theory of medicine. He never objected to the observation that germs were present in diseased organs, but he believed that their presence was adventitious and they were harmless and not the cause of disease.120 Gibbes supported his theory by observing that the tubercle bacillus was not the cause of tuberculosis because he could not find the bacillus in all forms of tuberculosis.121 Furthermore, Gibbes stated that he had proof that the disease did not develop after direct inoculation of the organism. In fact, he had a laboratory accident where he cut his finger but did not develop tuberculosis after he inoculated it with pus from the lungs of an animal with tuberculosis.122 Thus, Gibbes believed that microbiology offered limited guidance for situations in which the microbiologist’s judgment and that of the clinician or pathologist did not coincide. In those situations, he believed the clinicians’ judgment rather than the bacteriologists’ laboratory testing should prevail. Gibbes objected to Novy’s using his scientific knowledge to develop a new bacteriology course that introduced the germ theory into the medical



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curriculum.123 Gibbes began to plot strategies for how to eliminate Novy’s course from the curriculum and decided to team with H. L. Obetz, dean of the homeopathic school, to do so.124 The Homeopathic Medical College was established at the University of Michigan in 1875 as a result of the petitioning of the state legislature by practitioners of homeopathy.125 The legislature provided funds for two professors (theory and practice of homeopathy, and material medica and therapeutics) in the homeopathic school, which was separate from the medical school.126 But the relation between the two schools was always strained, with objections from the medical school over the state-­supported funding for the homeopathic school and two professor chairs.127 Vaughan, for example, himself wrote about the homeopathic school, where students were taking the same courses as in the medical department with the addition of those included under the two homeopathic chairs. Vaughan wrote that the Department of Homeopathy “was leeching off of the scientific courses . . . [was] parasitic and must fail in the end.”128 Obetz had been considering a strategy to amalgamate the two departments, perhaps in an effort to ward off any attempt by the allopathic physicians at Michigan to abolish the Department of Homeopathy.129 Gibbes and Obetz suggested a plan to the Board of Regents in 1895 to eliminate Novy’s position—­junior professor of hygiene and physiological chemistry.130 The plan included a merging of the two medical schools (allopathic and homeopathic), with the justification that it would reduce salaries and staff from the department of medicine and surgery.131 But Dr. Hermann Kiefer, chairman of the medical committee and a regent of the university, was not in agreement with the reorganization plan. Kiefer argued that the proposals reduced not costs but the quality of the medical and educational scientific research programs.132 Kiefer argued that “our professors should be educated scientific physicians and teachers just as our officials should be honest American citizens. . . . To eliminate these courses would be to the detriment of the scientific quality of the university,” and he made a counter-­motion to abolish Gibbes’s pathology position.133 After some consideration, a new professor of pathology was appointed, and Kiefer successfully lobbied to maintain Novy’s position.134 The two schools remained separate, the chair of pathology at Michigan was temporarily abolished in 1895, and the department was placed in charge of George Dock, professor of medicine.135 By the time the regents made the decision to abolish Gibbes’s position and maintain Novy’s position in September of 1895, Gibbes had already left town. Gibbes’s threat to Novy’s position underscores the role that Vaughan played in maintaining Novy’s position. When he was appointed dean by the regents in 1891, Vaughan created a culture of scientific medicine and set up

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Novy to thrive in that environment. But Vaughan could not remove already established faculty members like Gibbes, who had been appointed professor of pathology in 1885, well before Vaughan became dean. Nevertheless, Kiefer, a German physician who was trained in scientific medicine, was a member of the regents who appointed Vaughan as dean in 1891; Kiefer was committed to preserve the integrity of scientific experts whom Vaughan appointed to the faculty. Kiefer’s decision to abolish Gibbes’s position was announced in an executive session meeting of the regents (behind closed doors), and he announced that his decision was made “after consultation with the deans of both medical facilities,” indicating that he had directly conferred with Vaughan before deciding to maintain Novy’s position.136 Thus, with the help of his mentor and Dean Victor Vaughan, Novy weathered the controversy that initially surrounded his bacteriology course and sustained a long teaching career at the University of Michigan, spanning from 1889 to 1935. Throughout this time, he had extensive contact with medical students and aspiring researchers in his laboratory. His stated educational goal was to foster a spirit of science in all of them, regardless of whether they were to become practitioners or independent investigators. He maintained that his efforts resulted in higher standards feasible for medical education and medicine in general. He strove to accomplish this through his participation in educational reforms to raise the caliber of students admitted and extend the basic science curriculum to all medical students. He believed that teaching critical thinking and imparting hands-­on experience was important to all physicians. But how did Novy’s students, including those who were practitioners, receive his targeted goals? How were they influenced by Novy’s ideas? What meanings did they attribute to Novy’s work, and how do their perceptions of Novy compare with Novy’s own stated goals? Voices of Students

Many of Novy’s students, practitioners and researchers alike, wrote letters about their experience in Novy’s classroom and laboratory course.137 I use these notes to explore Novy’s influence throughout his students’ careers. I will ask what Novy represented to these students, then explore why they may have valued him so acutely. At the time that they wrote to Novy in the early twentieth century, only a few therapies were available to clinicians as the result of bacteriological research (e.g., diphtheria antitoxin and serum, antitetanus serum, antiseptic surgery). They were not likely to have been applicable to the bulk of routine illnesses that a practicing physician encountered on a day-­to-­day basis. The tools Novy offered practitioners probably did not substantially change the way they practiced



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medicine. However, these practitioners were willing to embrace what Novy symbolized for them—­the use of laboratory methods to search for pure truths in nature. During this period, David Sugar, a practitioner from Detroit, was a former student of Novy who wrote his recollections about him in the Detroit Medical News: Every medical student seeks the man who symbolizes his dream of a scientist and teacher. To us, Novy was that realization . . . he is the servant of truth. His love of truth dominates . . . his life in the laboratory. A dreamer who did things, a teacher with the divine spark. . . . A teaching Novy. A research Novy. An idealist, an exemplification of the nobility of ideals. And human. The greatest dramatic presentation we saw was not on the stage. The greatest sermon we heard was not from the pulpit. . . . All these were one in Novy’s lecture. If greatness be measured in terms of medical teaching, Novy was the greatest teacher we had. With reverence in his voice, with the zeal of a religious leader, Novy taught about his science to thousands of students the world over. His work flames on and on. His is the fire eternal of science in medicine. . . . Never since have we been pervaded with idealism such as emanated from and surrounded that man. . . . In the laboratory, Novy taught us humility—­He taught us technique. And he preached, the truth, the truth.138

Sugar had faith that Novy’s use of specialized methods and refined laboratory techniques would lead to the discovery of underlying truths in nature. For Sugar, these truths need not have utility, as Sugar did not mention prevention, cures, or practical results. For Sugar, a search for truths in and of itself was the scientific ideal. Sugar had faith that the pure search for truth, conducted with the zeal of a skillful scientist like Novy, was noble. Lewis Knapp, a practitioner from Monroe, Michigan, and a former student of Novy, wrote to Novy about the potential of laboratory science to benefit humanity. Knapp wrote, Your untiring and unselfish devotion to science and your students; your critical approach and your indomitable will in surmounting all obstacles to work on discovering the causes of so many ills that have afflicted mankind has rightly won for you the honored recognition of being one of the greatest bacteriologists, professors in our medical profession, and benefactors of humanity.139

Knapp wrote that Novy’s contribution to science and humanity was in discovering the causes of disease—­of gaining new knowledge. Knapp does not mention prevention or cures.

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A letter from Thomas Cooley, a practitioner from Detroit, also addresses the meaning of Novy’s ideal of science. Cooley wrote the following about his experience: No man in the University has made a more lasting impression upon his students, or is held in greater reverence. The debt we owe to the masters at whose feet it has been our fortune to sit is not the bare facts they have taught us; but by the impression made upon us by their example of high ideals of science. . . . There is none to whom we owe more for the inspiration we have had for high aims and honest effort than to you yourself. You are not eternal, but your teachings are for they are carried over the whole world by your students and their students who gained faith that your science was our only salvation. I measure your age by your original contributions and the disciples whom you have created. The influence of the great [teachers] has always come more from the degree to which their students have absorbed such ideals and exemplified them in the communities where they have lived and practiced than from any mere academic influence.140

Cooley’s comments suggest that he was eager to embrace Novy as the ideal of science, not necessarily because of practical applications. All three letters from former students show that the values Novy instilled created an ideal to continually emulate as his students moved into the workforce and became practitioners of medicine. The students had faith in the ideal Novy embodied: a life devoted to the search for underlying truths that would benefit mankind, simply because they existed and were true. In conjunction with the pursuit of this ideal, Novy helped to create a role for laboratory science in medical education and, ultimately, medical practice. As will be discussed below, all three of the students’ letters use religious words that project Novy as the prophet of a new religion: a religion of science that was based on finding not revealed truths, but truths in nature by adhering to Novy’s rigorous scientific methodology. They suggest that even supposedly “practical-­minded” clinicians could share the appeal of pure knowledge—­that truth was holy and that Novy had made them disciples of a True Faith. Former student John Dodson addressed his view on the key influence Novy had on the reforms in medical education. Dodson believed Novy’s efforts helped to contribute to an advance in the standards and methods of medical education in the United States. Of this advance, Dodson wrote: The purpose of the medical curriculum is not merely to supply information to the student, but to develop and train his faculties to the end



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that he become a keen, exact observer of medical phenomena within the laboratory. . . . The most conspicuous of the recent advances in medical pedagogy has been the substitution, for the older methods of empiricism and the rule of thumb, of the plan of first hand observation of facts by the student and the development of his powers of independent thinking. . . . In a science fundamental to medicine, effective training and instruction of students could be given only by one who was devoting his attention exclusively to research and teaching in his chosen branch. The most potent methods is the investigator who is seeking knowledge of the unknown as pursued, first, in the laboratories of the fundamental sciences of chemistry, anatomy and bacteriology. . . . To this kind of medical instruction the science of bacteriology lends itself especially well. Doctor Novy, one of the outstanding investigators and teachers in this field, was one of the pioneers in bringing about these changes in the methods of medical education and has been an important contributor to their wonderful development.141

Dodson situates Novy as a key force in galvanizing the reforms in medical education and the formation of basic science departments that would follow. Dodson underscores the crucial role that forward-­thinking educators such as Novy played in teaching not just facts, but the value of independent thought and learning by doing. According to Dodson, and as previously mentioned by Novy’s better-­ known colleague at Michigan, John Dewey, this type of medical instruction represented an advance over previous methods and was introduced by a new breed of full-­time experts like Novy. Dodson’s letter illustrates how Novy’s research and educational activities coincided with and reflected the dominant beliefs and objectives of the Progressive period in early twentieth-­century America. Novy’s former students considered his intentions selfless. Frederick Taylor, a practitioner from Ovid, Michigan, wrote to Novy that he admired Novy’s “virtue,” which he described as a motivation . . . singularly free from the economic or mercenary element. . . . In a period when the scientist is tempted to sell his birthright for a mess of pottage—­I have thought of you as one to whom this particular temptation makes no appeal. . . . You have been responsive to those motives which best befit the scholar, namely: an insatiable appetite to seek the truth and teach it, and a pride in maintaining the highest standards of workmanship.142

Taylor is likely alluding to the fact that Novy did not seek profit from his craftsmanlike work during a period of commercialization of scientific products for

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medical purposes. Taylor’s perceptions of Novy—­a yearning for truth and not commercialism—­match Novy’s own stated goals. The student notes show that the spirit Novy endorsed—­the pursuit of basic knowledge in itself—­was an ideal embraced by students who would go on to become practitioners even though that may have become less applicable to their daily clinical work. Their notes written to Novy show that students who intended to have careers practicing medicine valued Novy’s instruction, which focused above and beyond all else on the pursuit of pure knowledge.143 The pure science ideal that Novy’s students embraced had implications for medicine as a profession in America. Novy taught that incorporating pure science into medicine provided a specialized knowledge and introduced a degree of rigor and professionalization to a medical field that he viewed as in need of uplift and as possessing nothing distinctive from the heterogeneous medical sects that existed at the time. As a leader among a new breed of researcher educators, Novy was the source of this scientific knowledge. His research and education, he claimed, added a new, legitimate knowledge base to students trained in allopathic medicine.144 In turn, his students believed that an expert like Novy, with high ideals and using precise tools and methods, could create a more reliable, more truthful profession than the ad hoc experiential methods of an earlier era.145 In conjunction with the pursuit of this ideal of pure science, he established a durable space for a physician scientist in the medical profession. Moreover, he helped to create a role for laboratory science in medical education and, ultimately, medical practice. Even though it may not have been applicable in their-­day-­to-­day clinical activities, Novy’s colleagues and former students who later became practitioners viewed his activities and devotion to the pure science ideal as adding legitimacy to a medical profession in need of certainty. The letters that articulate an emulation of Novy’s scientific ideal as a motivation for students to gravitate toward his teachings do not dismiss a more self-­interested motive for a young practicing physician’s acceptance of Novy’s teachings. Doctors may have felt that scientific training would provide them with skills and prestige that the older generation of practitioners did not possess, possibly giving them an advantage in competition for patients. Possessing novel and potent approaches to patient care may, in fact, have provided an advantage in what was an unregulated and competitive marketplace for patients among established practitioners and alternative healers. Regardless of these considerations, the letters do reflect why practitioners were attracted to Novy’s science—­to join in the search for verifiable knowledge. The students’ comments show how practical physicians could share the attraction of Novy’s pure scientific knowledge.



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Students who became medical researchers reflected on their experience and also expressed the spirit they felt Novy symbolized—­the search for nature’s truths. As was the case with the practitioners, Novy represented a pure science ideal that the researchers emulated. Earl McKinley was a former student who was inspired by these research ideals. McKinley went on to become a medical researcher at the San Juan School of Tropical Medicine, Puerto Rico, and later wrote to Novy: The first day I entered your class as a student I well remember autoclaving culture media until midnight that day. . . . That was one of the hardest days’ work I had ever done. . . . After working under you, I learned th[ere] is such a thing as working for the love of pure scientific investigation. . . . It was this spirit, inculcated by you into all the members of the department, which accounted for the brilliantly lighted laboratories until the small hours of the night. The discipline we had been schooled in had taught us to do the thing right for the sake of the thing—­not because of rules [or] restrictions on topics of investigation. I can’t recall any [rules] except to . . . be skeptical . . . think critically and do the experiments promptly, accurately, efficiently, honestly and well. To us, there was always a spirit throughout the department of loyalty to “the chief,” esteem, affection and an intense desire “to do the thing right.” Because you always supported us to choose and pursue research questions that most intrigued us. . . . Time passed, and [your students] carried away with us . . . fundamental scientific lessons you had selflessly given us. We had intensive training in pure bacteriology and physiological chemistry, minute and careful instruction in technique and method, we had been taught a love of fundamental science for its own sake, and an . . . inspiration to continue in the field and make seeking an original contribution our life’s work. . . . These . . . are things which cannot be expressed in language, things which can only be felt. All your students feel these things.146

McKinley was inspired. Like those students who became practitioners, McKinley held Novy as the ideal of a scientist, and he had faith in performing pure science for its own sake. McKinley also elaborated on the broader meanings of the spirit, including Novy’s efforts to mold character by establishing ethical codes and disciplined work habits. McKinley noted the value in doubting, thinking critically, and using specialized methods and meticulous techniques to apprehend occult truths in nature. His quote also reveals the self-­sacrificing discipline of hard work and obedience to meticulous laboratory procedures, sometimes requiring working all night if required. Furthermore, Novy and his aspiring students felt a bond between them, forged by a shared duty of

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a disinterested search for truth through rigorous thought and arduous labor. McKinley joined Novy’s laboratory crew because he was inspired to become a participant in a community of expert evaluators who promoted inquiry and professional methods. Novy provided the guidance and the freedom for these investigators to become independent and make original contributions in bacteriology, which focused on the discovery of the fundamental behavior of organisms and not necessarily the control of the pathogen, and also shape the boundaries of knowledge. Novy was present to provide this guidance; he was not, according to McKinley, distracted by personal fame or material reward.147 McKinley’s account shows that Novy instilled in his students a reverence for original investigation and skepticism for the received teachings of the traditional medical environment. Novy’s brand of science served as a basis for his students’ professional identity. The established reverence for original investigation allowed Novy to create an environment in which he could find achievement within his own specialty. He was on top of a rising group of technocrats like McKinley who represented a new order, based on its own terms and logic. This was one way that researchers helped to establish disciplines such as bacteriology—­through the creation of a group of scholars and academic entrepreneurs, enthusiastic in their motivation and confident in their special knowledge and technical expertise (see figures 3.3 and 3.4).148 The cultivation of a group of adherents also enabled scientists like Novy to establish bacteriology as a discipline of medical science that provided positions for his students as they developed their own independent research careers (see chapter 4). During Novy’s career, bacteriological tools were just beginning to be defined and revised. Novy was at the forefront of this movement. At this moment, McKinley’s letter shows there was an excitement surrounding the promise of studying with a master scientist who had the expertise to use these specialized tools and to devise new methods to find truths that would ultimately benefit mankind. There was a sense of passion and thrill that surrounded studying with “the chief” or the “master,” as his students referred to Novy (see figure 3.5).149 His students had faith that Novy’s expert knowledge and technical virtuosity would help them to apprehend nature’s occult mysteries. Other student researchers wrote to Novy about their perceptions of the spirit of research and how Novy embodied the ideal of scientific investigation for them. One such student, Charles Behrens, from the University of Illinois, wrote to Novy, You follow great principles, e.g., that doubt and not faith is the beginning of wisdom in science; that skeptical judgment helps to reach the truth; that the fundamental requisite of scientific observation is accuracy. . . .

Figure 3.3  Novy with students outside his laboratory building in 1916. From left to right: Paul de Kruif, Charles Behrens, George Herrmann, and an unknown student. De Kruif became a medical writer; Behrens, a professor of microbiology at the University of Illinois; and Herrmann, a professor of microbiology at Tulane University. (Courtesy of Bentley Library)

Figure 3.4  Members of Novy’s laboratory, 1917. This is the only picture showing women who worked there. In Novy’s papers and letters, there is no mention of female graduate students who trained with him. (Courtesy of Bentley Library)

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Figure 3.5  Novy the scientist and mentor in his office adjacent to his laboratory. Novy’s pose with legs crossed and raised chin makes him appear austere, strict, and formidable to a student. But his calm expression may also have given the impression that he is welcoming a laboratory worker in need of assistance or advice. (Courtesy of Bentley Library)

Here . . . lies the secret of your influence; under the guidance of these principles you have produced work that lives on because it is helpful to other investigators, helpful in hypotheses, in methods, selection of controls, and in observations. . . . I regard you as the master scientist.150

To Behrens, Novy represented a force capable of replacing the passive reception of knowledge delivered in lecture halls with a culture of critical thinking and empirical testing of hypotheses in the laboratory. Students like Behrens and McKinley had faith that science remained the ideal vehicle for promoting critical inquiry, expert methods, and accuracy. They believed that Novy “influenced” their work by providing them with guidance in critical thinking (creating hypotheses) and technique (methods and observations), and in stressing accuracy. Novy’s work “lived on” in the independent investigations of other scientists, who in turn sought to establish their own valid truths. Through this process, his students embraced the attributes of a biomedical culture that Novy symbolized to them—­adventure, rational thinking, and objective methods. McKinley and Behrens elaborated on the Novy ideal. For his students and for Novy, freedom from the constraint of utility was a pivotal issue in Novy’s experimental motives. He operated under the principle that the most creative



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and the most important discoveries in science come from experiments whose guiding principle is not utility, but rather from investigations of science for its own sake. Ultimately, the products of these experiments could have important practical applications that could advance medical therapy, as a scientist cannot foresee what may someday be the practical application of laboratory discoveries, no matter how remote from practical utility they may seem at the time of experimentation. Fundamental discoveries that are not made in conjunction with how to treat a patient, Novy wrote, may at some future point prove to have significance for health care by providing a foundation for future medical advances.151 But for Novy and his students, their beliefs dictated that the application should not be part of the experimental design and should be considered only after the results were obtained, because any a priori considerations of practicalities could only constrain the scientific experimental design. Novy was successful in cultivating students such as McKinley and Behrens into biomedical careers. Novy doggedly provided his students the guidance they needed to master science’s technical demands. He fully supported junior researchers, and his relish for investigating new hypotheses and the encouragement he gave to his researchers provided the structure and independence for students to carry on their own work and relate their work to others. His reputation and his willingness to give student researchers latitude to pursue their own work, and the independence to change the direction of their research to pursue unexpected findings, attracted promising students to his laboratory. As McKinley indicates, there were no rules in Novy’s lab other than to do the experiments properly. McKinley approved of the way his mentor nurtured students—­by giving them the freedom and resources to work in their own way.152 Novy provided a permissive environment in his laboratory. He did not require a common theme for research topics, but gave students critical advice, sometimes harshly, when indicated. Perhaps this permissive environment accounted for the broad range of research projects carried out in Novy’s laboratory, which lacked a unifying scientific topic or theme (see chapter 2). Students such as McKinley sought Novy’s intellectual guidance, but his recommendations for what research should be pursued were not highly structured. Students investigated a wide range of topics that included the variability of disease, the chemical metabolism of microbes, the dynamic behavior of organisms over time, and host responses, including immunity (see chapter 2). A community of science supporters coalesced around his laboratory-­based version of scientific medicine, with a balanced emphasis on instruction in scientific methodology and a license to pursue topics of their choosing. In this atmosphere, students were provided the necessary tools to forge independence

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in their respective careers. The broad range of research topics pursued in Novy’s lab allowed his embodiment of the scientific spirit to provide the sole common rallying point for students. Novy’s insistence on the laboratory as a foundation of new knowledge served as a source of inspiration for his students—­practitioners and researchers alike. His brand of science also served as a basis for the medical students’ identity and for the work they carried out in their own careers. He helped to cultivate a rising group of academic entrepreneurs who possessed distinct technical competences who represented a new order, based on its own code of ethics, norms, and ideology. Strains of Religion

Each of Novy’s letter-­writing students believed in scientific truths and scientific progress. The letters show the students had a hearty belief that science would uncover hidden truths in nature that would benefit mankind. Their faith in an incessantly progressive science became a religion of its own, as it functioned to hold up a confidence that eventual beneficence would be attained through a natural process of discovery of hidden truths. They were assured of the goodness of their work for society because they believed it widened the existing boundaries of knowledge and at some point could provide the foundation for the amelioration of human suffering. Novy’s students could be considered religious in their own right: pilgrims searching for fulfillment in scientific truths. Novy’s students described their learning experience in religious language, which underscores their faith in science and bears a resemblance with faith in religion. Novy is projected as the incarnation of the spirit of science. While students worshipped Novy’s broad range of educational and scientific activities, they also portrayed him as a methodical, rational technocrat who possessed a unique knowledge and virtuosity in using his specialized tools. Nevertheless, he is illustrated as a seeker of truth who possesses a divine spark, who enlists students as disciples through the inspiration of their minds and hearts by the holy spirit of science. Adherents joined this new religion because they had faith in the spirit of science as preached by the prophet Novy, rather than being instructed to do so by a set of codified, institutionalized rules. The students’ spirituality is evident in their depiction of Novy’s work habits—­pious and carried out in a secluded laboratory. Furthermore, as Novy brandished his potent tools for the benefit of mankind, his teachings, as a consequence of his devoted student disciples, became eternal. A unifying religious tone in the letters is evident. David Sugar, for example, wrote about Novy possessing a “divine spark” and having the “zeal of a religious leader.” Cooley referred to Novy’s “inspirational” teachings as being “eternal” and of Novy’s “disciples.” McKinley wrote about Novy mystically, stating



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that Novy’s meaning cannot be expressed in words, but only felt. Knapp wrote about Novy’s “devotion” to science and his beneficence to humanity. Former student A. C. Furstenberg, who subsequently became dean of the University of Michigan Medical School, wrote to Novy, “We had gained faith and settled down to the job of learning bacteriology convinced that our only salvation lay in a diligent effort. The inspirations we gained from you in those days have left a grateful memory with us all. . . . You stand before us, touched with the immortal spark serenely pursuing unknown paths for the welfare of mankind.”153 A student named Campbell Bonner wrote of a “feeling” he was unable to describe in words and noted that Novy “worked in solitude.”154Another, B. T. Terry, lauded him for “revealing . . . [an] epiphany” of science that had guided him and his classmates in their subsequent careers.155 Bonner said he had “made himself a part of the machinery of creation.”156 W. C. Hoad wrote he joined the “hallelujah chorus of your former students and disciples . . . [to your] highest ideals and quest towards the ideal of truth of the scientific life, spirit and methods.”157 Viewing Novy’s teaching from the student perspective allows one to appreciate a parallel between religion and the student’s idolatry. The student letters connote a religious devotion to Novy as the incarnation of a faithful scientist pursuing his calling in the sanctuary of his laboratory and classroom, without distraction from material temptations as he stressed the need for rigorous technique, full concentration, and the absence of diversions (see figure 3.6). The students described the monetary sacrifices he made in his scientific career, and they commented on his devotion, humility, and dedication to his work.158 Former student George Herrmann, who then became professor of microbiology at Tulane University, wrote, I have held you as the true ideal of a pure scientist. Your staff has a hero worship along with them; you are in the true heroic mold. The inspiration and stimulation came to me then (when I was) a student of yours. The hope of increased salary, better teaching facilities, academic honors, added administrative power and position never tempted you to forsake your principles and I shall always honor you for it.159

The students admired his willingness to share data with other scientists for the benefit of the scientific community. Taking into consideration the qualities of selflessness and devotion, in combination with Novy’s special skills and knowledge, students invoked a concept of immortality. Novy’s students also viewed his works as a pinnacle of excellence toward which they strived. His supplicants strove toward the goal of scientific perfection. But Novy’s scientific skills ultimately proved elusive, as his students

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Figure 3.6  Novy in his laboratory. He was known for his dedication, dili-

gence, and mastery of instruments. He is shown in 1923 at his research bench, working on the respiration of microbes. (Courtesy of Bentley Library)

gradually came to terms with a realization that they could never reach the apogee of scientific mastery that Novy represented. But it was through this process of extension that his students found reward. They credited Novy for compelling them to stretch themselves to the utmost, as Novy’s mastery served as a yardstick against which they could measure the success of their own scientific pursuits. De Kruif wrote, “You will want only the truest expression of what



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you—­my first and only master—­have meant to me. I shall try hard, but I will never be as good a truth hunter as you tried to teach me to be” (see figure 3.7).160 L. R. Jones, former student and a professor of bacteriology at the University of Wisconsin, expressed similar sentiments about his relationship with what he viewed as the divine Novy: “In the most refined methods of research we still

Figure 3.7  Novy lecturing in the classroom in an undated photograph. Wearing his long white robe and with his high brow accentuated by dramatic lighting, Novy projected the appearance of a prophet of truths who upheld and embodied the ideals of pure science. (Courtesy of Bentley Library)

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follow you. Your forty years of truth making in fundamental medical science is an inspiration to those who struggle with hope but know they can never attain your height.”161 Humanizing Novy

Novy’s students and colleagues were clearly in a willing mood to construct Novy as an ideal of perfection toward which they could aspire.162 They elevated him to the status of a divine figure and what some students considered a “paragon” of a scientist and “pioneer” in his field.163 Their high regard for Novy as a scientist was based on his professional behavior—­the code of ethics that guided his science and his insistence on using exacting and precise methods. These idealized traits revolve around Novy’s skills and his behavior while at work. Novy’s day-­to-­day practice—­in the laboratory, in the classroom, or at the also involved social interactions with students, podium during meetings—­ colleagues, and lay citizens. The daily, personal interactions he had during long laboratory sessions each afternoon, or performing research, made their own type of impression on students and colleagues. Novy’s mannerisms and interpersonal conduct may not be directly related to his academic activities, but they were an inseparable component of the construction of Novy not only as an idealized scientist, but also one who was human, real, and imperfect. To understand this construction of Novy in a mode of realism, it is important to consider how students, colleagues, and the lay public viewed his personality traits, which they experienced on a quotidian basis. I will address some of the personal characteristics that served to humanize the idealized scientist. Novy’s students commented on many of his personal idiosyncrasies. They described him as being intolerant of carelessness and insisting on repeating experiments prior to publishing in order to verify results.164 Students mentioned that he disapproved of what he felt was the tendency of others to rush to publish, the tendency of editors to shortcut bibliographies because of publication costs, and the occasional author’s downright neglect to refer to earlier work.165 Novy’s students and associates noted that his uncompromising lectures on certain principles, such as his insistence on precision and exacting methodology, and his industry and logic in teaching, earned him a reputation as a strict disciplinarian.166 Some remarked on the high standards that he set for the validity of scientific data and his harsh critiques of their written work. Paul de Kruif, for example, noted in his memoirs how Novy “rip[ped] my . . . scientific reports to bits! In his precise, minute handwriting he wrote ‘bosh’ and ‘twaddle’ and ‘rot’ on the margin. He growled that every one of my conclusions was unjustified, exaggerated, untenable. Then he sat down by me and



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said, ‘Let’s start over’” (see figures 3.8 and 3.9).167 Novy, according to de Kruif, thought that every scientific worker should be his own taskmaster and most severe critic. Novy’s students remembered the genuine interest that lay behind his sharp comments. He occasionally used stern reproaches for those demonstrating

Figure 3.8  De Kruif’s laboratory notebook when he was working on the

cause of circulatory collapse and fever (anaphylaxis) in his laboratory animals inoculated with trypanosomes. Novy’s comments are penciled between lines and in margins. (Courtesy of Bentley Library)

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Figure 3.9  De Kruif camping in Michigan. De Kruif repeatedly wrote to Novy that he represented the paragon of a truth hunter that de Kruif strove to become but could never quite attain himself. In Arrowsmith, Sinclair Lewis collaborated with de Kruif and fictionalized the attraction that students had toward the truth-­searching Novy. (Courtesy of Bentley Library)

suboptimal technique. As Earl McKinley noted, “A word of reproof from [Novy] was enough to cause any of us to shake in our boots.”168 Walter Nungester remembers that Novy was likely to deliver a volley of contempt, phrased in choice bits of what he called “the King’s English,” in order to show his displeasure for a student’s careless written work or suboptimal technique.169 One



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of his assistants said that when he was angry, he would close his eyes and clench his teeth, and the top of his scalp would become red; the assistant then knew enough to stay out of his way.170 But Novy resorted to a wit to lessen the harshness of his caustic criticisms, and students noted that he frequently revealed his good humor.171 Nungester wrote that Novy’s keen sense of humor showed in his eyes, which came as a welcome antidote for the sting his sharp tongue inflicted on students who exercised poor judgment or engaged in misdirected activities. Nungester then commented, “this I know,” indicating that he himself had at times been the object of Novy’s disapproval.172 Some have enjoyed writing about Novy’s foibles. Students commented that Novy had scarcely any interest in nonscientific and social activities.173 He had a habit of paying his house bills in person rather than by mail, and took this opportunity to visit and chat briefly with Ann Arbor citizens. Ordinarily, he was absorbed in his work and after dinner would go directly to his lab, working at least until midnight and frequently until two or three o’clock in the morning.174 Although Novy was known to wear the same suit of clothes until threadbare, and it mattered little to him whether the coat, vest, or trousers matched, he would wear only tailor-­made clothes, and it was important that every buttonhole be made by hand and pass his exacting scrutiny. On holidays and some Sundays, when he spent time at his home with his wife and family, he wore a brightly colored vest or tie.175 Novy’s students were amused by his idiosyncrasies. His unique mannerisms served as a favorite theme for imitation by the students. For example, some remarked upon his unique gesticulations, the manipulation of his long fingers, and other mannerisms that were carried out in silence.176 His students also recalled his tall, conspicuous appearance while walking to work or riding his bicycle, or his distinctive posturing motions in the amphitheater, where he would often wind one leg around the other while lecturing. His writing was eloquent, and his speech was quiet and deliberate. Students found it fascinating to listen to him enunciate every syllable.177 Novy’s modesty was also legendary, as exemplified by a correspondence with Milton Rosenau, the dean of the Harvard School of Public Health. Rosenau wrote to ask for a signed picture of Novy to hang prominently among a group of celebrated scientists in Rosenau’s office.178 Novy apologetically declined Rosenau’s offer on the grounds that he didn’t have an extra picture of himself and that he had not sat for one in years.179 Novy was portrayed as a man so absorbed in his work that he was oblivious to the aspects of daily life. In attempting to capture his mannerisms, an article written about Novy by the student paper the Michigan Daily, entitled “University Professors, Their Eccentricities, and Their Everyday Life,” reported, “This

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tall, lean man wore a threadbare suit, an old cap, a low, turned down collar and a simple black tie. His study, in which he worked every night until long after midnight, was a small dingy room next to the roof.”180 This image of Novy as an eccentric scientist absorbed in the quest of truth-­searching was also depicted in a local paper, the Ann Arbor News. The article stated, Novy doesn’t like to talk about himself. He has a way of peering up at you from under half lowered eyelids and weighing your questions, and declining to answer. . . . [He] is so absorbed in research that he probably hasn’t found time to learn much about himself. He is tireless when delving into the mysteries of bacteria; he is persistent, relentless. Something that is sure to bring on gruffness is for a student to excuse an error by saying “I think”—­Novy will pound the desk and exclaim vehemently, “Don’t think—­know.”181

The article then said, “He is said to be the limit in thoroughness as a teacher. He’ll never let a student give up. One must keep at a thing until he masters it. That is Novy’s way.”182 Although Novy’s students portray him as being completely absorbed in his affairs at work, he did not live his life in an ascetic, isolated fashion. Despite earning a medical researcher salary that was lower than that of a private practitioner, he owned a stately brick house located on the perimeter of the Michigan campus.183 In addition, as indicated by the letters he wrote to his family members and his presence at holiday gatherings and family events, he remained connected with his devoted wife, Grace, and family throughout the years—­a connection that undoubtedly enabled him to accomplish what he did in his career.184 Notwithstanding these considerations, Novy’s idiosyncratic personal qualities—­his sometimes obliviousness to routine human rhythms and activities, his absorption with experimentation, and the high standards he demanded of others—­supply a real dimension to the idealized image Novy’s students upheld. The spirit of scientific research that Novy tried to impart in all medical students, in conclusion, was broader than training the agility of students’ minds in scientific methodology and content. Novy’s spirit was designed to mold their character and regulate their behavior according to shared beliefs, disciplined habits, and a moral code. Novy felt that if a spirit of science were fostered, students would be delivered from what he believed was their deplorable educational condition and become worthy citizens in a new order where they could find truths by carrying out experimental inquiry in a laboratory setting. Novy’s broad educational message, although not previously described in the context



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of medical education, had been laid out by science professors outside of the medical setting in late nineteenth-­century America. Through the integration of laboratory-­based courses in medical education, Novy believed that an older order in which students deferentially received fixed knowledge in a lecture hall would be replaced with a new order. In this new order, Novy’s students would independently participate in a laboratory ritual that would provide them with the “power” to modify knowledge. The autonomous student who was free to choose topics of investigation and conduct their experiments resembled the German ideal of the scientific researcher. But Novy’s version of the scientific spirit was more democratic than the German archetype, as Novy aimed to teach independent thinking to all medical students, not only the academically gifted few who were headed for a research career. By training the minds and molding the character of all students, Novy believed that the addition of laboratory-­based science courses would simultaneously elevate the quality of medical instruction and the medical profession in general by graduating students who had a new skill, discipline, and verifiable knowledge that had previously been lacking. Novy was at the vanguard of an elite group of medical researchers in America who were introducing something new to medicine—­laboratory science. His emphasis on morals reveals how he helped to institutionalize the new scientific activity of bacteriology in an established profession like medicine—­by attaching it to traditional Victorian values and ideals. These Victorian values included a certainty that truths exist and can be ascertained through a logical, precise process. The Victorians had a belief in progress, and their ideal of character was based on a notion of the self as controlled by morals and discipline.185 They valued hard work and the virtue of selflessness above self-­interest. Novy, by aligning the values of the science he was promoting with Victorian values, was easing, whether intentionally or not, the transition into making medicine scientific. Novy’s pure science with its disciplined, controlled, hard work, its search for truths, its moral code of selflessness, its denigration of self-­interest and commercialism, and its belief in progress, legitimated the new activity of bacteriology in medicine by aligning it with dominant and familiar late Victorian confidence and values. Students, both budding practitioners and researchers, regarded Novy’s ideal as influential, and they shared in the appeal of learning laboratory science. By instilling a unifying spirit of research, Novy was able to form a culture of science among students. His students had faith in the ideal he embodied: a life devoted to the search for underlying truths that would benefit mankind. But they also knew the idealized scientist Novy as human, real, and imperfect.

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Students connected with Novy as a human with foibles and highly valued the ideals of scientific medicine he espoused. By making scientific medicine relevant and accessible for his students, Novy was able to create something novel: a group of students who valued the pursuit of pure knowledge in itself and an enduring space for lecture and laboratory basic science courses. Novy’s students clearly believed in the ideal of performing research for science’s sake—­that pure knowledge and truth alone would benefit mankind. Still, questions remain: do student comments shed light on why they believe that every medical student must have extensive laboratory experience, not only in bacteriology, but also in anatomy, physiology, and pharmacology? Did the student letters reveal what they learned that made them a better physician? Did they feel that their education in laboratory science made them better problem solvers, more likely to look for the origins and not just the surface manifestations of disease? The students who wrote to Novy did not address these specific issues. Nonetheless, their letters provide insight into the valued qualities of their educational experience, specifically their subscription to the idea that Novy’s search for pure knowledge and truth alone would benefit their profession and mankind. Novy’s science mimicked religion and became a belief system for students. Students who embraced Novy’s instruction had faith that truths could be accessed through a formulaic process beginning with skepticism, development of a logical hypothesis, and the use of specialized instruments and disciplined, precise scientific methods in the laboratory. Novy’s students learned this ritualistic scientific process, albeit imperfectly, from their devout, selfless, and skillful scientific master. They had faith in the promise of science to expand the boundaries of knowledge and to benefit mankind. Novy is projected as a divine being who enlists students as disciples through the inspiration of their minds and hearts—­Novy’s holy spirit of science. Prophet Novy had an ethical imperative to seek truths through hard work and self-­sacrifice, rather than pursuit of profit, and also to disseminate this belief. His student-­disciples joined the new religion because they were inspired by Novy’s spirit, not because they were required to do so by a set of codified, institutionalized rules. The students’ letters were written during a time when religious beliefs were challenged by science, and a time-­worn faith in religion was transferred to faith in science. The acceptance of the existence of truths of nature took root during a period of upheaval in the late nineteenth century—­a time when people retreated and turned toward science for a belief in solid truths.186 The students’ embrace of Novy’s ideals of science at this historic moment resonated with the Victorian belief in the progress of science. One cannot infer, however,



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that all students who took Novy’s course shared the uniformly positive assessment of Novy conveyed in notes from students who wrote to him. The letter writers are a particular self-­selecting group, and therefore these uniformly laudatory notes represent the impressions of a fraction of the students who studied with Novy. One can only speculate what students who did not write to Novy thought. It is possible some considered his science irrelevant to their practice, his course too time-­consuming and an unfortunate diversion from more relevant topics, his insistence on thoroughness too tedious for their purposes, his insistence on detail as paradoxically forcing students to cram information by the rote method that he sought to escape, or his intolerance for error to be abrasive. While acknowledging that the voices of all his students cannot be heard, one can nonetheless consider the strong assessment and also the similar tone of the writings that have been preserved. As the expert scientist who had sought to replace traditional, subjective, experiential methods with precise, objective, systematic ones, Novy’s activities resonated with the dominant theme of progressivism in early twentieth-­ century American culture. Novy was operating during a historical moment when science held a powerful position in society.187 There was a belief that the techniques and methods of science were tools that, if used by a qualified expert, could yield truths that existed in nature and provide innumerable practical benefits to humanity. Students had faith that a scientific expert like Novy, using precise tools and methods, could create a more reliable, more truthful profession than the older, ad hoc experiential methods of an earlier era. By making scientific medicine relevant for all students, Novy was able to create something novel: an enduring basic discipline in bacteriology within a medical school setting. The following chapter considers the meanings that Novy’s educational and research activities had for the new science—­the growing field of bacteriology.

Chapter 4

Defining Bacteriology as a Discipline in Its Early Years

Late nineteenth-­century American scientists and physicians sought to shape bacteriology as a distinct, autonomous discipline. This chapter explores the significance of Novy’s activities in the process of shaping bacteriology in its early stages. Novy’s work coincided with the efforts made by early American bacteriologists to define their field as autonomous. How did bacteriologists create their argument for a separate science? What compelled them to do so? What ideologies did presidents of the newly formed Society of American Bacteriologists articulate while they were creating their field as a distinct specialty, and how did they explain its benefits and parameters? What did Novy and other leaders of the evolving specialty accomplish that encouraged the early bacteriologists to create an independent field? Novy and others articulated ideas regarding how a distinct and growing body of knowledge not only justified fashioning their field into a separate science but compelled them to do so. This chapter also addresses other activities and behaviors that may have contributed to the formation of bacteriology as a separate discipline. For example, how were codes of ethics, such as those instilled in their students by Novy, important in the construction of the distinct identity of bacteriologists in relation to other fields? Did norms and values articulated by Novy as a leader of the new researcher-­educator breed help to define a professional culture and identity? Professionalization and Specialization

A variety of historical studies written during the twentieth century addressing why professions and specialties arise have identified a broad array of underlying reasons. Some studies have emphasized how a group of experts tend to

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form specialties in response to a meaningful, distinct body of esoteric knowledge that emerges from their work, publication in journals, and presentations at meetings.1 Others describe how professions coalesce around a shared code of ethics and behavior as part of professions.2 Some authors have written about how, by including a shared code of ethics, specialization meant developing a unique culture—­a set of learned values that structured the attitudes and responses of the professional and the lay public.3 Burton Bledstein wrote that science was the spirit that united workers in a particular area (e.g., chemistry, geology, and mathematics) into a harmonious organization as each specialty emphasized the unique identity of its subject, distinct qualities, language, and research.4 Other authors have defined how the actual work done by a group—­ with its distinct use of instruments and methods—­unified and defined each profession or specialty itself.5 Thus, a broad array of items can be factored in when understanding how and why a specialty forms—­ranging from a unique body of knowledge, to a shared ideal, to a unifying type of work done on a daily basis. The creation of bacteriology as a specialty reflects each of these facets. This chapter examines the ideologies American bacteriologists articulated at the turn of the twentieth century as they were in the process of making their field into a distinct specialty. Behavioral norms and ethical codes were also important in constructing a distinct professional identity of bacteriologists. Defining Bacteriology as a Field

In the late 1890s, a cadre of American scientists and physicians assembled for the purpose of forming bacteriology into an autonomous field. The first stated mission of the charter members of this circle of scientists and physicians, who called their organization the Society of American Bacteriologists (SAB), was to “embrace a common interest irrespective of the particular field of study” and “to advance bacteriology as a pure science.”6 These bacteriologists included William Sedgwick, professor of public health at the Massachusetts Institute of Technology; A. C. Abbott, professor of hygiene and bacteriology at the University of Pennsylvania; Herbert W. Conn, professor of biology at Wesleyan University; and Frederick Novy. Novy became the society’s fifth president in 1904. The early founders also dedicated their society to promoting bacteriology as a fundamental discipline.7 The founding members resolved to cultivate bacteriology not for practical applications but as a science with a mission to develop a basic knowledge of microbes.8 Each president, who was elected for a one-­year term, gave a keynote talk outlining their vision for the shape of their young field and their justification for making bacteriology an independent field.

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William Sedgwick, in his inaugural address at the first annual meeting of the SAB in 1900, laid out his arguments for creating bacteriology as a distinct discipline. He felt the new science was justified because bacteriology’s expert practitioners possessed specialized tools and unique methods that enabled them to discover new knowledge about the vital role that bacteria play in nature.9 These discoveries led to an understanding of a range of natural phenomena (e.g., fermentation, putrefaction, and organic decomposition) that had previously been unknown.10 Other fields of science, he maintained, had done the same—­astronomy, physiology, and geology—­and this was what conferred independent status on those sciences.11 He argued that because only bacteriology and no other field could explain specific natural phenomena, including the decay of complex organic compounds into simpler elements that nourish plants, bacteriology deserved the status of a separate scientific field. Sedgwick claimed that bacteriology had proven itself as a science. He said bacteriology “had its beginning as a pure science” with the discovery of vital processes such as fermentation; later, “medical men [Lister, Koch] . . . provided practical results for human welfare.”12 Sedgwick defined the pure science of bacteriology as discoveries of “unseen microbial activity” that accounted for changes of “fundamental importance” in nature—­such as survival of the organism and its vital behavior in nature.13 Regarding the latter, he said, “Bacteria have a welcome unseen activity in removing from view dead animal bodies, dead leafage, worn out tree trunks, and waste matter . . . bacteria therefore have a fundamental importance in nature.”14 Because of bacteria’s “causative participation in such universal . . . important processes in nature,” Sedgwick said bacteriologists are in a unique position to “understand the scope and significance of the culturable microbes” and therefore nature itself.15 Bacteriology, according to Sedgwick, was a pure science because of its unique capacity to explain microbial life and important changes in the natural world. Although he did not mention the work of any particular bacteriologist, Sedgwick’s definition of pure science certainly encompassed the focus of Novy’s work as covered in chapter 2—­defining the chemical machinery of microbial life and the role that microbes play in nature through the decay of organic substances and their adaptation to their insect vectors and animal hosts. Sedgwick maintained that, like other sciences that had already become autonomous fields, bacteriology likewise had a legitimate basis to be an independent scientific field. He related the work, methods, and accomplishments of bacteriology to these independent branches of science. He linked bacteriologists’ disclosure of microscopic forms and the significance of their activities to those of Copernicus, who used telescopes to view and plot the changing



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positions of previously invisible celestial bodies and therefore explain planetary motions on a rational basis; and Newton, who explained the motion of objects in the natural world on a rational basis. Sedgwick believed that astronomy and physics earned the status of independent sciences because of the unique ideas and methods of their pure sciences that explained previously unknown phenomena in nature in terms of rational, predictable laws.16 He argued that bacteriologists, like astronomers, had the capacity to use their unique instruments (e.g., microscopes, stains) and methods to view previously invisible objects and test ideas about how microbial behavior caused changing natural phenomena, which therefore would replace older supernatural explanations with rational accounts. Sedgwick contended that bacteriology, like other sciences, dispels supernatural explanations of change in the world and provides a natural explanation for them. He said, “medieval ideas of magic and myth, thanks to sciences such as bacteriology and chemistry, [have] disappeared from science. [Similarly], bacteriology has replaced myth with fact.”17 Bacteriology should be considered an autonomous field, Sedgwick claimed, for the same reasons that astronomy and physics had achieved their independence. Novy Addresses the Society of American Bacteriologists

When addressing the Society of American Bacteriologists as president in 1904, Novy concurred that a basic, fundamental knowledge about microbes and their behavior should be the unifier of their growing field. After all, this had been the driving force behind his research operation since its inception. But Novy used his position as president of the SAB and as director of his independent bacteriology department at the University of Michigan Medical School to expand the definition of bacteriology’s special knowledge. Using his research program as a foundation, Novy contended that bacteriology had been too narrow in its scope and should include the basic biology of microbes besides bacteria. Novy contended that his field should encompass all microbes that cause infections in animals and humans, including protozoa as well as bacteria.18 The fundamental biology of these microbes should be studied in the laboratory, Novy claimed, as was already being done in Novy’s own space. In his address, he argued that there had been an “overshadowing interest in bacterial diseases.”19 Bacteria, he lamented, had been given an “almost exclusive role in the production of infectious disease.”20 Novy postulated that inherent difficulties in protozoan study, including technical difficulties in discovering culture techniques, had accounted for the “slow progress” that was being made in the study of protozoan illness.21 But now, he argued, the tools and methods used to study bacteria—­culture techniques to isolate microbes in pure culture—­constituted

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the means to open new directions into the mysteries of protozoan disease (see chapter 2).22 Novy maintained that bacteriologists should cast a wider gaze.23 The importance of the cultural method in the study of protozoa, he said, was no less than that of bacteria.24 His culture techniques allowed him to evaluate the basic biology and life histories of protozoa.25 Novy posited that expanding the focus of bacteriologists to include protozoa provided insight into the key role that environmental factors and insect carriers played in transmitting all microbial diseases. He argued that by restricting the scope of their observations to bacteria alone, bacteriologists had too narrow an understanding of the transmission of disease.26 Novy said that bacteriology had focused on routes of transmission that included direct contagion through inhalation or skin contact, but that the carrier as a route of transmission had been underplayed. Through his 1901 San Francisco plague experience, Novy was familiar with the role that insects such as fleas played in transmitting infection.27 By 1905, after he had discovered how to culture protozoa and view their evolving forms in the laboratory, he began to understand the complex ways in which insect carriers could transmit the microbes causing infection—­whether they be bacterial or protozoan.28 Thus, he argued that a greater understanding of the basic biology of protozoa would improve physicians’ and scientists’ grasp of microbes and how they spread in the environment. At the time Novy was making his argument about the importance of bacteriologists’ studying protozoa, protozoan diseases had been a discipline outside the mainstream of medicine that had been segregated from the growing field of bacteriology intellectually and separated from medical schools institutionally.29 Protozoology was taught in schools of tropical medicine, public health, and agriculture.30 Novy maintained that medicine should include the study of protozoa because they were as important as bacteria in causing human disease.31 Malaria and sleeping sickness, Novy noted, were responsible for a sizable disease burden in human populations throughout the world.32 Secondly, a study of protozoology would allow physicians to gain insight into the complex interplay between microbe, animal host, and environmental factors necessary for the microbe’s spread. This would allow development of a model that would be applicable to other microbes, including some bacteria.33 This would be particularly applicable to spirochetes such as those that propagated relapsing fever and bacteria such as plague, which, like the protozoa, also involved an insect vector and animal reservoir.34 The end to the segregation of protozoology from bacteriology and medicine would mean that the profession would cease to neglect these important diseases. Novy’s focus on fundamental aspects of microbes brought together the separately growing spheres of bacteriology and protozoology. Focusing on



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basic mechanisms of microbial behavior, Novy saw commonalities between parasitology and bacteriology, as both used similar techniques (e.g., cultures) to resolve basic issues of microbial ecology, transmission, and disease causality.35 To Novy, the notion of insects, life cycles, and reservoirs was as applicable to certain bacteria (e.g., plague, relapsing fever) as it was to parasites. He saw no good reason to segregate these fields, even though most pathogenic protozoa occurred in geographically remote regions.36 In his papers and speeches to the SAB, Novy stressed the common ground between the germ theory and protozoology—­a field that had developed tangentially from medicine. In the process, Novy sought to integrate the disciplines within his own local institution and local society. At this time, Novy advocated broadening the scope of bacteriology’s focus for theoretical (to gain a better understanding of microbial life) and medical purposes (protozoan illnesses accounted for a sizable burden of diseases globally). Throughout his career, Novy did not have to travel to the tropics to maintain his interest in protozoology, as he had access to specimens from the tropics, which colleagues working in the field shipped to him to study in his laboratory at Michigan.37 In his medical school environment, he was free to use these specimens to pursue his basic scientific interests in the biology of protozoa and their interaction with their vector and animal hosts. His goal was not a practical one of managing the epidemic by eradicating the microbe or controlling the vector—­the principal interest of Schools of Tropical Medicine located in European countries who were vested in safeguarding the economic interests of their colonies.38 Thus, through his research and laboratory activities, Novy integrated the two fields of bacteriology and parasitology in his institution in the early twentieth century. Subsequent presidents of SAB, however, did not further his plea to the society to end the segregation of these two fields. Subsequent Presidents

Other presidents of SAB extended Sedgwick’s and Novy’s arguments about the importance of understanding fundamental aspects of microbial behavior. They focused on the potential of basic science as the special knowledge that would unify the field of bacteriology as it grew and matured. C.E.A. Winslow, in 1914, felt that the practical application of bacteriology had fragmented the field into disparate spheres, including industrial and agricultural, and he reiterated an emphasis on pure science for unification.39 In 1931, J. Howard Brown, professor of bacteriology at Johns Hopkins Medical School, entreated members of the society to perform experiments with the intention to find fundamental truths about microbes rather than have practicality be the experimental motive.40

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Brown warned of the danger in allowing any other motives to enter into scientific research other than the disinterested discovery of truth.41 Although fruitful applications of bacteriologists’ work were acceptable to Brown, he favored excluding practicality from experimental design because he did not want utility to constrain potentially important research programs. Brown stated that his plea for pure research was not a radical new movement but was in fact a revival of an earlier phase of bacteriology that had focused on a purely biological interest in bacteria rather than practical application. He divided the history of the germ theory into phases with some chronological overlap.42 The first phase of bacteriology in the early nineteenth century, he said, had focused on basic investigations into fundamental biological aspects of what microbes are and what they do (e.g., bacterial metabolism, abiogenesis, heterogenesis, and fermentation) by investigators including Theodore Schwann, Charles Cagniard-­Latour, and Louis Pasteur. Brown claimed that this period was overtaken by a second phase later in the nineteenth century when there was an emphasis on the practical applications of bacteriology to improve the welfare of mankind—­how to prevent infection with vaccines (Pasteur beginning in 1881), or cure disease using antisera (von Behring 1891) or chemotherapy (Ehrlich 1908).43 In this second phase, microbe hunters searched for specific organisms as the cause of disease and sought to discover means of overcoming infection. During this period, he claimed, bacteriological work was inspired by medical and industrial interest; biological interest in bacteria was incidental. Brown viewed this devotion to practical results as limiting the development of bacteriology as a science. He claimed this latter period lacked innovation and was overshadowed by the application of old knowledge and technique. Brown, however, was heartened by what he called a third phase of bacteriology in which there was a “resurgence of pure research,” when investigators reclaimed the original interest in studying basic microbial biology.44 Older methods, he claimed, were no longer sufficient and it became necessary to dig deeper into chemistry and biology to broaden the foundations of bacteriology. Brown claimed the basic research emphasis of programs like Novy’s—­involving the use of chemistry to investigate microbic respiration, the metabolism of bacteria, and their chemical products—­represented a return to pure science that was the original focus of the earlier germ hunters.45 This new phase—­which he said also included an interest in defining life cycles and searching for filterable forms of microbes—­showed a tendency to approach medical science from the biological rather than the therapeutic avenue. Why were Brown and the early SAB presidents uniformly arguing and promoting the theme of pure biological science rather than practical applications?



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One possible explanation is that the bacteriologists were attempting to unify their field by holding the pure science ideal and its search for basic biological truths about microbes on the highest pedestal. Quoting H. L. Mencken, Brown believed that the bacteriologists should have an “insatiable curiosity to penetrate the unknown, to uncover the secret, to find what was not known before. . . . His prototype is not the Good Samaritan lifting the fallen but pure curiosity . . . the dog sniffing at a series of rat holes.”46 By stressing a “pure” motive to understand bacterial behavior, Brown, Novy, and other SAB presidents also tried to unify members of an organization that risked fragmentation as a result of its applications in differing areas. Novy, for example, said, “The common bond of interest which unites us is the search for truth.”47 Likewise, Brown said, “Diversity of interest does not necessarily imply diversity of motive.”48 The goal of Novy, Brown, and other SAB presidents was to rally around a common motive in order to unify individual workers into a distinct harmonious organization. They identified the biological knowledge about microbes that this pure science search yielded as the special knowledge that was needed to legitimize their field as an autonomous specialty and also to unify their field. For example, Leo Rettger, professor of biology at Yale University and an SAB president, contended that the very problems of life’s origin and of death belong as much to the realm of bacteriology as any other science.49 Thus, early and subsequent SAB presidents, including Mansfield Clark, professor of physiological chemistry at Johns Hopkins Medical School, argued that fundamental scientific programs that sought to explain biological secrets about microbes justified bacteriology becoming an autonomous field.50 The SAB presidents’ emphasis on pure biological science may have also helped to separate bacteriology from its position subordinate to pathology. Although several presidents mentioned that bacteriology had been considered a handmaiden to pathology for too long, and it was time to end this state of subordination, their reasons for separating bacteriology from this position were never directly stated in the presidents’ addresses. But why did the presidents so fervently wish to extricate bacteriology from the field of pathology? One possibility may have been an ideological one: to construct a separate field could free them to undertake their research on their preferred topics rather than restrict themselves to the pathologist’s focus on the relationship of microbes to human disease. But there may also have been pragmatic incentives to create their own discipline; providing bacteriology with an independent status could justify creating it as its own department within their respective institutions. Indeed, this was the case at the University of Michigan in 1902. Moreover, establishing an institutional base certainly assured lasting opportunities for their students

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following graduation. Additionally, it may have given them control over the increasing complexity of laboratory equipment that accompanied the growth of technology. Although there was no evidence of a direct relation between the Society of American Bacteriologists and the growth of new bacteriology departments, a growing number of presidents of the society, beginning with Novy in 1902, also became chairs of newly created bacteriology departments in their respective institutions.51 The opening of new faculty positions in these departments gave the founding SAB members the possibility to perpetuate the discipline they helped to establish by providing careers for their most promising students to perform the research that most interested them (see chapter 6). In addition to the special knowledge and methods of bacteriologists identified at the yearly meetings, the shared norms and codes of behavior fostered by leaders like Novy cannot be discounted in constructing professional identity and independent status. The code of behavior and morals that Novy sought to instill in his students are also elements that help define a distinct culture, which furthered the cause of constructing a distinct specialty. Novy’s students, for example, were willing to self-­regulate their behavior according to the values that Novy articulated in his spirit of science—­doubting the received word and assuming a duty above all else to perform pure science for its own sake. Many undertook a search for truth without necessarily thinking of its practical value.52 Thus, character traits developed from within the group were also important in defining the specialty as it formed. Bacteriologists’ work habits and their shared commitment to a search for truth formed the fabric of a unique culture of scientific bacteriology that was also important in creating a distinctive specialty. Members elected to join the culture of science because they were inspired to become participants in a community of expert evaluators who promoted, above all else, a reverence for original investigation and skepticism for the received teachings of the traditional medical environment. In his own institution, Novy provided the guidance and the freedom for these bacteriologists to become independent investigators. Novy shared his knowledge about special technology with his students, which allowed them to strive daily to discover the behavior of a broad range of microbes. As reflected in notes written by students who became bacteriologists, Novy’s spirit of science provided a unity of purpose for bacteriologists as they were defining their field (see chapter 3).53 The pure science ideal that Novy advocated and symbolized to his students cannot be discounted as helping to construct bacteriology as an independent field. Novy’s emphasis on the precise wielding of complex instruments to understand basic truths about bacterial behavior provided a means for a



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community of scientists to rally around, declaring their special knowledge and unique jurisdiction. In addition, Novy’s pure scientific ideal with its disciplined, controlled hard work, its search for truths, and its denigration of self-­interest and commercialism served as a code of behavior and provided a unifying culture for the newly forming field of bacteriology. The values that Novy promoted, combined with the essential character traits for a laboratory researcher (e.g., disciplined, precise work), served as a code that bound bacteriology during its formative years. In his own institution, Novy’s spirit served as a departmental norm that created an identity leading to the characterization of the profession of bacteriology. The letters from Novy’s students reviewed in chapter 3 showed the abundance of students motivated to adhere to a code of ethics in accord with Novy’s spirit of science. When viewed in this fashion, scholars were able to create these disciplines because they were enthusiastic in their motivation and confident in their special knowledge and technical expertise. Novy’s brand of science and his code of behavior served as a basis for his students’ work and also for the identity of his profession. The reverence for original investigation and the acceptance of a norm of behavior created a culture in which leaders and students alike found achievement within their chosen specialty. This was a new order of bacteriologists—­specialists who possessed a distinct knowledge and technical competence and doggedly adhered to a code of behavior. Acknowledging the Dual Nature of Bacteriology: The Fundamental and the Practical

The arguments made by SAB presidents to make bacteriology into its own discipline opened up the possibility for institutions to establish an independent bacteriology department whose research focus was distinct from that of pathology. Indeed, this was the case at Michigan. In 1902, Vaughan spearheaded the initiation there of a new Department of Bacteriology that was separate from pathology, and he appointed Novy as its first professor.54 As dean of the medical school, Vaughan streamlined his proposal for a new department and had it approved expeditiously. Vaughan’s first motion for the new department and its head was approved by a unanimous vote from his hand-­picked, scientifically minded faculty (e.g., Huber, Howell, Warthin) at a medical school faculty meeting held September 7, 1902.55 At a board of regents meeting the following month, Hermann Kiefer, chairman of the medical committee that appointed Vaughan as dean, approved Vaughan’s motion.56 The newly created department of bacteriology (later to be called microbiology in 1937) had its own budget, which was supported by university funds and was separate from pathology.57 By 1907, Novy’s research laboratory was no longer

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affiliated with the Hygienic Laboratory at the State Health Department, which moved its location to Lansing, Michigan, that year. Novy consistently argued that the basic knowledge he produced was valuable for two reasons. First, knowledge in itself was essential simply because it provided a better understanding of nature. Secondly, he never discounted the importance of the practical applications of bacteriology. In fact, he maintained that basic knowledge may at some future point provide what he called the “seed of research,” the essential first step that could provide a foundation for research into practical applications at a later time.58 He focused on this second aspect particularly when addressing the state legislature. During an 1894 speech, for example, Novy spoke about the basic experiments on the toxin that preceded inquiry into the practical development of antisera: Only a few weeks ago, the French Academy of Sciences divided a standing prize for the cure of diphtheria between Behring and Roux. More than prize money, the gratitude of the world belongs to these devoted, disinterested and persevering investigators in experimental medicine. . . . The discovery of antitoxin as a cure for diphtheria was not an accident, but the logical sequence of patient, prolonged, systematic investigation extending over many years. Its value was demonstrated in the laboratory long before it was applied to man. It is within a laboratory that the cause of a disease is ascertained and it is from the laboratory that our curative and preventive methods must come. In no other way is this possible, as the records of centuries that have rolled by abundantly testify.59

In this narrative, Novy carefully selects the facts of history and of biography in such a fashion as to give the impression of a necessary sequence and causal relationship. He constructs a useful history of the germ theory delivered to an audience who provided funding for his Hygienic Laboratory.60 He addressed how his laboratory, which does basic research, may benefit society by identifying basic mechanisms from which practical investigations, like those of Roux, can be performed. Thus, his laboratory may yield discoveries that are valuable on the basis that they provide new knowledge alone, or valuable because they provide the foundation for practical studies that can then be done at a separate place and a future time. In the late nineteenth century, Novy advocated for the high worth of a basic research laboratory, as the practical applications of a particular basic discovery might not be evident for years.61 He said: Within a comparably short period of time, perhaps 15 years, the field of knowledge has been enlarged by a new science—­bacteriology. . . .



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Without the recognition of the extraordinary significance of these organisms this sudden and remarkable evolution of the science would be impossible. We may . . . compare . . . bacteriology with electricity. Electricity had been known for more than a century, but it required an Edison and a Bell to develop its practical side just as bacteriology required a Pasteur and a Koch. It is well known what electricity has done, but is it known what has been accomplished through bacteriology?62

Thus, to the state legislators of Michigan, who provided funds to support his laboratory, Novy highlighted the potential for his own basic research operation to yield, at some future date that could not always be predicted, practical applications in the hands of another investigator. He promoted a linear story of innovation: a fundamental science provided an essential foundation for an applied science that benefited mankind. It should be noted that in constructing his progressive narrative, Novy omitted circumstances that did not support his contention that medical advancements were dependent on pure scientific laboratory discoveries. For example, medical advances had been achieved without the laboratory first yielding an understanding of disease causality. In actuality, at the time Novy was writing, physicians had instituted effective interventions to control several infections solely by making careful epidemiological observations alone (e.g., Edward Jenner: vaccination to prevent smallpox; Ignaz Semmelweis: handwashing to prevent childbirth fever; John Snow: closing a water pump to prevent cholera; etc.).63 Furthermore, the majority of basic science discoveries did not yield practical results at a later time. Highlighting these historical interventions would have weakened Novy’s assumption that medical advances depended on basic laboratory insights. Novy selected scientific and medical facts that fit his progressive, linear argument about the indirect merits of pure laboratory science. Novy extended his linear argument of pure science leading to applied science with social consequences by bluntly concluding that it is the state’s responsibility to fund the Hygienic Laboratory. He stated: The germ theory is a thing of the past. A theory ceases to be a theory when facts have been accumulated and proofs furnished. This has been done with a large number of infectious diseases. Today, the bacteriologist has already entered upon the cure of infectious diseases and even now two diseases have been robbed largely of their dreaded character (tetanus and diphtheria). It is the duty of the state to ensure protection of its citizens, not only from accident or violence, but disease as well.64

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Addressing audiences who provided financial support for his laboratory, Novy argued that basic science had a legitimate place in a medical and public health setting. Basic science discoveries, as Novy pointed out, preceded the practical discoveries of tetanus and diphtheria antisera. He maintained that ongoing basic research laboratory science could eventually protect citizens against an even greater number of diseases. It was the state’s obligation to fund this type of laboratory research, he asserted, to maximize the protection of its citizens against harm, just as it was the duty of the state to support a police department to protect citizens against crime.65 While acknowledging the dual nature of their specialty, Vaughan and Novy were steadfast in asserting that their primary function was to perform basic microbiology research investigations. Novy affirmed that the major purpose of his laboratory was to gain new fundamental knowledge about microbes and their behavior.66 He said that the “duty of the hygienic laboratory . . . [was to] . . . search for truths . . . [in order to] . . . uncover the cause of things.”67 Novy also emphasized the necessity of the autonomous role of the laboratory investigator to choose the topic and scope of research investigations. Novy insisted that the accumulation of new knowledge—­knowledge that at some future point might yield practical results—­required the independence of the investigator. Novy said that this knowledge was “not an accident [but rather] the result of a logical sequence of patient, prolonged, systematic investigations selected by medical researchers.”68 Despite the practical responsibilities that came with the state funding of his Hygienic Laboratory, Novy both avowed and justified the pure scientific research ideal—­that science should be done for science’s sake as its primary goal. This type of methodical, purely biological approach to research is necessary, he argued, as it could someday yield practical applications even if that was not the immediate aim in carrying out the research. He therefore defended his right to explore new knowledge with the help of public funds while maintaining his freedom to choose experiments without constraints placed on his experimental choices by the sources that funded him.69 In conclusion, Novy’s research program had important implications for bacteriology as it grew into an independent field. Novy’s study of the fundamental biological aspects of microbes and their behavior—­the metabolism, respiration, and life histories of microbes—­was the type of research that the founding members of SAB believed both merited and justified the creation of bacteriology as its own distinct field. Early statesmen in the SAB identified the basic search for microbial truths as a means to solidify their field, which they believed had become fragmented by its application in multiple realms.



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With the autonomous status of bacteriology actively and consistently promoted by the society’s presidents, and with institutional norms and a code of ethics regulating behavior on a more day-­to-­day basis, Novy and other scientists were able to effectively carry out their own special research and educational activities in the bacteriology departments of their individual academic institutions. Novy’s basic investigations into a broad range of microbes helped to define bacteriology as a distinct field and to broaden its scope by integrating into his medical school setting protozoology—­a subject that had traditionally been segregated from bacteriology and taught in schools of tropical medicine and public health.70 By providing his students with special knowledge and instilling in them distinct ideals, Novy cultivated a group of scholars who were confident in their special expertise. Novy provided students pursuing a career in bacteriology with a clear but rigorous pathway whereby they could access nature’s truths if they had the will and motivation to do so. Novy’s basic scientific investigations and the ideal of scientific research that he upheld for his students helped to construct bacteriology as an independent and inclusive scientific discipline with its own medical school department that endures today. Within the specialty of bacteriology and as head of his department at Michigan, Novy was able to justify his research activities, which stressed a search for basic microbial truths, and the freedom to pursue research projects motivated primarily by curiosity and not by practical concerns. He did this within the structure of his Hygienic Laboratory, where, as outlined in chapters 1 and 2, he performed work that met the needs and welfare of the population he was serving. According to historian George Weisz, the balance of activities, which included creativity and autonomy while acknowledging a duty to meet the needs of the population of the state, was typical of the balance that characterized specialties emerging in medicine in the early twentieth century.71 Bacteriology, in actuality, had both fundamental and practical elements, and these elements were not always easy to disentangle. Nevertheless, the particular aspect Novy and Vaughan chose to emphasize at any given moment depended upon their purpose. When building bacteriology as a distinct discipline, Novy stressed the fundamental side of his discipline and emphasized the inherent value of pure knowledge by itself in explaining microbial life and uncovering nature’s secrets. But when securing necessary funding, he emphasized the connections between fundamental discoveries and the future development of practical applications. Though so often obsessively focused and single-­minded, Novy was still able to play to his audience. It was the dual nature of bacteriology that allowed Novy to choose to highlight either the

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applied or the fundamental nature of his science, according to how it suited his most pressing concerns. Until now, we have focused on Novy’s scientific and educational activities and their significance for medical education and for bacteriology. The next chapter explores the significance of Novy’s activity in an even broader sense for American society.

Chapter 5

Significance for American Culture Arrowsmith

This chapter uses Sinclair Lewis’s popular, accessible novel Arrowsmith as a lens to view the meanings of Novy’s activities for American society. The best-­ selling, Pulitzer Prize–­winning novel was the result of a 1925 collaboration between Lewis and Novy’s student Paul de Kruif. Lewis based the characters and major themes of his novel on firsthand information about Novy supplied by de Kruif. Lewis relied on de Kruif’s inside knowledge to construct his themes. Lewis dramatized Novy’s spirit of science—­his devotion to search for nature’s truths as his primary objective above all other concerns—­practicality or self-­ interest.1 Furthermore, Lewis took de Kruif’s worship of Novy as the idealized medical researcher and applied it to American society at large. The novel popularized the image of the heroic medical researcher in twentieth-­century American society. The characters and themes of the novel Arrowsmith are representations of Novy’s scientific ideals. Lewis stocked his novel with details supplied to him by de Kruif that made the story seem real and believable to readers unfamiliar with a bacteriologist’s laboratory.2 Lewis includes many specific details about Novy’s spirit of science, his experiments, his personality traits, and the reverential manner of his students. Novy’s activities and ideals parallel those of the fictional character Max Gottlieb, who symbolized the ideal of science in medicine based largely upon observations of Novy. The self-­sacrificing, truth-­ seeking medical researcher had significance for medicine and for twentieth-­ century American society in general.

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Synopsis

Arrowsmith focuses on the sentimental education and moral growth of Martin Arrowsmith from youth to adulthood. The story begins with Martin as a medical student at the University of Winamac, a midwestern state university at the turn of the twentieth century. He becomes disillusioned with the university’s medical instruction, which he felt was passed on from one generation to another without being subject to rigorous scrutiny. Martin is conflicted throughout the novel—­he regards highly the healing aspects of medicine as epitomized by his professor of medicine, Dean Silva, but is most strongly attracted to the ideal of medical research as symbolized by his professor of bacteriology, Max Gottlieb. Following graduation, Martin takes various jobs—­ country doctor in Wheatsylvania, public health physician in Zenith, and pathologist working in the Rouncefield clinic, as he is attracted by the material rewards these opportunities provide. But in each circumstance his commercially oriented surroundings, which promote uncertain remedies, eventually alienate him. With the help of Gottlieb, the beacon toward which Martin’s meandering spirit increasingly steers, Martin is hired by the well-­funded, amply equipped, and esteemed McGurk Research Institute in New York City. Martin achieves scientific acclaim after testing his discovery, a bacteriophage against the plague bacillus, with therapeutic success but without scientific precision, while his first wife dies in a plague epidemic in St. Hubert Island. But he eventually comes to realize that the scientific ideals of Gottlieb’s truth searching are compromised in the McGurk environment, which demands practical applications of his research. Martin abandons his McGurk position and his new wealthy wife to retreat to the woods and work in pursuit of scientific truth in his homemade laboratory. At the end, Martin achieves a life that is in accordance with his true self. Lewis Patterns the Truth-­S earching Component of Gottlieb after Novy

The characters in the novel were patterned after real-­life characters whose stories de Kruif fed to Lewis. Gottlieb in actuality represented a blend of Novy and Jacques Loeb, a prominent scientist at the Rockefeller Institute whom de Kruif admired.3 Historians have examined the ways in which Gottlieb reflected the scientific mindset of Loeb—­his objection to older metaphysical vitalistic ideas and his conviction that living organisms are governed by the same principles and mechanisms as inanimate entities.4 While demonstrating the imprint



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of Loeb on Gottlieb, however, historians have not systematically explored the ways in which Gottlieb is also derived from Novy. Both de Kruif and Lewis acknowledge that the truth-­searching quality of Martin’s mentor Max Gottlieb was patterned after de Kruif’s own mentor, Novy.5 De Kruif states in his autobiography, The Sweeping Wind, “Gottlieb is a blend of the wisecracking Loeb and my dedicated truth hunter, my old master, Novy. Loeb was brilliantly surface; Novy was deep and difficult to do.”6 Likewise, Lewis acknowledged that he fully relied on de Kruif’s firsthand knowledge of Novy to construct the image of Gottlieb as the truth-­seeking researcher.7 According to Lewis’s biographer, Mark Shorer, the parts of Arrowsmith that symbolize the worshipful attitude that Martin has toward Gottlieb reflect de Kruif’s attitude toward Novy.8 Lewis, in fact, acknowledged that “Gottlieb was based largely on what de Kruif told me of Dr. Novy at the time I wrote the book.”9 Lewis confessed that “Novy furnished the pattern for the one really noble character I have ever created—­Max Gottlieb.”10 Martin Arrowsmith’s worship of Gottlieb, who dedicated his whole life to medical research and who allowed nothing to interfere with his duty, can be seen as a fictionalization of de Kruif’s veneration of Novy and his scientific ideals. Lewis acknowledged that the novel’s preoccupation with pure science reflected the ideals of Novy.11 The truth-­searching Gottlieb remains Martin’s greatest mentor in the novel. The reverence that Lewis’s fictional character Martin Arrowsmith has toward his mentor and bacteriology professor Gottlieb was drawn from the real-­life devotion that de Kruif had for Novy.12 De Kruif, in fact, wrote privately to tell Novy that he was his “first and only master” and his “truth-­hunter.”13 By fictionalizing de Kruif’s real-­life stories, Lewis attempted to make the pure science ideal that Professor Novy stood for come alive for the general reader.14 According to de Kruif, Lewis prodded de Kruif to dramatize Novy’s spirit of science, and turn Novy into a heroic figure of medical intrigue and romance.15 As de Kruif said, “[Lewis] kept teaching me to . . . dramatize real science. He kept prying out of me Frederick Novy’s deep, simple spirit of science.”16 To relay Novy’s spirit to Lewis, de Kruif drew upon his intensive experience working on the problem of anaphylaxis from 1913 to 1918 as Novy’s doctoral student (see chapter 2).17 In return, Lewis pondered the significance of the ideal medical researcher for American society at large.18 Consequently, Lewis’s novel popularized the medical scientist as a relentless seeker of nature’s truths rather than profit. To create the medical researcher as hero, Lewis constructed a realistic novel with a detailed environment and fictional characters that are based on real-­life individuals. He depicted a life of scientific and bacteriologic detail, rich with

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its scientific apparatus and dramatization of experimentation that makes the reader feel as if he or she is actually living and working in the laboratory.19 The novel’s degree of verisimilitude was due to de Kruif’s collaboration, and it helped demystify the specialized, unfamiliar world of the laboratory for the lay reader. Lewis’s realistic style permits an opportunity to identify the many parallels between the activities and ideals of Lewis’s character Gottlieb and those of Novy. Below, I analyze the text to illustrate the ways in which Lewis’s novel reflects Novy’s science ideal—­in motive, mind, and work. This analysis underscores the themes of Novy’s scientific attitudes, research conduct, and educational objectives, which de Kruif captured from his firsthand experience with Novy and brought forth to the novel. Novy’s Spirit of Science in Medicine Evident in Arrowsmith

The spirit of science in medicine that Novy sought to instill in his students is paralleled in the philosophy that Gottlieb professes. The all-­inclusive ingredients that comprised Novy’s spirit (see chapter 3) included a search for fundamental truths above all other concerns (especially commercial gain), doubt about the received word of medical lectures, and diligent work in the laboratory as the means to wisdom. Just as Novy symbolized this spirit, so too did Gottlieb. As Martin said about Gottlieb, “Gottlieb, The Greatest! The spirit of science.”20 As one of Novy’s former students, David Sugar, wrote about Novy, “The greatest of great teachers was the Great Novy. Never since have we been pervaded with idealism such as emanated from and surrounded that man. His idealism is the greatness of the book Arrowsmith.”21 Sugar went on to write, “Paul de Kruif with Sinclair Lewis immortalized Novy as Gottlieb in Arrowsmith.”22 Novy’s spirit of science reverberated in the novel Arrowsmith and in the character Max Gottlieb. Novy’s commitment to search for fundamental truths without regard to practicality—­his spirit of science—­is pervasive throughout Arrowsmith. De Kruif frankly stated that he was inspired by the scientific spirit of Novy, whom he called his “truth-­seeker master . . . [my] austere chief . . . [who] didn’t allow the littlest of lies in his simple ‘spirit of science.’”23 De Kruif’s sentiments toward Novy are mirrored in Martin’s comments about Gottlieb, or as he calls it “Gottliebism,” when he speaks of “the tyrannical honesty of Gottliebism, from the unswerving quest for causes which, as it drove through layer below layer, seemed even farther from the bottommost principles, from the intolerable strain of learning day by day how much he did not know.”24 Martin emulates the Gottlieb style of science—­“a wide-­ranging, sniffing, snuffling, undignified, unself-­dramatizing curiosity,” and “it drove him on.”25



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Lewis portrayed the ideal motive of a researcher as curiosity—­an instinctive type of search for basic truths rather than following a fixed master plan or representing aspirations targeted at healing an individual or controlling an epidemic. This style characterized Novy’s research investigations. For example, Novy would occasionally alter his original experimental intention to explore the basis of an unexpected experimental finding (e.g., when pursuing anaerobic bacteria as the cause of death in animals or the basis of anaphylaxis with his student de Kruif; see chapter 2). Martin’s characterization of Gottlieb’s ideal—­his commitment to seek basic microbial truths as the focus of his research, rather than practicality—­reflects Novy’s basic scientific philosophy. Regarding Gottlieb’s scientific focus, for example, Martin says, “Gottlieb’s work had been dealing with . . . the foundations of life and death, and with the nature of . . . infection.”26 Martin notes that Gottlieb’s interest, as with Novy, is “pure, authentic science” because he was devoted to “getting to the bottom; ignoring . . . practical issues.”27 Reflecting Novy’s reliance on chemistry to search for basic mechanisms of microbial life, Martin says about Gottlieb, “He sought their chemistry; their laws of existence, basic laws for the most part unknown”; he considers Gottlieb a “philosophical bacteriologist” because of his commitment to understanding microbial life rather than “destroy[ing] the amiable . . . germs.”28 Just as Novy’s students had characterized his scientific spirit or ideal, so Martin says about Gottlieb’s truth-­ searching ideal, “Gottlieb! Ideal of research! Never . . . content with what seems true! . . . a great benefactor of humanity.”29 De Kruif’s admiration of Novy’s research because it provided new microbial knowledge rather than its therapeutic utility is reflected in Martin’s veneration of Gottlieb. De Kruif’s reflections on Novy’s truth-­seeking philosophy of science—­his search for basic microbial truths as the most noble endeavor of the medical researcher—­were embraced by Lewis and brought to life in the scientific philosophy of Gottlieb. These striking parallels between Gottlieb and Novy do not mean to discount that the character Gottlieb was also based on Loeb. Indeed, strands of Loeb are undeniably evident in Gottlieb; in addition to his antivitalistic sentiments, these include his emphasis on quantitative methods and his German birth.30 While acknowledging these parallels, it is important to point out that some features of Gottlieb—­his topic of study (bacteriology and microbial behavior) and his midwestern medical school location—­precisely match Novy’s and bear no resemblance whatsoever to Loeb’s. Loeb, in fact, never wrote about bacteriology, as he exclusively studied physiology solely in research institutes—­ not at medical schools.31 My intention, however, is not to imply that Gottlieb is more representative of Novy than Loeb, or vice versa. Indeed, the character

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Gottlieb is a blend of the two scientists. Rather, my major objective is to show how Gottlieb’s scientific philosophy reflects Novy’s pure truth-­searching spirit of science. The high value that Novy placed on the duty to search for basic microbial facts above other interests, such as practical applications, is mirrored in Arrowsmith. One of Gottlieb’s principal messages to Martin is to search for “the mysterious source of life” and to protect science from misuse by “the doctors who want to use therapeutic methods they do not understand” and want to “snatch our science before it is tested and rush around hoping they heal people.”32 Gottlieb’s comment is consistent with Novy’s insistence on meticulously repeating fundamental experiments on various aspects of microbial life (e.g., respiration and metabolism) to ensure their accuracy by meticulously demonstrating they could be reproduced before rushing to print prematurely. Furthermore, Novy’s opposition to the commercial aspects of medicine is mirrored in Gottlieb’s objection to the “businesslike” culture of medicine. Martin characterizes Gottlieb as the symbol of “pure research; seeking the truth, unhampered by commercialism or fame-­chasing. Getting to the bottom. Ignoring consequences and practical issues.”33 In his quote, Lewis was referring to the commercialization of products of discovery and promotion of therapies by doctors who did not know whether they were helpful. Lewis’s criticism of commercialism is pervasive throughout the novel—­when Martin works in the clinical domain (Rouncefield Clinic), public health departments (Nautilus), and research (McGurk Institute). Lewis’s critique of commercialism in medicine is also evident when Gottlieb leaves the Hunziger Pharmaceutical Company. Gottlieb resigns because he wanted to perform further research investigations on a product of the company rather than market it for use and advertise its utility as the company’s executives had desired.34 Lewis offered laboratory science as the ideal that could transform the medical profession from a trade that sold untested goods to unsuspecting patients to a profession that beheld verifiable truths—­an ideology that both echoed and resonated with Novy’s views on the dangers of commercialism in medicine. Lewis also dramatized Novy’s objection to commercialism in medicine. Lewis linked this anticommercial sentiment with the self-­sacrificing nature of Novy’s ardent devotion to truth seeking at the expense of other pursuits—­a devotion that Gottlieb symbolizes. Novy, as noted in previous chapters, tended to work late hours at night in his office and laboratory, would wear clothes until they were threadbare, and declined jobs with higher pay in order to protect the autonomy and independence of his research operation (see chapter 6). Lewis wove these details into his story, too. Martin’s first girlfriend, Madeline,



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for example, says of Gottlieb, “think how much more money . . . a successful doctor has than one of these scientists that just putter and don’t know what’s going on in the world. . . . Somebody pointed [Max Gottlieb] out to me the other day, and he had on a dreadful old suit.”35 Martin later elaborates on Gottlieb’s self-­ sacrifices: “While medical quacks, manufacturers of patent medicines, chewing-­gum salesmen lived in large houses, . . . Gottlieb dwelt in a cramped cottage whose paint was peeling, and rode to his laboratory on an ancient and squeaky bicycle.”36 Thus, Lewis created a dramatic picture of the self-­sacrificing scientist whose mission was not to seek financial reward or expensive possessions, even those considered somewhat utilitarian. Novy’s insistence that doctors be guided by an ideal rather than monetary profit permeates the book, particularly in comments made by Martin. Novy believed, especially for proprietary medical schools, that the focus on commercial gain compromised the quality of medical education, and that scientific medicine could rectify this trend by providing a means to verify the knowledge that students were taught.37 Novy’s sentiments are evident in Martin’s impressions of his classmates in relation to his mentor, Gottlieb. About his medical school classmates, Martin says, “These darn’ [students], they a­ ren’t trying to learn science; they’re simply learning a trade. They just want to get the knowledge that’ll enable them to cash in. They don’t talk about saving lives but about losing cases—­losing dollars. . . . It’s dreadful the way people don’t have ideals about their work.”38 Martin regards Gottlieb’s ideals as a means to rectify the trend toward commercialism in medicine. He says, “I do know what a man like Max Gottlieb means. He’s got the right method, and all these other hams of profs, they’re simply witch doctors. [Gottlieb’s] . . . just being in a lab is a prayer . . . you [classmates] are the kind that keep medicine nothing but guess-­ work diagnosis, and here you have [Gottlieb]. . . . Do you see where [Gottlieb] leaves all these detail-­grubbing doctors buzzing in the manure heap, just as much as he does the commercial docs.”39 Martin, despite his own temptations to become wealthy, remains inspired and guided by Gottlieb’s ideal—­the spirit that Novy unapologetically professed. Novy’s comprehensive spirit of science required students to be doubtful of information they were taught, insisting that skepticism was the beginning of wisdom. Novy said students must not accept the information they were taught as true by what he called blind faith, meaning that they should first doubt the information. In Arrowsmith, Martin promotes the process of doubting the information received in lecture halls. Concerning Gottlieb’s skepticism about information passively received in a lecture hall, Martin says, “Gottlieb’s gods are the cynics, the destroyers. . . . Diderot and Voltaire . . . men that had more

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fun destroying other people’s theories than creating their own.”40 About Gottlieb, Martin says, “not once did he fail to be hated by his colleagues, . . . [who] called him diabolist, killjoy, pessimist, . . . destructive critic.”41 Novy’s contempt for didacticism is evident in Martin’s impressions of his own medical school teaching, about which Martin says, “In the study of the profession to which he had looked forward all his life, he . . . saw no clear path to Truth but a thousand paths to a thousand truths far-­off and doubtful.”42 Martin incorporates Gottlieb’s ideals, as “he preached to himself, as Max Gottlieb had once preached to him, the loyalty of dissent, the faith of being very doubtful, [and] the gospel of not [preaching] gospels.”43 Novy’s advocacy of doubt rather than passive acceptance—­or what he called blind faith—­as the first step to access nature’s truths is abundantly evident. Novy’s insistence on skepticism and doubt as an essential ingredient of the scientific path to true knowledge is dramatized by Martin’s actions and confrontations with his professors. Martin, for example, directly challenges his materia medica professor, Lloyd Davidson, about the validity of information he is teaching in class. Davidson contends that students should accept what is being taught in class based on his authority as a professor and based on experiential accounts. Lewis writes: [Davidson taught students] that most important of all things: the proper drugs to give a patient particularly when you cannot discover what is the matter with him. His class listened with zeal. . . . But Martin was rebellious. He inquired, “How do they know ichthyol is good for erysipelas?” . . . [Davidson replied], “How do they know? Why, my critical young friend, because thousands of physicians have used it for years and found their patients getting better; and that’s how they know.” [Martin answered], “But honest doctor, wouldn’t the patients maybe have gotten better anyway? . . . Have they ever experimented on a whole slew of patients together with controls?” . . . [Davidson replied], “My statements may be accepted . . . because they are conclusions of wise men . . . through many ages. . . . [Y]ou will accept and you will study and you will memorize because I tell you to.”44

This passage demonstrates Martin’s faith in doubt as a route to wisdom. The necessity of doubt is a critical component of the all-­inclusive spirit of science. Like Novy, Martin argued that truth could not be apprehended by passive learning of a didactic lecture. Novy taught that doubt was the first component of a multistep scientific method by which scientific truths can be apprehended. In his teaching, Novy specified the second component of the scientific path to obtaining wisdom—­ active participation in a laboratory setting. In



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Arrowsmith, Lewis mirrored Novy’s theme that truth can be obtainable only through diligent, meticulous work. Indeed Arrowsmith portrays the laboratory as a place that can have an uplifting power, where new knowledge is reformulated and created through the active inquiry into unknowns. For example, Gottlieb advises Martin that in laboratory experimentation he should “observe what you observe, and if it does violence to all the nice correct views of science—­ out they go! . . . Find out the Why, the underneath principle.”45 Gottlieb’s view reflects Novy’s own teachings about the provisional nature of knowledge; Novy wrote that the laboratory can yield “new discoveries [that] make their appearance [and can remain] with us . . . [or] drop by the wayside.”46 With Gottlieb’s advice in mind and heart, Martin is disposed toward the laboratory not only as a means to refute or verify teachings but also to fight his way to a higher level of existence. Lewis writes about Martin’s lingering conflict during an early period of his career when he had entered practice because of its financial security but remained predisposed to the laboratory: If [Martin] had given up Gottlieb-­worship and his yearning for the laboratory for a sanctuary, if he had resolved to be a practical and wealth-­ mastering doctor, yet something of Gottlieb’s spirit remained. He wanted to look behind details and impressive-­sounding lists of technical terms for the causes of things, for general rules which might reduce the chaos of disorder and contradictory symptoms to the orderliness of chemistry.47

Lewis proposed the laboratory as the locus where Martin could fulfill his to search for and apprehend fundamental truths and laws through ideal—­ meticulous, accurate work. The resistance that Novy encountered to teaching laboratory science in his bacteriology course at Michigan is also apparent in Lewis’s novel. As outlined in chapter 3, Henneage Gibbes, a faculty member who did not adhere to the germ theory, attempted to eliminate Novy and his bacteriology course from the medical school. But the Board of Regents overruled Gibbes’s proposal and instead eliminated Gibbes’s position. In Arrowsmith, Gottlieb also encounters resistance for attempting to make medical education scientific.48 But the circumstances do not accurately reflect Novy’s. In fact, they are the opposite, as Gottlieb’s colleagues at Winnemac force him to resign only after he has attempted to turn Winnemac into a medical school of pure science by proposing to eliminate the position of the clinically oriented Dean Silva.49 The Board of Regents at Winnemac votes to discharge Gottlieb on the grounds of egotism and disloyalty.50 Nonetheless, the resistance to the incorporation of laboratory science into medical education that Novy encountered is fictionalized in Arrowsmith.

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Just as was the case with Novy, Gottlieb’s laboratory demands diligent work, long labor, and patience. Novy’s students commented that he was uncompromising on accuracy, honesty, hard work, and the repetition of experiments to ensure no mistake had been made. One former student, L. R. Jones, epitomized this sentiment when he wrote to Novy, “your eager zeal, backed by splendid native ability and dogged hard work, while checked by strictest scientific integrity, is what we have all come to admire and respect in you.”51 De Kruif also had commented about how Novy “tried to beat honesty and accuracy into [his] head” by diligent repetition of experiments to verify results during the time de Kruif had worked in Novy’s laboratory.52 Similarly, Gottlieb lectures Martin on the necessity for accuracy, honesty, and patience; to Martin, Gottlieb says about laboratory work, “you are impatient with the beautiful dullness of long labors.”53 For Lewis, these long labors were “beautiful” because accuracy was the only means of obtaining truth; only by repeating experiments with logical controls could truths be obtained. Novy had taught his students that repeating experiments diligently, an activity he referred to as “plodding” in the laboratory, was a fundamental requisite of science.54 Only through this diligent, methodical approach could Martin sense “the thrill of uncharted discoveries, the quest below the surface and beyond the moment, the search for fundamental laws which the scientist . . . exalts above temporary healing as the religious exalts the nature and terrible glory of God above pleasant daily virtues.”55 Only through strict adherence to a plodding, rational technical process can Martin experience an emotion—­thrill. Paradoxically, it is only in this sterile laboratory that he can fulfill his romantic quest of discovery. By enduring what Lewis calls this “beautiful dullness,” Martin can rise above the everyday workers’ chores. As Novy’s experience shows, to thrive in the laboratory requires not only strict adherence to scientific method; it also requires technical virtuosity. Novy was renowned for his innovation of instruments and discovery of techniques, and his insistence on meticulous technical precision to ensure scientific accuracy. His students marveled about his adherence to technique. The theme of technical virtuosity as a means to access nature’s truths is evident in Arrowsmith, when Martin says of Gottlieb, “He had fingers of a pianist above the keys. . . . [Gottlieb taught] technique is the beginning of all science.”56 To flourish in the laboratory, Lewis maintains, a scientist must be adroit with one’s hands and precisely adhere to methods—­attributes that Novy’s students always credited him with mastering. This is the secret to Novy’s success—­what Lewis calls the “least known thing in science.”57 As former student Maxwell



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Marshall wrote in reference to Novy’s mastery of technique, “the science [of bacteriology] in your hands became an art.”58 Novy’s insistence never to deviate from logical and rigorous scientific methods in his experimentation is also reflected in Arrowsmith when Martin says of the scientifically uncompromising Gottlieb, “When a physician boasted of his successes with this drug or that electric cabinet, Gottlieb always snorted, ‘Where was your control? How many cases did you have under identical conditions?’”59 The critical components of the scientific method that Novy stressed—­ technical virtuosity, meticulous technique, and strict adherence to protocol in order to ensure accuracy in science—­is amply represented in Lewis’s novel. Gottlieb’s insistence that a medical researcher’s disciplined laboratory ritual is a pivotal, indispensable means of ascertaining nature’s secrets reflected Novy’s teachings. In uncovering these mysteries, Novy taught his students that they must be committed to work devoutly and diligently in the laboratory in order to represent nature with accuracy and fidelity. For Novy and by extension Gottlieb, being a laboratory scientist was more than a means to earn a living; it meant honoring a duty and following a code. Martin’s journey in the novel illustrates the difficulties he encountered as he struggled to reconcile his material temptations with ironclad scientific ideals. Thus, Arrowsmith is a moral tale: every step in Martin’s life brings him closer to his final redemption through his devotion to an ideal toward which he could aspire—­pure science and its prophet Gottlieb. Only in truly living the life of a pure, independent scientist does Martin discover a vocation in which his spiritual endowments could find meaningful expression. The students’ worship of Novy as a prophet of a new religion based on a belief that truth is holy is mirrored in Martin’s worship of Gottlieb in Arrowsmith. Novy’s objective true religion in which the laws of nature were accessed through a rational process rather than revealed through mystery is evident in Arrowsmith. Gottlieb, for example, preaches about the religion of a scientist that the scientist is intensely religious—­he is so religious that he will not accept quarter truths because they are an insult to his faith. . . . [A scientist] wants that everything should be subject to inexorable laws. He is . . . opposed to . . . preachers who talk their fables. . . . He speaks . . . [harshly] . . . of the doctors that want to snatch our science before it is tested and rush around hoping they heal people; . . . he hates . . . guess-­scientists . . . who know only one text book and how to lecture to nincompoops all so popular. . . . He alone knows how [little] he knows.60

Martin has faith that following Gottlieb’s methods will allow him to access nature’s holy truths, but he has material temptations and must seek the

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self-­discipline and selflessness needed to follow his religion. To obtain this discipline, Martin “prayed the prayer of a scientist”; he prayed, “God give me . . . the freedom from haste, a quiet and relentless anger against all pretense and all work left slack and unfinished. God give me a restlessness whereby I may [not] sleep . . . till my observed results equal my calculated results.”61 Martin prayed for the patience and self-­discipline he would need to be able to access nature’s holy truths through tedious experimentation in his sanctuary, the laboratory. Arrowsmith Mirrors a Multitude of Aspects of Novy

In addition to bringing to life Novy’s spirit, Lewis’s novel provides details that precisely mirror additional components of the scientist’s signature research style and his earnest devotion to his art. Novy’s curiosity, largely uninterrupted by traditional daily habits such as ending a day’s work before dinner, and his routine of working in a solitary fashion throughout the night, is mirrored in Gottlieb’s behavior. Martin says Gottlieb is “[never] content with what seems true! Alone . . . working all night getting to the bottom of things.”62 Just as Novy’s students had described working in Novy’s lab, Martin describes the “cool ascetic hours in the laboratory” in what was Gottlieb’s monk-­like sanctuary.63 Gottlieb’s research topics in microbiology are identical to Novy’s characteristic projects and his distinctive discoveries. About Gottlieb’s research projects, for example, Martin says, “Gottlieb was studying the ptomaine theory of disease . . . and trypanosomes from a rat. . . . An eight branched rosette.”64 Martin also says of Gottlieb, “He worked in the laboratories of Koch and Pasteur . . . and wrote vitriolic letters . . . long and intimate to the great ones from France and Germany.”65 Novy, as outlined in chapters 2 and 3, wrote long letters to his European colleagues, sometimes contesting their theories (e.g., Schaudinn’s conversion of species theory). And like Novy, Gottlieb was educated first as a scientist before being trained as a bacteriologist by Koch; he then obtained a full-­time position without practicing medicine at a medical school affiliated with a state university in the Midwest, the University of Winnemac (a fictional state bounded by Michigan and Ohio).66 Thus, many aspects of Novy’s activities—­including his devotion to research, the specific topics of investigation and unique discoveries, and his medical school appointment—­were brought forth as fictional details in Arrowsmith. Several themes of Novy’s San Francisco plague investigation are also mirrored and fictionalized in Arrowsmith. In the novel, plague has spread throughout St. Hubert’s, an island with trade routes to China, because the surgeon general, Inchcape Jones, denied that plague existed and failed to institute aggressive plague measures, including rat control, in order to protect the



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island’s flourishing tourism and trade business.67 Jones says that rat control and quarantine would “frighten everyone . . . [and] . . . ruin the tourist and export business.”68 But when the plague becomes rampant throughout the island, Gustave Sondelius, a national public health official, argues that the economy will be threatened unless optimal antiplague measures are urgently instituted. Sondelius argues that unless “rat-­killing” is implemented, “the plague might cling in St. Hubert forever, so [the town] would no more have the amiable dollars of the tourists and the pleasures of smuggling.”69 Following Sondelius’s argument, the town “immediately started rat killing.”70 Thus, the themes of Novy’s San Francisco plague investigation—­the conflict between business interests and public health duties, and the adoption of effective public health measures when it suited the overall interests of the town—­is reflected in Arrowsmith. Certain details of the novel were likely patterned after Novy’s experience, whereas others were not. Sondelius seeks to control the epidemic by administering Martin’s untested bacteriologic discovery (a bacteriophage, which Novy had never investigated) to the entire population. Although Martin initially wishes to have a control group to scientifically test whether cure is due to his phage, he eventually decides against withholding a potential cure after his wife, Leora, smokes a cigarette contaminated with plague germs and dies. Lewis likely patterned Leora’s acquisition of the plague bacillus after the circumstances of Charles Hare, Novy’s laboratory assistant.71 In addition, the mistrust by San Francisco physicians of laboratory-­based scientists like Novy and the commissioners because the scientists lacked clinical experience is evident in Arrowsmith. Dr. Coughlin, a practicing physician in Leopolis, for example, says about laboratory-­based physicians, “A GP may not have a lot of letters after his name, but he sees a slew of mysterious things that he can’t explain, and I swear I believe most of these damn alleged scientists could learn a whale of a lot from the plain country practitioners.”72 Furthermore, the perception among San Francisco physicians like Charles Kuhlman of laboratory-­based commissioners as detached researchers whose laboratory diagnoses had no clinical relevance is evident when Coughlin says, “These laboratory fellows get delusions unless they have some practical practice to keep ’em well balanced.”73 Various aspects of the novel also parallel Novy’s personal preferences and his idiosyncratic personality traits. Novy’s true love was laboratory science, and his decision to avoid activities that would divert his effort from the laboratory, including public health responsibilities, practice, or a position in a research institute, is echoed in Lewis’s text. The author writes, “Gottlieb was . . . never interested in practicing medicine. . . . Koch’s discoveries drew

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him into biology.”74 Novy’s inclination to avoid public health activities because they would derail him from his laboratory research focus is a theme that is mirrored in Arrowsmith; Martin considers his public health duties and responsibilities working under Almus Pickerbaugh, director of the Zenith Department of Public Health, to be mundane activities that take him away from his real love of the laboratory.75 Furthermore, like Novy, Gottlieb is mercilessly critical of his student’s occasional imprecision, as evidenced by his snarling at Martin because of his careless lab notebooks. “Do you call these notes? . . . Do you think that you are a Theobald Smith or a Novy that you should sit and meditate?” Gottlieb, like Novy, is also insistent that scientific papers never be rushed to print without all experiments being duplicated.76 Moreover, Martin’s description of Gottlieb’s “tall, lean, dark aloofness” is reminiscent of how Novy’s students described his persona.77 Finally, Novy’s insistence on the independence of the researcher to choose his or her experimental course is mirrored in Arrowsmith. This theme is evident when de Kruif and Lewis dramatize the potential of the practical orientation of research institutions like McGurk to threaten the integrity of pure university-­based research. Thus, the image of the autonomous scientist is iconized by Lewis. The author reproduces the essence of the earnest scientist Novy, who discovers happiness and adventure while truth-­searching in his sanctuary, the laboratory. The search for nature’s holy truths in his sanctuary reinforces the moral quality of his behavior. Lewis portrays solitude and autonomy as the companion of the true scientist as he seeks truths in his shrine of science. In his well-­equipped an physical space, Novy happily and independently searched for truths—­ image that is reproduced in Gottlieb. In this technological shrine, Novy lived for his science. He eschewed involvement in any activity—­laboratory work in the field or private practice—­that would divert his absorption in the laboratory. Similarly, Lewis depicts his scientist as solitary, working alone in the laboratory and devoted to his quest to seek holy truths in nature above and beyond personal gain. The character Gottlieb, although based on many realistic features of Novy, was not an entirely authentic portrayal of him. To create the image of a scientist who retreated to the laboratory for salvation, for example, Lewis portrayed Gottlieb as isolated and separated from his wife and children.78 Gottlieb lived as ascetically as a monk and had an unhappy family life.79 Although Novy’s work habits were all-­absorbing and his laboratory inquiry was excessive, he remained rooted in family life.80 Novy, in addition, did not live in a dilapidated house. Furthermore, Novy was never forced to resign from his medical school position, as had happened to Gottlieb when he attempted to overtake Dean Silva’s



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position in an attempt to create a school of his own made for pure science. Gottlieb subsequently found a position in Hunziger Pharmaceutical Company—­a position that Novy never assumed. Thus, although Lewis based his character Gottlieb on many of Novy’s real features, he embellished the character with fictional elements. Although many of these facets of Gottlieb’s behavior are an accurate reflection of Novy (e.g., his work habits, clothing preference, mode of transportation), others are not an entirely authentic portrayal (e.g., Novy lived in a spacious home adjacent to his campus). Gottlieb is no exact replication of Novy. In his roman à clef, Lewis based his character Gottlieb on many of Novy’s real features and then overlaid them with fictional elements. When Martin works at the McGurk Institute, which places constraints on his experimental choice by demanding that he choose research projects with practical applications, he yearns for the autonomy of his previous laboratory work. To resolve his conflict, Martin moves from the urban McGurk Institute to the woods with his colleague from McGurk, Terry Wickett. There, they establish their own improvised laboratory as Martin achieves scientific autonomy.81 By retreating to the woods, the laboratory scientists can search for nature’s truths unencumbered by the restrictions of practicality and commercial concerns that McGurk places on them. Thus, at the conclusion of Lewis’s drama, Martin lives his life in accord with his inner calling by embracing the same spirit that Novy preached to his students. De Kruif regarded Novy—­who remained at a university laboratory his entire life pursuing independent research studies—­ as an autonomous researcher whose programs were not constrained by competing considerations.82 For Lewis the extent to which a scientist like Novy was able to free himself from the constraints of his surrounding environment defined his nobility. Despite his native abilities, Martin could never transcend the social relationships and commercial obligations that defined his professional existence as a practicing physician at the Rouncefield Clinic and public health official at Nautilus and constrained the creativity of his experimental programs as a researcher at McGurk. In contrast to the practitioner or the researcher at the medical institute, Lewis portrayed the individualism of the medical scientist, as fictionalized in Gottlieb and embraced by Martin, as able to disengage himself from commercial American society in his truth-­searching pilgrimage. Consequently, medical researchers like Gottlieb and Novy who worked in scientific laboratories were capable of creativity and integrity—­qualities that could not exist in other professions in American society. Thus, Lewis found it natural to accept the pure medical scientist’s vocation as a higher one than the practitioner of medicine or other professions.

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The Noble Medical Researcher in American Society

Novy’s ideas and activities had significance in the creation of a heroic image of a medical researcher in American society. Novy’s student Paul de Kruif formulated the scientist’s philosophy based on his experience with his teacher and then supplied Sinclair Lewis with his impression. According to Mark Shorer, Lewis questioned de Kruif about the motivations of his mentor not only to understand the methods and materials of bacterial research, but also to create the idealism of the scientist who transcends the activities of patient care and the struggle of the everyday worker in society.83 Lewis fictionalized Novy’s ideals of scientific research to create a story about one occupation that stood above others in American society—­the medical researcher.84 Lewis’s portrayal of Max Gottlieb served to create the iconography of the noble, selfless, autonomous laboratory researcher in American society.85 De Kruif independently published another book called Microbe Hunters that glorified the lives of bacteriologic researchers.86 Like Arrowsmith, Microbe Hunters dramatized the characters in a romantic, dramatic, heroic fashion to hold the attention of readers. In the book, de Kruif highlighted the intellectual powers of twelve medical scientists to elevate these men in the minds of readers to the pinnacles of distinction. But there is also realism in his depictions, as their discoveries, sometimes reached by accident rather than through intentional experimental design, occasionally led to practical applications that benefited mankind in tangible ways (e.g., Paul Ehrlich’s chemotherapy, Emil von Behring’s serum therapy, Walter Reed’s identification of mosquito vectors, etc.).87 De Kruif omitted both Novy and Loeb in Microbe Hunters, as his emphasis was not on medical researchers whose work focused on fundamental biology. Nonetheless, his dramatizing style helped reshape popular culture by making medical history and laboratory science exciting for readers.88 While both books enlisted the general public interest in medical science, Microbe Hunters stressed its practical accomplishments and Arrowsmith emphasized its pure science dimension. The resulting popularized image of the medical researcher—­noble, selfless, autonomous, independent, honest—­can be further appreciated by examining Arrowsmith in relation to Lewis’s other novels. In Babbitt and Elmer Gantry, Lewis portrays an American culture that was bereft of a resonant truth.89 In these novels, he offers nothing other than a depiction of vacuous, commonplace individuals in business and religion and a mercenary American soul. His novels express a general discouragement with a society that was lacking an ideal, whether it was precision and reliability in medicine, scrupulousness in business, or spirituality in religion. Unlike in Elmer Gantry and Babbitt, both



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commentaries on the shallowness of early twentieth-­century society, Lewis offers a positive alternative in Arrowsmith—­the work of noble, selfless, truth-­ searching laboratory scientists who are morally superior to those working in other professions. Lewis offered laboratory science as a potential salvation for a vague and imprecise medical culture that was lacking certainty. Lewis implies that laboratory science confers the medical profession privilege, power, and perhaps an authority because science provides medicine with a transformative capacity lacking in other professions. Thus, unlike his other novels in which he offers solely a portrayal of an empty, mercenary American culture, in Arrowsmith, Lewis conveys a positive alternative—­laboratory science as having the potential to provide a resonant truth and substance to early twentieth-­century American society. The novel had widespread appeal in America. The book’s initial reviews were favorable, stating that Lewis continued his critique of 1920s American society and its mercenary nature. But the reviews noted that unlike his previous satires, Arrowsmith offered something positive—­the medical researcher’s transcendent spirit of science.90 Citing these reasons, some reviewers, including the literary critic H. L. Mencken, considered Arrowsmith the best of Lewis’s works, a “display of his talents in its full brilliance.”91 In addition, some critics believe that it was in large part because of Arrowsmith that Lewis won the Nobel Prize for literature; he was the first American author to win this prize.92 Thus, reviewers gave wide acclaim to his book, and Lewis’s reputation as a great author of American literature was cemented. Following the popular reception of the book, a movie patterned closely after the novel was created in 1931. Released in that same year by Goldwyn Studios, the one-­hour, thirty-­nine-­minute film had a pedigree of Hollywood talent of the day. Its stars, the Academy Award–­winning actors Ronald Colman (Martin) and Helen Hayes (Leora)—­were well-­respected actors at the time. Max Gottlieb was played by Albert Edward Anson, a highly regarded British stage and screen Shakespearian actor. Screenwriter Sidney Howard adapted the film and was best known for his later work on Gone with the Wind. The director, John Ford, has arguably been called the Great American director and was best known for directing the popular film The Grapes of Wrath. The movie version of Arrowsmith essentially followed the plot of the book and offered a visual parallel to the novel. Like the book, the movie focused on the career of a young medical researcher. Ford’s work again showed audiences how Martin was a modern scientific doctor who sought truths by using test tubes and flasks in the laboratory (see figure 5.1).93

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Figure 5.1.   Arrowsmith, the 1931 movie, stars Ronald Colman as Martin.

Here he conducts his search for truths in a laboratory adorned by glistening flasks and beakers that surround and define him. The movie dramatized Martin’s truth-­searching quest to attract an audience unfamiliar with the intricacies of bacteriology, who were seeking escape during the Great Depression.

The film visually contrasts the locus of Martin’s work, the laboratory, with the traditional office practice of the country doctor with whom Martin apprenticed as a teenager. The movie dramatizes Martin’s efforts to live up to the high standards and harsh demands of Gottlieb’s scientific life. His struggles reach a breaking point as Martin renounces his faith when he is unable to support his wife on a research assistant’s salary, and he decides to practice medicine. The film portrays the McGurk Institute in New York City as a breathtaking structure. Huge doors and long white corridors suggest a sterile, well-­funded environment that Martin eventually leaves in order to obtain the autonomy of the independent scientist.94 Thus, the movie echoes the main themes of Lewis’s book—­the virtue of the autonomous researcher in the individual laboratory,



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which transcends the constraints placed on innovation by corporate institutions like McGurk. The movie, like the novel, received widespread acclaim and popularity. The movie itself was initially praised as a “transformation of a great novel into a splendid film.”95 For its acting, screenwriting, and film work, the New York Times called it an “impressive picture.”96 The Chicago Daily Tribune stated that Lewis was pleased with the adaptation, and that it was the “finest film to come out of Hollywood this year.”97 In addition to being a critical darling, the movie was a box office success. Ticket sales beat expectations at multiple locations, and the film was held over due to high ticket sales, overcoming its release during the Great Depression.98 The movie eventually received three Academy Award nominations, including Best Picture. With its favorable critical reception and box office success, the movie familiarized the public with the medical researcher and, together with the book, helped to popularize the image of the heroic medical scientist in American society. The themes of the popular novel were reinforced by the successful movie and had long-­lasting appeal in twentieth-­century American society. The book and movie lionized a new type of unlikely hero, the medical scientist, in America.99 To see how pervasive this exalted view of a scientist was in American society, anthropologists Margaret Mead and Rhoda Metraux selected a random sample of high school students in the early 1960s. The students depicted medical scientists as objective, dedicated men and women who work not for money and fame or self-­ glory but for truth and the benefit of mankind.100 Likewise, in a study of American college students during the same period, sociologists David Beardsley and Donald O’Dowd reached similar conclusions.101 These favorable accounts demonstrate that decades after the publication of the book and release of the movie, the image of a medical scientist as a loyal truth searcher was durable, at least among American students in the 1960s. In part due to the literary and cinematic representations in Arrowsmith, the elevating purity of the medical scientist’s conduct became rooted in American thought.102 Sinclair Lewis, in conclusion, helped to popularize the image of the noble medical researcher-­educator based on de Kruif’s descriptions of Novy’s ideals of scientific investigation.103 By fostering an ideal of pure science in students, Novy created a group of disciples who had faith that they would expand the boundaries of knowledge (see chapter 3). Novy and his students had unwavering faith that the search for pure truth above any competing motives would elevate the medical profession above all others by making it scientific and more certain, and providing the work with an uplifting spirit.104 De Kruif used Novy’s pure science ideal as a foundation for the construction of a glorified image of

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a medical scientist as an exemplar of nobility in his selfless search for nature’s truths.105 Lewis depicted the pure medical scientist’s vocation as elevated above other professions in American society. In searching for truth and righteousness, the selfless, honest medical scientist was disposed to find a level of existence higher than those that surrounded him.106 Lewis implies that laboratory science confers on the medical profession an ideal—­verifiable truths that had been lacking in other professions and therefore could have a transformative capacity for all of American society. Lewis’s image of the ennobled medical researcher had long-­lasting appeal in twentieth-­century American society.107 Arrowsmith played an important part in shaping the attitudes of a generation of students and even inspired some students to study medicine.108 Students reading the novel identified with Martin’s curiosity for science and truth, which are the virtues that Max Gottlieb both represents to him and recognizes in him.109 They sympathized with Martin’s disappointment with the uncertainty of experiential medicine and his search for truth. For Martin, laboratory science offers a possibility of elevating medicine from what he believed was a vague, unsubstantial endeavor to a legitimate field in pursuit of truths that can be verified using precise instruments and standardized methods that de Kruif learned firsthand in Novy’s laboratory. The scientific ideal of searching for verifiable truths resonated with students in America and inspired some to enter careers as a medical researcher.110 What was Novy’s reaction to the book that was based on him? In all the long letters that Novy wrote, he only mentioned Arrowsmith once in direct response to an inquiry by de Kruif. Following publication of the book, de Kruif forwarded Novy a copy and asked what he thought.111 In his characteristic understated manner, Novy replied two weeks later and said that he wouldn’t promise to read it right away, “but will do so some day on the train.”112 Novy never mentioned the book again in his letters to de Kruif and others, and his remaining family members who had lived with Novy at some period during his life do not ever recall him mentioning the book.113 Novy did watch the movie when it was released in 1931, however, and a reporter wrote about it afterward in an article entitled “Dr. Novy checks on himself in Arrowsmith.” The reporter said, “Novy watched the movie Arrowsmith. This is unusual for Novy, who usually spends nights in his tireless research. . . . [Novy] said they did a pretty good job of picturing ‘something that never happened anyway.’ The ‘chief’ refused to comment about Gottlieb in the film. Gottlieb was of course the chief’s counterpart in the story.”114 Novy’s silence about the book and movie may have been due to his personal preference to devote attention to his work



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and deflect attention away from himself—­a trait that became part of his legend for his students. In addition, he may have questioned the genuineness of the character Gottlieb on the basis of its fictional elements (e.g., his dismissal from the medical school, his alienation from his family, etc.). For his entire career, Novy carried out his own special research and educational activities in the bacteriology department he helped to create. In his laboratory, he carried out his unique research program that earned him international recognition as a preeminent bacteriologist (see chapter 2), and he promoted a group of scholars and academic entrepreneurs who were confident in their specialized knowledge and technical expertise (see chapter 4). With these composite activities, Novy was able to maintain a lasting base for his career, his student bacteriologists, and his department within his institution—­one that endures today. The final chapter explores how Novy was able to make, maintain, and thrive in a vigorous scientific career in medicine.

Chapter 6

Making a Scientific Career in Medicine

Novy’s professional achievements were atypical for his day in that he succeeded in making a living as a physician-­scientist without practicing medicine. Initially appointed as an assistant in the Hygienic Laboratory in 1888, and then a full-­time junior faculty member in 1891, he became professor and chief of the Department of Bacteriology that Victor Vaughan helped to establish in 1902. When Novy retired from the lab in 1933, the department had expanded to several faculty members who were former students of Novy’s: Malcolm Soule, Harold Roehm, W. G. Nungester, and A. C. Furstenberg.1 Novy became the leader of an intellectual enterprise that he helped to create. With Vaughan’s backing, Novy created a full-­time researcher-­educator position in medicine. Large-­scale funding opportunities from federal governmental sources such as the National Institutes of Health would not become available for investigators located at universities like Novy until after the Second World War.2 Nonetheless, Novy and Vaughan were able to obtain support from the state for the Michigan Hygienic Laboratory, which provided a foundation for Novy’s original research. Novy’s decision to remain at Michigan throughout his long research career was an active choice, as he declined offers with higher salaries and more spacious facilities from competing institutions. To some extent, his professional life matured due to Novy’s agency—­his capacity to make choices among the alternatives and impose his decisions on his surroundings. But contingent factors also played a role in how his career evolved. Tracing Novy’s footsteps throughout his career provides an opportunity to examine the interplay of agency and contingency and the impact of each on his long professional life in Michigan.

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Making His Scientific Career in Medicine

In his high school and college years, Novy pursued a path to make a career as a scientist. He worked after school to earn money to buy experimental equipment to further his amateur scientist hobby.3 Later at college, he chose advanced courses in chemistry that stressed instrumental design and strict methodology, which provided a foundation for his research career in laboratory science.4 But there were also elements of contingency as his career unfolded. He reentered graduate school in 1887, for example, because he had been unable to find a job as an industrial chemist.5 Furthermore, becoming a physician was not an aspiration he articulated during his high school or college years—­a period when his stated ambition was to become a chemist. His interest in medicine, in fact, may have been sparked by the educational opportunities available to him at the University of Michigan where his professors (e.g., Prescott and Vaughan) taught physiological and organic chemistry at the medical school and the college.6 This was part of the overall plan of President James Angell to provide a closer relationship of the medical school with the college in order to enhance the quality of the science at the medical school, and also provide opportunity for practical applications of the basic sciences.7 One can speculate that Novy’s interest in medicine was a by-­product of this trend, as Prescott and Vaughan may have interested Novy in the medical aspects of physiological chemistry. Novy later assumed a position as a researcher-­educator in the medical school department that Vaughan helped to create. Novy sought this full-­time position at a time when newly created governmental funding sources to support scientists working in academic institutions were scant. For example, the Morrill Acts of 1862 and 1890 granted federally controlled land to states to endow land grant colleges whose mission was to teach science and engineering.8 In addition, the Hatch Act of 1887 extended federal funding to scientists who worked in Agricultural Experiment Stations affiliated with the land grant colleges and who had college teaching assignments as well as station duties in entomology, horticulture, or poultry husbandry.9 Funding from the latter source, according to Charles Rosenberg, played a role in the careers of individual scientists and also provided a secure level of support for state universities. Thus, during a time when governmental funding for scientists was in its nascency, Vaughan and Novy sought and obtained funding from the state legislature to support the Michigan Hygienic Laboratory. Novy and Vaughan were not under any obligation to report the results of their experiments to responsible funding agencies. Nonetheless, when addressing these agencies, Novy, as reviewed in chapter 4, constructed a narrative in

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which he highlighted select historical facts in order to give the impression that original scientific work would produce discoveries that could, at some future point, provide a practical benefit. In his comments to the state legislature in 1931, for example, Novy argued that research to expand the boundaries of knowledge was useful for the public and valuable for humanity.10 In his argument, he cited how the development of life-­saving antisera for lethal diseases such as diphtheria was preceded by basic discoveries about immunologic responses to toxins. Novy concluded that “science owes a debt to government for its tax money that made possible the work of those engaged in study, and government owes a debt to science it never can repay for what it has done for humanity.”11 Even though there was no formal system put into place to assess the potential of his scientific findings to generate practical interventions, Novy told the legislature that state funding of basic research like his own was justified because it could provide the foundation for a practical benefit. Vaughan undoubtedly played an important role both in creating Novy’s initial position in 1891 and advancing him to his fully established post as professor and head of a new Department of Bacteriology in 1902. Vaughan, as outlined in chapter 1, created and funded the Hygienic Laboratory that enabled Novy’s career in research and education to ascend. This state-­funded laboratory furnished him with specimens that he used to carry out his original research operation and also provided him a platform for the instruction of medical students. Moreover, after being appointed dean of the medical school, Vaughan appointed Novy in his first faculty position as assistant professor in the Department of Hygiene in 1891. Vaughan then used his position as dean to maintain Novy’s position. As outlined in chapter 3, Vaughan conferred with his like-­minded, scientifically oriented member of the regents of the university, Hermann Kiefer, who voted to overrule a motion made by Henneage Gibbes to eliminate Novy’s position.12 In addition, Vaughan spearheaded a move to create a new department in the medical school for the newly created field of bacteriology in 1902 and appointed Novy as professor and chair.13 Vaughan’s motion had no resistance from his handpicked medical faculty at the medical school level or from the chairman of the medical committee of the regents. Thus, Vaughan used his powerful position to appoint Novy and advance him rapidly to an authoritative position in the medical school. Novy’s ability to attract students, serve as an idealized mentor for them, and establish a structure in which they found achievement in their activities allowed him to become an academic leader of an intellectual enterprise that he helped to create. Several students who trained under Novy were able to assume full-­time faculty positions in newly established bacteriology departments at



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Michigan or other university-­affiliated medical schools.14 In this fashion, Novy helped to usher in a new type of doctor to the medical profession—­the physician scientist. Before Novy’s time, physicians associated with medical schools had made their living by practicing medicine, and they used fees collected from their medical school activities to supplement their income.15 Novy, however, was among the first generation of physicians working full-­time at a medical school. After over forty years of active research, Novy curtailed his experimental activities and assumed administrative duties as dean of the medical school in 1933 (see figure 6.1). He retired two years later in 1935, at seventy years old.16 His long stay at one institution, however, was not a passive affair—­it was the result of an active choice. His preeminent reputation among scientists meant that several institutions actively recruited Novy. But he chose to remain at Michigan to work in an environment he considered uniquely rewarding. In order to gain insight into what was most meaningful to Novy, one can examine how he evaluated one offer of employment and also how personal considerations influenced his decisions. In May 1901, a group of prominent medical researchers assembled in Washington, DC, to discuss the possibility of establishing a new medical research institution.17 The group consisted of Professors William Welch (professor of pathology at Johns Hopkins University in Baltimore), T. Mitchell Prudden (professor of pathology in the College of Physicians and Surgeons of Columbia University in New York), Christian Herter (physician and clinical pathologist in New York), Hermann Biggs, Simon Flexner, and Theobald Smith.18 They read a letter from the American businessman and philanthropist John D. Rockefeller Jr.19 Rockefeller informed the prominent researchers that his father, John D. Rockefeller Sr., would provide funds to create an institute for medical research of $20,000 per year for ten years, and requested the doctors to serve on a committee that would manage the fund and carry out its goals.20 Subsequently, Rockefeller decided he could make one million dollars available for the next ten years for buildings and operations.21 The group of men named the organization the Rockefeller Institute for Medical Research, and they designated themselves as its board of directors. Flexner later agreed to become the director of the institute on July 1, 1903. The certificate of incorporation of the institute declared that the purpose of the corporation was medical research with special reference to the “prevention and treatment of disease.” The institute’s focus was explicitly specified in a detailed report of its activities for 1902, stating, “while the study of lower animals is highly important from their bearing upon the understanding of many forms of human disease, the intimate relation with the problems of human disease

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Figure 6.1   Novy at age sixty-­eight in 1933. At this time, Novy had completed his experiments, closed his laboratory, and begun his tenure as dean of the medical school until his retirement at age seventy in 1935. He would continue to publish articles, mainly addressing the value of introducing laboratory science in medical education. (Courtesy of Bentley Library)

should not for a moment be lost sight of.”22 Thus, the original objective of the institute was a practical one, to conduct investigations into the cause of disease and to improve methods of its prevention and treatment, and to make knowledge relating to these various subjects available for the protection of the health of the public.



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The Rockefeller Institute for Medical Research was incorporated under the laws of the State of New York and was established in 1901. From 1901 to 1904, the $20,000 per year pledge of the institute was applied only in the form of grants to support the work of investigators in different parts of the world. In 1904, anticipating the completion of its own laboratory, the institute leased a building, formerly a part of the Nursery and Child’s Hospital at 127 East Fiftieth Street. Here the first investigations conducted by the institute were begun under the direction of Simon Flexner. In October 1902, Rockefeller gave a site for the larger institute, the cost of which was about $40,000. The new building was under construction for four years and opened on May 11, 1906. Later that year, the work of the institute was established on a permanent basis with a gift from Rockefeller of $250,000.23 By 1907, the Rockefeller Institute–­lavishly funded, well equipped, and with large laboratories in a newly constructed building and a group of the most prestigious medical researchers serving on the board of directors—­was considered by many researchers to have been the premiere research institute in America at the time.24 By 1907, Simon Flexner, then the director of the Rockefeller Institute in New York City, sought to recruit prominent researchers to head various departments within the institute. For the position of director of bacteriology, Flexner turned to his fellow commissioner from the San Francisco plague investigation in 1901, Novy. Flexner stated that he had a high regard for the diligence and ingenuity Novy displayed when he served as bacteriologist of the commission.25 He also admired Novy’s research accomplishments, particularly the innovative techniques Novy devised to visualize disease-­causing organisms.26 In spring of 1907, Flexner offered Novy a position as the director of research at the institute. The position must have been tempting to Novy. From his perspective, a well-­equipped, expansive laboratory funded on an ongoing basis by one of the country’s wealthiest philanthropists in an institute with the most prominent medical researchers in the country must have been an attractive proposition. After all, Novy had been based at a state-­affiliated institution where he and Vaughan had lobbied to build and fund a laboratory from their bootstraps.27 If he accepted Flexner’s offer, Novy would be able to give his undivided attention to his research program, while working in the premium research facility in the country and also not having any diverting activities, including the instruction of medical students. Novy may have also considered Flexner’s offer attractive for personal reasons. The Rockefeller position would have increased Novy’s salary to twice what he was receiving at Michigan: his annual salary at Michigan in 1907 was

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$3,500; he was offered $7,500 per year from Rockefeller. To give a longitudinal perspective, his Michigan salary in 1887 was $200 per year, by 1921 it had risen to $7,500 per year, and in 1932, it reached $8,500 per year. So a large raise in salary in 1907 must have been tempting for Novy, who at the time financially supported his wife, Grace, and five young children, and owned a home in Ann Arbor. Novy knew that working at Rockefeller meant a greater salary, a superbly equipped laboratory, and a leadership position at a prestigious research institute. Despite these attractions, a series of correspondence with Flexner discloses the factors that influenced Novy’s ultimate choice to remain at Michigan. Novy felt that the position at Rockefeller would derail him from pursuing what he called the pure laboratory scientific endeavors that he was accustomed to pursuing. In addition, he wished to avoid getting bogged down with the “red tape” attached to an administrative position within a research institute as large as the Rockefeller.28 He felt that he would have less control over the direction of his research agenda than he had at a university because he believed that at Rockefeller, he would need to justify whether his research programs had relevance for therapeutics. Novy was fearful that this requirement would impair the quality of the science he was accustomed to performing by restricting his selection of research topics, limiting his choice of experiments, and forcing him to publish his material before the results had been validated through experiments that met his exacting standards.29 He feared the job would take him away from association with young students and ideas, and that the position would not give him the freedom to choose and pursue the fundamental research topics he was accustomed to pursuing in an academic setting.30 The latter was of particular concern to Novy because he did not wish to abandon the latitude that his scientific research program had provided him.31 Novy had been receiving independent funding from Rockefeller to perform research in his Michigan laboratory. William Welch, then head of the board of directors at the institute, wrote to Novy in 1901, before a public announcement of the new institute had been made, inviting him to apply for a grant.32 Welch explained to Novy that Rockefeller was targeting research with a practical application in mind. He said, the “money is to go into the prevention or treatment of disease. The decision was made to make use of existing labs for this purpose, rather than start a new lab. Work that has come from Pasteur in making vaccines and Koch in searching for treatment of disease indicates the general scope of the research that is desired.”33 Welch informed Novy about the annual sum of $20,000 that would be used to fund laboratory research of this practical nature. He asked Novy to propose a subject for study, and then funding could be granted after review by a committee consisting of Herman Biggs, Theobald Smith, Simon Flexner, and Welch.34



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In response to Welch’s invitation, Novy submitted a one-­page proposal to develop an animal model to determine the nature of immune responses to trypanosomes, a line of investigation that could establish the basis for the development of a vaccine for human disease at some future date.35 The institute awarded Novy $1,000 per year as they deemed that his proposal was aligned with the overall goals of the institute, a sum which they began issuing him in 1902.36 By the time Novy was invited to take a job at Rockefeller five years later, his efforts to devise a means for securing immunity to disease-­causing trypanosomes in a rat model had not yielded a positive result.37 Nevertheless, Novy continued this line of research, and he submitted a one-­page progress report to the institution each year. He continued to receive funding in the sum of $1,000 per year to further this project, even after declining the institute’s offer of in-­ house employment.38 But Novy sometimes showed impatience at the administrative rules of the Rockefeller.39 For example, he informed the administrators of Rockefeller that he felt he had not always received his funding in a timely manner.40 On another occasion, he petitioned the board because he had applied for funding for two $500 grants and only received funding for one of them.41 On May 17, 1907, Flexner wrote to Novy, offering him a position at the Rockefeller Institute.42 On May 23, Novy responded to Flexner, saying that he had given the matter some thought, and then Novy expressed his reservations about the Rockefeller offer. Although he conceded that his Michigan salary was small, Novy wrote that things “on the whole are satisfactory at Michigan,” including the location for raising his family. He then voiced concerns about accepting a position at Rockefeller—­whether that might entail giving up his freedom to pursue science for science’s sake, as he had been accustomed to at Michigan. He insisted that the position would need to be “free from restraints in the matter of the nature of my experiments and publications.”43 Novy also had reservations about losing the autonomy he possessed by running the bacteriology department at a university-­affiliated medical school, and the bureaucratic obstacles he might encounter at an institution the size of Rockefeller. To Flexner, Novy wrote: The salary at Michigan is small, but I enjoy absolute independence in the scope and conduct of my research and as the head of the department, I am not answerable to any other than Faculty and regents. Having lived under these conditions, I cannot consider a subordinate position to find myself checked by rules, orders and red tape. The position at Rockefeller would need to have to be one of about the same independence as here and that it would carry ample provision for conduct of research wherever deemed

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expedient and be free from any restraints, expressed or implied, in the matter of the nature of my experiments, publications, etc.44

Novy was reluctant to relinquish what he valued most highly: a complete lack of restrictions on the selection of research topics and the freedom to choose and design experiments. Novy then went on to say that even if all conditions were satisfactory, he would still have some hesitation about what he described as transplanting his family from country to city life. Novy indeed authentically seemed to consider the offer, as he asked Flexner to address what the advantages of city life over country life might be. In two subsequent letters, Flexner addressed Novy’s concerns and tried to persuade him to come to Rockefeller. On May 27, Flexner stated that he would be able to “offer [Novy] whatever [Novy] want[s].”45 Flexner himself had been a faculty member at a medical school prior to accepting his position at Rockefeller, having been a professor of pathology at the University of Pennsylvania. He used this personal experience in an academic institution to identify with Novy’s concerns and validate them, but also to ensure him that there would be no restraints if he were to join the institute. In a reply to Novy, Flexner wrote: There are no conditions of status and work mentioned that the institute cannot afford you in the fullest measure. I know . . . the liberty [with] which a university affords its higher staff, and I believe that less than that in any scientific institution would not only be intolerable but also utterly unwise. I would like to go over with you the project which has been forming itself in my mind and see how it strikes you.46

To convince Novy that he would have every freedom, Flexner maintained that he did not have a “specific plan” for Novy, but a general one—­to offer what he called “the greatest promise of fruitfulness in research.”47 Flexner was hoping that his word about a flexible atmosphere at Rockefeller would carry weight with Novy—­ after all, Flexner had considered the same issues about sacrifice of academic freedom as he moved from a university to a research institute. Flexner hoped that his word and advice would resonate. Flexner went so far as to travel to Ann Arbor to visit with Novy in person to address any lingering reservations and coax Novy to accept the offer. Novy left no account of this meeting, but after Flexner returned to New York, he again wrote to Novy.48 In the letter, Flexner bluntly told Novy he would have the largest, best-­equipped laboratory possible in New York, and he would have a higher salary as well. Flexner assured Novy that he would also have a well-­trained staff. Flexner wrote, “I sincerely hope that you will decide to come to the institute



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where I can assure you everything possible will be done to advance your work and interests.”49 He offered Novy a chance for a permanent appointment and an opportunity to run the research department. After considering Flexner’s offer for one month, on July 3, 1907, Novy declined the Rockefeller position. In a letter to Flexner, Novy acknowledged that he had “endeavored to look at [the offer] from all sides.”50 Novy conceded that the facilities and salary were preferable at Rockefeller, saying that he “fully realized the advantages associated with . . . the position.” He admitted that the University of Michigan officials “realize[d] they cannot compete with the institute either in facilities or in the salary.” He then admitted, “it was not expected that [university officials] influence my decision, it was wholly a matter for me to decide one way or another.”51 In making this distinction, Novy did not mention the issue that had previously troubled him—­the possible loss of absolute freedom of his research program and the opportunity to pursue the research topic of his choice for both him and the promising students who worked under him. Flexner spent such effort trying to persuade Novy that he would have unmitigated freedom that this topic had become the focus of Flexner’s efforts to attract Novy to Rockefeller. But in his final response to Flexner’s offer, Novy suddenly shifted the focus away from the issue of academic freedom to the topic of his preference for bringing up his children in rural Ann Arbor. Novy wrote: Your letter of the 23rd acquainting me with the action of the board and formally offering me an appointment in the staff of the institute while very gratifying in itself brought me face to face with the question of removal which I have endeavored to look at from all sides. Everything considered, I feel that it would be unwise to make the change. The university authorities while anxious that I should stay . . . could not influence my decision. But there is an aspect which after all must be [a] factor and that concerns the best interests of the family (particularly the children). It was wholly a matter for me to decide one way or the other and I much regret that I cannot bring myself at this point in time to meet your sincere wishes and accept the position.52

Thus, the actual reason Novy declined the Rockefeller Institute offer remains a matter of speculation. It is very possible that Novy believed he would have been offered the freedom to select his experiments at Rockefeller and that he would not be overburdened with administrative tasks. But it is also possible that he believed he would have to target the selection of his experiments according to practical application rather than doing science for science’s sake. Novy in his initial response to Flexner stated that the Rockefeller offer would have to be

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“free from any restraints, expressed or implied” (emphasis added) in the nature of his experiments. It is possible Novy felt that there was something implicit about Rockefeller’s restricting the nature of his academic pursuits. If so, what may have led Novy to persistently harbor this concern? To receive ongoing funding from Rockefeller for the research carried out at Michigan, Novy needed to target his research for practical matters. As Welch wrote to Novy requesting an application for funding, “making vaccines and searching for treatment of disease [was] the general scope of the research that is desired.”53 To receive Rockefeller funding, Novy wrote grants to ensure his intentions were aligned with the practical goals of the committee. Novy was not required to go through a similar process of approval before he could begin a project at Michigan. In his truth-­driven laboratory he carried out whatever experiments he wished to perform regardless of whatever practical application they may or may not have. Performing experimentation for science’s sake had been of crucial importance to Novy throughout his career. This freedom was evident in the vast expanse of topics he chose to investigate throughout his career that were not motivated by practical application, the large number of techniques he innovated, and the number of investigations he performed that were never published to make organisms and their behavior visible to others. Michigan, as he admitted, gave him ample leeway to investigate the topics of his choice, and he was certainly weary about losing this latitude if he relocated to another institution—­even if this possibility was only implicit. Although Novy never elaborated on what he meant by not getting involved in “red tape,” it is possible he was referring to the need to obtain approval from a Rockefeller grant committee. If indeed he declined the offer on the basis of lack of freedom of experimentation or concern about becoming bogged down with “red tape,” it is possible that he used his family simply as a more convenient explanation in declining the offer. Novy may have reasoned that Flexner would not have any avenue to put forth a counteroffer if Novy invoked his family as a reason to decline the Rockefeller offer. Furthermore, in decisions Novy made at other points in his career (e.g., deciding whether to study in Europe, or to choose a career path in which a high salary was not available), he did not bring family matters into consideration. Notwithstanding these considerations, one cannot exclude the possibility that Novy indeed based his response to the Rockefeller offer on the needs of his family alone. Although these possibilities remain speculative, the correspondence with Flexner again highlights the facets of his work that Novy valued deeply. In actuality, five years after he declined the institute’s offer, Novy’s Rockefeller-­ funded program to seek an immune response had not progressed to the stage of



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practicality. Partnered with de Kruif, Novy began to search for the basic chemical cause for anaphylaxis and did not begin to explore the practical applications of either antisera or vaccine to trypanosomes.54 In a letter Novy addressed the board of scientific directors in 1912, he provided his rationale for continued financial support from Rockefeller, which was that his work may at some future day lead to protection against infection in animals and then in humans.55 In 1913, without specifying a reason, Flexner wrote to Novy, informing him that the board of science had decided to withdraw Rockefeller’s yearly $1,000 in support, ending ten years of continuous funding from the organization.56 One can speculate that the reason for terminating the funding was that Novy’s line of research, although providing knowledge about basic scientific biology, had not yielded anything of preventive significance after a decade of financial support. Novy also considered an invitation to head the newly formed Department of Bacteriology at Northwestern Medical School. On February 18, 1909, he received a recruitment letter from Robert Gait, professor of pathology. The letter stated that Northwestern and its “benevolent patron, Mr. James A Patten, would grant, without hesitation or condition, every wish you might have your own way.”57 On February 21, Novy wrote to Gait: “This university [Michigan] has been so liberal with me in granting complete control in selecting the course of my research program that I can hardly put myself in the position of considering a change. Owing to the long years of service here and the generally satisfactory conditions, I do not feel that I can consider the position with which you have honored me.”58 Just as he had done with Rockefeller, Novy weighed the various factors that had meaning for him at Michigan, and he saw no compelling reason to leave for Northwestern.59 At Michigan, Novy valued the freedom to select the course of his research program and provide guidance to promising young students who were eager to work under his supervision. Paul de Kruif was one such student who worked in Novy’s laboratory from 1911 until 1918.60 One year after he obtained his doctorate in 1916, de Kruif entered the military during the First World War.61 During his army service, de Kruif characterized Novy as “a ‘pure’ scientist; never rushing to print, lashing his sharp tongue out with a few selected words at the student who was guilty of sloppy work, and possessing disdain for publishing one’s results too early instead of verifying with repeat experimentation.”62 When de Kruif returned to Michigan in 1918, he had decided to accept a position at the Rockefeller Institute. Years later, when recounting this decision, de Kruif characterized Novy’s laboratory as a disciplined, scientific “shrine” that upheld “honesty and accuracy,” whereas he portrayed “mistakes frequently made” in the Rockefeller laboratory, which was too consumed with “sensational scientific events.”63 Based

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on de Kruif’s observations, Novy may have been concerned about the potential for a research institute’s allegiance to practicality to compromise the methodical experimental conduct that was necessary to ensure scientific accuracy. Novy’s heightened concerns about the potential for constraints that institutions like the Rockefeller Institute could place on his freedom of experimentation are also evident in the novel Arrowsmith. In his novel, Lewis patterned the McGurk Institute after the Rockefeller. There is no direct evidence that de Kruif told Lewis about Novy’s offer from Rockefeller or Northwestern, or that de Kruif was recounting Novy’s sentiments toward Rockefeller rather than his own. Nevertheless, de Kruif and Lewis dramatize the potential of the practical orientation of research institutions like Rockefeller to threaten the integrity of pure university-­based research. In Arrowsmith, Martin accepts the position at McGurk in part because of the high salary, $10,000 per year.64 At McGurk, Martin continues to practice the pure brand of science Gottlieb taught him—­the search for nature’s truths without regard to practicality.65 But the institute gradually becomes intolerant of the Gottlieb-­like brand of science that most attracts Martin. For example, McGurk’s scientific director, A. Dewitt Tubbs, reminds Martin that the “aim of this Institution is the conquest of disease, not making pretty scientific notes” and criticizes him for “working brilliantly, but without a complete vision of broader humanity. . . . [You are] . . . merely plug[ging] along doing individual work.”66 Another McGurk official, Major Holabird, attempts to convince Martin to make his experiments more practically oriented; he says to Martin, “[If you] extended your work to practical proofs. . . . There’s no limit to the honors that’ll come to you . . . acclaim by scientific societies . . . prizes.”67 Martin, who perceives the “horror of the . . . bawdy thing called success, with its demand that he give up quiet work,” comes to regret his decision to join the institute.68 Gottlieb criticizes McGurk’s officials for rushing results to practical applications before adequately understanding the fundamental biology of microbes. Gottlieb says to Martin, “You let a doctor try it before you finished your research? You want fake reports of cures to get into the newspapers, to be telegraphed about places? . . . You want to be a miracle man and not a scientist?”69 Eventually, Martin becomes alienated from McGurk’s intolerance to Gottlieb’s scientific ideal and leaves McGurk with a colleague, Terry Wickett, to pursue his ideal of science in rural Vermont. In Vermont, Martin and Terry strive to achieve their true calling by performing science in isolation, “without trying to solve anything for anybody but our own fool selves.”70 Novy’s insistence on the individuality and independence of the researcher to choose experiments, as outlined in chapter 3, is a theme that reverberates



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throughout Arrowsmith. Martin’s dissatisfaction with the strictures placed on the choice of his experiments by the McGurk Institute compels him to leave the institute and retreat to the woods, where he can carry out his experiments independently and autonomously. Novy was uncompromising in his stance on the autonomy of the researcher to choose experiments without the constraint of practicality or the allure of fame. To Novy, the independence of the investigator was an essential component for scientific integrity and the mission to seek basic scientific facts in nature. Novy’s students had recognized the value that Novy placed on the integrity of science above his personal recognition or financial reward. They frequently referred to him as selfless. As epitomized by a letter one of his students, George Herrmann, wrote to Novy, “The hope of increased salary, better teaching facilities, academic honors, never tempted you to forsake your principles.”71 Novy’s Long Academic Career at Michigan

Novy thrived in a university base for a long forty-­five-­year span without the support of federal funds. A variety of federal grants for scientists were indeed becoming increasingly available during this period, but none was applicable to the brand of basic microbial research Novy was doing at Michigan. At the time Novy began his research in 1889, for example, federal funding had already been available. At this time, federal funding (e.g., the Morrill Act, the Coast and Geodetic Survey, and the Land Grant College acts) was becoming available on a gradually increasing scale, but only for scientists who worked exclusively in land grant colleges in specific fields (e.g., horticulture, poultry husbandry, geological surveys).72 By 1902, Congress approved funds for bacteriological research in matters pertaining to public health that was carried out at the Marine Public Health Service Hygienic Laboratory in Washington, DC.73 Public funding for medical research had expanded when Congress appropriated $750,000 in the Ransdell Act for the construction of buildings when the name of the Hygienic Laboratory in Washington was changed to the National Institute of Health (NIH).74 These funds were exclusively earmarked for intramural research done at the increasing number of scientific agencies established within the federal government, but no funds were available for university-­ based researchers. By 1938, the government was authorized to award grants to medical researchers for research on cancer.75 Thus, a variety of federal funding was becoming available to support medical research during Novy’s time, but none of it was applicable to Novy. During and after World War II, long after Novy retired, federal grants to support medical research, including research carried out at extramural university

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locations, expanded. During World War II, grants to investigators at universities to study treatments for malaria were provided because therapies for tropical diseases became important to the war effort.76 In 1945, Vannevar Bush, who headed the US Office of Scientific Research and Development (OSRD), through which all wartime research was carried out, recommended that the president of the United States expand government support for science, including medical science.77 He made an argument similar to Novy’s—­that new basic scientific knowledge is required for medical advances. He argued that because “expansion of the frontiers of knowledge” comes from universities that devote their efforts to this endeavor, the “government should extend financial support to basic medical research in medical schools and in universities” in order to strengthen these medical schools and universities.78 Bush’s arguments proved successful, and the NIH federal budget, including grants awarded to extramural, university sites, skyrocketed in the postwar period from less than $4 million in 1947 to over $1 billion in 1966.79 Novy was able to flourish in his university-­based research position during a period that preceded the availability of federal funds to support his activities. He was regarded in his day as a towering figure of scientific medicine in general and bacteriology in particular (see figure 6.2). Novy received recognition from his peers for his original research investigations, contributions to the field of bacteriology, and educational activities he carried out during his many years at Michigan.80 He gave keynote addresses at national and international meetings, and he published extensively—­a total of 151 manuscripts in peer-­ reviewed medical and scientific journals, and two authoritative texts that were considered to be the standard in bacteriology.81 Furthermore, he was elected to leadership positions in prominent professional organizations, including the Michigan Academy of Science (president 1910) and the Society of American Bacteriologists (president 1905). He also received prestigious honors, including election to the National Academy of Sciences in America; Chevalier, Legion d’honneur in France; and the Order of the White Lion, Czechoslovakia.82 Leaders in academic medicine of his day—­from America (William Welch of Johns Hopkins, C.E.A. Winslow of Yale, and Milton Rosenau of the Harvard School of Public Health); France (Emile Roux, Charles Calmette of Pasteur Institute); Germany (Karl Fraenkel, Paul Ehrlich of Koch Institute); and Czechoslovakia (Jan Kabrlik, professor at Masaryk University)—­ recognized Novy as a preeminent medical researcher and scientist who made original contributions to bacteriology.83 It is possible that Novy chose to remain in his position at Michigan not only to engage in laboratory science with minimal distractions and restraints



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Figure 6.2   Novy in retirement at age seventy-­ seven with his wife Grace, 1941. Novy had earned a worldwide reputation as a basic microbiologist well before the widespread availability of federal funding to permit the basic research he did following World War II. (Courtesy of the Novy family)

on his experimentation, but also because he felt that such a position gave him the greatest opportunity to influence students, other physicians and scientists, and the general public on the value of laboratory science and its microbiological representations to medicine and society.84 In a lecture delivered to medical students at the University of Michigan in 1908, he stated his optimism about the spirit of science for medicine:

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In recounting the evolution of the modern laboratory spirit in medicine . . . the onward and upward evolution in search of truth has left the old school, the old medicine, far behind in its shadowy past. In its place we have the new school, the new medicine based on the solid rock of experimental research. It is this scientific medicine of today which strives to unravel the mystery of life [and] seeks for the causes of things. . . . The science of bacteriology has enabled man to unveil the . . . connections between bacteria and the processes of nature.85

Many years in his prestigious position allowed Novy to instill in students his belief that laboratory science had the potential to offer certainty to a medical profession that he felt was in need of truth.86 Novy, in conclusion, was a nineteenth-­century American academic entrepreneur, the son of Czech immigrants, who achieved employment in an enterprise to which he aspired. The story of American entrepreneurialism in the nineteenth century has traditionally been told in the context of an industrial American capitalist framework.87 Novy’s path can be viewed as a middle-­class version of American entrepreneurialism in which he achieved success in a profession he helped to create. He succeeded in becoming a physician scientist, a full-­time, laboratory-­ based medical researcher in bacteriology at a time when such positions were being created and well preceded the large-­scale federal grants that first became available for medical researchers after the Second World War.88 In this position, it was the fundamental investigations that most intrigued Novy throughout his career and compelled him to remain at Michigan where he could carry out his autonomous program without the strictures of practicality. Novy found achievement in an operation that continues to thrive after his retirement in 1935 and death in 1957. Novy was an aspiring first-­generation medical investigator who established and then sustained a full-­time career in medical research in America. Vaughan played a key role in establishing, maintaining, and advancing Novy’s position. Novy and Vaughan set out their priorities of performing fundamental research in the context of public health service from the beginning. At this time, most aspiring researchers were unable to obtain full-­time university positions, of which there were few.89 At a time when opportunities for government support were newly available and limited in number, Novy cast his field in a particular fashion in an attempt to justify its special relationship with government—­to obtain funding, have the freedom to choose experiments, and not be accountable to government sponsors. In the late nineteenth century, Charles Rosenberg maintained, given the years of austere academic budgets, almost any position



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was a good one.90 Thus, when taken in context, Novy’s ability to attain his goal as a full-­time medical researcher at this historic moment was noteworthy. How did Novy sustain a scientific life in medicine? His decision to remain at Michigan was a conscious choice to continue working in an academic environment of his own making, one that provided a suitable environment in which he could carry out his intellectual research operation in the deliberate, methodical way he considered rewarding. With high regard for the permissive research environment of his academic institution as a means to provide verifiable discoveries, he professed the pure scientific research ideal at a time when practical-­ minded institutes like the Rockefeller were established to perform research that had relevance for therapeutics.91 Novy was fearful that this type of requirement would impair the independence of his science by restricting his selection of research topics, limit his choice of experiments, and force him to publish material before his results had been validated through further experiments.92 He made a thoroughly considered decision to decline an offer to be the director of research at the Rockefeller Institution because of the potential restraints it would pose on the conduct of his research at the University of Michigan, which he believed provided him the latitude to design experiments without the encumbrance of practical implications.93 Throughout Novy’s career, preserving autonomy to pursue “pure science” without any scientific constraints remained of highest concern. Throughout the long years he remained in his academic position at Michigan, Novy successfully institutionalized his conception of an experimental program that approached bacteriology from a basic science rather than a therapeutic avenue. This aspect of Novy’s career—­his unfettered line of fundamental research, from youth to old age, with minimal distractions and diversions—­is what distinguished him from other medical scientists of his day (e.g., Theobald Smith, William Welch). His ability to attract students, serve as an idealized mentor for them, articulate a spirit of science in which he believed, and establish a structure in which his students found achievement in their activities, allowed him to create a culture of scientific medicine and build an enduring bacteriology department that remains today

Conclusion

The pure science ideal that Novy embraced adds another dimension to historians’ portrayal of bacteriology during late nineteenth-­century America. Focusing on bacteriologists working in public health laboratories during that time, historians characterized American bacteriology as an applied science.1 Novy’s work was different. His experiments were not carried out with any practical intention of curing human disease, but rather to discover unknown aspects about the fundamental biology of a diverse array of microbes, their mechanisms of survival, and their behavior in nature. Novy never dissuaded investigators from considering the full scope of these applications; indeed, he pointed out that the practical implications could not be fully appreciated at the time of experimental design.2 He simply insisted that a search for scientific truth is in itself a laudable goal and that adding to the sum of scientific knowledge ought to be considered a fully legitimate justification to carry out medical research.3 He therefore never personally worked to move his discoveries toward their practical application. It was exactly this type of inquiry that led Novy’s contemporaries to consider him a basic scientist whose research provided a greater understanding of microbes.4 Novy’s unwavering focus on fundamental microbial research distinguished him from traditionally quoted American medical scientists during this time period. Unlike Theobald Smith or William Welch, for example, Novy was first trained as a scientist, and his basic scientific orientation occupied his principal focus from his adolescent days as an amateur scientist to his virologic investigations as a ninety-­year-­old retiree. Furthermore, Novy actively eschewed positions (e.g., at research institutes and public health departments) that he believed would have diverted him from his line of basic scientific research and

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pedagogic activities. Novy’s contemporaries viewed him as the “ideal embodiment of the scientific creative tradition—­satisfying one’s curiosity and to contribute to the sum of knowledge.”5 Novy’s sustained focus on basic mechanisms without utilitarian purposes was a lifelong mission undiverted from competing obligations. Novy’s emphasis on original investigation also differed from that of his better known European colleagues with whom he corresponded. These investigators focused their concerns on counteracting pathogenic bacteria or their toxins that caused disease. Paul Ehrlich, for example, did extensive testing of dyes to be used as chemotherapy against the trypanosomes that were the subject of Novy’s scientific investigations.6 In addition, Emile Roux continued his practical investigations on the immune therapy of microbes and their chemical products, which Novy was interested in to explain how organisms live in nature.7 Novy’s experiments earned him the reputation among his American and European colleagues as a scientist who used technical innovations to ascertain previously unknown aspects of nature’s truths.8 Novy’s scientific activities helped to shape the foundations of biomedicine as we know it today. He championed the idea that knowledge in itself was noble and he sought to incorporate laboratory science into medicine. Novy’s pursuit of this knowledge, independent of the remarkable therapies that it spawned, helped fuel the rise of contemporary scientific medicine. His research and educational activities shed light on the origin of several aspects of modern biomedicine: the establishment of the basic science courses in medical education; the introduction of a new type of physician—­the physician scientist—­into the medical profession; and the widespread appeal of the researcher’s activities in society. As he was a champion of pure science during a transitional moment in late nineteenth-­century America, Novy’s story provides insight into the origins of contemporary biomedicine. Novy’s educational goals stemmed from his basic laboratory science focus.9 Some of his educational goals, such as training students in critical thinking, have been identified by historians as a key educational aim of nineteenth-­ century physicians.10 But another of Novy’s goals—­to instill in every one of his medical students an all-­inclusive “spirit of research”—­has gone unnoticed by historians.11 Novy sought to foster a comprehensive code that included a duty to search for truths in nature above all competing motives and the adoption of disciplined, methodical work habits in a laboratory. The inclusion of methods and habits suggested that the actual participation in rigorous, precise scientific work in the laboratory could refine the student’s moral sensibility. For Novy, it was more than the principles of science that were ennobling; the practice

184 Conclusion

itself, done diligently, was purifying. For Novy, the labor of the laboratory had a moral efficacy that could discipline students’ habits and mold their character as well as instruct their minds—­goals that were aligned with traditional Victorian norms and values of late nineteenth-­century America.12 Novy’s insistence on incorporating basic bacteriologic science in the first year of medical school was a catalyst in the structural reforms in medical education that took place in the 1890s and helped to form a cornerstone of medical education today. Novy’s rationale for medical school reforms at Michigan in the 1890s in order to accommodate basic science laboratory courses preceded similar reforms that would take place in American medical education in the 1910s following the Flexner report when the Rockefeller Foundation, which had sponsored the report, offered financial support to schools that were deemed scientific.13 Novy contended that laboratory science would not only improve the quality of medical education, but also ameliorate the medical profession. He maintained that the incorporation of laboratory science in university-­affiliated medical schools would infuse the profession with competent graduates who possessed the necessary mental skills and work ethic to apprehend new knowledge throughout their career.14 He also posited that the elimination of proprietary schools would diminish the influx of students who had insufficient training to understand this knowledge.15 These latter schools, Novy maintained, had validated unqualified physicians who were incompetent in the practice of medicine.16 According to Novy, the adoption of science provided allopathic physicians with a new skill and a specialized body of knowledge. By furnishing verifiable knowledge and new treatments, Novy believed that laboratory science helped to change the profession from a heterogeneous, sectarian profession to a cohesive one with an increased authority and status. The pure science ideal that Novy advocated had broad-­reaching implications beyond the medical profession. Novy’s “pure” scientific ideal with its disciplined, controlled hard work and its search for truths served as a code of behavior and a unifying culture for the newly forming field of bacteriology.17 In addition, Sinclair Lewis’s popularization of a new type of hero—­the medical scientist as a relentless seeker not of profit but of nature’s truths—­had significance for American culture. Lewis depicted the pure medical scientist’s vocation as elevated above other professions in American society. The affirmation of scientific medicine was reinforced in twentieth-­century America when popular writers Paul de Kruif and Berton Roueché portrayed medical researchers and the practical applications of their research in a venerable light. De Kruif, in Microbe Hunters, revered researchers whose work led to therapies

Conclusion 185

(e.g., antisera, chemotherapy), and Roueché touted the potential of antibiotics to altogether banish infectious diseases.18 The exalted image of the scientific medical researcher captivated students’ attention and even impelled some to enter careers as laboratory researchers in biomedical centers.19 The incorporation of laboratory science into medicine that Novy championed throughout his career helped to establish the contours of the biomedical system as it remains today. Novy’s success in his career as a medical researcher was independent of infusions of federal government funds that were not available to support his brand of basic science research at the time he was operating.20 With funding sources from the state legislature for establishing his Hygienic Laboratory, Novy was able to create and maintain a full-­time medical research and teaching career—­the prototype of what we now call a physician scientist. Physician scientists have blossomed in the elite American academic centers since World War II, when they began to receive large infusions of federal grant funding to support their laboratories, equipment, and salaries.21 The increase in federal support for medical research was an indicator that biomedicine had become a national priority, and it enabled the genesis of contemporary scientific medical centers. Modern medical centers indeed court properly credentialed physician scientists to work at their institutions and prosper by receiving a sizable percentage of federal grants (e.g., for indirect costs) awarded to full-­time faculty members.22 Medical facilities can then allocate these indirect costs to strengthen their facilities by erecting new well-­equipped laboratories that provide the institution prestige and status.23 Thus, physician scientists who work in basic science departments play a major role in the development of elite modern university medical centers that have financial and academic incentives to recruit and retain them. Novy’s story in some ways helped to shape the characteristics of American medicine. Novy espoused the merits of laboratory science and succeeded in his goal to firmly establish the basic sciences, and bacteriology in particular, in medical education. I have not intended to depict Novy as a heroic figure of medicine or argue that his work was an advance over traditional medicine as it was done before the introduction of laboratory science. Nor have I wished to portray Novy’s advocacy of laboratory science as having had a dehumanizing influence, which is often cited as the root of perceived failings of modern medicine. Any connotation that science has represented an advance over previous practices may have been due to the use of Sinclair Lewis’s idealized portrayal of medical science in his novel Arrowsmith. It is also important to avoid a contemporary sentiment that making medicine scientific was unfortunate, as some

186 Conclusion

propose, because its emphasis on technology and the laboratory has disrupted the primary mission of the doctor of providing sympathetic care for the patient, has raised the cost of medical care so that it is unaffordable to many who are infirm, or has done society a disservice by prolonging the lives of moribund individuals with incapacitating chronic diseases.24 It is also important to avoid the public’s increasing resentment of modern medicine for falling short of their expectations, despite the now substantial allocation of federal funds for biomedical research, that it would deliver cures in many situations.25 Novy is not to blame for these perceived failings of a modern medicine he never envisioned or that seemingly never quite interested him. Likewise, neither are there accolades here for the subsequent successes in the treatment or prevention of many previously incurable diseases. Rather, I have tried to credit Novy for his own vision of medical research and the ideals of the brand of scientific medicine that he as a first-­generation basic medical investigator-­educator espoused. By tracing the historical roots of today’s physician scientist who works in a basic science department, this book has emphasized the linkages between Novy’s activities and those of today’s biomedical centers. Novy, as early as the 1890s, was among a new breed of full-­time researcher-­educators in positions in academic medicine that remain highly desirable and viable today. Perhaps as a consequence of tracing these linkages, many of Novy’s ideas and activities in research and education that have not been covered until now may seem familiar to those working in biomedical institutions today. Other facets of Novy’s ideals of scientific research may nonetheless seem outdated to today’s readers. Novy operated at a time when science was powerful in society but not yet vexed. Since Novy’s time, however, there has been a growing dissatisfaction and disillusionment with the concept of scientific medicine in the wake of several occurrences. The misconduct of scientists in several realms may have made the noble, moral image of the medical scientists seem no longer applicable.26 For example, the image of the medical scientist as selfless may seem hard to reconcile with scientists today who have engaged in public priority disputes over credit for scientific discoveries.27 In addition, the portrayal of the medical scientist as sharing accurate information with other scientists may not seem appropriate in today’s times given instances of fraudulent research.28 Also, the idea that medical researchers are ethically and morally superior to those in other professions may no longer seem apt in light of the ethical breaches in medical experimentation that have occurred throughout the twentieth century.29 Finally, the significant amount of time that medical researchers must spend writing proposals that have a low likelihood of success in today’s challenging funding environment may lead some aspiring college students to view entering a medical

Conclusion 187

research career not with idealism, but with reservation, if not outright cynicism. Notwithstanding these considerations, public interest in the activities of medical researchers today has remained acute since Arrowsmith and Microbe Hunters popularized their activities in the early twentieth century. In fact, their work is frequently headlined in today’s media. The image promoted in Arrowsmith of the medical researcher as a noble searcher in pursuit of nature’s pure truths through hard work in the laboratory may no longer resonate with the general public today.30 Moreover, the very notion of the pure science ideal may no longer seem applicable. The claims that Novy championed about the objectivity and nobility of scientific knowledge itself have been interrogated in the late twentieth century. Michel Foucault, for example, has questioned the neutrality of knowledge and has accused experts of using special knowledge as a means to exert social control over others whose behavior is considered undesirable.31 The use of science to regulate society according to homogeneous norms, Foucault claims, shows that science is not more noble or objective than at earlier times, but is also prey to bias and unfairness. The misuse of the power of knowledge by medical experts, he argues, shows that scientific medicine is not more advanced or rational than in previous times because it remains subject to prejudice. Thus, the dramatic technical achievements of biomedicine may seem to simply redefine problems, not solve them. Regardless of whether one adheres to Foucault’s theories, his arguments demonstrate that the unconditional enthusiasm for the truth-­searching scientific ideal championed by Novy and others is no longer unambiguously embraced. A sentiment has, in fact, arisen that the ideal of pure science has not fulfilled its promises. No matter how impressive the technical achievements of scientific medicine may be, the confident belief in the benevolence of scientific knowledge of Novy’s generation is no longer held. Medical scientists today may also have a disincentive for the investigation of fundamental science that Novy advocated. Today, for example, most physician scientists who seek federal funding for their research focus on practical applicability because they feel that their likelihood of obtaining funding is greater if they work on projects that have clinical applications.32 Also, in today’s economic downturn, there have been reductions in federal funding available to researchers, and the number of federally funded physician scientists has declined as a consequence. The reduced funding has had the effect of shifting the focus of research grant applications away from fundamental research and has led physician scientists to stress the clinical applicability of their work.33 A group science model of basic science researchers teaming

188 Conclusion

together with clinical researchers to apply for federal grants has, in fact, become commonplace in today’s funding environment.34 This group model makes the notion of the individualism of the medical researcher, symbolized by Novy and represented by Terrie Wickett and Martin in Arrowsmith, appear antiquated. The same imperative to stress clinical applicability applies to physician scientists who seek funds from private agencies, which they must do in order to stay solvent in a climate where federal monies are becoming increasingly sparse.35 Notwithstanding the forces that compel researchers to make their work practical in today’s times, the debate over the value of performing basic research over practical applications remains alive today. Some argue that it is neither pragmatic nor logical to continue clinical studies in a diverse range of medical areas until more basic research in these areas is carried out. As a case in point, some scientists argue that due to the poor performance of HIV vaccines to date, clinical field trials of vaccine candidates should not be studied in humans until further basic research to better understand the scientific principles of the immune correlates that confer protection against HIV infection is carried out.36 Similarly, other scientists have lobbied for a greater amount of research to be done on the basic science of cancer and the understanding of how normal cells become cancerous.37 Furthermore, some have argued for a vigorous program of basic research on gene-­editing technology before testing in human embryos with hereditary disorders to resolve questions about how to prevent unexpected DNA cutting at normal sites.38 Until answers to these questions are known, some argue, there will never be an effective vaccine for HIV, cure for cancers, or genetic means to correct hereditary disorders. In fact, researchers today such as Harold Varmus, former head of the National Cancer Institute, echo the sentiments once articulated by Novy and Vannevar Bush that basic pioneering discoveries are not made in conjunction with a notion of how to treat a patient.39 Nonetheless, as the value of furthering basic research in several medical areas continues to be debated, the once-­steady voice of Novy may be perceived as advocating too precarious of an approach to take by cautious, risk-­averse physician scientists applying for grants in today’s funding climate. The unconditional passion for discovery of nature’s fundamental truths exhibited by the medical scientists in Arrowsmith may no longer seem applicable to aspiring medical researchers today. The relevance of some educational reforms championed by Novy is also being questioned today. The need for a two-­year basic science block that is mandatory for all medical students, for example, has been challenged recently.40 Courses in these blocks have a format similar to Novy’s bacteriology course—­a

Conclusion 189

lecture-­laboratory format that stresses learning by doing. Today, some academic leaders question the wisdom of providing two years of detailed scientific information to students who will be entering inherently practical fields.41 These leaders claim that there is now too much medical science for anyone to learn in two years and that this scientific education can become dissociated from the clinical training that students receive during their latter two years. As a consequence, students fail to correlate their basic science knowledge with their clinical work.42 The sheer amount of medical science has grown tremendously since the 1890s, so students today can feel overwhelmed by the weight of the information they are exposed to during their basic science block. Although educators like Novy strived to avoid passive memorization of information in lecture halls, medical students have never been able to escape the perception that they are cramming a vast amount of basic science information by rote memory. The value of continuing this model is currently being reappraised. Thus, there are continuities as well as differences between the ideals that Novy championed and the ideas that dominate current American medicine. Novy, as this book has discussed, articulated his ideals about the conduct of research and reforms in medical education from a position of authority; in his day, he was recognized as a preeminent bacteriologist and a leader in academic medicine. Regardless of his reputation at the height of his career, however, his name is little recognized today. One can speculate why in histories of microbiology and medicine Novy is given passing mention, unlike the medical scientists Koch or Pasteur. Indeed, Novy was not as intimately involved in the creation of his own myth to the degree that, as Gerald Geison has claimed, Pasteur sought recognition in the history books.43 Novy promoted the value of bacteriology for medicine and for society, but his orientation toward fundamental research may have lacked the sensation that surrounded more well-­known endeavors, such as Pasteur’s public trial of his anthrax vaccine at Pouilly-­le-­Fort. Also, his scientific investigations, unlike those of other bacteriologists of the day (e.g., Pasteur and Koch), were never publicly recognized. Consequently, his investigations, although highly influential among the bacteriologists and physicians of his day, which also formed the basis for a popular fictional work, were not recognized by the public at large. Perhaps for these reasons, his name, activities, and the ideals he stood for, despite their importance in shaping the contours of modern medicine, are little recognized by today’s physicians, bacteriologists, and infectious disease doctors. The plea for pure science in medicine had a real impact in late nineteenth-­ and early twentieth-­century America. A true intellectual interest in microbial

190 Conclusion

biology rather than obvious utility emerged from Novy’s practical obligations. This interest in fundamental microbial behavior helped to shape the special knowledge and scope of bacteriology during its formative years, provided a common ideology for the merging of two separate subjects—­ bacteria and parasites—­and provided cohesiveness for bacteriology to develop as an autonomous discipline. This discussion provided the lever for medical school reform with regard to expanding the basic science portion of the curriculum, extending the years of study, and providing justification for standards to admit only better-­prepared students. It also had representations in popular culture where the truth-­seeking medical researcher-­educator was depicted as more heroic and noble than members of other professions. Novy’s original microbiologic investigations, his focus on technological innovation, and his ideal of the pure medical researcher’s quest for truth had far-­ranging consequences for medical education, the profession of medicine, the creation of bacteriology as a separate field, and the elevation of medical researchers to a highly visible position in American culture.

Acknowledgments

This book is derived from research I began while pursuing the degree of Doctor of History at the University of Michigan. I gratefully acknowledge my colleagues and teachers in the History Department at the University of Michigan who made this book possible. I was fortunate to work under the direction of my committee chair, Joel Howell, and members John Carson and Martin Pernick. Their critical comments and suggestions have added a depth to my work that I had aspired toward but would not have been able to achieve otherwise. I also thank James Tappenden from the Department of Philosophy at the University of Michigan for his critical advice. I would like to thank the members of the Division of Infectious Diseases at the University of Michigan for their understanding while I wrote this book. I would also like to acknowledge Laura Sloan, Holly Maples, and Andrew Read for helping to research, assemble, and catalogue primary documents. I would like to thank Ferdinand Kappes for his expert interpretation of documents written in German. I am also grateful to Zuzana Hodkova for her interpretation of documents written in Czech. I thank Carly Kish, Rachel Wilkins, and Jessica Sciberras for their help in preparing the manuscript and Megan Orringer for critically reading and editing the manuscript. I acknowledge Dr. Novy’s remaining family members Dorothy Novy Wilson, Doranne Jacobson, Jackie Wilson, and Dr. Frederick Novy III for their valuable recollections of Dr. Novy and for providing family photographs and documents. I also thank the staff of the Bentley Historical Library at the University of Michigan for their guidance and help during my archival research. I thank Kenneth Burdsall for his photographic assistance. Finally, I am most grateful to my wife, Sahira, and my children Powel III, Louisa, and Sarine for their love and encouragement during the time I spent researching and writing this book.

191

Notes

Introduction

1 See C.E.A. Winslow, “Some Leaders and Landmarks in the History of Microbiology,” Journal of Bacteriology 2 (1950): 99–­114. See also Kenneth Ludmerer, Learning to Heal: The Development of American Medical Education (Baltimore: Johns Hopkins University Press, 1996). 2. Frederick G. Novy, “Autobiographical notes,” February 4, 1954, Frederick G. Novy Papers, Bentley Historical Library, University of Michigan, Ann Arbor. 3. Histories of early American bacteriology have addressed work done at public health laboratories. See Howard D. Kramer, “The Germ Theory and the Early Public Health Program in the United States,” Bulletin of the History of Medicine 22 (1948): 233–­248; see also George Rosen, A History of Public Health (Baltimore: Johns Hopkins University Press, 1993). 4. Frederick G. Novy Papers (1880–­1954), Boxes 1–­13, Call no. 852257 Aa/2 UAm; University of Michigan Medical School, Records Boxes 127–­129, (1850–­2002), Call no. Bimu C 46 2; Proceedings of the Board of Regents at the University of Michigan; Rare Book Collection at the Taubman Medical Library (Novy 1894 and 1899 textbooks of bacteriology). 5. See Frederick G. Novy, “The Hygienic Institute at Berlin,” Pharmaceutical Era 2 (1888): 427. See also Fifteenth Annual Report of the Secretary of State of Michigan (Lansing, 1887). 6. Frederick G. Novy, “Research in Medicine” (notes from Novy’s address given before the legislature of Michigan, April 14, 1931), Frederick G. Novy Papers, Box 1. 7. Frederick G. Novy, “Fifty Years’ Progress in Medical Education,” in A Half Century of Nu Sigma Nu, 1882–­1932, ed. Will Walter and Stuart Graves (Louisville, KY: Nu Sigma Nu Fraternity, 1935), 1669–­1685. 8. Ludmerer, Learning to Heal, 1–­46 (n1). See also Thomas Bonner, Becoming a Physician: Medical Education in Britain, France, Germany, and the United States (Baltimore: Johns Hopkins University Press, 1995), 175–­182, 195–­200; and William Rothstein, American Medical Schools and the Practice of Medicine (Oxford: Oxford University Press, 1986), 1–­216. 9. Ludmerer, Learning to Heal. 10. Horace W. Davenport, Victor Vaughan: Statesman and Scientist (Ann Arbor: University of Michigan Press, 1996). See also Burke A. Hinsdale, History of the University of Michigan: From 1837 to 1906 (Ann Arbor: University of Michigan Press, 1906), 91–­97. 11. Novy, “Fifty Years’ Progress in Medical Education.” 12. See William Welch to Frederick Novy, May 1, 1899, and Theobald Smith to Frederick Novy, November 28, 1903, Frederick Novy Papers. For a discussion on how the introduction of laboratory courses like Novy’s was a key factor in medical education reform, see Ludmerer, Learning to Heal. 13. See William T. Sedgwick, “The Origin, Scope and Significance of Bacteriology,” Science 13 (1901): 121–­128.

193

194

Notes to Pages 6–9

14. For overviews of bacteriology laboratories in nineteenth-­ century American health departments, see Howard Kramer, “The Germ Theory and the Early Public Health Program”; William W. Ford, Bacteriology (New York: Paul B. Hoeber Inc., Medical Book Department of Harper & Brothers, 1939); Rosen, A History of Public Health; Frederic Gorham, “The History of Bacteriology and Its Contribution to Public Health Work,” in A Half Century of Public Health, ed. Ravenel Mazyck (New York: American Public Health Association, 1921), 66–­93. For the Massachusetts Department of Public Health laboratory, see Barbara Rosenkrantz, Public Health and the State: Changing Views in Massachusetts, 1842–­1936 (Cambridge, MA: Harvard University Press, 1972). For the New York City Public Health Department laboratory, see Evelynn Hammonds, Childhood’s Deadly Scourge (Baltimore: Johns Hopkins University Press, 1999). 15. William Bulloch, The History of Bacteriology (New York: Dover, 1938). 16. See John Duffy, The Sanitarians (Chicago: University of Illinois Press, 1990). See also James Cassedy, Charles V. Chapin and the Public Health Movement (Cambridge, MA: Harvard University Press, 1962); Hammonds, Childhood’s Deadly Scourge; Scott Podolsky, Pneumonia before Antibiotics (Baltimore: Johns Hopkins University Press, 2006). 17. See Rosenkrantz, Public Health and the State, 1842–­1936; Duffy, The Sanitarians; Charles E. Rosenberg, The Cholera Years (Chicago: University of Chicago Press, 1962, 1987). 18. Rosenkrantz, Public Health and the State, 1842–­1936. 19. Ibid.; Judith W. Leavitt, The Heathiest City: Milwaukee and the Politics of Health Reform (Madison: University of Wisconsin Press, 1996); Duffy, The Sanitarians. 20. Jacob Henle, “Von den Miasmen und Contagien und von den Miasmatisch contagiösen Krankheiten,” in Pathologische Untersuchungen (Berlin: August Hirschwald Verlag, 1840), 1–­ 82, in Milestones in Microbiology, trans. Thomas Broch (Washington, DC: ASM Press, 1999), 76–­79. 21. Ibid., 77–­78. 22. William Ford, “Development of Our Early Knowledge Concerning Magnification,” Science 79 (1934): 578–­581. 23. See Christian Gram, “Ueber die isolirte Färbung der Schizomyceten in Schnitt-­und Trockenpräparaten,” Fortschritte der Medicin 2 (1884). 24. See ibid. See also Robert Koch, “Die Aetiologie der Milzbrand-­Krankheit, begründet auf die Entwicklungesgeschichte des Bacillus Anthracis,” Beiträge zur Biologie der Pflanzen 2 (1876): 277–­310, in Milestones in Microbiology, trans. Thomas Broch (Washington, DC: ASM Press, 1999), 89–­95. 25. Robert Koch, “Die Aetiologie der Tuberkulose,” Mittheilungen aus dem Kaiserlichen Gesundheitsamte 2 (1884): 1–­88, in Milestones in Microbiology, trans. Thomas Broch (Washington, DC: ASM Press, 1999), 109–­115. 26. See Ford, Bacteriology. See also Bulloch, The History of Bacteriology. 27. C.E.A. Winslow, The Life of Hermann M. Biggs, M.D., D.Sc., LLD: Physician and Statesman of the Public Health (Philadelphia: Lea & Febiger, 1929), 236. 28. See L. Pasteur, “Sur les virus-­ vaccins du cholera des poules et du charbon,” Comptes rendus des travaux du Congres international des irecteurs des stations agronomiques, session de Versailles (June 1881): 151–­162, in Milestones in Microbiology, trans. Thomas Broch (Washington, DC: ASM Press, 1999). 29. Christoph Gradmann, Laboratory Disease, trans. Elborg Forster (Baltimore: Johns Hopkins University Press, 2009), 121–­125. 30. Emil von Behring and Shibasaburo Kitasato, “Ueber das Zustandekommen der Diphtherie-­ Immunität und der Tetanus-­ Immunität bei Thieren,” Deutsche



Notes to Pages 9–10

195

Medizinische Wochenschrift 16 (1890): 1113–­1119, in Milestones in Microbiology, trans. Thomas Broch (Washington, DC: ASM Press, 1999), 138–­144. See also Emile Roux, “Sur les serums antitoxiques,” Ann de l’Institute Pasteur 7 (1894): 722–­727. 31. See Frederick G. Novy, “Bacterial Toxins and Anti-­toxins,” Medical and Surgical Reporter 74, no. 12 (March 21, 1896): 351–­359; Frederick G. Novy, “Practical Benefits of Bacteriology,” in First Report of the Michigan Academy of Science 1, ed. Walter B. Barrows (Lansing: Robert Smith Printing, 1894), 14–­18. For a discussion of how these applications would lead to treating pneumonia with type-­specific antisera, see Podolsky, Pneumonia before Antibiotics. See also Scott Podolsky, The Antibiotic Era (Baltimore: Johns Hopkins University Press, 2014), 1–­328. 32. Bulloch, The History of Bacteriology, 242–­245. 33. Hammonds, Childhood’s Deadly Scourge; Rosenkrantz, Public Health and the State: Changing Views in Massachusetts, 1842–­1936; Winslow, The Life of Hermann M. Biggs, M.D., D.Sc., LLD: Physician and Statesman of the Public Health. 34. Kramer, “The Germ Theory and the Early Public Health Program in the United States.” Hermann Biggs directed the New York City Public Health Department laboratory and Charles Chapin was the director of the Public Health Department in Providence, Rhode Island. 35. Kramer, “The Germ Theory and the Early Public Health Program,” 233–­247; Rosen, A History of Public Health; Hammonds, Childhood’s Deadly Scourge. 36. See Rosen, A History of Public Health; see also Duffy, The Sanitarians. 37. Louis Galambos and Jane E. Sewell, Vaccine Development at Merck, Sharpe & Dohme, and Mulford, 1895–­1995 (Cambridge: Cambridge University Press, 1995). The authors trace the mass production of serums and vaccines by American public health departments. 38. Stephen Smith, “The History of Public Health, 1871–­1921,” in A Half Century of Public Health, ed. Mazyck P. Ravenel (New York: American Public Health Association, 1921), 1–­15. 39. Ibid., 13. 40. Ibid. 41. Charles V. Chapin, “History of State and Municipal Control of Disease,” in A Half Century of Public Health, ed. Mazyck P. Ravenel (New York: American Public Health Association, 1921), 133–­161. See also Cassedy, Charles V. Chapin and the Public Health Movement, 94–­112. 42. Charles V. Chapin, “Dirt, Disease, and the Health Officer,” Public Health: Papers and Reports 28 (1902): 296–­299. 43. Steven Diner, A Very Different Age: Americans of the Progressive Era (New York: Straus and Giroux, 1998). 44. Rosen, A History of Public Health, 307–­308. 45. Ibid., 308. 46. Kramer, “The Germ Theory and the Early Public Health Program,” 235–­236. 47. Ibid., 237. 48. Duffy, The Sanitarians. 49. Ibid.; Rosen, A History of Public Health. 50. Daniel J. Kevles, The Physicists: The History of a Scientific Community in Modern America (Cambridge: Cambridge University Press, 2001). 51. Esmond R. Long, “Frederick G. Novy and Some Origins of American Bacteriology,” Transactions & Studies of the College of Physicians of Philadelphia 26 (1957): 34–­39. Quote from 35.

196

Notes to Pages 11–18

52. Rosen, A History of Public Health, 307–­319. 53. Ibid., 308. 54. Duffy, The Sanitarians, 205–­206. 55. Barnett Cohen, “Comments on the Relation of Dr. Welch to the Rise of Microbiology in America,” Bulletin of the History of Medicine 24 (1950). Quote from 18. 56. Kramer, “The Germ Theory and the Early Public Health Program,” 235. 57. Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982), 135. 58. Winslow, “Some Leaders and Landmarks in the History of Microbiology,” 112. 59. See Elizabeth Fee, Disease and Discovery: A History of the Johns Hopkins School of Hygiene and Public Health, 1916–­1939 (Baltimore: Johns Hopkins University Press, 1987), 111. 60. Thomas J. Burrill, “Pear and Apple Tree Blight,” Transactions of Illinois State Horticultural Society (New Series) 14 (1880): 157–­167. 61. Ibid. Burrill reproduced disease by inoculating pears with bacteria isolated from diseased pears. 62. Bulloch, The History of Bacteriology. 63. Donald Fleming, William H. Welch and the Rise of Modern Medicine (Baltimore: Johns Hopkins University Press, 1954), 67–­89. See also Brendan Lucey and Grover Hutchins, “William H. Welch and the Discovery of Bacillus welchii,” Archives of Pathology and Laboratory Medicine 128 (2004): 1193–­1194. 64. Claude E. Dolman and Richard J. Wolfe, Suppressing the Diseases of Animals and Man: Theobald Smith, Microbiologist (Boston: Boston Medical Library in The Francis A. Countway Library of Medicine and Harvard University Press, 2003). 65. Sedgwick, “The Origin, Scope, and Significance of Bacteriology.” 66. Mark Schorer, Sinclair Lewis: An American Life (New York: McGraw-­Hill, 1961), 405. 67. See Paul de Kruif, The Sweeping Wind (New York: Harcourt Brace, 1962). See also Schorer, Sinclair Lewis, 421–­435; Fred W. Neal, “Arrowsmith Based on Dr. Novy,” Michigan Daily News, January 29, 1939, p. 4. 68. Schorer, Sinclair Lewis, 421–­435. See also Neal, “Arrowsmith Based on Dr. Novy.” 69. Sinclair Lewis, Arrowsmith (1925; New York: Signet, 1961), 280. 70. See “Arrowsmith Movie a New Success,” Chicago Daily Tribune, February 14, 1932. 71. Frederick G. Novy to Dr. William Johnson, September 5, 1901, Frederick Novy Papers. 72. See Simon Flexner to Frederick G. Novy, May 27, 1907; see also Frederick G. Novy to Simon Flexner, July 3, 1907. Frederick Novy Papers, Box 1. 73. See Bulloch, The History of Bacteriology. 74. See ibid. See also Ford, Bacteriology. 1. Frederick Novy and the Origins of the Michigan Hygienic Laboratory

1. First Annual Report of the Secretary of the State of Michigan (Lansing, 1873), 5–­29. 2. Ibid., 78. 3. John Duffy, The Sanitarians (Chicago: University of Illinois Press, 1990), 205–­211. 4. Ibid. 5. First Annual Report of the Secretary of the State of Michigan (Lansing, 1873), 210–­215. 6. Ibid., 1–­18. 7. Second Annual Report of the Secretary of the State of Michigan (Lansing, 1874).



Notes to Pages 18–21

197

8. Fifth Annual Report of the Secretary of the State of Michigan (Lansing, 1877). 9. Eighth Annual Report of the Secretary of the State of Michigan (Lansing, 1880). 10. Sixth Annual Report of the Secretary of the State of Michigan (Lansing, 1878). 11. See Albert Prescott, “Food Adulterations,” Tenth Annual Report of the Secretary of the State of Michigan (Lansing, 1882), 203–­208. See also Frederick G. Novy, “Organic chemistry notebook,” Albert Prescott, Professor, Frederick G. Novy Papers, Box 4, Bentley Historical Library, University of Michigan, Ann Arbor. 12. Victor Vaughan, “Meats,” Tenth Annual Report of the Secretary of the State of Michigan, 220–­224. 13. Frederick G. Novy, “Victor Clarence Vaughan,” Science 70 (1929): 624–­626. 14. Horace W. Davenport, Not Just Any Medical School (Ann Arbor: University of Michigan Press, 1999), 26–­29. 15. See H. B. Baker, “Poisonous Cheese,” Annual Report of the Secretary of the State Board of Health of the State of Michigan for the Fiscal Year Ending September 30, 1884 12 (1885): 122–­128. See also Victor Vaughan, “Poisonous Cheese,” Annual Report of the Secretary of the State Board of Health of the State of Michigan for the Fiscal Year Ending September 30, 1885 13 (1886): 221–­226; and Victor Vaughan, “Report of Progress in Our Knowledge of Tyrotoxicon,” Annual Report of the Secretary of the State Board of Health of the State of Michigan 14 (1888): 161–­164. 16. Thirteenth Annual Report of the Secretary of the State of Michigan (Lansing, 1885). 17 Victor Vaughan, Healthy Homes and Foods for the Working Classes (Concord, NH: Republican Press Association, 1886), 3–­62. 18. See Vaughan, “Poisonous Cheese.” See also Fifteenth Annual Report of the Secretary of the State of Michigan (Lansing, 1887). 19. Fifteenth Annual Report of the Secretary of the State of Michigan. See also Frederick G. Novy, “The Hygienic Laboratory,” The Michigan Alumnus 6 (1900): 242–­244. 20. Fifteenth Annual Report of the Secretary of the State of Michigan, 248–­262. 21. Ibid., 256. 22. Ibid., 259. 23. Ibid., 261. 24. See “A Brief History of the Library of Congress,’” accessed September 26, 2014, http://​www​.loc​.gov/​loc/​legacy/​loc​.html. For the Geologic Survey, see S. G. Thibodeau, “Science in the Federal Government,” in Historical Writing on American Science: Osiris, ed. S. G. Kohlstedt and M. W. Rossiter (1985), 1:81–­96. For the Morill Acts, see “History of US Land Grant Extension Services,” accessed March 12, 2015, http://​nifa​.usda​.gov/​history#. 25. Burke A. Hinsdale, History of the University of Michigan: From 1837 to 1906 (Ann Arbor: University of Michigan Press, 1906), 91–­97. 26. Howard H. Peckham, The Making of the University of Michigan, 1817–­1967 (Ann Arbor: University of Michigan Press, 1967), 69–­113. 27. Hinsdale, History of the University of Michigan: From 1837 to 1906. 28. Peckham, The Making of the University of Michigan, 1817–­1967. 29. Alexandra Oleson and John Voss, eds., The Organization of Knowledge in Modern America, 1860–­1920 (Baltimore: Johns Hopkins University Press, 1976), 72–­151. 30. Hinsdale, History of the University of Michigan: From 1837 to 1906. 31. See Frederick G. Novy, “Organic Chemistry Notebook,” 1883, Frederick Novy Papers, Box 4. See also Frederick G. Novy, “Bacteriology—­The Hygienic Laboratory” (unpublished lecture presented to the Michigan Health Society, Detroit, May 1946), Frederick Novy Papers, Box 4, p. 3.

198

Notes to Pages 21–24

32. “Medical School faculty meeting notes, 1878–­1891,” University of Michigan Medical School, Records, 1850–­2002, Box 128. 33. Burton J. Bledstein, The Culture of Professionalism: The Middle Class and the Development of Higher Education in America (New York: Norton, 1976), 10–­180. 34. Fifteenth Annual Report of the Secretary of the State of Michigan, 35. 35. Julie A. Reuben, The Making of the Modern University (Chicago: University of Chicago Press, 1996), 1–­87. 36. “December 7 meeting, 1888,” Proceedings of the Board of Regents at the University of Michigan, Bentley Historical Library. 37. Fifteenth Annual Report of the Secretary of the State of Michigan, 34–­37. 38. Ibid., 35. 39. Journal of the Senate of the State of Michigan (Lansing: Thorp and Godfrey, State Printers and Binders, 1887), 1:92–­93. 40. Ibid., 968. 41. Novy, “The Hygienic Laboratory.” 42. Journal of the Senate of the State of Michigan, 968. 43. James Angell to Frederick G. Novy, “Appointment as Instructor of Hygiene,” July 11, 1887, Frederick Novy Papers. 44. Novy, “The Hygienic Laboratory,” 243. 45. Novy, “Bacteriology—­The Hygienic Laboratory,” 5. 46. Ibid., 7. 47. Fifteenth Annual Report of the Secretary of the State of Michigan, 183. 48. Twenty-­fifth Annual Report of the Secretary of the State of Michigan (Lansing, 1897), 172. 49. Fifteenth Annual Report of the Secretary of the State of Michigan; Victor Vaughan, “First Quarterly Report, Michigan State Laboratory of Hygiene,” Report of the Michigan State Board of Health 15 (1887): 2–­11, 20–­23. 50. Twenty-­fifth Annual Report of the Secretary of the State of Michigan, 11–­19. 51. Novy wrote about the University of Michigan Medical School. See Frederick G. Novy, “Speech at Zina Pitcher,” Frederick Novy Papers. 52. See University of Michigan Medical School Lecture Course Outline, “Physiology,” 1890, University of Michigan Medical School, Box 135. See also Davenport, Victor Vaughan: Statesman and Scientist, 5–­18. 53. Horace W. Davenport, Victor Vaughan: Statesman and Scientist (Ann Arbor: University of Michigan Press, 1996), 15–­16. See also Frederick G. Novy, “Fifty Years’ Progress in Medical Education,” in A Half Century of Nu Sigma Nu, 1882–­1932, ed. Will Walter and Stuart Graves (Louisville, KY: Nu Sigma Nu Fraternity, 1935), 1669–­1685. 54. Frederick G. Novy to Frederick G. Novy III, July 23, 1955, Frederick Novy Papers. 55. Kenneth Ludmerer, Learning to Heal: The Development of American Medical Education (Baltimore: Johns Hopkins University Press, 1996), 56–­57. 56. Davenport, Victor Vaughan: Statesman and Scientist, 18–­46. 57. See S. E. Gould, “Frederick George Novy, Microbiologist, 1864–­1957,” American Journal of Clinical Pathology (1958): 297–­309. See also Esmond R. Long, “Frederick G. Novy and Some Origins of American Bacteriology,” Transactions & Studies of the College of Physicians of Philadelphia 26 (1957): 34–­39.



Notes to Pages 25–28

199

58. See Geoffrey Wawro, The Austro-­Prussian War: Austria’s War with Prussia and Italy in 1866 (Cambridge: Cambridge University Press, 1997). See also Gould, “Frederick George Novy, Microbiologist.” 59. Frederick G. Novy and Marguerite Novy Lambert, Novy-­Garwood Family Records and Connections (Elverson, PA: Mennonite Family History, 1990), 1–­412. 60. Ibid. 61. Frederick G. Novy, “Autobiographical notes,” February 4, 1954, Frederick G. Novy Papers. 62. Gould, “Frederick George Novy, Microbiologist, 1864–­1957.” 63. Frederick G. Novy, “High school history notes,” 1881, Frederick Novy Papers. 64. Ibid. Novy read and took notes on Heinrich Schliemann’s Troy and Its Remains, published in 1875. 65. Novy studied at West Division High School in Chicago. See Frederick G. Novy, “High school history notes,” 1881, Frederick Novy Papers. 66. See Frederick G. Novy, “Introductory lecture, bacteriology course 1890,” Frederick Novy Papers. See also Frederick G. Novy, “Germs, What They Are and How They Produce Disease,” Teachers’ Sanitary Bulletin 1 (1898): 1–­7; Frederick G. Novy, “The Spirit of Research in Medicine,” Physician and Surgeon 24 (1902): 385–­405. 67. Novy and Lambert, Novy-­Garwood Family Records and Connections. 68. Frederick G. Novy, “Lectures on chemistry,” 1881 (Delafontaine, professor, West Division High School), Frederick Novy Papers. 69. Ruth Good, “Dr. Frederick G. Novy: Biographic Sketch” University of Michigan Medical Bulletin 16 (1950): 257–­268. 70. Novy, “Lectures on chemistry.” Delafontaine lectured about chemical equations including fermentations and putrefaction; there were classroom demonstrations. 71. Good, “Dr. Frederick G. Novy: Biographic Sketch.” 72. See Frederick G. Novy to Frederick G. Novy III, June 13, 1955, Frederick Novy Papers. See also Gould, “Frederick George Novy, Microbiologist, 1864–­1957.” 73. Frederick G. Novy to Frederick G. Novy III, June 13, 1955. 74. Gould, “Frederick George Novy, Microbiologist, 1864–­1957.” 75. William Osler, “Christmas and the Microscope,” Hardwicke’s Science-­Gossip; An Illustrated Medium of Interchange and Gossip for Students and Lovers of Nature 5 (1869): 44. 76. Gould, “Frederick George Novy, Microbiologist, 1864–­1957.” 77. Ibid. 78. Ibid. 79. Good, “Dr. Frederick G. Novy: Biographic Sketch.” 80. Frederick G. Novy to Frederick G. Novy III, July 23, 1955, Frederick Novy Papers, Box 3. 81. Gould, “Frederick George Novy, Microbiologist, 1864–­1957.” 82. Ibid. Novy purchased the following texts: A Treatise on Chemistry, by Roscoe and Schorlemmer, an Encyclopedia of Chemistry, and a large Micrographic Dictionary, by Griffith and Henfrey. 83. Novy and Lambert, Novy-­Garwood Family Records and Connections. 84. Long, “Frederick G. Novy and Some Origins of American Bacteriology.” 85. Novy and Lambert, Novy-­Garwood Family Records and Connections. 86. Ibid.

20 0

Notes to Pages 28–32

87. See Frederick G. Novy, “Notebooks in Qualitative, Analytic, Organic Chemistry and Mineralogy,” 1882, 1883, Frederick Novy Papers. See also Reuben, The Making of the Modern University, 363. 88. Frederick G. Novy, “University of Michigan student notebooks,” 1882, Frederick Novy Papers. 89. Frederick G. Novy, “University of Michigan student notebooks,” notebook in Logic, 1882, Frederick Novy Papers. 90. Frederick G. Novy, “Geology notebook 1883,” Frederick Novy Papers. 91. Frederick G. Novy, “Analytic Chemistry” and “Organic Chemistry,” Frederick Novy Papers. 92. Ibid. 93. Frederick G. Novy, “Analytic Chemistry notebook,” 1883, Frederick Novy Papers. 94. Ibid. 95. Ibid. 96. Albert B. Prescott, “Frederick Novy recommendation letter,” 1886, Frederick Novy Papers. 97. William Campbell, “Frederick Novy recommendation letter,” 1886, Frederick Novy Papers. 98. Prescott, “Food Adulterations.” 99. Ibid. 100. Ibid. 101. Ibid., 205. 102. “June meeting, 1886,” Board of Regents Proceedings, Frederick Novy Papers, 25. 103. Prescott, “Frederick Novy recommendation letter.” 104. See Prescott, “Frederick Novy recommendation letter.” See also V. M. Spalding, “Frederick Novy recommendation letter,” 1886, Frederick Novy Papers. 105. Good, “Dr. Frederick G. Novy: Biographic Sketch.” 106. Frederick G. Novy, “Organic Chemistry notebook,” 1883 (Albert Prescott, professor), Frederick Novy Papers. 107. Good, “Dr. Frederick G. Novy: Biographic Sketch.” 108. Frederick G. Novy to Frederick G. Novy III, July 23, 1955, Frederick Novy Papers. 109. A. B. Prescott to Frederick G. Novy, September 22, 1886. Frederick Novy Papers. 110. See Frederick G. Novy, Cocaine and Its Derivatives (Detroit: George S. Davis, 1887), 98. In the 1880s, cocaine was used as a local anesthetic for surgeries; surgeons such as William Halstead who used cocaine for operations developed an addiction. See also Howard Markel, An Anatomy of Addiction (New York: Pantheon, 2011), 1–­32. 111. “June meeting, 1887,” Proceedings of the Board of Regents at the University of Michigan, Bentley Historical Library. 112. “June meeting, 1890,” Proceedings of the Board of Regents at the University of Michigan. 113. “Faculty meeting notes,” February 7, 1882, Frederick Novy Papers, Box 128. 114. Frederick G. Novy, “The Medical School,” Semi-­Centennial Celebration Nu Sigma Nu; Historic and Biographic, 1882–­1932 (1935), 1:77–­87. 115. See “University of Michigan Department of Medicine and Surgery: Course Outline,” 1889–­1890, University of Michigan Medical School, Box 135, Bentley Historical Library. See also Novy, “Fifty Years’ Progress in Medical Education.” 116. Davenport, Victor Vaughan: Statesman and Scientist, 5–­18. See also “October meeting, 1891,” Proceedings of the Board of Regents at the University of Michigan. 117. “University of Michigan Department of Medicine and Surgery: Course Outline.”



Notes to Pages 32–37

201

118. Frederick G. Novy, “Medicine notebook,” 1890 (Walter Christopher, professor), Frederick Novy Papers. 119. Ibid. The course did not provide an opportunity to empirically test the information the students received in lectures. 120. Ibid. 121. Ibid. 122. See Frederick G. Novy, “The Trend of Modern Medicine” (lecture notes delivered to medical students, 1891), Frederick Novy Papers 1880–­1954, Box 4. 123. Novy, “The Trend of Modern Medicine.” 124. Ibid. 125. Ibid. 126. Ibid. 127. Ibid. 128. Novy, “The Spirit of Research in Medicine,” 387. 129. Ibid. 130. Ibid. Novy noted in his talk to medical students that lectures alone do not provide students an opportunity to investigate causes; laboratory exercises are designed for this purpose. 131. Frederick G. Novy, “Physiology notes,” 1889, Frederick Novy Papers. 132. Novy, “The Hygienic Laboratory.” 133. Sixteenth Annual Report of the Secretary of the State of Michigan (Lansing, 1888), 24. 134. Novy, “Bacteriology—­The Hygienic Laboratory,” 3–­4. 135. Novy, “The Hygienic Institute at Berlin,” 426–­427; Ferdinand Hueppe, “Die Methoden de Bakterien-­Forschung,” Wiesbaden (1886): 1–­230. 136. Novy, “The Hygienic Laboratory.” 137. Novy, “Bacteriology—­The Hygienic Laboratory.” 138. See Frederick G. Novy, “Diary of the Hygiene Institute, Berlin,” 1888, Frederick Novy Papers. See also Novy, “Bacteriology—­The Hygienic Laboratory,” 1–­4. 139. Novy, “Bacteriology—­The Hygienic Laboratory,” 1–­4. See also Novy, “The Hygienic Institute at Berlin,” 426–­427. 140. Novy, “Bacteriology—­The Hygienic Laboratory.” 141. Ibid. 142. Novy, “The Hygienic Institute at Berlin,” 426–­427. 143. Novy, “Bacteriology—­The Hygienic Laboratory,” 1–­4. 144. Novy, “The Hygienic Institute at Berlin,” 426–­427. 145. Ibid. See also Frederick Novy to Professor Fraenkel, May 14, 1907, Frederick Novy Papers. See also Novy, “Bacteriology—­The Hygienic Laboratory.” 146. Novy, “The Hygienic Institute at Berlin.” 147. T. N. Bonner, “The German Model of Training Physicians,” in Sickness and Health in America, ed. Judith Walzer Leavitt and Ronald Numbers (Madison: University of Wisconsin Press, 1997). 148. Thomas Bonner, Becoming a Physician, Medical Education in Britain, France, Germany, and the United States (Baltimore: Johns Hopkins University Press, 1995), 175–­182, 195–­200. 149. William Rothstein, American Medical Schools and the Practice of Medicine (Oxford: Oxford University Press, 1986), 1–­216; Joseph Ben-­David, “The Universities and the Growth of Science in Germany and the United States,” Minerva 7 (1969): 6–­9.

202

Notes to Pages 37–39

150. Charles McClelland, State, Society, and University in Germany 1700–­1914 (Cambridge: Cambridge University Press, 1980). 151. Rothstein, American Medical Schools and the Practice of Medicine; Ben-­David, “The Universities and the Growth of Science in Germany and the United States.” 152. See Donald Fleming, William H. Welch and the Rise of Modern Medicine (Baltimore: Johns Hopkins University Press, 1954), 67–­89. See also Bonner, The German Model of Training Physicians; F. P. Mall, “Wilhelm His: His Relation to Institutions of Learning,” American Journal of Anatomy 4 (1905): 141; Ludmerer, Learning to Heal. 153. See Howard D. Kramer, “The Germ Theory and the Early Public Health Program in the United States,” Bulletin of the History of Medicine 22 (1948): 233–­248. See also George Rosen, A History of Public Health (Baltimore: Johns Hopkins University Press, 1993). 154. “June meeting, 1891,” Proceedings of the Board of Regents of the University of Michigan, Bentley Historical Library. Novy’s initial academic appointment was as junior professor of hygiene and physiological chemistry in 1891. 155. T. N. Bonner, “The German Model of Training Physicians in the United States, 1870–­1914: How Closely Was It Followed?,” Bulletin of the History of Medicine 64 (1990): 18–­34; Ludmerer, Learning to Heal: The Development of American Medical Education, 62–­119. 156. Ludmerer, Learning to Heal, 62–­119. 157. See Frederic Gorham, “The History of Bacteriology and Its Contribution to Public Health Work,” in A Half Century of Public Health, ed. Ravenel Mazyck (New York: American Public Health Association, 1921), 66–­93. See also Kramer, “The Germ Theory and the Early Public Health Program in the United States.” 158. Novy, “Bacteriology—­The Hygienic Laboratory.” 159. Frederick G. Novy to Dr. William Johnson, September 5, 1890, Frederick Novy Papers. 160. See Frederick G. Novy to Grace Novy, July 26, 1894, and September 2, 1894, Frederick Novy Papers. Novy’s granddaughter, Dorothy Wilson, who lived with Novy in Ann Arbor for five years during the 1930s, stated that Dr. Novy was a “laboratory man.” See also Dorothy Wilson Novy (granddaughter of Frederick G. Novy), in discussion with the author, October 29, 2009, and November 11, 2015. 161. Novy to Dr. Johnson, September 5, 1890. 162. Fleming, William H. Welch and the Rise of Modern Medicine. 163. Frederick G. Novy, “Introductory lecture, bacteriology course,” 1890, Frederick Novy Papers. 164. Christopher Crenner, Private Practice in the Early Twentieth-­Century Medical Office of Dr. Richard Cabot (Baltimore: Johns Hopkins University Press, 2005), 7–­22. 165. See Frederick G. Novy to Simon Flexner, July 3, 1907, Frederick Novy Papers, Box 1. See also Ludmerer, Learning to Heal, 126. 166. Vaughan, “First Quarterly Report, Michigan State Laboratory of Hygiene.” 167. Frederick G. Novy, “Analysis of Fluid with Which to Make Fraudulent Milk,” State Board of Health, Michigan 98 (1892): 20. 168. Ibid. 169. Ibid. 170. Frederick G. Novy, “What Is Ice-­Cream Poisoning?,” Pharmaceutische Rundschau 5 (1887): 152–­153.



Notes to Pages 39–49

203

171. Frederick G. Novy, “Exposure of the Stenocarpine Fraud,” Quarterly Report of the Michigan State Laboratory of Hygiene (1887): 20–­23. 172. Ibid. 173. Novy, “Analysis of Fluid with Which to Make Fraudulent Milk.” 174. Twentieth Annual Report of the Secretary of the State of Michigan (Lansing, 1892), 69–­81. 175. Victor Vaughan, “Work Done in the Laboratory of Hygiene,” in Public Health Reports, Nineteenth Annual Report of the Secretary of the State of Michigan (Lansing, 1891), 104–­121. 176. Twenty-­fifth Annual Report of the Secretary of the State of Michigan, 87. 177. Fifteenth Annual Report of the Secretary of the State of Michigan, 2–­11. Quote from 5. 178. Vaughan, “Work Done in the Laboratory of Hygiene,” 272–­278. 179. Novy, “The Hygienic Laboratory,” 243. 180. Ibid., 244. 181. Ibid. Novy said, “Epidemic diseases received only such consideration as could be obtained from a purely epidemiologic standpoint.” 182. Frederick G. Novy and Victor Vaughan, eds., Poison Producing Bacillus Found in Cheese and Ice Cream (Lansing, MI, 1896), 5–­9. 183. Vaughan, “Work Done in the Laboratory of Hygiene,” 72. 184. Vaughan, “First Quarterly Report, Michigan State Laboratory of Hygiene.” 185. Twenty-­fifth Annual Report of the Secretary of the State of Michigan, 144–­148. See also Novy, “The Hygienic Laboratory.” 186. Twenty-­fifth Annual Report of the Secretary of the State of Michigan, 151–­153. 187. Ibid., 149. 188. Ibid., 151. 189. Novy, “The Hygienic Laboratory.” 190. Ibid., 251. 191. Ibid., 251–­253. 192. Terrie M. Romano, Making Medicine Scientific: John Burdon Sanderson and the Culture of Victorian Science (Baltimore: Johns Hopkins University Press, 2002), 1–­34. 193. Novy, “The Hygienic Laboratory,” 255. 194. James E. Cassedy, The New Age of Health Laboratories 1885–­1915, in U.S. Department of Health and Human Resources—­National Institutes of Health (Bethesda, MD: National Library of Medicine, 1987), 1–­18. 195. Frederick G. Novy to Charles Nicolle, October 23, 1906, Frederick Novy Papers. 196. Novy, “The Hygienic Laboratory,” 268. 197. Cassedy, The New Age of Health Laboratories 1885–­1915. Chapter 2. What Novy Did in His Medical School Laboratory

1. George Rosen, A History of Public Health (Baltimore: Johns Hopkins University Press, 1993), 310–­355. 2. The estimate is based on a blueprint of the Hygienic Laboratory at Michigan. See Frederick G. Novy, “Bacteriology—­The Hygienic Laboratory” (unpublished lecture presented to the Michigan Health Society, Detroit, Michigan, May 1946), Frederick Novy Papers, Box 4, Bentley Historical Library, University of Michigan, Ann Arbor. 3. The benches are seen in a simulated photograph of Novy’s laboratory in Michigan Medicine in June 1967. See “Biographical Information,” Frederick Novy Papers.

204

Notes to Pages 49–57

See also Frederick G. Novy, “The Hygienic Laboratory,” The Michigan Alumnus 6 (1900): 242–­244. 4. Frederick G. Novy, “Bacteriological Technique,” Reference Handbook of Medical Sciences 8 (1904): 370–­404. 5. Novy detailed the equipment that was in his laboratory in the 1890s in two publications: his 1899 textbook, Laboratory Work in Bacteriology (Ann Arbor: George Wahr, 1899), and an article, “Bacteriological Technique” (ibid.). 6. See Frederick G. Novy, “Cell Chemistry,” Intercollegiate Medical Journal 2 (1898): 129–­140. See also Frederick G. Novy, “Respiration of Microorganisms,” Journal of Laboratory and Clinical Medicine 17 (1932): 731–­747. 7. Jacob Henle, Von den Miasmen und Contagien und von den Miasmatisch contagiösen Krankheiten, in Pathologische Untersuchungen (Berlin: August Hirschwald Verlag, 1840), 1–­82, in Milestones in Microbiology, trans. Thomas Broch (Washington, DC: ASM Press, 1999). 8. See ibid. Henle referred to Schwann’s work on bacterial putrefaction. See also Theodore Schwann, “Vorläufige Mitteheilung, Betreffend Versuche über die Weingährung und Fäulnis,” Annalen der Physik und Chemie 41 (1837): 184–­193. 9. Henle, Von den Miasmen und Contagien und von den Miasmatisch contagiösen Krankheiten. 10. Frederick G. Novy, “The Spirit of Research in Medicine,” Physician and Surgeon 24 (1902): 13–­15, 385–­405. Quote from 402. 11. See Frederick G. Novy, “Fermentation and Putrefaction,” Pharm Era 6 (1892): 68–­ 70. See also Frederick G. Novy, “Introductory lecture, Bacteriology course,” 1890, Frederick Novy Papers. 12. Frederick G. Novy, “The Toxic Products of the Hog Cholera Bacillus,” Med News 57 (1890): 231–­237. 13. Ibid. 14. Ibid. 15. See Frederick G. Novy, “Germs, What They Are and How They Produce Disease,” Teachers’ Sanitary Bulletin 1 (1898): 1–­7. See also Frederick G. Novy, “Ptomaines,” undated, Frederick Novy Papers, Box 1. 16. Frederick G. Novy, “Fermentation and Putrefaction,” Pharm Era 6 (1892): 68–­70. 17. Novy, “Cell Chemistry.” 18. See Novy, “Ptomaines.” See also Novy, “Cell Chemistry.” 19. Quote from Novy, “Fermentation and Putrefaction.” See also Frederick G. Novy, “Bacterial Toxins and Anti-­ toxins,” Medical and Surgical Reporter 74, no. 12 (March 21, 1896): 351–­360. 20. Novy, “Fermentation and Putrefaction.” 21. Novy, “Bacterial Toxins and Anti-­Toxins,” 351–­360. 22. Novy, “The Toxic Products of the Hog Cholera Bacillus.” 23. Novy, “Ptomaines.” 24. See Frederick G. Novy and M. H. Soule, “Some Observations on the Gas Exchange of the Bovine Tubercle Bacillus,” Contributions to Medical Science (dedicated to Aldred Scott Warthin, 1927), 13–­18. See also Frederick G. Novy, H. R. Roehm, and M. H. Soule, “Microbic Respiration: I. The Compensation Manometer and Other Means for Study of Microbic Respiration,” Journal of Infectious Diseases 36 (1925): 109–­167. 25. Novy, “Respiration of Microorganisms,” 3–­19. 26. Novy and Soule, “Some Observations on the Gas Exchange of the Bovine Tubercle Bacillus.”



Notes to Pages 57–61

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27. Frederick G. Novy and M. H. Soule, “Microbic Respiration: II. Respiration of the Tubercle Bacillus,” Journal of Infectious Diseases 36 (1925): 168–­170. 28. Novy and Soule, “Some Observations on the Gas Exchange of the Bovine Tubercle Bacillus.” 29. Novy, Roehm, and Soule, “Microbic Respiration: I. The Compensation Manometer,” 109–­115. 30. Ibid. 31. Ibid., 109–­267. See also Horace W. Davenport, Not Just Any Medical School (Ann Arbor: University of Michigan Press, 1999), 1–­45. 32. Novy, Roehm, and Soule, “Microbic Respiration: I. The Compensation Manometer,” 109–­118. 33. Novy, “Respiration of Microorganisms,” 3–­19. 34. Novy and Soule, “Microbic Respiration: II. Respiration of the Tubercle Bacillus.” 35. Ibid., 124. 36. C.E.A. Winslow, “Some Leaders and Landmarks in the History of Microbiology,” Journal of Bacteriology 2 (1950): 107. 37. Frederick G. Novy, “Trypanosomes,” Journal of the American Medical Association (1907): 1–­5. 38. Ibid., 3–­5. 39. Frederick G. Novy, “On Trypanosomes,” Journal of the American Medical Association 48 (1907): 124–­127. 40. Frederick G. Novy, “A New Anaerobic Bacillus of Malignant Oedema,” Transactions of the First Pan-­American Medical Congress (1893): 49. 41. Ibid. See also Frederick G. Novy, “The Immunizing Power of Nucleohiston and of Histon,” Journal of Experimental Medicine 1 (1896): 693–­716. Later in the twentieth century, “nuclei” as used here were referred to as nucleic acids. 42. Novy, “The Immunizing Power of Nucleohiston and of Histon,” 693. 43. See Novy, “A New Anaerobic Bacillus of Malignant Oedema.” See also Novy, “The Immunizing Power of Nucleohiston and of Histon.” 44. Novy, “A New Anaerobic Bacillus of Malignant Oedema.” 45. Novy was not the first to develop anaerobic culture techniques. Others had developed techniques, including Gruber’s tubes and Liborius’s tubes; but they did not completely deplete oxygen from the environment and therefore could not grow “obligate” anaerobes. See ibid., 49–­57. 46. Frederick G. Novy, “The Culture of Anaerobic Bacteria,” Transactions of the First Pan-­American Medical Congress (1893): 213–­224. 47. Frederick G. Novy, “New Apparatus for the Culture of Anaerobic Bacteria,” Transactions of the 8th International Congress of Hygiene and Demography, Budapest 2 (1894): 437–­441. 48. Walter Migula in 1897 renamed the organism in his Systematics of Bacteria as Clostridium novyi because of its similarity to the organism that causes gas gangrene in humans. See W. Migula, “System der Bakterien,” Jena Band 1 (1897). 49. See Novy, “A New Anaerobic Bacillus of Malignant Oedema,” 49–­57. 50. Central Research Institute, Kasauli, Punjab, India, to Frederick G. Novy, March 7, 1908; H. T. Ricketts to Frederick G. Novy, August 1, 1907; David Bruce to Frederick G. Novy, June 6, 1904 (Entebbe, Uganda); Charles Hare to Frederick Novy, January 4, 1904 (Manila, Philippines). Frederick Novy Papers, Box 1. 51. Charles Morris to Frederick G. Novy, November 2, 1905, Frederick Novy Papers. 52. Ibid.

206

Notes to Pages 61–64

53. Otto Obermeier described the etiological agent Spirochaete obermeieri in 1870 but he was unable to culture it. See R. E. Knapp and Frederick G. Novy, “Spirochaete obermeieri,” Journal of the American Medical Association 46 (1906): 1–­3. See also R. E. Knapp and Frederick G. Novy, “Spirochaete obermeieri,” Science 23 (1906): 206–­207. 54. See Morris to Novy. See also Knapp and Novy, “Spirochaete obermeieri.” 55. See Knapp and Novy, “Spirochaete obermeieri.” See also Frederick G. Novy, “Laboratory notebooks,” 1905–­1907, Frederick Novy Papers. 56. R. E. Knapp and Frederick G. Novy, “Studies on Spirillum obermeieri and Related Organisms,” Journal of Infectious Disease 3 (1906): 291–­393. 57. See Frederick G. Novy and R. E. Knapp, “The Cultivation of Spirillum obermeieri,” Journal of the American Medical Association 47 (1906): 2152–­2154. See also Frederick G. Novy, “Relapsing Fever, a Discussion,” Transactions of Clinical Society 5 (1914): 74–­75. 58. Frederick G. Novy to W. C. Hoad, 1929, Frederick Novy Papers. 59. “Lost and Found (Rat Virus),” Time 61, no. 6 (February 2, 1953). 60. W. J. Nungester, “Recovery of the Novy Rat Virus,” University of Michigan Medical Bulletin 19 (1953): 55–­58. 61. See Frederick G. Novy, “The Etiology of Yellow Fever,” Medical News 73 (1898): 326–­331. See also Frederick G. Novy, “Ultramicroscopic Organisms,” Transactions of the Clinical Society of the University of Michigan 2 (1911): 179–­186. 62. See Friedrich Loefler and P. Frosch, “Berichte der Kommission zur Erforschung der Maul, Zentralblatt fur Bakteriologie,” Parasitenkunde und Infektionskrankheiten 2 (1898): 371–­391. See also M. W. Beierjnick, “Ueber ein Contagium vivum fluidum als Ursache der Fleckenkrankheit der Tabaksblatter,” Centralblatt fur Bacteriolgie und Parasitenkunde 2 (1899): 27–­33; Sally Hughes, The Virus: A History of the Concept (London: Heinemann Books, 977), 1–­138. 63. Frederick G. Novy, “A New Filterable Virus,” Reprints of the Michigan Academy of Science 12 (1910): 17; Frederick G. Novy, “The Viability of the Rat Ultra-­Virus,” 1910, Frederick Novy Papers. 64. Unable to classify the “ultrasomes,” he began to refer to them as “filterable viruses” by 1911. Novy, “Ultramicroscopic Organisms.” 65. Ibid. 66. Novy reported in the Reports of the Michigan Academy of Science in 1910 his evidence of a “filterable agent” responsible for encephalitis on inoculation of filtered blood in experimental animals. See Novy, “A New Filterable Virus”; Novy, “The Viability of the Rat Ultra-­Virus.” 67. See “A Virus Survives Oblivion,” The Michigan Alumnus 59 (March 14, 1953): 285–­287. See also Nungester, “Recovery of the Novy Rat Virus.” 68. “A Virus Survives Oblivion.” 69. Frederick G. Novy, “Laboratory notebooks,” Notebook 20, 1911, Frederick Novy Papers. 70. See “Lost and Found (Rat Virus)”; “Deadly Virus Being Studied by Famous Bacteriologist,” The Sun, January 25, 1953; “A Virus Survives Oblivion,” 285–­288; see also Nungester, “Recovery of the Novy Rat Virus.” 71. “Virus Lost in UM Laboratory for 30 Years Discovered,” Detroit Times, January 25, 1953; “University Researcher’s Very Name Means Medicine,” Ann Arbor News, December 10, 1953, p. 1.



Notes to Pages 64–66

207

72. R. Jordan, W. J. Nungester, and W. S. Preston, “Recovery of the Novy Rat Virus,” Journal of Infectious Diseases 93 (1953): 124–­129. 73. See ibid. See also “A Virus Survives Oblivion.” 74. See Frederick G. Novy, W. A. Perkins, R. Chambers, and Paul de Kruif, “The Rat Virus,” Journal of Infectious Diseases 93 (1953): 111–­123. Novy was unable to name the virus in 1953. Properties of the virus—­high stability, resistance to extremes of temperature and pH, small size of 20 nanometers, transmission fecal-­orally, and production of symptoms of encephalitis in rats—­are consistent with a parvovirus, HER-­1 (Hemorrhagic Encephalopathy of Rats) Kilham rat virus. See also G. Cole, N. Nathanson, and H. Rivet, “Viral Hemorrhagic Encephalopathy of Rats,” American Journal of Epidemiology 91 (1970): 339–­349. 75. Frederick G. Novy and Ward J. MacNeal, “On the Cultivation of Trypanosoma lewisi,” in Contributions to Medical Research, Dedicated to Victor C. Vaughan (Ann Arbor: George Wahr, 1903), 549–­577. 76. Frederick G. Novy, “Trypanosoma: Flagellate Organisms of the Blood,” Journal of the Michigan State Medical Society 3 (1904). 77. See Novy and MacNeal, “On the Cultivation of Trypanosoma lewisi.” See also Frederick G. Novy, “Laboratory Notebooks,” Notebook III, 1903, Frederick Novy Papers. 78. See Frederick G. Novy, “Recent Achievements in Parasitology,” Report of the Michigan Academy of Science 13 (1911): 18–­32. See also Frederick G. Novy, “Laboratory Notebooks,” 1903, Frederick Novy Papers, Box 6. 79. See Novy, “Trypanosoma: Flagellate Organisms of the Blood.” See also Frederick G. Novy to C. Hare, July 9, 1904, Frederick Novy Papers. 80. See Ruth Good, “Dr. Frederick G. Novy: Biographic Sketch,” University of Michigan Medical Bulletin 16 (1950): 257–­268. See also Ward J. MacNeal and Frederick G. Novy, “On the Cultivation of Trypanosoma Evansi,” Report of the Michigan Academy of Science 6 (1904): 179. 81. Novy and MacNeal, “On the Cultivation of Trypanosoma lewisi.” 82. Novy used standard hematoxylin and eosin dyes to observe the trypanosomes. Ibid. 83. Frederick G. Novy, “The Artificial Cultivation of Trypanosomes (Parasites of Man and Animals),” Proceedings of the 4th General Conference of Health Officers, Michigan (1904): 104–­112. 84. See Frederick G. Novy, “Laboratory Notebooks,” 1903, Frederick Novy Papers. See also Novy to Hare, July 9, 1904. 85. See Frederick G. Novy, “Laboratory Notebooks,” 1903. See also Novy, “The Artificial Cultivation of Trypanosomes.” 86. Novy, “The Artificial Cultivation of Trypanosomes.” 87. Ibid. See also Novy, “Trypanosomes,” 1–­36; Frederick G. Novy, “Laboratory notebook,” Book 10, 1906. 88. Novy and MacNeal, “On the Cultivation of Trypanosoma lewisi.” 89. See E. D. Greib to Frederick G. Novy, July 28, 1904, Frederick Novy Papers. See also Frederick G. Novy, “The Role of Protozoa in Pathology,” Proceeding of the Pathologic Society of Philadelphia 10 (1907): 17. 90. See Novy, “The Role of Protozoa in Pathology,” 1–­27. Koch, in East Africa in 1898, had encountered a similar disease Bruce had earlier recognized. See also Christoph Gradmann, Laboratory Disease, trans. Elborg Forster (Baltimore: Johns Hopkins University Press, 2009), 223–­244. 91. Novy, “On Trypanosomes,” 1–­10, 124–­127.

208

Notes to Pages 66–70

92. Imperial nations construct schools of tropical medicine to protect their colonial interests. 93. See Frederick G. Novy and Ward J. MacNeal, “On the Cultivation of Trypanosoma brucei,” Journal of Infectious Disease 1 (1904): 1–­30. See also Frederick G. Novy, “Laboratory notebooks,” 1903–­1927, Frederick Novy Papers. 94. MacNeal and Novy, “On the Cultivation of Trypanosoma evansi.” 95. In the culture forms, Novy used the location and size of the centromere, from which the flagella originated, to differentiate among protozoan species. See Ward J. MacNeal and Frederick G. Novy, “The Cultivation of the Surra Trypanosome of the Philippines,” Journal of the American Medical Association 40 (1904): 1413–­1417. 96. Frederick G. Novy, “Successful Canine Infection with Cultures of Leishmania infantum (Ch. Nicolle),” Journal of the American Medical Association 51 (1908): 1423–­1424. See also Charles Nicolle to Frederick G. Novy, October 23, 1906, Frederick Novy Papers. 97. Frederick G. Novy, “Statement Relative to Work Bearing on Tropical Diseases at the University,” September 23, 1921 (unpublished), Frederick Novy Papers. 98. Novy, “Successful Canine Infection.” 99. Ludwig Hektoen, editor-­ in-­ chief of the Journal of Infectious Diseases, credited Novy’s highly detailed method sections in his publications on protozoa. See Ludwig Hektoen to Frederick Novy, undated, Frederick Novy Papers. 100. William Councilman to Frederick G. Novy, June 22, 1904; Theobald Smith to Frederick G. Novy, November 28, 1903; Paul Ehrlich to Frederick G. Novy, July 19, 1904; Milton Rosenau to Frederick G. Novy, December 14, 1904; Robert Ross to Frederick Novy, January 1905, Frederick Novy Papers. 101. William Welch to Frederick G. Novy, May 21, 1903. 102. David Bruce to Frederick G. Novy, September 8, 1904, Frederick Novy Papers, Box 1. 103. Novy, “The Artificial Cultivation of Trypanosomes.” 104. W. MacNeal to Frederick G. Novy, 1929, Frederick Novy Papers. 105. See Novy and MacNeal, On the Cultivation of Trypanosoma lewisi. See also Ward J. MacNeal, “The Life History of Trypanosoma lewisi,” Journal of Infectious Diseases 4 (1904): 517–­543. 106. Novy and MacNeal, On the Cultivation of Trypanosoma Lewisi. 107. Ibid. See also Novy, “Trypanosomes,” 1–­36. 108. Novy and MacNeal, On the Cultivation of Trypanosoma Lewisi. 109. Novy, “Trypanosomes,” 1–­36. 110. Novy, “The Artificial Cultivation of Trypanosomes.” 111. See Novy, “Trypanosomes,” 1–­36. See also Frederick G. Novy, “The Trypanosomes of Tsetse Flies,” Journal of Infectious Diseases 3, no. 3 (1906): 394–­411. 112. Novy, “On Trypanosomes,” 1–­36, 124–­127. 113. Frederick G. Novy, “On the Trypanosomes of Tsetse Flies,” Journal of Infectious Diseases 3, no. 2 (1906): 394–­411. 114. Frederick G. Novy, “The Role of Protozoa in Pathology,” Proceedings of the Pathological Society of Philadelphia 10 (1907): 1–­27. 115. Friedrich K. Kleine, “Weitere wissenschaftliche Beobachtungen uber die Entwicklung von Trypanosomen in Glossinen,” Dtsch Med Wochenschr 35 (1909): 924–­925. 116. Frederick G. Novy, “Recent Achievements in Parasitology,” Thirteenth Report of the Michigan Academy of Science 13 (1911): 18–­32. 117. Novy, “On Trypanosomes,” 1–­36, 124–­127.



Notes to Pages 70–77

209

118. See Frederick G. Novy, Ward J. MacNeal, and H. N. Torrey, “On Mosquito Trypanosomes,” Science 23 (1906): 206–­207. See also Frederick G. Novy, Ward J MacNeal, and H. N. Torrey, “The Trypanosomes of Mosquitoes and Other Insects,” Journal of Infectious Diseases 4 (1907): 223–­276. 119. Frederick G. Novy, “Recent Achievements in Parasitology,” Thirteenth Report of the Michigan Academy of Science 13 (1911): 18–­32. 120. Novy, “Recent Achievements in Parasitology.” 121. Novy, “Trypanosomes,” 1–­36. 122. Novy, MacNeal, and Torrey, “The Trypanosomes of Mosquitoes and Other Insects.” 123. Novy, “The Trypanosomes of Tsetse Flies.” 124. Novy, “The Role of Protozoa in Pathology,” 1–­27. 125. See Novy, “On Trypanosomes,” 1–­36. See also C. Behrens, “An Attenuated Culture of Trypanosoma brucei,” Journal of Infectious Diseases 15 (1914): 24–­62. 126. Novy, MacNeal, and Torrey, “On Mosquito Trypanosomes.” 127. Ibid. 128. Dietmar Steverding, “The History of African Trypanosomiasis,” Parasites and Vectors 1, no. 3 (2008), doi:10.1186/1756–­3305–­1–­3. 129. Peter de Raadt, “The History of Sleeping Sickness,” World Health Organization (2005), http://​www​.who​.int/​trypanosomiasis​_african/​country/​history/​en/​print​.html. 130. Daniel Headrick, “Sleeping Sickness Epidemics and Colonial Responses in East and Central Africa, 1900–­1940,” PLOS Neglected Tropical Diseases 8 (2014): e2772. 131. Claude E. Dolman and Richard J. Wolfe, Suppressing the Diseases of Animals and Man: Theobald Smith, Microbiologist (Boston: Boston Medical Library in The Francis A. Countway Library of Medicine and the Harvard University Press, 2003). 132. See Frederick G. Novy, “Successful Canine Infection with Cultures of Leishmania infantum,” Journal of the American Medical Association 30 (1908): 49–­64. See also Frederick G. Novy, “Recent Achievements in Parasitology,” Thirteenth Report of the Michigan Academy of Science 13 (1911): 18–­32. 133. Ibid. See also Frederick G. Novy, “Laboratory notebooks,” notebook 14, 1906–­1908, Frederick Novy Papers. 134. See Novy, “Successful Canine Infection with Cultures of Leishmania infantum.” The amastigote forms, the forms he saw in the spleen of his dogs, also occurred in humans. See also Frederick G. Novy, “Leishman-­Donovan Bodies,” The Physician and Surgeon 32 (1910): 369–­372. 135. William Welch to Frederick G. Novy, October 13, 1908, Frederick Novy Papers. 136. Winslow, “Some Leaders and Landmarks in the History of Microbiology,” 107. 137. Ibid. 138. See Frederick G. Novy to Professor Robert Ross, February 7, 1906, Frederick Novy Papers, Box 1. See also Novy, MacNeal, and Torrey, “On Mosquito Trypanosomes.” 139. See Theobald Smith to Frederick Novy, October 13, 1911. See also Frederick Novy to Theobald Smith, November 13, 1911, Frederick Novy Papers, Box 1. 140. See “Dr. Schaudinn’s Work on Blood Parasites,” British Medical Journal (1905): 442–­444. See also Fritz Schaudinn, “Generations-­Und Wirtswechsel Bei Trypanosoma und Spirochaete,” Arbeiten aus dem Kaiserlichen Gesundheitsamte 20 (1904). 141. See “Dr. Schaudinn’s Work on Blood Parasites.” See also Schaudinn, “Generations-­ Und Wirtswechsel Bei Trypanosoma Und Spirochaete.” 142. See Schaudinn, “Generations-­ U nd Wirtswechsel Bei Trypanosoma und Spirochaete.” 143. Frederick G. Novy to Ronald Ross, September 25, 1905, Frederick Novy Papers.

210

Notes to Pages 77–79

144. Early germ theorists believed that bacteria could convert from one to another. Ernst Hallier, professor of botany in Jena, based his idea on polymorphism among fungi. See William Bulloch, The History of Bacteriology (New York: Dover, 1938), 188–­ 208. See also E. Hallier, “Ueber Einen Pflanzlichen Parasiten auf dem Epithelium Bei Diphtheritis,” Botanische Zeitschrift 23 (1865): 144–­ 146. Theodor Billroth, professor of surgery at the University of Zurich, thought that bacteria that stained differently were different stages of the same species. See William W. Ford, Bacteriology (New York: Paul B. Hoeber Inc., Medical Book Department of Harper & Brothers, 1939), 77–­90. Ferdinand Cohn contested the doctrine of heterogenesis. See F. Cohn, “Organismen in der Pockenlymphe,” Archive für Pathologische Anatomie und Physiologie (1872): 229–­238. 145. Frederick G. Novy to Fritz Schaudinn, February 4, 1905, Frederick Novy Papers. 146. See Novy, “The Role of Protozoa in Pathology,” 15–­17. See also Frederick G. Novy and Ward J. MacNeal, “Trypanosomes and Bird Malaria,” American Medicine 8 (1904): 932–­984; Frederick G. Novy and Ward J. MacNeal, “On the Trypanosomes of Birds,” Journal of Infectious Diseases 2 (1905): 257–­308. 147. Novy, MacNeal, and Torrey, “The Trypanosomes of Mosquitoes and Other Insects.” 148. See Frederick G. Novy to David Bruce, September 27, 1904; see also Fritz Schaudinn to Frederick G. Novy, March 3, 1905, Frederick Novy Papers. 149. Frederick G. Novy to Fritz Schaudinn, March 18, 1905, Frederick Novy Papers. 150. See Frederick G. Novy to Ronald Ross, February 25, 1906; see also Novy to Schaudinn, March 18, 1905, Frederick Novy Papers. 151. See Fritz Schaudinn to Frederick G. Novy, March 3, 1905. See also Frederick Novy to Fritz Schaudinn, March 18, 1905, Frederick Novy Papers. 152. Frederick G. Novy to Fritz Schaudinn, March 18, 1905, Frederick Novy Papers. 153. Novy, “The Role of Protozoa in Pathology,” 1–­27. 154. J. Kinyoun, “Letter to: My Dear Aunt and Uncle,” June 29, 1901, Kinyoun Manuscript Collection, History of Medicine Division, National Library of Medicine Bethesda, MD, MS C 464, Box 1, pp. 32–­40. 155. See Guenter B. Risse, “The Politics of Fear: Bubonic Plague in San Francisco, California, 1900,” in New Countries and Old Medicine: Proceedings of an International Conference on the History of Medicine and Health, Auckland, New Zealand, 1994, ed. Linda Bryder and Derek A. Dow (Auckland: Pyramid Press, 1995), 1–­18. See also Nyan Shah, Contagious Divides: Epidemics and Race in San Francisco’s Chinatown (Berkeley: University of California Press, 2001), 124; Howard Markel, When Germs Travel: Six Major Epidemics That Have Invaded America Since 1900 and the Fears They Have Unleashed (New York: Pantheon Books, 2004). 156. “Minutes from Meeting of Commission, Occidental Hotel,” January 28, 1901, Frederick Novy Papers, Box 4. 157. Guenter B. Risse, Plague, Fear, and Politics in San Francisco’s Chinatown (Baltimore: John Hopkins University Press, 2012), 113–­166. 158. Walter Wyman to Frederick G. Novy, January 14, 1901, Frederick Novy Papers; in this confidential letter, Wyman invited Novy to join the commission. 159. Walter Wyman to Frederick G. Novy, January 14, 1901, Frederick Novy Papers. 160. Ibid. 161. Frederick G. Novy to Grace Novy, 1901, Frederick Novy Papers, Box 3. Novy wrote to his wife on a daily basis from his departure on January 24 until his return on March 6. 162. Frederick Novy to Grace Novy, January 27, 1901, Frederick Novy Papers.



Notes to Pages 79–82

211

63. “Minutes from commissioner’s meeting,” February 5, 1901, Frederick Novy Papers. 1 164. “Report of the commission appointed by the Secretary of the Treasury for the investigation of plague in San Francisco,” February 26, 1901, Frederick Novy Papers. 165. Frederick G. Novy, “On the Bacteriology of Plague,” American Journal of the Medical Sciences 122 (1901): 4. 166. Frederick G. Novy, “University of Michigan laboratory notebooks,” March 13, 1901, Frederick Novy Papers, Box 5. 167. Novy, “On the Bacteriology of Plague.” 168. “The Plague Fake: How San Francisco Has Been Outraged by a Set of Charlatans,” San Francisco Chronicle, October 20, 1901, p. 21. 169. “Minutes from meeting of commission,” January 31, 1901, Frederick Novy Papers, Box 4. Eight of the eleven physicians interviewed believed plague did not exist in the city. 170. “Proceedings of the San Francisco County Medical Society, Monthly Meeting, February 21,” Occidental Medical Times 15, no. 4 (April 1901): 139. 171. Charles G. Kuhlman, “The Government’s Plague Commission,” San Francisco Bulletin, February 21, 1901. 172. Ibid. 173. Ibid. 174. “The Plague Fake: How San Francisco Has Been Outraged by a Set of Charlatans.” 175. “The Bubonic Plague Fake,” San Francisco Chronicle, October 20, 1901. 176. “Gage’s Anti Plague Contention Sustained,” Los Angeles Herald, June 16, 1901. 177. Alonzo Taylor to Frederick G. Novy, May 30, 1901, Frederick Novy Papers, Box 1. 178. “How Dr. Novy Destroys the Microbes of Infectious Diseases with a New Germicide Based on the Chemical Principles of Gold and Sunlight,” Ann Arbor News, January 19, 1902. 179. “A Good Appointment,” Los Angeles Times, January 14, 1903. 180. “Plague Situation in San Francisco Becomes Alarming,” Washington Post, November 3, 1902. 181. “The Plague in California. Wanted: The Plain Truth,” Los Angeles Times, December 3, 1902. 182. “First Steps in War on Plague, Bubonic Plague Hidden for Three Years by California Officials: Nation Is Now Aroused. Delegates from Nineteen States Demand Prompt Measures for Public Safety,” Chicago Daily, January 20, 1903. 183. Stephen Toulmin, The Philosophy of Science: An Introduction (London: Hutchinson’s University Library, 1953). 184. Several peers commented on the breadth of Novy’s investigations. See Winslow, “Some Leaders and Landmarks in the History of Microbiology.” See also John Jacob Abel to Frederick G. Novy, 1929; Frederick Gay to Frederick G. Novy, November 8, 1929, Frederick Novy Papers. 185. Earl McKinley to Frederick G. Novy, June 26, 1929, Frederick Novy Papers. 186. Max Marshall to Frederick G. Novy, October 24, 1929, Frederick Novy Papers. 187. Anaphylaxis was a phenomenon described by the French physiologist Charles Richet in 1907. See C. Richet, “De L’anaphylaxie en General et de L’anaphylaxie Par La Mytilo-­Congestine en Particulier,” Annals de l’Institute Pasteur 21 (1907): 497–­524. 188. See Frederick G. Novy and Paul H. de Kruif, “Anaphylatoxin and Anaphylaxis,” Journal of the American Medical Association 58 (1917): 1524–­1528. See also “Laboratory notebook,” notebook 30, 1914.

212

Notes to Pages 82–87

189. Novy and de Kruif, “Anaphylatoxin and Anaphylaxis,” 536–­ 565; Frederick G. Novy and Paul H. de Kruif, “III. Agar Anaphylatoxin: Rabbit Serum,” Journal of Infectious Diseases 20 (1917): 566–­588. 190. Frederick G. Novy and Paul H. de Kruif, “IV. Agar Anaphylatoxin: Rat Serum,” Journal of Infectious Diseases 20 (1917): 589–­617. 191. See Frederick G. Novy, Paul H. de Kruif, and Robert L. Novy, “Anaphylatoxin and Anaphylaxis. I. Trypanasome Anaphylatoxin,” Journal of Infectious Diseases 20 (1917): 499–­535. See also Paul H. de Kruif and A. H. Eggerth, “Anaphylatoxin and Anaphylaxis. XI. Ultrafiltration and Fractionation of Anaphylatoxin,” Journal of Infectious Diseases 20 (1917): 507–­532. 192. See Paul H. de Kruif, “Anaphylatoxin and Anaphylaxis. VIII. The Primary Toxicity of Normal Serum,” Journal of Infectious Diseases 20 (1917): 718–­775. See also Frederick G. Novy and Paul H. de Kruif, “Anaphylatoxin and Anaphylaxis. IX. Specific Anaphylactic Shock,” Journal of Infectious Diseases 20 (1917): 718–­775; de Kruif and Eggerth, “Anaphylatoxin and Anaphylaxis. XI. Ultrafiltration and Fractionation of Anaphylatoxin.” 193. Novy, “The Hygienic Laboratory.” 194. Frederick G. Novy, M. Gomberg, and R. Kahn, “Address before the Michigan Legislature,” Journal of the Michigan State Medical Society 29 (1931): 7–­10. 195. Ibid. 196. Christoph Gradmann, Laboratory Disease, trans. Elborg Forster (Baltimore: Johns Hopkins University Press, 2009), 121–­125. 197. Dolman and Wolfe, Suppressing the Diseases of Animals and Man. 198. William Welch to Frederick G. Novy, October 1, 1929; John Abel to Frederick G. Novy, 1929; Frederick Gay to Frederick G. Novy, November 8, 1929, Frederick Novy Papers. Frederick Gay was a bacteriologist at Columbia University Medical School. 199. Frederick G. Novy, “Disinfection of Rooms,” Teachers’ Sanitary Bulletin 1 (1898): 17–­35. 200. Novy, Laboratory Work in Bacteriology. Quote from 3. Chapter 3. Making Medical Education Scientific

1. See Frederick G. Novy, “Fifty Years’ Progress in Medical Education,” in A Half Century of Nu Sigma Nu, 1882–­1932, ed. Will Walter and Stuart Graves (Louisville, KY: The Nu Sigma Nu Fraternity, 1935), 1669–­1685. See also Frederick G. Novy, “Zina Pitcher lecture,” February 22, 1908, Frederick Novy Papers, Box 1, Bentley Historical Library, University of Michigan, Ann Arbor. 2. See C.E.A. Winslow, “Some Leaders and Landmarks in the History of Microbiology,” Journal of Bacteriology 2 (1950): 1–­46. See also Thomas Bonner, Becoming a Physician: Medical Education in Britain, France, Germany, and the United States (Baltimore: Johns Hopkins University Press, 1995), 175–­182, 195–­200; William Rothstein, American Medical Schools and the Practice of Medicine (Oxford: Oxford University Press, 1986). 3. In 1850, the medical school at the University of Michigan was opened and staffed by seven full-­time faculty. See Novy, “Zina Pitcher lecture.” 4. See Horace W. Davenport, Victor Vaughan: Statesman and Scientist (Ann Arbor: University of Michigan Press, 1996). See also Burke A. Hinsdale, History of the University of Michigan: From 1837 to 1906 (Ann Arbor: University of Michigan Press, 1906), 91–­97. 5. Terrie M. Romano, Making Medicine Scientific: John Burdon Sanderson and the Culture of Victorian Science (Baltimore: Johns Hopkins University Press, 2002), 1–­34.





Notes to Pages 87–92

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6. Novy, “Fifty Years’ Progress in Medical Education.” 7. Davenport, Victor Vaughan: Statesman and Scientist, 94–­98. 8. Novy, “Fifty Years’ Progress in Medical Education.” 9. Frederic Gorham, “The History of Bacteriology and Its Contribution to Public Health Work,” in A Half Century of Public Health, ed. Mazyck P. Ravenel (New York: American Public Health Association, 1921), 66–­93. 10. Ibid. 11. Frederick G. Novy, “Position of Bacteriology in a Medical Course,” Transactions of the First Pan-­American Medical Congress 2 (1893): 2209–­2210. 12. Novy, “Fifty Years’ Progress in Medical Education.” 13. Novy, “Position of Bacteriology in a Medical Course.” 14. Novy, “Bacteriology—­The Hygienic Laboratory” (unpublished lecture presented to the Michigan Health Society, Detroit, May 1946), Frederick Novy Papers, Box 4. 15. See Davenport, Victor Vaughan: Statesman and Scientist. See also David H. Bergey, “Early Instruction in Bacteriology in the United States,” Annals of Medical History 1 (1917): 426–­427. 16. Bacteriology at this time occupied 384 hours per semester. See Frederick G. Novy, “Bacteriology—­The Hygienic Laboratory,” Frederick Novy Papers, Box 4, p. 3. 17. See Frederick G. Novy, “Lecture notes for bacteriology course” (1890), Frederick Novy Papers. See also Frederick G. Novy, Direction for Laboratory Work in Bacteriology (Ann Arbor: George Wahr, 1894); Frederick G. Novy, Laboratory Work in Bacteriology (Ann Arbor: George Wahr, 1899). 18. Novy, Direction for Laboratory Work in Bacteriology. 19. Novy, Laboratory Work in Bacteriology. 20. Ibid., 5. 21. See Novy, “Position of Bacteriology in a Medical Course.” See also Frederick G. Novy, “The Hygienic Laboratory,” The Michigan Alumnus 6 (1900): 242–­244. 22. Students were taught how to count bacterial colonies, practice sterilization, and assess which methods of sterilization were effective. See Novy, Laboratory Work in Bacteriology, 295–­385. 23. Novy, “Lecture notes for bacteriology course”; Novy, Direction for Laboratory Work in Bacteriology; Novy, Laboratory Work in Bacteriology. 24. Michael Worboys, Spreading Germs: Disease Theories and Medical Practice in Britain, 1865–­1900 (Cambridge: Cambridge University Press, 2000). 25. Henneage Gibbes, “Pathology of Acute Miliary Tuberculosis,” Transactions of the Michigan State Medical Society for the Year 1888 (Detroit, 1888): 124–­143. 26. Frederick G. Novy, “The Spirit of Research in Medicine,” Physician and Surgeon 24 (1902): 385–­405. 27. Ibid. 28. Novy, “Lecture notes for bacteriology course.” 29. Novy, “Fifty Years’ Progress in Medical Education.” 30. Novy, Direction for Laboratory Work in Bacteriology. 31. Novy, Laboratory Work in Bacteriology, 253–­257. 32. Students were asked to identify pathogenic bacteria such as Streptococcus pyogenes. See ibid., 255–­261. 33. Ibid., 344–­346. 34. Novy, “The Spirit of Research in Medicine.” 35. Ibid.

214

Notes to Pages 92–95

36. See Novy, “The Spirit of Research in Medicine.” See also Novy, Laboratory Work in Bacteriology. 37. See Novy, “Fifty Years’ Progress in Medical Education”; see also Frederick G. Novy, “Notes on Medical Education and Medical Institutions in Michigan,” Annals of Internal Medicine 9 (1936): 1035–­1042. 38. William Welch to Frederick G. Novy, May 1, 1889, Bentley Historical Library—­ letter stating that he used Novy’s text. 39. Edwin O. Jordan to Frederick G. Novy, May 6, 1899, Bentley Historical Library—­ letter stating that he used Novy’s text. 40. Theobald Smith to Frederick G. Novy, November 28, 1903, Bentley Historical Library—­letter stating that he used Novy’s text. 41. Novy, “Fifty Years’ Progress in Medical Education.” See also “Faculty meeting notes,” June 18, 1890, University of Michigan Medical School Papers, Box 128, Bentley Historical Library. 42. “October meeting, 1891,” Proceeding of the Board of Regents at University of Michigan, Bentley Historical Library. 43. See Novy, “Fifty Years’ Progress in Medical Education,” 1672. See also “Faculty meeting notes,” May 4, 1886, University of Michigan Medical School Papers, Box 128, Bentley Historical Library; “Faculty meeting notes,” April 1, 1890, and April 11, 1890, University of Michigan Medical School Papers, Box 128, Bentley Historical Library. 44. “October meeting, 1891.” See also “Faculty meeting notes,” January 19, 1898, and November 6, 1900, University of Michigan Medical School Papers, Bentley Historical Library. 45. Novy, “Fifty Years’ Progress in Medical Education.” 46. Ludmerer, Learning to Heal: The Development of American Medical Education, 63–­67, 78–­103. 47. Abraham Flexner, Medical Education in the United States and Canada (New York: Carnegie Foundation for the Advancement of Teaching, 1910), 36–­37, 62, 92. 48. See Merle Curti, The Social Ideas of American Educators (Paterson, NJ: Pageant Books, 1959), 491–­ 542. Dewey’s full views on education are contained in his Democracy and Education (New York: Macmillan, 1916). 49. John Dewey to Frederick G. Novy, 1929, Frederick Novy Papers. 50. Ibid. 51. Ibid. 52. Dewey, Democracy and Education. 53. Novy, “Lecture notes from bacteriology course”; Novy, Laboratory Work in Bacteriology, 15–­531. 54. Novy, “The Spirit of Research in Medicine.” 55. See Frederick G. Novy, “Doctor Vaughan’s Influence in Medical Education Address,” Memorial Meeting, University of Michigan Official Publication (December 3, 1929); Journal of Laboratory and Clinical Medicine 15 (1930): 833–­838. See also Novy, “Fifty Years’ Progress in Medical Education.” 56. Novy, “Fifty Years’ Progress in Medical Education.” See also Novy, “The Spirit of Research in Medicine,” 1–­20. 57. Ludmerer, Learning to Heal, 1–­64. 58. Novy, “The Spirit of Research in Medicine.” 59. Novy, Laboratory Work in Bacteriology, 2–­5. 60. Ibid., 3. 61. Novy, “The Spirit of Research in Medicine,” 392.



Notes to Pages 95–10 0

215

62. Ibid., 393. 63. Ibid., 394. 64. Ibid. 65. Ibid., 394–­395. 66. Ibid., 404. 67. Novy, “Fifty Years’ Progress in Medical Education.” 68. Novy, “The Spirit of Research in Medicine,” 385. 69. Ibid., 405. 70. Ibid., 399. 71. Ibid., 385–­405. 72. Ludmerer, Learning to Heal, 1–­64. 73. See Novy, Laboratory Work in Bacteriology. 74. Owen Hannaway, “The German Model of Chemical Education in America: Ira Resen at Johns Hopkins (1876–­1913),” Ambix 23 (1976): 145–­164. 75. Larry Owens, “Pure Sound Government: Laboratories, Playing Fields, and Gymnasia in the Nineteenth-­Century Search for Order,” Isis 76 (1985): 182–­194. 76. H. A. Rowland, “A Plea for Pure Science,” Science 2 (August 24, 1883): 242–­250. 77. Daniel J. Kevles, The Physicists: The History of a Scientific Community in Modern America (Cambridge: Cambridge University Press, 2001). 78. Hannaway, “The German Model of Chemical Education.” 79. Rowland, “A Plea for Pure Science.” 80. Owens, “Pure Sound Government,” 12. 81. Novy, “The Spirit of Research in Medicine.” 82. Ibid., 391. 83. Ibid., 395. 84. Ibid., 396. 85. Novy used Paracelsus as an example of someone who doubted, but replaced Galenism with his own dogma, because he lacked the scientific method. See ibid., 397. 86. Novy belonged to the church as an adult, but he didn’t attend or consider himself religious. Dorothy Wilson (granddaughter of Frederick G. Novy), in discussion with the author, November 7, 2015. 87. Novy, “Fifty Years’ Progress in Medical Education.” 88. Ibid., 1676–­1677. 89. Harry Marks, Progress of Experiment (Cambridge: Cambridge University Press, 1997), 25. 90. Louis Galambos and Jane E. Sewell, Vaccine Development at Merck, Sharpe & Dohme, and Mulford, 1895–­1995 (Cambridge: Cambridge University Press, 1995). The authors trace the mass production of serums and vaccines by American public health departments. 91. Frederick G. Novy, “Exposure of the Stenocarpine Fraud,” Quarterly Report of the Michigan State Laboratory of Hygiene (1887): 20–­23. 92. “Frederick Novy notes on Chinosol and Afridiol,” March 13, 1912 (unpublished notes), Frederick Novy Papers. 93. Novy, “Fifty Years’ Progress in Medical Education,” 1673. 94. Ibid. 95. Ibid. 96. Ibid., 1674. 97. Frederick G. Novy, “The Trend in Modern Medicine” (lecture notes, 1890), Frederick Novy Papers.

216

Notes to Pages 10 0–105

98. See Novy, “The Spirit of Research in Medicine,” 392. See also Novy, “Fifty Years’ Progress in Medical Education.” 99. See Novy, “Fifty Years’ Progress in Medical Education.” See also Frederick G. Novy, “Doctor Vaughan’s Influence in Medical Education,” Journal of Laboratory and Clinical Medicine 15 (1930): 1685. 100. Novy, “Fifty Years’ Progress in Medical Education.” 101. Ibid., 1692. 102. Frederick G. Novy and Marguerite Novy Lambert, Novy-­Garwood Family Records and Connections (Elverson, PA: Mennonite Family History, 1990), 1–­412. 103. Novy, “Fifty Years’ Progress in Medical Education.” 104. Ibid., 1670. 105. Ibid., 1683. 106. Ibid., 1685. 107. Ibid., 1682. 108. Ibid., 1678. 109. Ludmerer, Learning to Heal, 1–­46. 110. Ibid. 111. Curti, The Social Ideas of American Educators. 112. Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982). 113. Ibid., 79–­144. 114. Davenport, Victor Vaughan: Statesman and Scientist, 91–­98. 115. Curti, The Social Ideas of American Educators. 116. Ludmerer, Learning to Heal, 1–­46. 117. See Frederick G. Novy, “Laboratory Methods in Bacteriology (six papers). I. Examination of Bacteria,” Journal of Applied Microscopy 1 (1898): 157–­160. 118. Bonner, Becoming a Physician. 119. See Novy, “The Hygienic Laboratory.” See also Novy, “Notes on Medical Education and Medical Institutions in Michigan,” 1024–­1042. 120. Henneage Gibbes, “Annual Address on Practice of Medicine. Phthisis,” Transactions of the Michigan State Medical Society for the year 1891 (1891): 1–­31. 121. Gibbes, “Pathology of Acute Miliary Tuberculosis,” 130. 122. Henneage Gibbes, “Pathology of Consumption,” Transactions of the Michigan State Medical Society for the Year 1894 (1894): 136. 123. Novy wrote the section about Gibbes in this chapter. Wilfred B. Shaw, The University of Michigan, An Encyclopedic Survey, Part V, The Homeopathic Medical College (Ann Arbor: University of Michigan Press, 1951), 1003–­1013. 124. Victor N. Kobayashi, “From ‘Germ Theory’ to Bacteriology: A Case in Academic Freedom at the University of Michigan,” 1962, Bentley Historical Library. 125. Wilfred B. Shaw, The University of Michigan, an Encyclopedic Survey, Part 5, The Medical School, the University Hospital, the Law School, 1850–­1940 (Ann Arbor: University of Michigan Press, 1951), 773–­808, 821–­827. 126. Shaw, The University of Michigan, An Encyclopedic Survey, Part 5, The Homeopathic Medical College. 127. Ibid., 1004. 128. Victor Vaughan, A Doctor’s Memories (Indianapolis: Bobbs-­Merrill, 1926), 106. 129. Shaw, The University of Michigan, an Encyclopedic Survey, Part V, The Medical School, the University Hospital, the Law School, 1850–­1940, 1009. 130. Kobayashi, “From ‘Germ Theory’ to Bacteriology.”



Notes to Pages 105–120

217

131. “June meeting, 1895,” Board of Regents of the University of Michigan, Proceedings, p. 402, Bentley Historical Library. 132. Vaughan, A Doctor’s Memories. 133. “June meeting, 1895.” 134. Ibid. 135. Kobayashi, “From ‘Germ Theory’ to Bacteriology.” 136. Proceedings of the Board of Regents, November 1891–­October 1896 (1895): 401. 137. “Letters to Novy on His 65th Birthday,” Frederick Novy Papers. 138. David Sugar, “Novy: Our Teacher,” Detroit Medical News 26 (1937). 139. Lewis C. Knapp to Frederick G. Novy, September 28, 1929, Frederick Novy Papers, Box 1. 140. Thomas Cooley to Frederick G. Novy, October 15, 1929, Frederick Novy Papers, Box 1. 141. John Dodson, “Doctor Novy in Medical Education,” 1929, Frederick Novy Papers, Box 1. 142. Fred Taylor to Frederick G. Novy, 1929, Frederick Novy Papers, Box 1. 143. See Thomas Cooley to Frederick G. Novy, 1929, Frederick Novy Papers, Box 1. See also Sugar, “Novy: Our Teacher.” 144. Novy, Laboratory Work in Bacteriology, 2. 145. See, for example, Lewis C. Knapp to Frederick G. Novy, 1929, Frederick Novy Papers, Box 1. See also Cooley to Novy, 1929. 146. Earl McKinley to Frederick G. Novy, June 26, 1929, Frederick Novy Papers. 147. Ibid. 148. Charles E. Rosenberg, No Other Gods: On Science and American Social Thought (Baltimore: Johns Hopkins University Press, 1976). 149. Justin Hill to Frederick G. Novy, June 26, 1929, Frederick Novy Papers, Box 1. 150. Charles Behrens to Frederick G. Novy, November 29, 1929, Frederick Novy Papers. 151. Frederick G. Novy, “Bacteriology in Its Relations to Public Health,” Teachers’ Sanitary Bulletin 3 (1900): 60–­66. 152. McKinley to Novy, June 26, 1929. 153. A. C. Furstenberg to Frederick G. Novy, December 1929, Frederick Novy Papers, Box 1. 154. Campbell Bonner to Frederick G. Novy, August 24, 1929, Frederick Novy Papers, Box 1. 155. Benjamin T. Terry to Frederick G. Novy, February 28, 1918, Frederick Novy Papers, Box 2. 156. Bonner to Novy, August 24, 1929. 157. See W. C. Hoad to Frederick G. Novy, 1929, Frederick Novy Papers, Box 1. 158. T. J. Mackie to Frederick G. Novy, 1929, Frederick Novy Papers, Box 1. 159. George Herrmann to Frederick G. Novy, October 31, 1929, Frederick Novy Papers, Box 1. 160. Paul de Kruif to Frederick G. Novy, April 17, 1917, and October 21, 1929, Frederick Novy Papers, Box 2. 161. L. R. Jones to Frederick G. Novy, June 27, 1929, Frederick Novy Papers, Box 1. 162. Ivan Hall to Frederick G. Novy, 1929, Frederick Novy Papers. 163. Henry Bates to Frederick G. Novy, 1929, Frederick Novy Papers. 164. See Henry Sewell to Frederick G. Novy, July 9, 1929. See also W. D. Frost to Frederick G. Novy, November 11, 1929; D. M. Cowie to Frederick G. Novy, 1929; Harlow Brooke to Frederick G. Novy, 1929, Frederick Novy Papers, Box 1.

218

Notes to Pages 120–129

165. James Reeves to Frederick G. Novy, 1929. See also Ivan Hall to Frederick G. Novy, October 13, 1929, Frederick Novy Papers. 166. M. Gomberg to Frederick G. Novy, 1929, Frederick Novy Papers, Box 1. 167. Paul de Kruif, The Sweeping Wind (New York: Harcourt Brace, 1962), 83. 168. McKinley to Novy, June 26, 1929. 169. W. J. Nungester, “Frederick George Novy, 1864–­1957,” Journal of Bacteriology 74 (1957): 545–­547. 170. Ibid. 171. See John F. Norton to Frederick G. Novy, 1929; see also Max S. Marshall to Frederick Novy, October 24, 1929, and R. G. Leland to Frederick G. Novy, 1929, Frederick Novy Papers, Box 1; Ruth Good, “Dr. Frederick G. Novy: Biographic Sketch,” University of Michigan Medical Bulletin 16 (1950): 257–­268. 172. A. C. Furstenburg and W. J. Nungester, “Doctor Frederick George Novy,” The Pharos (1958): 31–­35. 173. See Mackie to Novy, 1929; see also G. McCoy to Frederick G. Novy, June 16, 1929, Frederick Novy Papers. 174. George Dock to Frederick G. Novy, November 7, 1929, Frederick Novy Papers, Box 1. 175. “Films by Robert L Novy, 1927–­1957.” Robert Novy, Dr. Novy’s eldest son, took videos of family gatherings and vacations. Dr. Novy is seen in several of the scenes laughing and engaging with his family (Christmas, 1927; Belle Isle skating, 1929; Hope Bay swimming). 176. Behrens to Novy, November 29, 1929. 177. Justin Hall to Frederick G. Novy, September 21, 1929, Frederick Novy Papers, Box 1. 178. J. Rosenau to Frederick Novy, August 28, 1915, Frederick Novy Papers, Box 2. 179. Frederick G. Novy to J. Rosenau, September 8, 1915, Frederick Novy Papers. 180. “University Professors, Their Eccentricities, and Their Everyday Life,” Michigan Daily, October 18, 1898. 181. See Ray Baker, “The Diagonal Walk,” Ann Arbor Daily, July 19, 1928, p. 3. 182. Ibid. 183. Dorothy Wilson (granddaughter of Frederick G. Novy), in discussion with the author, November 8, 2015. 184. See Frederick G. Novy to Grace from San Francisco, January 24–­March 6, 1901, Frederick Novy Papers. See also: “Films by Robert L Novy, 1927–­1957.” 185. George Cotkin, Reluctant Modernism: American Thought and Culture, 1880–­1900 (New York: Twayne Publishers, Maxwell Macmillan Canada & Maxwell Macmillan International, 1992), xi–­xvi, 148–­154. 186. Ibid. 187. John Chambers, The Tyranny of Change: America in the Progressive Era, 1890–­1920 (New Brunswick, NJ: Rutgers University Press, 1992). Chapter 4. Defining Bacteriology as a Discipline in Its Early Years

1. See A. P. Carr-­Saunders and P. A. Wilson, The Professions (Oxford: Oxford University Press, 1933). See also Geoffrey Millerson, The Qualifying Associations (London: Routledge, 1964). 2. Millerson, The Qualifying Associations. 3. Andrew Abbott, The System of Professions (Chicago: University of Chicago Press, 1988). 4. Burton J. Bledstein, The Culture of Professionalism: The Middle Class and the Development of Higher Education in America (New York: Norton, 1976), 10–­180.



Notes to Pages 129–132

219

5. See Talcott Parsons, Essays in Sociological Theory (New York: Free Press, 1954), 34–­49. See also Abbott, The System of Professions. 6. See Barnett Cohen, “Chronicles of the Society of American Bacteriologists 1899–­ 1950” (Baltimore: Waverly Press, 1950). See also Barnett Cohen, “Comments on the Relation of Dr. Welch to the Rise of Microbiology in America,” Bulletin of the History of Medicine 24 (1950). 7. Cohen, “Chronicles of the Society of American Bacteriologists 1899–­1950,” 17–­20. 8. Ibid. 9. See Cohen, “Comments on the Relation of Dr. Welch to the Rise of Microbiology in America”; see also Paul F. Clark, “A Half Century of Presidential Addresses of the Society of American Bacteriologists,” Bacteriological Reviews 17 (1953). 10. Sedgwick’s speech was published in Science. See William T. Sedgwick, “The Origin, Scope, and Significance of Bacteriology,” Science 13 (1901): 121–­128. 11. Ibid., 124. 12. Ibid., 121–­128. 13. Ibid., 127. 14. Ibid. 15. Ibid., 124. 16. Ibid., 125. 17. Ibid. 125. 18. Novy’s presidential speech at the 1904 SAB meeting was published in abstract form. See Frederick Novy, “Hematozoa in Birds,” Science 21 (1905): 481. The content of the speech was included in separate articles: Frederick G. Novy and Ward J. MacNeal, “Trypanosomes and Bird Malaria,” American Medicine 8 (1904): 932–­934; and Frederick G. Novy and Ward J. MacNeal, “On the Trypanosomes of Birds,” Journal of Infectious Diseases 2 (1905): 256–­308. 19. Novy, “Hematozoa in Birds.” 20. Frederick G. Novy, “Trypanosomes,” Journal of the American Medical Association (1907): 1–­5. 21. Novy, “Hematozoa in Birds.” 22. Novy, “Trypanosomes.” 23. Frederick G. Novy, “The Role of Protozoa in Pathology,” Proceedings of the Pathologic Society of Philadelphia 10 (1907): 17. 24. See Novy, “Hematozoa in Birds.” See also Novy, “Trypanosomes.” 25. See Frederick G. Novy, Ward J. MacNeal, and H. N. Torrey, “On Mosquito Trypanosomes,” Science 23 (1906): 206–­207. See also Novy, “The Role of Protozoa in Pathology,” 1–­27. 26. Novy, “Recent Achievements in Parasitology,” Report of the Michigan Academy of Science 13 (1911): 18–­32. 27. See Frederick G. Novy, “The Bacteriology of Bubonic Plague,” American Journal of Medical Sciences 122 (1901): 416–­426. See also Frederick G. Novy, “The Plague in California,” Teachers’ Sanitary Bulletin 6 (1903): 59–­64. 28. See Frederick G. Novy, “Disease Carriers,” Address of Vice-­President and Chairman of Section K,.Science 36 (1912): 1–­10. See also Frederick G. Novy, “Recent Achievements in Parasitology,” 18–­32. Novy chaired a session for protozoology at the 1916 meeting of the SAB. See also “Novy, Frederick George,” accessed January 21, 2015, http://​www​.asmusa​ .org/​index​.php/​travel​-­­grants/​71​-­­membership/​archives/​861​-­­novy​-­­frederick​-­­george. 29. John Farley, “Parasites and the Germ Theory of Disease,” in Framing Disease: Studies in Cultural History, ed. Charles E. Rosenberg and Janet Golden (New Brunswick, NJ: Rutgers University Press, 1997), 33–­49.

220

Notes to Pages 132–138

30. Ibid. See also C. Schwabe, “A Brief History of American Parasitology: The Veterinary Connection between Medicine and Zoology,” in The Current Status and Future of Parasitology, ed. K. S. Warren and E. Purcell (New York: Josiah Macy, 1981), 22–­43. 31. See Novy, “The Role of Protozoa in Pathology,” 1–­27. See also Novy, “Trypanosomes.” 32. Novy, “Trypanosomes.” 33. Novy, “The Role of Protozoa in Pathology,” 1–­27. 34. See Frederick G. Novy, Ward J. MacNeal, and H. N. Torrey, “The Trypanosomes of Mosquitoes and Other Insects,” Journal of Infectious Diseases 4 (1906): 223–­238. See also Novy, “Disease Carriers.” 35. David Bruce to Frederick G. Novy, June 6, 1904, Frederick Novy Papers. 36. See Novy, “Hematozoa in Birds.” See also Novy, “Trypanosomes.” 37. Novy, “Hematozoa in Birds.” 38. Christoph Gradmann, Laboratory Disease, trans. Elborg Forster (Baltimore: Johns Hopkins University Press, 2009), 121–­125. 39. C.E.A. Winslow, “The Characterization and Classification of Bacterial Types,” Science 39 (1914): 106. 40. Howard J. Brown, “The Biological Approach to Bacteriology,” Journal of Bacteriology 23 (1932): 1–­12. 41. Ibid., 11. 42. Ibid. 43. Ibid. 44. Ibid., 7. 45. Ibid. 46. Ibid. 47. Frederick G. Novy, “The Spirit of Research in Medicine,” Physician and Surgeon 24 (1902): 2. 48. Brown, “The Biological Approach to Bacteriology.” 49. Leo Rettger said this. See Leo F. Rettger, “The Science of Bacteriology and Its Relation to Other Sciences,” Journal of Bacteriology 3 (1918): 103–­113. 50. W. Mansfield Clark, “Evolution toward a Mature Scientific Literature,” Journal of Bacteriology 27 (1933): 1–­18. 51. See University of Michigan Medical School, Records, 1850–­2002. See also “Proceedings of the Board of Regents,” October 8, 1902, Bentley Historical Library, University of Michigan, Ann Arbor. 52. Earl McKinley to Frederick G. Novy, June 26, 1929, Frederick Novy Papers, University of Michigan, Ann Arbor. 53. Ibid. 54. “Department of Bacteriology Budget Folder,” Frederick Novy Papers. 55. “Dean’s notes,” September 7, 1902, University of Michigan Medical School Records, 1850–­2002. 56. “Proceedings of the Board of Regents,” October 8, 1902, Bentley Historical Library. 57. “Department of Bacteriology Budget Folder,” Frederick Novy Papers, no. 51. 58. Frederick G. Novy, “Research in Medicine” (notes from Novy’s address given before the legislature of Michigan, April 14, 1931), Frederick G. Novy Papers, Box 1. 59. Frederick G. Novy, “Practical Benefits of Bacteriology,” in First Report of the Michigan Academy of Science 1, ed. Walter B. Barrows (Lansing: Robert Smith Printing, 1894), 14–­18. 60. Ibid.



Notes to Pages 138–146

221

61. See Frederick G. Novy, “Germs, What They Are and How They Produce Disease,” Teachers’ Sanitary Bulletin 1 (1898): 1–­7; see also Novy, “The Spirit of Research in Medicine.” 62. Novy, “Practical Benefits of Bacteriology,” 88. 63. C.E.A. Winslow, The Conquest of Epidemics (Madison: University of Wisconsin Press, 1943). 64. Novy, “Germs, What They Are and How They Produce Disease,” 6. 65. Novy, “Practical Benefits of Bacteriology,” 79. 66. Ibid. 67. Ibid. 68. Frederick G. Novy, “Bacterial Toxins and Anti-­toxins,” The Medical and Surgical Reporter 74, no. 12 (March 21, 1896): 351–­360. 69. Novy, “Research in Medicine.” 70. Farley, Parasites and the Germ Theory of Disease. 71. George Weisz, Divide and Conquer: A Comparative History of Medical Specialization (Oxford: Oxford University Press, 2006). Chapter 5. Significance for American Culture: Arrowsmith

1. Mark Schorer, Sinclair Lewis: An American Life (New York: McGraw-­Hill, 1961), 337–­341. 2. Ibid., 416–­419. 3. See Schorer, Sinclair Lewis. See also Paul de Kruif, The Sweeping Wind (New York: Harcourt Brace, 1962). 4. See Charles E. Rosenberg, “Martin Arrowsmith: The Scientist as Hero,” in No Other Gods: On Science and American Social Thought, ed. Charles E. Rosenberg (Baltimore: Johns Hopkins University Press, 1976). See also Ilana Lowy, “Immunology and Literature in the Early Twentieth Century: Arrowsmith and The Doctor’s Dilemma,” Medical History 32 (1988): 314–­332. 5. See Schorer, Sinclair Lewis. See also de Kruif, The Sweeping Wind. 6. De Kruif, The Sweeping Wind. 7. Fred W. Neal, “Arrowsmith Based on Dr. Novy,” Michigan Daily News, January 29, 1939. 8. Schorer, Sinclair Lewis, 460. 9. Neal, “Arrowsmith Based on Dr. Novy.” 10. Ibid. 11. Schorer, Sinclair Lewis, 337–­341. 12. De Kruif, The Sweeping Wind, 83. 13. Paul de Kruif to Frederick G. Novy, December 1929, Frederick Novy Papers, Box 2, Bentley Historical Library, University of Michigan, Ann Arbor. 14. De Kruif, The Sweeping Wind, 58. 15. Ibid. 16. Ibid., 85. 17. Frederick G. Novy, “Laboratory notebooks 28–­ 30,” 1913–­ 1918, Frederick Novy Papers. 18. See de Kruif, The Sweeping Wind, 58. See also Schorer, Sinclair Lewis, 460. 19. Sinclair Lewis, Arrowsmith (1925; New York: Signet, 1961). 20. Ibid., 182. For Novy’s “spirit” of science, see Frederick G. Novy, “The Spirit of Research in Medicine,” Physician and Surgeon 24 (1902). 21. David Sugar, “Teachers of Fiery Flare,” Detroit Medical News 36 (1934), 10.

222

Notes to Pages 146–154

22. David Sugar, “Novy: Our Teacher,” Detroit Medical News 26 (1937), 12. 23. De Kruif, The Sweeping Wind, 85. 24. Lewis, Arrowsmith, 110–­111. 25. Ibid., 292. 26. Ibid., 19. 27. Ibid., 120, 123. 28. Ibid., 38, 123. 29. Ibid., 22, 123. 30. See Rosenberg, “Martin Arrowsmith: The Scientist as Hero.” See also Lowy, “Immunology and Literature in the Early Twentieth Century.” 31. W.J.V. Osterhout, “Biographical Memoir of Jacques Loeb,” Journal of General Physiology 8, no. 1 (September 15, 1928): ix–­xcii. 32. Lewis, Arrowsmith, 279. 33. Ibid., 120. 34. Ibid., 133–­138. Gottlieb leaves Hunziger. 35. Ibid., 25. 36. Ibid., 124. 37. Frederick G. Novy, “Fifty Years’ Progress in Medical Education,” in A Half Century of Nu Sigma Nu, 1882–­1932, ed. Will Walter and Stuart Graves (Louisville, KY: The Nu Sigma Nu Fraternity, 1935). 38. Ibid., 24. 39. Ibid., 29. 40. Ibid., 123. 41. Ibid., 119. 42. Ibid., 18. 43. Ibid., 227. 44. Ibid., 40. 45. Ibid., 52. 46. Ibid., 118. 47. Ibid., 110. 48. Lewis, Arrowsmith, 127–­129. 49. Ibid., 127–­128. 50. Ibid. 51. L. R. Jones to Frederick G. Novy, June 27, 1929, Frederick Novy Papers. 52. De Kruif, The Sweeping Wind, 7. See also Paul de Kruif to Frederick G. Novy, December 1929, Frederick Novy Papers. 53. Lewis, Arrowsmith, 37. 54. Novy, “The Spirit of Research in Medicine.” 55. Lewis, Arrowsmith, 118. 56. Ibid., 33. 57. Ibid., 33. 58. Max Marshall to Frederick Novy, December 1929, Frederick Novy Papers. 59. Lewis, Arrowsmith, 120. 60. Ibid., 278. 61. Ibid., 280. 62. Ibid., 22. 63. Ibid., 114.



Notes to Pages 154–161

223

64. See ibid., 37. See also Frederick G. Novy, “Ptomaines” (undated), Frederick Novy Papers, Box 1; Frederick G. Novy, “The Cultivation of Trypanosoma brucei,” Journal of the American Medical Association 41 (1903): 1266–­1268. 65. Lewis, Arrowsmith, 121, 124. 66. Ibid., 6–­7, 9. 67. Lewis, Arrowsmith, 343. 68. Ibid., 347. 69. Ibid., 370. 70. Ibid., 371. 71. Ibid., 390. 72. Ibid., 175. 73. Ibid., 178. 74. Ibid., 121. 75. Ibid., 224–­225. See also Howard Markel, “Prescribing ‘Arrowsmith,’” New York Times, September 24, 2000. 76. Lewis, Arrowsmith, 87. 77. Ibid., 115–­132. 78. Ibid. 79. Ibid. 80. Dorothy Wilson (granddaughter of Frederick G. Novy), in discussion with the author, November 6, 2015. See also “Films by Robert L. Novy, 1927–­ 1957.” Robert Novy, Dr. Novy’s eldest son, took videos of family gatherings and vacations. Dr. Novy is seen in several of the scenes laughing and engaging with his family (Christmas 1927; Belle Isle skating, 1929; Hope Bay swimming). 81. Lewis, Arrowsmith, 440–­450. 82. De Kruif, The Sweeping Wind, 7, 11, 39, 85. 83. Schorer, Sinclair Lewis: An American Life, 367. 84. Ibid., 321, 450. 85. The symbol of the noble, autonomous researcher in America has been discussed by several authors. See William C. Summers, “On the Origins of the Science in Arrowsmith: Paul de Kruif, Felix d’Herelle, and Phage,” Journal of the History of Medicine and Allied Sciences 46 (1991): 315–­332. See also Rosenberg, “Martin Arrowsmith: The Scientist as Hero”; Howard Markel, “Prescribing ‘Arrowsmith.’” 86. Paul de Kruif, Microbe Hunters (New York: Harcourt Brace, 1926). 87. Ibid. See also William C. Summers, “Microbe Hunters Revisited,” International Microbiology 1 (1998): 65–­68. 88. Bert Hansen, Picturing Medical Progress from Pasteur to Polio (New Brunswick, NJ: Rutgers University Press, 2009). 89. Sinclair Lewis, Babbitt (San Diego: Harcourt Brace, 1922). See also Sinclair Lewis, Elmer Gantry (New York: Harcourt Trade, 1926). 90. “Arrowsmith,” The New Statesman, March 7, 1925, p. 629. 91. The Spectator, March 7, 1925, p. 372; see also H. L. Mencken, “Sinclair Lewis’ Arrowsmith,” Chicago Tribune, March 8, 1925. 92. Schorer, Sinclair Lewis: An American Life, 1–­347. 93. Arrowsmith. Goldwyn Studios, 1931. 94. Susan Lederer, “Arrowsmith,” Isis 84 (1993): 771–­772. 95. “Arrowsmith,” Chicago Daily Tribune, February 14, 1932.

224

Notes to Pages 161–165

96. “Arrowsmith,” New York Times, December 13, 1931. 97. “Arrowsmith in Films Achieves a New Success,” Chicago Daily Tribune, December 13, 1931. 98. See “Picture Grosses,” Variety, February 9, 1932. See also “Arrowsmith to Stay for Another Week,” Los Angeles Times, February 16, 1932. 99. Summers, “On the Origins of the Science in Arrowsmith.” 100. M. Mead and R. Metraux, “The Image of the Scientist among High School Students,” in The Sociology of Science, ed. B. Barber and W. Hirsch (New York: Free Press, 1969). 101. D. C. Beardsley and D. D. O’Dowd, “The College Student Image of the Scientist,” in The Sociology of Science, ed. B. Barber and W. Hirsch (New York: Free Press, 1962). 102. Rosenberg, “Martin Arrowsmith: The Scientist as Hero.” 103. See de Kruif, The Sweeping Wind. See also Schorer, Sinclair Lewis: An American Life, 421–­435. 104. Novy, “Fifty Years’ Progress in Medical Education.” 105. Neal, “Arrowsmith Based on Dr. Novy.” 106. Summers, “On the Origins of the Science in Arrowsmith.” 107. Mead and Metraux, “The Image of the Scientist among High School Students.” 108. Summers, “On the Origins of the Science in Arrowsmith.” See also Jay Tepperman, “The Research Scientist in Modern Fiction,” Perspectives in Biological Medicine 3 (1960): 550–­553. 109. Tepperman, “The Research Scientist in Modern Fiction.” 110. Marc Lippman, MD, in discussion with the author, December 5, 2012. An academic medical researcher (oncology), Lippman said, “I was raised in an . . . overly idealistic world when it came to medicine. . . . [I] felt physicians were special . . . Not like other professions. . . . We were professors not guild members. We had a code.” See also Mark Kaplan, MD (medical researcher in virology) in discussion with the author, January 12, 2016. Kaplan stated that he was motivated to choose his career by reading Microbe Hunters and Arrowsmith as a teenager. 111. Paul de Kruif to Frederick G. Novy, March 1, 1925, Frederick Novy Papers. 112. Frederick G. Novy to Paul de Kruif, March 16, 1925, Frederick Novy Papers. 113. Dorothy Wilson Novy (granddaughter of Frederick G. Novy), in discussion with the author, February 26, 2015. Ms. Wilson does not recall Dr. Novy’s mentioning the book or the movie. 114. “Dr. Novy Checks on Himself in Arrowsmith,” Ann Arbor Daily News, May 20, 1932. Chapter 6. Making a Scientific Career in Medicine

1. Frederick G. Novy, “Notes on the Department of Bacteriology,” Frederick Novy Papers, Box 3, Bentley Historical Library, University of Michigan, Ann Arbor. 2. Daniel S. Greenberg, The Politics of American Science (Harmondsworth, UK: Penguin, 1969). 3. Frederick G. Novy to Frederick G. Novy III, September 25, 1954, Frederick Novy Papers, Box 3. 4. Frederick G. Novy, “Organic Chemistry college notebook,” 1894, William Prescott, Professor, Frederick Novy Papers, Box 3. 5. Frederick G. Novy to Frederick G. Novy III, July 23, 1955, Frederick Novy Papers, Box 3. 6. Frederick G. Novy, “Organic chemistry notebook,” 1884, Frederick Novy Papers.



Notes to Pages 165–170

225

7. Burke A. Hinsdale, History of the University of Michigan: From 1837 to 1906 (Ann Arbor: University of Michigan, 1906). 8. “History of US Land Grant Extension Services,” accessed January 21, 2015, http://​ www​.csrees​.usda​.gov/​qlinks/​extension​.html​#yesterday. 9. Charles E. Rosenberg, “Science, Technology, and Economic Growth: The Case of the Agricultural Experiment Station Scientist,” in No Other Gods: On Science and American Social Thought, ed. Charles E. Rosenberg (Baltimore: John Hopkins University Press, 1976), 153–­172. 10. “Three Faculty Members Honored by Legislature,” Ann Arbor Daily News, April 15, 1931, p. 4. 11. Ibid. 12. Proceedings of the Board of Regents, November 1891–­October 1896 (October 1895): 401–­403. 13. “Dean’s notes,” September 7, 1902, University of Michigan Medical School Records, 1850–­2002. 14. Several of Novy’s students assumed full-­time bacteriology positions at university-­ affiliated medical schools: Michigan (Soele, Nungester), Illinois (Charles Behrens), Tulane (George Herrmann), Wisconsin (L. R. Jones), and Columbia (Ward MacNeal). 15. Kenneth Ludmerer, Learning to Heal: The Development of American Medical Education (Baltimore: Johns Hopkins University Press, 1996). 16. See Esmond R. Long, “Frederick G. Novy and Some Origins of American Bacteriology,” Transactions & Studies of the College of Physicians of Philadelphia 26 (1957). See also Esmond R. Long, Frederick George Novy, 1864–­1957 (Washington, DC: National Academy of Sciences, 1959). 17. Frank F. Katz, The Rockefeller Institute for Medical Research and a Change in the State of New Jersey’s Animal Experimentation Laws in 1915 (Newark: Medical History Society of New Jersey, 2008). 18. Who’s Who in America: A Biographical Dictionary of Notable Living Men and Women of the United States (Chicago: A. N. Marquis, 1903–­1905), 120, 689, 719, 1201, 1578. 19. Katz, The Rockefeller Institute for Medical Research, 7–­9. 20. Ibid., 12–­15. 21. Ibid., 16. 22. Ibid., 17–­21. 23. “Rockefeller Institute for Medical Research,” British Medical Journal 1 (1912): 560–­561. 24. Ibid. 25. Simon Flexner to Frederick G. Novy, 1929, Frederick Novy Papers, Box 1. 26. Ibid. 27. Frederick G. Novy, “The Hygienic Laboratory,” The Michigan Alumnus 6 (1900). 28. Frederick G. Novy to Simon Flexner, May 23, 1907, Frederick Novy Papers, Box 1. 29. Ibid. 30. Ibid. 31. See Frederick G. Novy to Emmett Holt, March 30, 1907; see also Frederick G. Novy to Emmett Holt, June 28, 1909, and Frederick G. Novy to Emmett Holt, January 14, 1912, Frederick Novy Papers, Box 1. 32. William Welch to Victor Vaughan, May 14, 1901, Frederick Novy Papers, Box 1. 33. Ibid. 34. Ibid.

226

Notes to Pages 171–177

35. Frederick G. Novy to Emmett Holt, September 13, 1901, Frederick Novy Papers, Box 1. 36. Emmett Holt to Frederick G. Novy, June 16, 1902, Frederick Novy Papers, Box 1. 37. Frederick G. Novy to Emmett Holt, March 30, 1907; see also Frederick Novy, “Laboratory notebooks, book 13,” 1907, Frederick Novy Papers, Box 5. 38. Frederick G. Novy to Emmett Holt, April 8, 1903, Frederick Novy Papers, Box 1. 39. Frederick G. Novy to William Welch, 1903, Frederick Novy Papers. 40. Novy to Holt, April 8, 1903. 41. Novy to Welch, 1903. 42. Simon Flexner to Frederick G. Novy, May 27, 1907, Frederick Novy Papers, Box 1. 43. Ibid. 44. Ibid. 45. Flexner to Novy, May 27, 1907. 46. Ibid. 47. Simon Flexner to Frederick G. Novy, June 7, 1907, Frederick Novy Papers, Box 1. 48. Simon Flexner to Frederick G. Novy, June 23, 1907, Frederick Novy Papers, Box 1. 49. Ibid. 50. Frederick G. Novy to Simon Flexner, July 3, 1907, Frederick Novy Papers, Box 1. 51. Ibid. 52. Ibid. 53. Welch to Vaughan, May 14, 1901. 54. Emmett Holt to Frederick G. Novy, August 3, 1912, Frederick Novy Papers, Box 1. 55. Frederick G. Novy to Rockefeller board, June 1, 1912, Frederick Novy Papers, Box 2. 56. Simon Flexner to Frederick G. Novy, January 13, 1913, Frederick Novy Papers, Box 2. 57. Robert Gait to Frederick G. Novy, February 18, 1909, Frederick Novy Papers, Box 1. 58. Frederick G. Novy to Robert Gait, February 21, 1909, Frederick Novy Papers, Box 1. 59. Ibid. 60. See Paul de Kruif to Frederick G. Novy, 1918, Frederick Novy Papers, Box 2. See also Paul de Kruif, “Laboratory Notebook 32,” January 14, 1918, Frederick Novy Papers, Box 7. 61. De Kruif to Novy, 1918. 62. Paul de Kruif to Frederick Novy, April 17, 1917, Frederick Novy Papers, Box 2. 63. Paul de Kruif, The Sweeping Wind (New York: Harcourt Brace, 1962). 64. Sinclair Lewis, Arrowsmith (New York: Signet, 1925), 325. 65. Ibid., 314. 66. Ibid., 321. 67. Ibid., 322. 68. Ibid., 323. 69. Ibid., 316. 70. Ibid., 443. 71. George Hermann to Frederick G. Novy, December 1929, Frederick Novy Papers, Box 1. 72. Robert Kohler, “Science, Foundations, and American Universities in the 1920s,” Osiris, 2nd series, 3 (1987): 135–­164. 73. Harry Marks, Progress of Experiment (Cambridge: Cambridge University Press, 1997). 74. Victoria A. Harden, “A Short History of the National Institute of Health,” NIH Historian, https://​history​.nih​.gov/​exhibits/​history/​index​.html.



Notes to Pages 177–182

227

75. Marks, Progress of Experiment. 76. Harden, “A Short History of the National Institute of Health.” 77. Vannevar Bush, Science: The Endless Frontier (Washington, DC: United States Government Printing Office, 1945), http://​www​.nsf​.gov/​od/​lpa/​nsf50/​vbush1945​.htm​ #summary. 78. Ibid. 79. Greenberg, The Politics of American Science. 80. C.E.A. Winslow, “Some Leaders and Landmarks in the History of Microbiology,” Journal of Bacteriology 2 (1950): 102. 81. Frederick G. Novy, Curriculum Vitae, Frederick Novy Papers (1887), x–­xii, Taubman Medical Library, Ann Arbor. 82. S. E. Gould, “Frederick George Novy, Microbiologist, 1864–­1957,” American Journal of Clinical Pathology (1958). 83. C.E.A. Winslow to Frederick G. Novy, December 1929. See also William Welch to Frederick G. Novy, December 1929; Milton Rosenau to Frederick G. Novy, December 1929; Emile Roux to Frederick G. Novy, December 1929; Charles Calmette to Frederick G. Novy, November 4, 1923; Karl Fraenkel to Frederick G. Novy, May 14, 1907; Paul Ehrlich to Frederick G. Novy, May 19, 1904; and Jan Kabrlik to Frederick G. Novy, June 22, 1929; Frederick Novy Papers, Box 1. 84. Frederick G. Novy, “Miscellaneous speeches and speech notes,” 1895–­1901, Frederick Novy Papers, Box 1. 85. Frederick G. Novy (lecture, Zina Pitcher, Ann Arbor, Michigan, February 22, 1908), Frederick Novy Papers, Box 1. 86. Frederick G. Novy, “Some Results of Microscopical Research Which Have Been Significant for Human Welfare,” Science 84 (1936): 124–­125. 87. Andrew Carnegie, Autobiography of Andrew Carnegie (Boston: Houghton Mifflin, 1920). 88. Greenberg, The Politics of American Science. 89. See Ludmerer, Learning to Heal. See also Thomas Bonner, Becoming a Physician, Medical Education in Britain, France, Germany, and the United States (Baltimore: Johns Hopkins University Press, 1995). See also William Rothstein, American Medical Schools and the Practice of Medicine (Oxford: Oxford University Press, 1986). 90. Rosenberg, “Science, Technology, and Economic Growth.” 91. Katz, The Rockefeller Institute for Medical Research. 92. Frederick G. Novy to Simon Flexner, July 3, 1907, Frederick Novy Papers, Box 1. 93. Ibid. Conclusion

1. See Howard D. Kramer, “The Germ Theory and the Early Public Health Program in the United States,” Bulletin of the History of Medicine 22 (1948): 233–­248. See also George Rosen, A History of Public Health (Baltimore: Johns Hopkins University Press, 1993). 2. Frederick G. Novy, “The Spirit of Research in Medicine,” Physician and Surgeon 24 (1902): 385–­405. 3. Frederick G. Novy, “Research in Medicine” (notes from Novy’s address given before the Michigan legislature, April 14, 1931), Frederick G. Novy Papers, Box 1, Bentley Historical Library, University of Michigan, Ann Arbor. 4. C.E.A. Winslow, “Some Leaders and Landmarks in the History of Microbiology,” Journal of Bacteriology 2 (1950): 99–­114.

228

Notes to Pages 183–185

5. C.E.A. Winslow to Frederick G. Novy, December 1929, Frederick Novy Papers. 6. Paul Ehrlich to Frederick G. Novy, July 19, 1904, Frederick Novy Papers. 7. Emile Roux to Frederick Novy, April 12, 1906, Frederick Novy Papers, Box 1. 8. See William Welch to Frederick Novy, October 13, 1908; see also Emile Roux to Frederick Novy, November 23, 1915, and Paul Ehrlich to Frederick Novy, January (undated), 1905, Frederick Novy Papers, Box 1. 9. Frederick G. Novy, Laboratory Work in Bacteriology (Ann Arbor, MI: George Wahr, 1899). 10. Kenneth Ludmerer, Learning to Heal: The Development of American Medical Education (Baltimore: Johns Hopkins University Press, 1996). 11. See Novy, “The Spirit of Research in Medicine.” See also Novy, Laboratory Work in Bacteriology. 12. George Cotkin, Reluctant Modernism: American Thought and Culture, 1880–­1900 (New York and Toronto: Twayne Publishers, Maxwell Macmillan Canada, & Maxwell Macmillan International, 1992), xi–­xvi, 148–­154. 13. Abraham Flexner, Medical Education in the United States and Canada (New York: Carnegie Foundation for the Advancement of Teaching, 1910), 36–­37, 62, 92. 14. Frederick G. Novy, “Fifty Years’ Progress in Medical Education,” in A Half Century of Nu Sigma Nu, 1882–­1932, ed. Will Walter and Stuart Graves (Louisville, KY: The Nu Sigma Nu Fraternity, 1935), 1669–­1685. 15. Ibid. 16. Ibid. 17. See Earl McKinley to Frederick G. Novy, 1929, Frederick Novy Papers, Box 1; see also George Herrmann to Frederick G. Novy, October 31, 1929, Frederick Novy Papers, Box 1. 18. See Paul de Kruif, Microbe Hunters (New York: Harcourt Brace, 1926). See also Berton Roueché, “Something Extraordinary,” in Eleven Blue Men (New York: Berkley Medallion Books, 1947), 139–­159. 19. See Jay Tepperman, “The Research Scientist in Modern Fiction,” Perspectives in Biological Medicine 3 (1960): 550–­553. See also Marc Lippman, MD (present-­day leader in academic medicine), in discussion with the author, December 5, 2012. An academic medical researcher (oncology), Lippman said, “I was raised in an . . . overly idealistic world when it came to medicine. . . . [I] felt physicians were special . . . not like other professions. . . . We were professors not guild members. We had a code.” Kaplan, a medical researcher (virology), stated that he was motivated to choose his career by reading Microbe Hunters and Arrowsmith as a teenager. 20. Daniel S. Greenberg, The Politics of American Science (Harmondsworth, UK: Penguin, 1969). 21. Ibid. See also G. H. Daniels, “The Process of Professionalization of American Science,” ISIS 58 (1967): 150–­166; G. H. Daniels, “The Pure-­Science Ideal and Democratic Culture,” Science 156 (1967). 22. Frances Collins, “Medical Research that Benefits Everyone’s Health,” NIH Medline Plus, a publication of the National Institute of Health (2009). Accessed April 24, 2015, http://​www​.nlm​.nih​.gov/​medlineplus/​magazine/​issues/​fa1109/​articles/ ​fa1109pg2-4.html. 23. US News and World Report rankings of top medical centers. The amount of federal funds awarded to each center is one criterion that enters the medical rankings. “Best Medical Schools: Research,” U.S. News and World Report (2015),



Notes to Pages 186–189

229

http://​grad​-s­­ chools​.usnews​.rankingsandreviews​.com/​best​-g­­ raduate​-s­­ chools/​top​ -­­medical​-­­schools/​research​-­­rankings. 24. Charles E. Rosenberg, “Disease and Social Order in America: Perceptions and Expectations,” Milbank Quarterly 64 (1986): 34–­55. 25. Ibid. 26. Michael Mulkay, “Norms and Ideology in Science,” Social Science Information 15 (1976): 637–­656. 27. A. Rawling, “The AIDS Virus Dispute: Awarding Priority for the Discovery of HIV,” Science Technology Human Values 19, no. 3 (1994): 342–­360. 28. David Cyronski, “Woo Suk Hwang Convicted, but Not of Fraud,” Nature 461 (2009): 1181. 29. See S. Reverby, Tuskegee’s Truths (Chapel Hill: University of North Carolina Press, 2000). See also S. Reverby, “Ethical Failures and History Lessons: US Public Health Service Research Studies in Tuskegee and Guatemala,” Public Health Reviews 34 (2014): 1–­17. 30. Howard Markel, “Prescribing ‘Arrowsmith,’” New York Times, September 24, 2000. 31. M. Foucault, Birth of a Clinic: An Archeology of Medical Perception (New York: Random House, 1973). 32. See “Effects of Early Career NIH Programs on Physician-­Scientists with a Medical Degree.” Accessed April 24, 2015, http://​report​.nih​.gov/​workforce/​psw/​early​ _career​_programs​.aspx. See also S. Tavernise, “The Condition Cancer Is In,” interview by Harold Varmus, New York Times, March 30, 2015, S3. 33. Tavernise, “The Condition Cancer Is In.” 34. L. M. Bennett and H. Gadlin, “Collaboration and Team Science: From Theory to Practice,” Journal of Investigational Medicine 60 (2012): 768–­775. 35. H. H. Garrison and A. M. Deschamps, “NIH Research Funding and Early Career Physician Scientists: Continuing Challenges in the 21st Century,” Journal of the Federation of American Societies for Experimental Biology 28, no. 3 (2014): 1049–­1058. 36. See Keith Alcorn, “Leading AIDS Experts Criticize Major US Vaccine Trial.” Accessed April 24, 2015, http://​www​.aidsmap​.com/​Leading​-­­AIDS​-­­experts​-­­criticise​ -­­major​-­­US​-­­vaccine​-­­trial/​page/​1417282/. See also Jon Cohen, Shots in the Dark: The Wayward Search for an AIDS Vaccine (New York: W. W. Norton, 2001). 37. Tavernise, “The Condition Cancer Is In.” 38. Editorial, “A Pause to Weigh Risks of Gene Editing,” New York Times, December 18, 2015, A34. 39. Tavernise, “The Condition Cancer Is In.” 40. J. Rovner, “Medical Schools Try to Reboot for 21st century,” Kaiser Health News, April 9, 2015. 41. William Rothstein, American Medical Schools and the Practice of Medicine (Oxford: Oxford University Press, 1986). 42. D. Beaulieu-­Volk, “New Medical School Curriculums Emphasize Communication, Teamwork.” Accessed April 24, 2015, http://www.fiercehealthcare.com/practices/new -med-school-curriculums-emphasize-communication-teamwork. 43. G. Geison, The Private Science of Louis Pasteur (Princeton: Princeton University Press, 1995).

Index Page references to figures are indicated by f, to tables by t. Abbott, Alexander C., 12, 129 Abel, John Jacob, 24 adulterated food, 19, 22, 29–­30, 39–­40, 100 anaerobes, 59–­60, 84, 147, 205n45 anaphylaxis, 83, 121, 145, 147, 175 anaphylotoxin, 83 Angell, James, 21–­22, 23, 28, 29, 165 Armour, Philip D., 31 Bacillus novyi, 60 bacteriology: early studies in, 5–­12, 134, 138–­139; independent status of, 14, 112, 128–­142; Novy’s attraction to, 35–­39, 94, 104, 131; practical applications of, 38, 41–­42, 84, 134, 138 Baker, Henry, 18 Barker, Lewellys, 79 Bartell, Floyd, 61 Bartholomew, Ira, 18 Behrens, Charles, 112–­115 (113f) Behring, Emil von, 8–­9, 134, 138, 158 Ben-­David, Joseph, 37 Berlin Institute, 36–­37 Biggs, Hermann, 167, 170 Bledstein, Burton, 129 Bonner, Campbell, 117 Bonner, Thomas, 27 Brown, J. Howard, 133–­134 Bruce, David, 66, 69, 72–­73, 84 Bulloch, William, 9 Burrill, Thomas, 12 Bush, Vannevar, 178, 188 Cagniard-­Latour, Charles, 134 Calmette, Charles, 178 Chapin, Charles, 9–­10 Christopher, Walter, 32 Clark, Mansfield, 135 Cohen, Barnett, 11 collodium sac, 55t, 61 Colman, Ronald, 159, 160f

Conn, Herbert W., 129 conversion of species (microbic), 78 Cooley, Thomas, 108, 116–­117 Cushing, Harvey, 8 Cushney, Arthur, 24 de Kruif, Paul, 14, 82–­83, 113f, 118–119, 120–­ 121, 122f, 152, 157, 161–­162, 175–­176; Lewis and, 6, 14–­15, 122, 143–­147, 156, 176; Microbe Hunters, 158, 184–­185, 187 Delafontaine, Marc, 25, 28 Dewey, John, 93–­94, 103, 109 diamines, 52, 53 diphtheria, 33–­34, 138, 139–­140, 166 Dock, George, 24, 105 Dodson, John, 108–­109 Duffy, John, 7, 10–­11 Ehrlich, Paul, 134, 158, 178, 183 Eliot, Charles, 22 Ellinwood, C. N., 80 Ernst, H. C., 88 federal funding for medical research, 165, 177–­178, 185, 187–­188 filterable viruses, 63–­64, 134, 206n64, 206n66 Flexner, Abraham, 3, 5, 93–­94, 103, 184 Flexner, Simon, 79, 167, 169–­175 Ford, John, 159 Formad, Henry, 12 Foucault, Michel, 187 Fraenkel, Karl, 36–­37, 178 Furstenberg, A. C., 117, 164 Gait, Robert, 175 Garwood, Grace. See Novy, Grace Geison, Gerald, 189 germ theory, 7–­9, 11, 37, 38–­39, 52, 59, 80, 85, 87, 91–­92, 104, 210n44; protozoology and, 133

231

232 Index

Gibbes, Henneage, 91, 104–­106, 151, 166 Gilman, Daniel, 98 Gottlieb, Max. See Lewis, Sinclair: Arrowsmith and Novy Hare, Charles, 80, 155 Hatch Act, 165 Henle, Joseph, 7–­8, 38–­39, 52–­53 Herrmann, George, 113f, 117, 177 Herter, Christian, 167 heterogenesis, 77 Hoad, W. C., 117 hog cholera bacillus, 41 Homes, George, 88 Howard, Sidney, 159 Howell, William, 137 Huber, Gotthelf Carl, 137 Hueppe, Ferdinand, 35–­36 insect vector, 69–­70, 75 Jenner, Edward, 139 Jones, L. R., 119–­120, 152 Jordan, Edwin O., 93 Kabrlik, Jan, 178 Kiefer, Hermann, 22, 105–­106, 137, 166 Kinyoun, Joseph, 78–­79 Kleine, Friedrich, 70 Knapp, Lewis, 107, 117 Koch, Robert, 1, 8–­9, 16, 17, 36–­37, 42, 69, 72–­73, 84, 92, 130, 154, 170 Kramer, Howard, 10–­11 Kuhlman, Charles, 80, 155 Langley, John, 29, 31–­32 Leavitt, Judith Walzer, 7 leishmania parasite, 73–­74, 74f–­76f Lewis, Sinclair: Arrowsmith and Novy, 2, 6, 14–­15, 122, 143–­163, 176–­177, 184, 185, 187–­188; film version of Arrowsmith, 15, 159–­161, 160f; Novy’s response to, 162–­ 163; other novels by, 158–­159 Lippman, Marc, 224n110, 228n19 Lister, Joseph, 130 Loeb, Jacques, 14, 144–­145, 147–­148, 158 Lombard, Warren, 24

Long, Esmond, 10 Ludmerer, Kenneth, 97 MacNeal, Ward, 67 Mall, Franklin, 24 Marshall, Maxwell, 82, 152–­153 McClelland, Charles, 37 McFarland, Joseph, 12 McGurk Research Institute, 144, 156, 176 McKinley, Earl, 111–­112, 114–­115, 116–117, 122 medical school curriculum, basic courses in, 2, 94, 126, 183 Mencken, H. L., 135, 159 metabolism, 13, 41, 52, 53, 55–­56, 59, 88, 134, 140, 148 Michigan Board of Health, 18–­19, 38 Michigan Department of Health, 17, 19, 22, 29, 138 Migula, Walter, 205n48 Moore, Veranus, 12 Morrill Acts, 165, 177 Morris, Charles, 61 Nicolle, Charles, 66–­67 Novy, Frances, 28 Novy, Frederick: background and education, 1, 12–­13, 17–­18, 23, 24–­39, 165; career trajectory, 164–­181; equipment used by, 50–­51t, 52f, 53, 54–­55t, 57, 58f, 59–­62, 91; German research influence, 35–­37, 42, 44, 90, 102, 125; honors received, 178; legacy of, 183–­ 186, 189–­190; notebook illustrations, 30f, 34f, 89f, 121f; pedagogical views and practices, 13–­14, 33–­37, 82, 85, 86–­127, 136–­137, 141, 149–­151, 183–­184, 188–­189, 201n130; personality, 120–­124; photographs of, 26f, 46f, 49f, 58f, 65f, 113f, 114f, 118f, 119f, 168f, 179f; professional organizations membership, 178; public health concerns, 31, 39–­42, 99–­100, 139–­140, 166; pure science ideal, 1, 3–­4, 6, 15, 18, 38, 41–­42, 44, 97–­99, 107–­111, 114–­ 115, 125, 135–­137, 140, 145, 149, 161–­162, 174, 182, 184, 187; religious affiliation, 99, 215n86; retirement, 64, 167; salary, 31, 124, 169–­170, 171–­173; textbook publications, 88, 90f, 93, 95, 178. See also Lewis, Sinclair;



Index 233

“spirit of research” concept; University of Michigan Hygienic Laboratory Novy, Grace (née Garwood), 45, 79, 101, 122, 124, 170, 179f Novy, Joseph, 24–­25, 28 Novy, Theodore, 28 Novy jar, 54t, 60 nucleins, 60 Nungester, Walter G., 122–­123, 164 Obermeier, Otto, 206n53 Obetz, H. L., 105 Pamell, Harold, 88 Pardee, George, 81 Park, William, 9 Pasteur, Louis, 1, 8–­9, 16, 53, 56, 85, 134, 170, 189 Pasteur Institute, 17, 66, 178 physician-­scientist role, 2, 183, 164 plague epidemiology, 79–­81 Prescott, Albert, 19, 21, 27–­28, 29–­32, 40, 165 protozoa (and protozoology), 13, 27, 59, 64–­67, 71, 73, 75–­77, 84, 88, 141; life history of, 67, 75–­76, 132; need for study of, 131–­133 Prudden, T. Mitchell, 12, 167 ptomaines, 55–­56, 154 pure science ideal, 44, 110, 125, 136, 182, 184. See also Novy, Frederick: pure science ideal Reed, Walter, 158 religion and science, 98–­99, 108, 116–­117, 126, 153–­154 Remsen, Ira, 98 respiration (microbic), 3, 52, 53, 57, 59, 83, 134, 140, 148 Rettger, Leo, 135 Rockefeller Institute for Medical Research, 14–­15, 84, 144, 167–­176, 181 Roehm, Harold, 164 Romano, Terrie, 42 Rosen, George, 10–­11 Rosenau, Milton, 123 Rosenberg, Charles, 165, 180–­181

Rosenkrantz, Barbara, 7 Rothstein, William, 37 Roueché, Berton, 184–­185 Roux, Emile, 9, 138, 178, 183 Rowland, H. A., 98 Russell, Harry Lyman, 12 San Francisco plague, 13, 15, 78–­82, 132, 154–­155 Schaudinn, Fritz, 77–­78, 154 Schwann, Theodore, 134 Sedgwick, William, 129–­131, 133 Semmelweis, Ignaz, 139 Sewell, Henry, 24, 35, 87 Shorer, Mark, 145 Smith, Stephen, 9–­10 Smith, Theobald, 12, 39, 73, 76, 84, 88, 93, 156, 167, 170, 181, 182 Snow, John, 139 Society of American Bacteriologists, 2, 5, 14, 128, 129–­137, 140–­141 Soule, Malcolm, 164 “spirit of research” concept, 4, 14, 86, 95–­ 100, 106, 112–­115, 124–­126, 134–­136, 180; in Arrowsmith, 146–­154 Spirochaeta novyi, 62 spirochetes, 61–­63, 77–­78, 84 Starr, Paul, 11 Sternberg, George, 12 Sugar, David, 107, 116, 146 Taylor, Alonzo, 81 Taylor, Frederick, 109–­110 Terry, B. T., 117 Trelease, William, 12 trypanosomes, 27, 65–­72, 68f–­69f, 71f, 74–­ 75, 77–­78, 82–­84, 154, 183; immunity to, 82, 84, 171, 174–­175 tsetse flies, 69–­72, 72f typhoid fever, 40 University of Michigan Homeopathic Medical College, 101, 105 University of Michigan Hygienic Laboratory, 3, 13, 48–­49f, 166; anomalous position of, 42–­43, 164, 165; Berlin Institute influence on, 36, 44; establishment of, 17,

234 Index

University of Michigan Hygienic Laboratory (continued) 20–­24, 185; Novy’s work at, 35, 39–­45, 47–­77, 82–­85, 91, 137–­141 University of Michigan Medical School, 17, 23–­24, 87, 93, 102, 105, 131, 165; Department of Bacteriology at, 137, 164, 166 Varmus, Harold, 188 Vaughan, Victor, 3, 13, 17, 19–­24, 32, 35–­36, 39–­45, 87, 93, 102–­103, 105–­106, 140,

165–­166, 180; Department of Bacteriology and, 137, 164, 166 Warthin, Aldred, 24, 137 Weisz, George, 141 Welch, William, 12, 38–­39, 67, 73–­75, 84, 93, 167, 170–­171, 174, 178, 181, 182 White, Andrew, 22 Winslow, C.E.A., 11, 59, 73–­75, 133, 178 Wyman, Walter, 78–­79

About the Author

Powel Kazanjian is a medical historian and a professor in the Department of History at the University of Michigan. He is an infectious disease physician, a professor, and the chief of infectious diseases, University of Michigan Medical Center. He writes, teaches, and publishes scholarly work on the history of infectious epidemics.

Titles available in the Critical Issues in Health and Medicine series Emily K. Abel, Suffering in the Land of Sunshine: A Los Angeles Illness Narrative Emily K. Abel, Tuberculosis and the Politics of Exclusion: A History of Public Health and Migration to Los Angeles Marilyn Aguirre-­M olina, Luisa N. Borrell, and William Vega, eds., Health Issues in Latino Males: A Social and Structural Approach Anne-­Emanuelle Birn and Theodore M. Brown, eds., Comrades in Health: U.S. Health Internationalists, Abroad and at Home Susan M. Chambré, Fighting for Our Lives: New York’s AIDS Community and the Politics of Disease James Colgrove, Gerald Markowitz, and David Rosner, eds., The Contested Boundaries of American Public Health Cynthia A. Connolly, Saving Sickly Children: The Tuberculosis Preventorium in American Life, 1909–­1970 Patricia D’Antonio, Nursing with a Message: Public Health Demonstration Projects in New York City Tasha N. Dubriwny, The Vulnerable Empowered Woman: Feminism, Postfeminism, and Women’s Health Edward J. Eckenfels, Doctors Serving People: Restoring Humanism to Medicine through Student Community Service Julie Fairman, Making Room in the Clinic: Nurse Practitioners and the Evolution of Modern Health Care Jill A. Fisher, Medical Research for Hire: The Political Economy of Pharmaceutical Clinical Trials Charlene Galarneau, Communities of Health Care Justice Alyshia Gálvez, Patient Citizens, Immigrant Mothers: Mexican Women, Public Prenatal Care and the Birth Weight Paradox

Gerald N. Grob and Howard H. Goldman, The Dilemma of Federal Mental Health Policy: Radical Reform or Incremental Change? Gerald N. Grob and Allan V. Horwitz, Diagnosis, Therapy, and Evidence: Conundrums in Modern American Medicine Rachel Grob, Testing Baby: The Transformation of Newborn Screening, Parenting, and Policymaking Mark A. Hall and Sara Rosenbaum, eds., The Health Care “Safety Net” in a Post-­Reform World Laura L. Heinemann, Transplanting Care: Shifting Commitments in Health and Care in the United States Laura D. Hirshbein, American Melancholy: Constructions of Depression in the Twentieth Century Laura D. Hirshbein, Smoking Privileges: Psychiatry, the Mentally Ill, and the Tobacco Industry in America Timothy Hoff, Practice under Pressure: Primary Care Physicians and Their Medicine in the Twenty-­first Century Beatrix Hoffman, Nancy Tomes, Rachel N. Grob, and Mark Schlesinger, eds., Patients as Policy Actors Ruth Horowitz, Deciding the Public Interest: Medical Licensing and Discipline Powel Kazanjian, Frederick Novy and the Development of Bacteriology in Medicine Rebecca M. Kluchin, Fit to Be Tied: Sterilization and Reproductive Rights in America, 1950–­1980 Jennifer Lisa Koslow, Cultivating Health: Los Angeles Women and Public Health Reform Susan C. Lawrence, Privacy and the Past: Research, Law, Archives, Ethics Bonnie Lefkowitz, Community Health Centers: A Movement and the People Who Made It Happen

Ellen Leopold, Under the Radar: Cancer and the Cold War Barbara L. Ley, From Pink to Green: Disease Prevention and the Environmental Breast Cancer Movement Sonja Mackenzie, Structural Intimacies: Sexual Stories in the Black AIDS Epidemic David Mechanic, The Truth about Health Care: Why Reform Is Not Working in America Richard A. Meckel, Classrooms and Clinics: Urban Schools and the Protection and Promotion of Child Health, 1870–­1930 Alyssa Picard, Making the American Mouth: Dentists and Public Health in the Twentieth Century Heather Munro Prescott, The Morning After: A History of Emergency Contraception in the United States James A. Schafer Jr., The Business of Private Medical Practice: Doctors, Specialization, and Urban Change in Philadelphia, 1900–­1940 David G. Schuster, Neurasthenic Nation: America’s Search for Health, Happiness, and Comfort, 1869–­1920 Karen Seccombe and Kim A. Hoffman, Just Don’t Get Sick: Access to Health Care in the Aftermath of Welfare Reform Leo B. Slater, War and Disease: Biomedical Research on Malaria in the Twentieth Century Matthew Smith, An Alternative History of Hyperactivity: Food Additives and the Feingold Diet Paige Hall Smith, Bernice L. Hausman, and Miriam Labbok, Beyond Health, Beyond Choice: Breastfeeding Constraints and Realities Susan L. Smith, Toxic Exposures: Mustard Gas and the Health Consequences of World War II in the United States Rosemary A. Stevens, Charles E. Rosenberg, and Lawton R. Burns, eds., History and Health Policy in the United States: Putting the Past Back In Barbra Mann Wall, American Catholic Hospitals: A Century of Changing Markets and Missions Frances Ward, The Door of Last Resort: Memoirs of a Nurse Practitioner