INFANTILE PARALYSIS EPIDEMIC Rutland, Vermont 1894 The First Pol
t
Preface
Although men may battle with men, and nations with nations, man knows neither
personal grudge nor national enmity in the fight against a common foe that threatens
all mankind, such as disease. In the field of medicine and public health man has con­
quered and will continue to conquer only by cooperative effort and the benefit of
cumulative experience. The knowledge of the cause of a disease and its treatment
must not die with him who discovered it; and when a disease is still unconquered
it is quite as important that all the ground gained should be held, and all possible
information as to the enemy's strength and weakness should be known to those who
are still fighting the battle.
Infantile paralysis [had been] fairly well described [as] early as 1774. The first
known epidemic of any considerable size in the United States occurred in Vermont
in the summer of 1894. [It] was reported by Dr. Charles S. Caverly, President of
the State Board of Health.
Not only was Vermont to be associated with the history of infantile paralysis
because of this first epidemic, but later epidemics made heavy inroads upon the com­
paratively small population of the state, leaving many crippled children to be cared
for. This situation became so serious that after an epidemic of 306 cases in 1914,
through the efforts of Dr. Caverly and the generosity of an anonymous friend of
the state whose interest he enlisted, a special fund was provided for the study of the
cause and treatment of infantile paralysis.
Thus it happened that from being the first state in which the disease occurred
in epidemic form, Vermont also became the first to undertake on a state-wide scale
the after-care of the victims of infantile paralysis. The special fund, as stated, also
provided for research as to the cause and transmission of the disease, and in this
field, too, much valuable knowledge resulted from efforts of those carrying on the
work.
From Infantile Paralysis in Vermont-1894-1922,
State Department of Public Health, p. 9-10.
CHARLES SOLOMON CA
on 30 September 1856, the only Sl
Charles Caverly's father was also
ticed medicine in Troy and Pitt:
Charles was educated in the!
for college at Kimball Union A
graduated from Dartmouth con
valedictorian of his class. Upon
from which he received the degr'
and recipient of three prizes. Su
College of Physicians and Surgec
in January 1883. For a year he '
an eminent physician who was, a
opened his own office in his hom
He specialized in diseases of the
Doctor Caverly married M~
She was the daughter of Harley C
husband had one son, Harley, VI;
of his death, Harley Caverly wa.
Johns Hopkins University in B~
Charles Caverly lived to be
fluenza that swept the country c
His Public Works l
Although decidedly successfl
health movements that Dr. Caver
Health officer of Rutlan
national guard, member VeT:
dent and animating spirit [f
society in 1892, director an
vice president and director I
health association and coun
American medical associati
He was professor of hy
sity of Vermont, and was to
the week following his deat]
to have every student atten
He was a member of the
F. and A.M., of Davenport
NO.6 Knights Templar.
58 The First Polio Epidemic in the U.S.
1894
by Jean C. Ross
)ns with nations, man knows neither
,gainst a common foe that threatens
;ine and public health man has con­
loperative effort and the benefit of
lUse of a disease and its treatment
vhen a disease is still unconquered
~d should be held, and all possible
ness should be known to those who
scribed [as] early as 1774. The first
United States occurred in Vermont
'. Charles S. Caverly, President of
:h the history of infantile paralysis
made heavy inroads upon the com­
many crippled children to be cared
an epidemic of 306 cases in 1914,
~rosity of an anonymous friend of
d was provided for the study of the
state in which the disease occurred
•to undertake on a state-wide scale
s. The special fund, as stated, also
mission of the disease, and in this
lm efforts of those carrying on the
rntile Paralysis in Vermont-1894-1922,
e Department of Public Health, p. 9-10.
CHARLES SOLOMON CAVERLY, M.D., was born in Troy, New Hampshire,
on 30 September 1856, the only son of Abiel Moore and Sarah P. (Goddard) Caverly.
Charles Caverly's father was also a doctor. He attended Dartmouth College and prac­
ticed medicine in Troy and Pittsford, Vermont, where he moved in 1862.
Charles was educated in the high schools of Pittsford and Brandon. He prepared
for college at Kimball Union Academy in Meriden, New Hampshire. In 1878 he
graduated from Dartmouth College where he was a member of Phi Beta Kappa and
valedictorian of his class. Upon graduation he entered the University of Vermont,
from which he received the degree of M.D. in 1881. At UVM he was a class leader
and recipient of three prizes. Subsequently, he studied for eighteen months at the
College of Physicians and Surgeons in New York City, beginning practice in Rutland
in January 1883. For a year he was in association with Dr. Middleton Goldsmith,
an eminent physician who was, also, a close friend. Dr. Caverly then independently
opened his own office in his home at 9 Court Street, next to the County Courthouse.
He specialized in diseases of the nose, throat and chest.
Doctor Caverly married Mabel Alice Tuttle in Rutland on 5 November 1885.
She was the daughter of Harley C. and Mary (Root) Tuttle of Rutland. She and her
husband had one son, Harley, who died in 1910 at the age of 23 years. At the time
of his death, Harley Caverly was enrolled in a post-graduate course in medicine at
Johns Hopkins University in Baltimore.
Charles Caverly lived to be 62 years of age. He died in the 1918 scourge of in­
fluenza that swept the country at the close of World War I.
His Public Works!
Although decidedly successful in private practice, it was in connection with public
health movements that Dr. Caverly was best known. Some of the offices he filled were:
Health officer of Rutland, assistant surgeon 1st regiment, Vermont
national guard, member Vermont state board of health in 1890 and its presi­
dent and animating spirit [from] 1891, president Rutland County medical
society in 1892, director and vice president Rutland hospital association,
vice president and director Pittsford sanatorium, director American public
health association and counsellor for New England district, fellow [of the]
American medical association.
He was professor of hygiene and preventive medicine [at] the Univer­
sity of Vermont, and was to have commenced his annual course of lectures
the week following his death. The United States government had intended
to have every student attend this course.
He was a member of the Congregational church, Rutland lodge, No. 79,
F. and A.M., of Davenport chapter, R.A.M., and Killington commandery,
No.6 Knights Templar.
59
-l
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o
endemic. The first cases occurre i
By mid-July towns around the co
prevailed chiefly in Rutland City.
Dr. Charles Caverly, sen iog
among parents of young children.
the outbreak. In his official capa,­
Caverly sought detailed informati
practicing in the area. T he s
e.
affected by an epidemic of a e
Of the cases about whi­
Otter Creek Valley. Dr. Ca e .
In his preliminary report p t ­
there were more afflicted males
10 died, leaving 50 per mane " .
contribution in America of' e
Meeting of the American . Ie.:!
1895, Dr. Caverly read the 0
Jurisprudence:
NOTES OF
A~
EPIDE
C (
The following 'So"e: -e
an official capacity at the . ~e
and professional imerco -se.
Charles S. Caverly (1856-1918), Rutland physician, president of the State Board of
Health, 1891-1918.
He was a charter member of the Rutland Country Club . He received
the honorary degree of Doctor of Science from the University of Vermont
[for] his distinguished services in the interest of literature and art, acquired
and cultivated during a life of active reading and observation, both at home
and abroad.
He took no active personal part in politics, but may fairly be credited
with fathering all the advanced legislation on public health which passed
[the] Vermont Legislatures, with the result that both in legislation and prac­
tice, the state [was] a recognized leader. In addition, he succeeded in building
up a department of research in connection with the state laboratory of
hygiene, which at times astounded the medical world with the originality
and importance of its discoveries.
Early in the summer of 1894 physicians in parts of Rutland County observed
that an acute nervous disease, almost invariably accompanied by some paralysis, was
The epidemic was 0 - e .­
characteristic was mOlOr Ci;"
or groups of muscles , and
valley,duringthesummerof l
the time, were published in t e Y
York Medical Record for D -.
not seem possible to speak 0 ­
disease of unusual type." A fun
however, and of the subseque
roborative opinions of many a e
at the time existed, as to the orr
The epidemic, as I have ind _.
1894. It prevailed with increasing se
about the first of August, and srea
last case occurring early in that m
The early summer was popular
official figures do not substantiate t
statistics show little variation fro m
outbreak is a portion of the Otter
twelve to fifteen wide , including th
the largest stream of water in the SI
....,
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endemic. The first cases occurred in the City of Rutland about the middle of June.
By mid-July towns around the county began to report cases, although the disease
prevailed chiefly in Rutland City.
Dr. Charles Caverly, sensing the general feeling of unease prevailing primarily
among parents of young children, began to undertake a systematic investigation of
the outbreak. In his official capacity as president of the State Board of Health, Dr.
Caverly sought detailed information, in regard to their own cases, from all physicians
practicing in the area. The survey convinced Dr. Caverly that the region had been
affected by an epidemic of a nervous disease very rarely observed.
Of the cases about which he took notes, all but six of 123 cases occurred in the
Otter Creek Valley. Dr. Caverly found several degrees of severity among the patients.
In his preliminary report published in the New York Medical Record, among children
there were more afflicted males than females; among 110 children 50 recovered fully;
10 died, leaving 50 permanently disabled. The report was acknowledged as the best
contribution in America of the disease up to that time. At a subsequent 46th Annual
Meeting of the American Medical Association at Baltimore, Maryland, in May of
1895, Dr. Caverly read the following report in the Section on Neurology and Medical
Jurisprudence:
NOTES OF AN EPIDEMIC OF ACUTE ANTERIOR POLIOMYELITIS
By Charles S. Caverly, M.D.
The following "Notes" are the result of an investigation undertaken by me in
an official capacity at the time of the outbreak, and since continued through private
and professional intercourse.
In,
president of the State Board of
ld Country Club. He received
()m the University of Vermont
of literature and art, acquired
and observation, both at home
ics, but may fairly be credited
m public health which passed
at both in legislation and prac­
iition, he succeeded in building
. with the state laboratory of
ical world with the originality
parts of Rutland County observed
ccompanied by some paralysis, was
The epidemic was one of an acute nervous disease whose chief distinguishing
characteristic was motor paralysis, more or less complete, of one or more members
or groups of muscles, and which prevailed in the State of Vermont, chiefly in a single
valley, during the summer of 1894. The results of my investigations, as far as completed at
the time, were published in the Yale Medical Journal for Nov., 1894, and in the New
York Medical Record for Dec. 1, 1894. At the time of making these reports, it did
not seem possible to speak of the epidemic more definitely than as one of "acute nervous
disease of unusual type." A further careful study of the complex features of the epidemic,
however, and of the subsequent history of many of the cases, together with the cor­
roborative opinions of many able medical men, seems to clear up any doubt that
at the time existed, as to the correct diagnosis of the essential disease that prevailed.
The epidemic, as I have indicated, invaded our valley in the early summer of
1894. It prevailed with increasing severity during July, apparently reached its climax
about the first of August, and steadily declined until about the first of October, the
last case occurring early in that month.
The early summer was popularly considered unusually hot and dry, though the
official figures do not substantiate the former opinion. The temperature and humidity
statistics show little variation from the average. The territory mainly covered by this
outbreak is a portion of the Otter Creek Valley, about thirty miles long and from
twelve to fifteen wide, including the sides of the bounding mountains. Otter Creek,
the largest stream of water in the State, has its source in the mountains to the south
61
of the affected area, and sluggishly flows in a northerly direction through it, empty­
ing some miles below into Lake Champlain. That part of its course through the affected
district is the most populous and likewise the narrowest part of the valley. The city
of Rutland is the commercial and geographical center of this area. The towns affected
have a combined population of 26,000, of which fully two-thirds dwell in the quarrying
and manufacturing centers of Rutland, West Rutland and Proctor.
The starting point of the epidemic, and most of the earlier cases, were at Rutland.
In this city occurred 55 of the 132 cases of which I have notes; 27 of the remainder
occurred in the town of Proctor, one-sixth the population of Rutland. This town
suffered the worst of any in the valley. The remaining fifty cases were scattered over
the rural districts in fourteen towns. The most of these cases occurred at considerable
elevation above the creek, and many well up on the Green Mountains. Four of these
towns with eight of the cases are not in the Otter Creek Valley. The natural drainage
of the valley is the creek, and this stream, below Rutland, carries a large amount
of sewage. If the disease had shown any preference for those houses immediately
on the stream below Rutland, it might at once be inferred that the low water in a
sewerage-contaminated stream had some bearing on the etiology of the disease. But
such did not appear to have been the case, except possibly, in the town of Proctor,
which is six miles below Rutland and is built on the abrupt bluffs above the stream.
Drainage defect in general did not seem to influence the distribution of the disease.
The water supply was excluded as an etiologic factor, it being largely from wells in
the rural communities, and in the villages from mountain streams and springs. That
the general sanitary surroundings and methods of living were in anywise responsible
for the outbreak is also more than doubtful, since the disease showed no partiality
to that class of the population whose habits and surroundings are the most unsanitary.
The so-called laboring classes were oftenest affected, but not out of proportion to
their numbers. These classes here, whether among the farming population or in the
mills and quarries, have usually pure air, food and water. Hence, general sanitary
conditions did not seem to have any influence on the epidemic.
The geologic formation of the valley is not peculiar. The prevailing formation
is limestone, and in the range that skirts the western border of the valley is found
the chief marble deposit of Vermont. The valley as a whole is an old lake basin and
is pronounced by Prof. G. W. Perry, the State Geologist, as a very ordinary valley.
The outbreak of which I speak consisted of upward of 130 cases of disease in
which the commonest clinical manifestation was some degree of motor paralysis of
widely varying extent. It will not surprise anyone that so large a number of cases
presenting a bewildering variety of initiatory constitutional symptoms, as well as local
paralyses, should have proved a very knotty problem for the diagnostician. It was
long a question whether this was an epidemic of one, two, or more diseases, and
along the established lines of symptomatology and pathology there was no solution
of the problem. I have been able to collect histories more or less complete of 132
cases directly affected in this epidemic, and this number probably represents at least
90 per cent of the whole number.
Case J. Boy, 3 years, American. Hygienic surroundings good; previous health
good; active child; stronger than his brother two years older. No apparent cause.
Fell sick June 20. Moderate fever, coated tongue, loss of appetite, sluggish bowels.
His condition was confidently ascribed to indigestion, and after two or three days
62
the continuance of the symptoms, 1
of explanation. On the third day}
It was soon evident that this was the
no anesthesia or noticeable hyperes
extensors of the thigh. After the enti
weakness began to improve, at fir
full recovery.
I
This case is an excellent iIlusl
that included about forty cases.
Case 2. Boy, 3 Y2 years, Irish
active of a family of three childreI
day. Taken with high fever, tempel
and headache. Had incontinence of I
subsided except incontinence of u
of his legs. Patellar reflexes dimin
There was also diminution of fara
right slowly. After six weeks was I
of chairs. After three months the
glutei and lower spinal muscles. H
curvature. The incontinence of uril
it was relieved by circumcision. The
spinal muscles and promises to be
This case illustrates a very con
cases there is probably some peru
Case 88. Practice of Dr. Gale,
had been frail. Had had a spinal Cl
with high fever, nausea, head- anc
was paralyzed in all the extremitiel
sided at this time. There was extreI
constipation from seeming lack of
speedily passed off. Hyperesthesia
phine for several weeks. After nine
being able to flex the fingers and tc
has passed off.
Case 4. Practice of Dr. Fox,
two or three occasions had convul
bance. Was seized with convulsior
nine hours. Moderate fever, rapid I
and back. No paralysis noted dud.
the last three days of illness. Deal
These four cases represent vari
these cases there were eighteen de
The paralysis. which was the Ie
in 119 instances. Of the remaining
or it could not be determined whethe
therly direction through it, empty­
through the affected
row est part of the valley. The city
Iter of this area. The towns affected
Uy two-thirds dwell in the quarrying
Itland and Proctor.
irt of its course
,f the earlier cases,
were at Rutland.
I have notes; 27 of the remainder
)opulation of Rutland. This town
Iling fifty cases were scattered over
hese cases occurred at considerable
Ie Green Mountains. Four of these
:reek Valley. The natural drainage
'i Rutland, carries a large amount
nce for those houses immediately
e inferred that the low water in a
on the etiology of the disease. But
: possibly, in the town of Proctor,
b.e abrupt bluffs above the stream.
lce the distribution of the disease.
~tor, it being largely from wells in
ountain streams and springs. That
living were in anywise responsible
:e the disease showed no partiality
Toundings are the most unsanitary.
ted, but not out of proportion to
~ the farming population or in the
nd water. Hence, general sanitary
n the epidemic.
leculiar. The prevailing formation
tern border of the valley is found
LS a whole is an old lake basin and
~ologist, as a very ordinary valley.
upward of 130 cases of disease in
>orne degree of motor paralysis of
e that so large a number of cases
tutional symptoms, as well as local
)Iem for the diagnostician. It was
. one, two, or more diseases, and
d pathology there was no solution
ries more or less complete of 132
Imber probably represents at least
Irroundings good; previous health
I years older. No apparent cause.
loss of appetite, sluggish bowels.
;tion, and after two or three days
the continuance of the symptoms, though in decreasing severity, proved troublesome
of explanation. On the third day his parents insisted that he could not use his legs.
It was soon evident that this was the case. His reflexes were normal, sphincters unaffected,
no anesthesia or noticeable hyperesthesia. The weakness was most marked in the large
extensors of the thigh. After the entire subsidence of his febrile symptoms, his muscular
weakness began to improve, at first very slowly. In three weeks he had gone on to
full recovery.
This case is an excellent illustration of the mildest type of the disease, a type
that included about forty cases.
Case 2. Boy, 3 Yz years, Irish. Hygienic surroundings fair; sturdy child; most
active of a family of three children. Only apparent cause playing too hard on a hot
day. Taken with high fever, temperature 102° to 104° F., nausea, general restlessness
and headache. Had incontinence of urine, no albuminuria. On third day acute symptoms
subsided except incontinence of urine. It was then noticed that he had lost the use
of his legs. Patellar reflexes diminished and considerable hyperesthesia of the legs.
There was also diminution of faradic irritability. The left leg improved rapidly, the
right slowly. After six weeks was able to stand and take a few steps by taking hold
of chairs. After three months the paralysis and wasting were confined to the right
glutei and lower spinal muscles. His efforts to walk have brought on a slight spinal
curvature. The incontinence of urine continued in this child until Feb. 1, 1895, when
it was relieved by circumcision. The paralysis, however, persists in the glutei and lower
spinal muscles and promises to be permanent.
This case illustrates a very common phase of this epidemic, and in most of these
cases there is probably some permanent impairment of certain muscles.
Case 88. Practice of Dr. Gale, Rutland. Girl, 6 years, American. Previous health
had been frail. Had had a spinal curvature since she began to walk. Taken suddenly
with high fever, nausea, head- and backache. On the fourth day of the attack she
was paralyzed in all the extremities and one side of the face. Febrile symptoms sub­
sided at this time. There was extreme hyperesthesia of the whole body and obstinate
constipation from seeming lack of power in the abdominal muscles. Facial paralysis
speedily passed off. Hyperesthesia and pains in the joints required the use of mor­
phine for several weeks. After nine months she is still paralyzed in all the extremities,
being able to flex the fingers and toes slightly and raise the head. The hyperesthesia
has passed off.
Case 4. Practice of Dr. Fox, Rutland. Boy, 6 years, previous health fair. On
two or three occasions had convulsions, presumably due to gastro-intestinal distur­
bance. Was seized with convulsions while playing on the street; they continued for
nine hours. Moderate fever, rapid pulse, vomiting and rigidity of muscles of the neck
and back. No paralysis noted during conscious intervals. Retention of urine during
the last three days of illness. Death on the sixth day.
These four cases represent various types of the severe form of the disease; among
these cases there were eighteen deaths.
The paralysis, which was the leading and most common characteristic, occurred
in 119 instances. Of the remaining 13, 7 died before paralysis had time to develop,
or it could not be determined whether there was really paralysis or not, and the remaining
63
6 that had no paralysis, all had a group of symptoms very common in the initial stage
in those which were paralyzed, such as headache, fever, convulsions or nausea, one
or all. In those cases in which the exact day of the paralysis is noted, it is stated to
have occurred four times on the first day, eight times on the second, ten times on
the third, five times on the fourth, three times on the fifth, once on the sixth, four
times on the seventh and one on the tenth day of illness. It is quite likely that the
actual duration of premonitory symptoms prior to the appearance of the paralysis
was often overestimated, since loss of power in the extremities, especially in children,
might easily go unnoticed for some time, unless the physician or friends were look­
ing for it. In several instances the loss of power in the legs was the first symptom
noticed. The initial paralysis was located as follows:
Both legs ............................................ .
Arm and leg, same side ................................ .
One arm ............................................. .
One leg .............................................. .
Both legs and one arm ................................ .
Tongue and throat .................................... .
Both arms ........................................... .
All the extremities .................................... .
Extensors of one thigh ................................ .
"Variously in the arms and legs" ........................ .
External rectus of one eye ............................. .
One side of the face ................................... .
One arm and the opposite leg .......................... .
All the extremities and abdominal muscles ............... .
Stated to have had no paralysis ......................... .
Not determined ....................................... .
69 cases 10 " 5
"
7
"
4
2
"
"
"
"
"
"
"
"
"
"
"
3
4
2
8
1
1
1
2
6
7
"
Of the six cases that are said to have had "no paralysis" all had distinct nervous
symptoms explainable only on the supposition that they belonged to this epidemic.
All the seven cases in which it was not certain whether they were paralyzed, died early,
often with convulsions, and their occurrence at this time seems to warrant their being
included in this series.
A further analysis of the de,
the legs, three in all the ext remit
the great majority of fatal cases t
usually not at all inconsistent with
the whole number of cases, those
in recovery (74 in all), there rem
Permanent Paralysis. - Of tI
I have been able to get reports of
after the initial attack. Of these 1
are under 6 years, 7 are between l
again we see the high percentag~
All the extremities are paral
Both arms in ............ ,
Extensors of one thigh in . ,
Glutei and lower spinal mu~
Both legs in ............. '
Extensors of one thigh and
One leg in .............. ,
Glutei alone of one side in ,
One foot and ankle in ....
Extensors of one hand in .
Both legs, thigh and hips ill
One arm in ............ .
Complete hemiplegia in .. .
The muscular atrophy in mt
the usual treatment of rubbing,
During this epidemic and in t
paralytic in its nature, affected d
these symptoms.
That there have been more complete recoveries than this, viz., 56, is quite cer­
tain, but I have not been able to trace them.
The only reliable facts whic
these cases among the lower anirn
that died paralyzed in the hind I,
which was paralyzed in its legs a
made the examination of the he
lumbar portion of the cord sh01
the ganglion cells of the anteriOl
He further states that there was I
made the examination of the f(
Laboratory, found "an acute p(
no meningitis." A bacteriologic,
negative results, and it was found
parts.
Fatal Cases: [T]en deaths were among males and 5 among females, and the sex
is not stated in three cases. Seven of those that died are known to have been under
6 years, three between 6 and 14 years, while one died at 19 years, two at 21 years,
one at 22 years, and one at 38 years. The percentage of deaths among adults is seen
to have been very high.
While epidemics of poliomye
speak only vaguely of their OCCli
the descriptions of this disease ..
suggests, of course, an infectiOl
has only been recently discussC4
Of those cases that are known to have fully recovered according to the latest
information I can obtainBoth legs were paralyzed in ............................ .
Arm and leg, on same side, in ......................... .
One arm in .......................................... .
One arm and both legs in .............................. .
External rectus of one eye in ........................... .
One leg in ........................................... .
There was no paralysis in .............................. .
64
43 cases 4
"
1
1
"
"
1
1
"
"
5
"
ns very common in the initial stage
fever, convulsions or nausea, one
Ie paralysis is noted, it is stated to
times on the second, ten times on
1 the fifth, once on the sixth, four
f illness. It is quite likely that the
to the appearance of the paralysis
: extremities, especially in children,
he physician or friends were look­
in the legs was the first symptom
ows:
69 cases
10
"
5
"
7
4
2
3
4
2
8
1
1
1
2
6
7
"
"
"
"
"
"
"
"
"
"
"
"
"
, paralysis" all had distinct nervous
tat they belonged to this epidemic.
her they were paralyzed, died early,
lS time seems to warrant their being
, recovered according to the latest
43 cases
4
"
1 "
1
"
1
1
5
"
"
"
ies than this, viz., 56, is quite cer­
and 5 among females, and the sex
ied are known to have been under
died at 19 years, two at 21 years,
age of deaths among adults is seen
A further analysis of the deaths shows that five of the cases were paralyzed in
the legs, three in all the extremities, and one was hemiplegic. I might state that in
the great majority of fatal cases the diagnosis was meningitis. Such a diagnosis was
usually not at all inconsistent with the clinical features of the disease. Deducting from
the whole number of cases, those which are known to have terminated fatally, and
in recovery (74 in all), there remain 58 cases to be accounted for.
Permanent Paralysis. - Of the 58 cases which my report left unaccounted for,
I have been able to get reports of 30 which are still maimed, from six to nine months
after the initial attack. Of these 16 are stated to be males, and 12 females. Eighteen
are under 6 years, 7 are between 6 and 14 years, and 5 are over 14 years of age. Here
again we see the high percentage among the older patients. Of these 30 casesAll the extremities are paralyzed in ..................... .
Both arms in ......................................... .
Extensors of one thigh in .............................. .
Glutei and lower spinal muscles in ...................... .
Both legs in . . . . . . . . . . ................................ .
Extensors of one thigh and one leg in ................... .
One leg in ........................................... .
Glutei alone of one side in ............................. .
One foot and ankle in ................................. .
Extensors of one hand in .............................. .
Both legs, thigh and hips in ............................ .
One arm in .......................................... .
Complete hemiplegia in ................................ .
1
1
6
1
6
case
"
"
"
"
2
"
6
1
"
1
"
1
"
"
1
2
"
1
"
The muscular atrophy in most of these cases is marked though combatted by
the usual treatment of rubbing, massage and electricity.
During this epidemic and in the same geographical area, an acute nervous disease,
paralytic in its nature, affected domestic animals. Horses, dogs and fowls died with
these symptoms.
The only reliable facts which I am able to give of the pathologic conditions in
these cases among the lower animals are from the examinations of the cord of a horse
that died paralyzed in the hind legs, and from that of the cord and brain of a fowl
which was paralyzed in its legs and wings. Dr. W. W. Townsend, of Rutland, who
made the examination of the horse, says that the examination of a section of the
lumbar portion of the cord showed a "granular degeneration and pigmentation of
the ganglion cells of the anterior cornua, and atrophy of the anterior nerve roots."
He further states that there was no meningitis in this case. Dr. Charles L. Dana, who
made the examination of the fowl, with the aid of Dr. Dunham of the Carnegie
Laboratory, found "an acute poliomyelitis of the lumbar portion of the cord and
no meningitis." A bacteriologic examination of the same cord by Dr. Dunham gave
negative results, and it was found that the inoculating needle did not strike the diseased
parts.
While epidemics of poliomyelitis are not unknown or unrecorded, recent authorities
speak only vaguely of their occurrence. It has not thus far found a definite place in
the descriptions of this disease. The fact that poliomyelitis may occur epidemically,
suggests, of course, an infectious origin, a view of the nature of the disease which
has only been recently discussed.
65
That a disease occasionally prevails epidemically suggests a specific poison, a '
definite toxin, and this phase of the etiology of poliomyelitis has recently received
attention from foreign observers as well as others in this country. Thus far, however,
there does not seem to have been any substantial progress made toward isolating any
specific microorganism peculiar to this disease.
Our epidemic suggests, though on purely clinical grounds, the possibility of such
a cause. The unfortunate absence of an autopsy in our cases, though strenuous efforts
were several times made to secure them, prevents us from throwing any light on this
part of the subject. That domestic animals suffered with human beings in our epidemic
is a noteworthy fact and one, so far as I can learn, hitherto unobserved. That such
was the case cannot be doubted. It has long been known that animals were often
attacked by meningitis during an outbreak of that disease in epidemic form. Poliomyelitis
has been produced artifically in rabbits and guinea-pigs, but so far I have been unable
to find an instance of its spontaneous occurrence simultaneously with the disease in
man. This fact again emphasizes the possible infectious character of the disease and
lends additional interest to the epidemic here recorded. 2
Doctor Caverly maintained a close professional involvement with the after-care
of polio victims. From the time of the initial 1894 epidemic in Rutland and over the
next two decades into the 20th century, on a state-wide scale, Vermont had the most
fully-developed plan in this country for the after-care of poliomyelitis. Vermont has
9,565 square miles, much of it mountainous, with many of the less-traveled roads
difficult at that time to negotiate, even in good weather. Following a severe epidemic
of polio in the northern part of Vermont in 1914, a friend of Dr. Caverly made an
anonymous and generous gift of a large sum placed at the disposal of the State Department
of Public Health. Part of the mon
children as possible. The best soluti
physicians and parents could be ad'
patient.
Five regional centers were set­
Ernest G. Martin, Ph.D., Professl
ing assistants were invited to cond
by the nursing assistants. Treatmen
and less highly regarded use of galv
examinations were made.
Moreover, such was the pub Ii
Governor John A. Graham atten(
issued the following action (quoH
In the past years we have
ings of people from any tow:
In view of these facts ..
town the local board of health
gatherings or excluding all chi
also from lunch, soda water, it
drinking places. It is hereby 0
nivals or circuses be held in
There were no serious objection!
qua Company which had several con
ing order through the U.S. District
S. Caverly, Et AI.
The case went to court with I
arguing for the defendants. The (
sional opinion: impairing a contra!
The restraining order was dissolv
The Proctor Hospital, Proctor, Vermont, 1919
66
In the meantime, the State C
quiring surgery. Urgent cases had
the Hospital for the Ruptured and
plan had to be adopted to allevial
lists; parents were often opposed
the patient available until the casts \I
was resolved in the winter of thai
Proctor Hospital. Doctor F. R. Ot
arrived to take charge. Doctor Ob
to observe. After that, he returne~
and to change plaster casts. By J
improvement in the children and
to alleviate the dread of operatiol
was followed closely at home.
ally suggests a specific poison, a
>liomyelitis has recently received
l this country. Thus far, however,
ogress made toward isolating any
al grounds, the possibility of such
ur cases, though strenuous efforts
s from throwing any light on this
..ith human beings in our epidemic
, hitherto unobserved. That such
known that animals were often
ase in epidemic form. Poliomyelitis
)igs, but so far I have been unable
imultaneously with the disease in
:ious character of the disease and
)rded. 2
tl involvement with the after-care
:pidemic in Rutland and over the
ride scale, Vermont had the most
lIe of poliomyelitis. Vermont has
many of the less-traveled roads
.her. Following a severe epidemic
a friend of Dr. Caverly made an
he disposal of the State Department
'ermont, 1919
"Q
~
~
'"r1
"til
r
til
">
"
-<
of Public Health. Part of the money was used to provide care for as many stricken
children as possible. The best solution seemed to be to establish regional clinics where
physicians and parents could be advised as to the care and treatment to be given each
patient.
Five regional centers were set-up. Doctor Robert W. Lovett, Boston physician;
Ernest G. Martin, Ph.D., Professor of Physiology, Stanford University, and nurs­
ing assistants were invited to conduct the clinics. Follow-up home visits were made
by the nursing assistants. Treatment depended largely upon massage, muscle training
and less highly regarded use of galvanic electricity. Overall, in 1915 alone, 334 clinical
examinations were made.
Moreover, such was the public anxiety about poliomyelitis that in July of 1917
Governor John A. Graham attended a meeting of the State Board of Health and
issued the following action (quoted in part):
In the past years we have had reason to think that large general gather­
ings of people from any towns have distributed this infection.
In view of these facts .... [w]hen one or more cases develop in any
town the local board of health should take action either prohibiting all public
gatherings or excluding all children under 16 years of age from gatherings,
also from lunch, soda water, ice cream counters and other public eating and
drinking places. It is hereby ordered that no fairs, Chautauquas, street car­
nivals or circuses be held in the State of Vermont until further notice.
By order of the State Board of Health,
CHARLES F. DALTON,
Secretary
There were no serious objections to the governor's proclamation except by a Chautau­
qua Company which had several contracts that summer in Vermont. It secured a restrain­
ing order through the U.S. District Court: Community Chautauqua, Inc., VS. Charles
S. Caverly, Et AI.
The case went to court with Herbert G. Barter, Attorney General of Vermont,
arguing for the defendants. The decision was in favor of the political and profes­
sional opinion: impairing a contract under the circumstances is not unconstitutional.
The restraining order was dissolved and the preliminary injunction denied. 3
In the meantime, the State Department of Health was besieged with cases re­
quiring surgery. Urgent cases had been sent to Children's Hospital in Boston or to
the Hospital for the Ruptured and Crippled in New York City. By 1919 some definite
plan had to be adopted to alleviate deformities. Out-of-state hospitals had waiting
lists; parents were often opposed to the procedures. It was also important to have
the patient available until the casts were removed and apparatus was fitted. The dilemma
was resolved in the winter of that year by renting two wards of six beds from the
Proctor Hospital. Doctor F. R. Ober and his staff from Children's Hospital in Boston
arrived to take charge. Doctor Ober operated for two days and stayed one more day
to observe. After that, he returned for four weekends to perform additional surgery
and to change plaster casts. By March the last patient was discharged. The great
improvement in the children and their happy experience in the hospital did much
to alleviate the dread of operations on the part of parents and children. Each case
was followed closely at home.
67
With his death on 16 October 1918, Dr. Charles Caverly unfortunately did not
live to see the outcome of the pioneer project at Proctor Hospital and its subsequent
extension to other locations within the state. A sixth location in Barre was also added
to the group of clinic centers. Sixty-eight new patients in 1920 applied to the clinics
for treatment.
Sometimes it was impossible to obtain the best results for children returning from
hospital care if their home conditions were sub-marginal. In many cases a combina­
tion of circumstances made it impossible for the children to attend school. On 1 January
1921 the dreams of after-care workers were realized. Through the generosity of Miss
Emily Proctor, daughter of Governor Redfield Proctor, Sr., a school for crippled
children was opened in her hometown of Proctor. It was located in the Ormsbee House
at 25 High Street. A contemporary account tells the story:
Ormsbee House is a school and home for crippled children. It was opened
the first of January, 1921, admitting both boys and girls between the ages
of six and twelve, and has a capacity for fifteen. It was expected to take
only those children who had been crippled as a result of infantile paralysis,
and so far but one other case has been taken.
No payment towards the ordinary care and maintenance of the children
is required, though parents may contribute anything toward the work that
they like and are expected to provide clothing and to take care of expenses
other than those incurred in connection with the boarding and schooling
of the children; as, for example, dentistry and special medical treatment
or care because of other illness.
Ormsbee House, 25
Children are given carefully regulated and prescribed exercises daily
and their school work is arranged according to their strength and capacity,
with the idea of putting them forward in the ordinary grade work as rapidly
as possible. No children below full normal mentality are admitted but, of
course, most of them, because of their infirmity, have been kept out of school
so much that they are behind the normal grade for their age.
Children are selected because of their inability, owing to their infirmity,
to attend school at home or any public school; because of the financial needs
of their parents and their particular need of care and special exercises to
assist in the improvement of their disability and upbuilding of their general
health.
The institution is open all the year around, the children continuing in
school throughout the year except for a two or three-weeks vacation in the
summer. The children are selected and sent to the school largely by the in­
fantile paralysis after-care workers in the state. 4
Ormsbee House remained in operation until 1929. The house itself is no longer
standing. In 1937 the ongoing need was again met, this time by the organization of
the Vermont Association for the Crippled, located in Rutland City.5
Not all of the earlier generous, anonymous gift made available to the State Depart­
ment of Health in 1914 was earmarked for direct service to polio victims. The Research
Laboratory of the State Board was dedicated to its investigation of the infectious
agent for polio. The work was organized in 1914 by Dr. Harold L. Amoss of the
68
A c/assro
aries Caverly unfortunately did not
Proctor Hospital and its subsequent
xth location in Barre was also added
ltients in 1920 applied to the clinics
-0
:.;l
o
~
:.;l
'"r1
:;r;l
m
m
C
st results for children returning from
narginal. In many cases a comb ina­
ildren to attend school. On 1 January
~ed. Through the generosity of Miss
Proctor, Sr ., a school for crippled
It was located in the Ormsbee House
Is the story:
Cl
:;r;l
»
:.;l
-<
crippled children. It was opened
oys and girls between the ages
ifteen. It was expected to take
a result of infantile paralysis,
.en .
~d maintenance of the children
Ormsbee House, 25 High Street, Proctor, Vermont
la nything toward the work that
g and to take care of expenses
th the boarding and schooling
and special medical treatment
:a
8
c
:;r;l
o-j
~
-<
and prescribed exercises daily
o their strength and capacity,
ordinary grade work as rapidly
entality are admitted but, of
_". have been kept out of school
~ad e for their age .
m
r
»
Z
m
-0
c
:;r;l
o
-<
.:are and special exercises to
upbuilding of their general
.•he ch ildren continuing in
• dlree-weeks vacation in the
"~e school largely by the in­
e.
.
_J. The house itself is no longer
-- rime by the organization of
Rml and City. 5
available to the State Depart­
polio victims. The Research
·.e5tigation of the infectious
J Dr. Harold L. Amoss of the
'0
A classroom at Ormsbee House
69
IThe Vermonter, published monthly 1
Vrhe State Department of Public Heald
by The Vermont Printing Co., Brattl
3Ibid., p. 176-178; Charles S. Caver 4Gale, David c., Proctor: The Story tleboro, VT, 1922; p. 232. 5Bellerose, George, The Vermont Ach
p. 42-53. ~he State Department of Public He,
309, W. L. Aycock, M.D . 7Centers for Disease Control, U.S. 0 October, 1992. Six vaccine-associated and territories. Ormsbee House children at play
Rockefeller Institute for Medical Research and carried on by a number of successors.
During his lifetime Dr. Caverly remained in close touch with the activities of the
department and was a source of inspiration to those who worked under his supervi­
sion. The approach and format of the research lab did not essentially change with
the years ... "a tribute to the wisdom and foresight of its founder, Dr. Caverly.,,6
Over time and with many dead-end failures, the infectious polio virus was isolated.
It can exist in the central nervous system and upon 't he mucous membrane of the
nose, throat and intestines. It can also be present in the mucous of healthy persons
who may not become ill themselves, but may infect other persons with the virus. They
in turn, may develop the disease. By 1938 the search for a vaccine was worldwide.
A great stride was taken when Austrian scientists found that monkeys could be infected.
This gave scientists an experimental animal to work with. A major turning-point was
reached in 1949 when the laboratory at Harvard University developed the growth
of the virus in quantities great enough for use in a vaccine. Four years later Dr. Jonas
E. Salk of the University of Pittsburgh was able to make a vaccine using all three
forms of viruses which cause polio (spinal, bulbar, spinal-bulbar).
Nearly a hundred years after the first epidemic which occurred in Rutland, Dr.
Jan Carney, Vermont Commissioner of Health, is able to report that there was not
a single case of polio in 1991 anywhere in the New England states. 7
Before retirement in 1981, JEJ
mont Achievement Center. Since
Historical Society Quarterly and
ACK~
The author appreciates the al
with this issue and for her research
Carney, Commissioner of the VT 1
to quote pertinent portions from II
for providing current statistics reI
No piece of constructive wei
by one man alone. but it is.
taken the idea has assumed c
is the leader and inspiratioll
and has caught the vision of
live to see the disease agaim
ingly really conquered and
did live to see many of the
on the road to happy, useful;
that real contributions to d
by those working in coopeJ:
his presidency.
1
70
FOOTNOTES
()
o
c:
::0
-i
tT1
(Il
-<
tT1
r
»
Z
tT1
"C
c:
::0
"-<
'en at play
IHied on by a number of successors.
)se touch with the activities of the
lose who worked under his supervi­
lab did not essentially change with
5ight of its founder, Dr. Caverly. ,,6
'
e in~ectious polio virus was isolated.
pon the mucous membrane of the
t in the mucous of healthy persons
~t other persons with the virus. They
larch for a vaccine was worldwide.
rund that monkeys could be infected.
~k with. A major turning-point was
d University developed the growth
vaccine. Four years later Dr. Jonas
~ to make a vaccine using all three
ar, spinal-bulbar).
~
ic which occurred in Rutland, Dr.
~ s able to report that there was not
ew England states. 7
The Vermonter, published monthly by Charles S. Forbes, St. Albans; Vol. 23, p. 254-255.
2The State Department of Public Health; Infantile Paralysis in Vermont . .. 1894-1922; Printed
by The Vermont Printing Co., Brattleboro, VT 1924; p. 21-38 .
3Ibid., p. 176-178; Charles S. Caverly, Sc.D., M.D.
4Gale, David c., Proctor: The Story of a Marble Town; The Vermont Printing Co., Brat­
tleboro, VT, 1922; p. 232.
5Bellerose, George, The Vermont Achievement Center; Academy Books, Rutland, VT, 1977;
I
p. 42-53. 6The State Department of Public Health; Infantile Paralysis in Vermont . .. 1894-1922; p. 309, W. L. Aycock, M.D. 7Centers for Disease Control, U.S. Department of Health and Human Services, Atlanta, Ga., October , 1992. Six vaccine-associated cases (outside N.E.) were reported for 1991 in the U.S . and territories . AUTHOR
Before retirement in 1981, JEAN Ross held an administrative position at the Ver­
mont Achievement Center. Since 1979 she has been managing editor of the Rutland
Historical Society Quarterly and chairs the Publicaton Committee.
ACKNOWLEDGMENTS
The author appreciates the assistance of Elaine Purdy for her helpful interest
with this issue and for her research and proofreading. Appreciation, also, to Dr. Jan
Carney, Commissioner of the VT Department of Health, Burlington, for permission
to quote pertinent portions from Infantile Paralysis in Vermont . .. 1894-1922, and
for providing current statistics regarding the national status of infantile paralysis.
No piece of constructive work of any magnitude was ever accomplished
by one man alone, but it is usually true that long before the first step is
taken the idea has assumed definite form in the mind of one person, who
is the leader and inspiration of the other workers. He has seen the need
and has caught the vision of the goal to be achieved. Dr. Caverly did not
live to see the disease against which he had fought so long and so untir­
ingly really conquered and the fear of future epidemics removed: but he
did live to see many of the victims of infantile paralysis in Vermont well
on the road to happy, useful, and in some cases normal lives, and to know
that real contributions to the knowledge of the disease had been made
by those working in cooperation with the State Board of Health under
his presidency.
From Infantile Paralysis in Vermont, 1894-1922,
State Department of Public Health, p. 10-11
71
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