Gareth Williams. Paralysed with Fear: The Story of Polio. New York: Palgrave
Macmillan, 2013. Illustrations. xvii + 354 pp. $29.99 (cloth), ISBN 978-1-137-29975-8;
$20.00 (paper), ISBN 978-1-137-50658-0.
Reviewed by Daniel J. Wilson (Muhlenberg College)
Published on H-Disability (July, 2015)
Commissioned by Iain C. Hutchison
Gareth Williams’s recent history of polio, Paralysed
with Fear: The Story of Polio, traces the rise and fall of
epidemic polio in the twentieth century. Focused on the
medical and scientific aspects of the disease, the book
pays relatively little attention to the men and women
who had the disease and then lived with permanent muscle weakness and paralysis. Williams traces the clinical
and laboratory research on polio from the late eighteenth
century to the late twentieth century, and he rehearses
the familiar story of the competition between Jonas Salk
(1914-95), Albert Sabin (1906-93), and others to produce
an effective and safe vaccine. While Williams is attentive
to polio epidemics and polio research worldwide, much
of his book is focused on the United States where the
polio epidemics were the most severe, where much of
the research leading to the vaccines was conducted, and
where the fundraising strategies of the National Foundation for Infantile Paralysis turned polio into the most
feared childhood disease of the mid-twentieth century.
rare complication of the disease; most individuals infected had no symptoms and no paralysis. Only about
1 percent of individuals infected with the virus experienced paralysis, and the extent of that paralysis varied significantly. He claims that “the acute attack was
just the start of a grim life with paralysis, deformities,
and disability” (p. 32). While a significant number of
polio survivors did indeed live with paralysis, deformities, and disability, many, including the reviewer, would
strongly disagree with Williams’s assessment that their
lives were “grim.” This chapter concludes with several
brief accounts of lives following polio.
In succeeding chapters, Williams traces the history
of medical research into the poliovirus and the disease.
For the late nineteenth and early twentieth centuries, he
explores all sorts of investigations into the illness, many
of them ultimately dead ends or wrongheaded. He frequently passes judgment on the scientific validity and
value of these experiments, many of which were dubious at the time and which now appear to have been bad
science. What Williams seems to forget is that these scientists and doctors did not have our scientific knowledge
and tools. They were working with a disease-causing entity they could not see and with a clinical picture that
was anything but clear and straightforward. Perhaps the
Williams begins with an overview of polio and the
early history of its discovery. He describes polio as “one
of the diseases that defined the twentieth century” (p.
26). In chapter 2, “The Crippler,” Williams briefly explores the impact of the disease on the individuals who
were infected. As he notes, paralysis was a relatively
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most notable of these wrong turns was the conviction of
Simon Flexner (1863-1946) that polio entered the body
through the nose, based on his ability to induce infections in monkeys by injecting their nasal passages with
the virus. Flexner’s prestige as director of the Rockefeller Institute in New York meant that his views were
not seriously challenged for more than two decades. In
addition to Flexner’s misguided approach, Williams explores other reasons advanced as the cause of polio, including “teething, pesticides, ptomaine poisoning, electrical appliances or misaligned vertebrae in the neck” (p.
69). Even when scientists focused on germs as the cause
of polio, there were several early candidates, including
streptococci, bacteria, and “globoid bodies” (p. 79). After
disposing of several of the wrongly identified causes of
polio, Williams turns to the scientific and medical explorations that eventually led to our modern understanding
of the poliovirus and the disease.
1940s, and he credits her with helping to end immobilization as the standard polio treatment. The chapter includes a discussion of the development and use of the
iron lung for patients whose paralysis left them unable
to breathe on their own. While he acknowledges that
the iron lungs saved some lives, and that some individuals lived a long time reliant on the iron lung, his analysis
stresses that “life inside the iron lung was difficult and
sometimes horrific” (p. 157). He concludes the chapter by
examining briefly some of the other therapies proposed
and often tried in the effort to cure those left crippled by
polio. Although he discusses the impact these therapies
had on the patients who endured them, his emphasis is on
the men and women who developed the therapies rather
than the experience of those who were being treated.
Chapters 8 through 10 focus on the scientific effort
to develop a successful vaccine. There were several contenders for this prize and Williams stresses the competition among these scientists. He characterizes the campaign as a “lively saga, in which scientific endeavor and
the thrill of discovery were often eclipsed by the baser
aspects of human nature [which] was not a dignified unfolding of the scientific process, but an unseemly race
which often descended into backstabbing and bitchiness”
(p. 168). Williams begins with the early history of vaccination devised by Edward Jenner (1749-1823) for smallpox and with the failed polio vaccines developed in the
1930s by Maurice Brodie (1903-39) and William H. Park
(1863-1939) and the competing vaccine created by John
Kolmer (1886-1962). The failure of these vaccines to protect against polio and, in a small number of cases, vaccines’ actually being a cause of the disease, discouraged
vaccine research for years. He then turns to the story
of Salk and his killed virus vaccine. Rather than the triumphalism that marks many accounts of Salk’s achievement, Williams emphasizes the problems associated with
the vaccine. Then, in a chapter unfortunately titled “Poles
Apart,” Williams describes the intense competition between two Polish immigrant scientists, Hilary Koprowski
(1916-2013) and Sabin, to develop an attenuated livevirus vaccine. While Williams discusses the science behind Koprowski’s and Sabin’s achievements, he seems
more interested in the intense competition between the
two men and their jockeying for financial and scientific
support. Both eventually developed viable and safe vaccines, but for a variety of reasons that Williams explores,
Sabin’s vaccine became the widely adopted and standard
vaccine in most countries for several decades.
In a chapter titled “Fear Is the Key,” Williams describes how fear of polio came to be pervasive, especially
in the United States following the large polio epidemic
in 1916 in New York and surrounding states. He looks
at several epidemics in the United States and compares
them to epidemics occurring elsewhere, including England and Sweden. Williams argues that several factors
conspired to keep the threat of polio before the American public and, thus, to keep fear levels high. These were
the press coverage of the 1916 epidemic with its twentyseven thousand cases and six thousand deaths; the wellknown case of Franklin D. Roosevelt (1882-1945); and the
fundraising campaigns of Basil O’Connor (1892-1972),
the National Foundation for Infantile Paralysis, and the
March of Dimes. He describes the fundraising of the
March of Dimes as a terror campaign based on a “classic
stick-and-carrot strategy, but with both elements carved
from fear” (p. 133).
Following his account of fundraising through carefully manipulated fears, Williams devotes a chapter to the
care of acute and recovering polio patients. In “First Do
No Harm,” Williams argues that many of the treatments
devised for the rehabilitation of polio patients were barbaric, painful, and often useless. As with his fascination
with the wrong turns of polio research, he is equally fascinated with the more unusual and bizarre polio treatments contrived to prevent and correct the typical deformities of paralytic polio. He characterizes many of these
treatments as “forms of torture” (p. 141). There is also
a brief discussion of the work of Sister Elizabeth Kenny
In the last three chapters, Williams details the history
(1880-1952) whose method of hot packs and guided therapy eventually became the standard for polio care by the of polio subsequent to the widespread adoption of the
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Salk, and then the Sabin, vaccines. Most dramatically,
of course, was the significant reduction of polio cases
in those nations that conducted organized mass vaccination campaigns, which after the early 1960s usually
employed the Sabin vaccine. He examines movements
in several countries to resist and oppose vaccination, often for religious reasons. And he explores more unusual
consequences, such as the alleged connection between
polio vaccines and the development of AIDS in central
Africa, an idea he dismisses. He also describes some of
the challenges facing the World Health Organization’s
polio eradication campaign that has restricted polio to a
handful of countries in Asia and Africa, but has failed to
bring the campaign to a successful close because of political and military strife in such countries as Afghanistan,
Pakistan, and Nigeria. Williams includes brief biographies of key individuals in the effort to understand and
conquer polio, focusing on their lives following their significant polio contributions.
cines in the 1950s, he is more interested in exposing the
flaws of modern science and its practitioners. He pays
careful attention to powerful egos, sloppy research techniques, competition among scientists, and outlandish and
bizarre theories and treatments. He is also skeptical of
earlier triumphalist accounts of the National Foundation
for Infantile Paralysis, O’Connor, Salk, and Sabin, finding all too human flaws in the running of the organization and in the lives of the three men. He also relies significantly on the work of previous historians, including
John R. Paul, Jane Smith, David Oshinsky, and Paul Offit. Still, readers seeking an engaging account of the polio
epidemics from an English perspective will find much to
appreciate in Williams’s volume.
Readers of H-Disability may, however, be more disappointed. Williams clearly adopts a medical model of
disability in which the emphasis is on the doctors and scientists engaged in trying to understand the disease and
to treat patients afflicted with it. There are brief biographies of several individuals who had polio and a chapter
devoted to the treatment of polio’s characteristic deformities. However, that chapter deals almost exclusively
with the medical professionals who designed the treatments rather than with the patients who endured them.
When he addresses the lives of polio survivors, he concludes that “the acute attack was just the start of a grim
life with paralysis, deformities and disability” (p. 32).
That conclusion is contradicted by the mini-biographies
included in his book, as well as by the many polio memoirs published in the last fifty years and a growing body
of scholarship that includes my Living with Polio: The Epidemic and Its Survivors (2005). There is no denying that
many polio patients and survivors had experiences that
can only be described as grim, but most polio survivors
proved to be amazingly resilient in building good lives in
spite of their paralysis and deformities and the social and
physical barriers that society placed in their path. Readers seeking to understand what it was like to experience
acute polio and the many disabilities resulting from permanent paralysis will have to look elsewhere.
Williams’s style is breezy and cheeky, and his book
is an easy read. The scientific aspects of the conquest of
polio are clear and easy to understand. Though focused
on the American experience, his account includes significant developments in other nations. There are, however, errors that mar the text. For example, Haven Emerson (1874-1957), health commissioner of New York City
during the 1916 epidemic, did not invent the Emerson
iron lung. His son, John Haven Emerson (1906-97), developed an iron lung that improved on the original design of Philip Drinker (1894-1972). Williams also states
that O’Connor “sacked” the writer Paul de Kruif (18801971) in 1936. In fact, de Kruif resigned from the National
Foundation for Infantile Paralysis on August 10, 1941, in a
dispute with O’Connor over the failure of the foundation
to award a research grant to a friend. Errors of this kind
undermine confidence in Williams’s overall account.
Williams’s Paralysed with Fear places the focus
clearly on the medical and scientific quest to understand
polio and to produce a successful vaccine. Although he
recounts the many successes on the way to effective vac-
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Citation: Daniel J. Wilson. Review of Williams, Gareth, Paralysed with Fear: The Story of Polio. H-Disability, H-Net
Reviews. July, 2015.
URL: http://www.h-net.org/reviews/showrev.php?id=43474
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This work is licensed under a Creative Commons Attribution-NoncommercialNo Derivative Works 3.0 United States License.
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