Charles Armstrong, M.D.: A Biography Edward A. Beeman, M.D., F.A.C.P. 2007 Beeman, Charles Armstrong, M.D.: A Biography, 2007 1 “Give Dr. Armstrong a mouse and a syringe, and he can do research.” Quoted by Dr. Robert J. Huebner to the author. Dr. Charles Armstrong in the mid-to-late 1950s. Courtesy of the National Library of Medicine. Beeman, Charles Armstrong, M.D.: A Biography, 2007 2 Armstrong – Table of Contents Acknowledgments……………………………………………………………………………………...3 Introduction……………………………………………………………………………………………..5 Chapter 1. Early Years: Family background; Education……………………………………………..13 Chapter 2. Initial Assignments……………………………………………………………………….24 Chapter 3. Influenza; Botulism………………………………………………………………….……44 Chapter 4. Typhus; Dengue; Devil’s Grip…………………………………………………………....79 Chapter 5. Smallpox Vaccination and Tetanus; Postvaccinal Encephalitis………………………....104 Chapter 6. Psittacosis (“Parrot Fever”)………………………………………………………………132 Chapter 7. Domesticity, Career Recapitulation Update, Philosophical Musings……………………153 Chapter 8. “Green Thumb Virologist”: Saint Louis Encephalitis; Lymphocytic Choriomeningitis...167 Chapter 9. Poliomyelitis……………………………………………………………………………...208 Chapter 10. Hail to the Chief………………………………………………………………………….248 Chapter 11. Final Years and Legacy………………………………………………………………….294 Appendices. Appendix A. Curriculum Vitae……………………………………………………………………….311 Appendix B. Bibliography……………………………………………………………………………318 Appendix C. Personnel of the Viral and Rickettsial Unit; Attendees at Building 7 Luncheon Sessions……………………………………………………………………...325 Beeman, Charles Armstrong, M.D.: A Biography, 2007 3 Armstrong – Acknowledgments The author was the fortunate recipient of the cooperation and steadfast support of Ms. Mary Emma Armstrong, Dr. Armstrong’s daughter, in writing this biography. She contributed a treasure trove of documentation that she had collected and maintained conscientiously for many years. She had compiled three large loose leaf notebooks containing personal papers, correspondence, newspaper clippings, magazine articles, book chapters and other descriptive material detailing various aspects of her father’s life and activities. In addition, she had kept a brief autobiographical sketch written by her father as well as the oral autobiographical interview conducted by Dr. Wyndom Miles of the National Library of Medicine about a year before Dr. Armstrong died. She also outlined her father’s curriculum vitae and kept account of personal family matters. The author had frequent and generous access to all of the above material. Mrs. Harriet Huebner, the widow of Dr. Robert J. Huebner, provided additional items of source information. Dr. Huebner, a young associate, confidant, and a successor Chief of the Laboratory of Infectious Diseases, was unable, due to illness, to complete a short biography of Dr. Armstrong authorized by the National Academy of Sciences for one of its volumes of Biographical Memoirs. Dr. Huebner was suffering severe intellectual impairment caused by rapidly advancing Alzheimer’s disease. Mrs. Huebner contributed a large packet of reprints covering many of Dr. Armstrong’s major discoveries along with some of Dr. Huebner’s very sparse marginal notes and commentary. Beeman, Charles Armstrong, M.D.: A Biography, 2007 4 The author wants to credit the help of Mrs. Marjorie Ciarlante of the National Archives at College Park, Maryland for providing access to the files of RG (Record Group) – 90 that contained information about Dr. Armstrong’s early years in the United States Public Health Service and the Hygienic Laboratory. The History of Medicine Division of the National Library of Medicine helped authenticate Dr. Armstrong’s bibliography. The staff of the Office of NIH History deserves abundant praise for providing support and encouragement to the author in this undertaking. Dr. Victoria A. Harden “primed the pump” when she suggested a full biography to fill in the gaps or ignored aspects in the historical record of Dr. Armstrong’s career. She also started the initial review of the first few chapters before her retirement as Director of the Office; she also continued to provide the author the stimulus to persevere. The remainder of the editorial activities occurred under the masterful attention of Dr. Leo Slater, Acting Deputy Director of the Office. Ms. Brooke Fox, the Office Archivist, has been invaluable in preparing the illustrations for digital presentation and for preserving the Armstrong documents. Mrs. Michelle Lyons, the Office and DeWitt Stetten Museum Curator retrieved some of the illustrations from the files of the National Library of Medicine. Dr. Buhm Soon Park, Office Associate Historian, conducted an extensive oral interview with the author about Dr. Armstrong to help document virus research history at the National Institutes of Health. The author also wants to extend his gratitude to all the persons responsible for the actual publication of the manuscript. Beeman, Charles Armstrong, M.D.: A Biography, 2007 5 Introduction I first became acquainted with Dr. Charles Armstrong in January 1948. It was during the year of my internal medicine internship in 1947-1948 at the Robert Dawson Evans Memorial Hospital (then Massachusetts Memorial), now University Hospital, a component of Boston University Medical Center. Influenced during my previous training by charismatic teachers of laboratory and clinical microbiology, I became attracted to the possibility of pursuing a career in the study of infectious diseases. Fortunately, I encountered a benefactor in the person of Dr. William Lane Hewitt who was then a Fellow in Medicine at the Evans. He was working on the wards of the hospital, and he was also assisting Dr. Chester S. Keefer in the analysis of the therapeutic value of the antibiotic, streptomycin, in the first 3000 cases. They were performing this project under a producer’s grant to the Committee on Chemotherapy, Division of Medical Sciences of the National Research Council. Dr. Hewitt also held the rank of Surgeon (equivalent to a Naval lieutenant-commander or an Army major) in the Commissioned Corps of the United Public Health Service. He had also worked at the National Institute of Health for about six years (2). During the course of our professional association, which was extremely cordial, he became aware of my interest in infections. Initially, he suggested that I start a project in my “off-duty hours” with the hospital’s chief bacteriologist to see if I could help isolate “L-forms” (cell wall-deficient bacteria that did not grow in conventional bacteriological media) from a patient with blood culture-negative infective endocarditis (infection of a heart valve). This project, Beeman, Charles Armstrong, M.D.: A Biography, 2007 6 however, was short-lived since successive culture plates became contaminated with common skin bacteria. About the same time, I had to confront the problem of deciding how to plan my training for the coming few years. Competition for residencies and fellowships at this time was keen because of the preferential acceptance of the many young medical officers returning from their World War II service who wanted to complete their training before returning to civilian practice. In view of this situation, I decided that since I had graduated from medical school at an age several years younger than most of my classmates, I could afford to spend several years acquiring some laboratory experience in infectious diseases prior to entering a residency training program. When I discussed this with Dr. Hewitt, he suggested that I might be interested in and profit from working at the National Institutes of Health in the Division (later Laboratory) of Infectious Diseases. As mentioned previously, he had worked in the Division, knew most of the prominent investigators and was personally friendly with Dr. Armstrong, the current Chief of the Division. I did not know at that time about Dr. Armstrong’s prominence as an investigator in microbiology, especially in virus diseases. Dr. Hewitt described in glowing terms the scientific accomplishments of Dr. Armstrong. Hewitt stated that, despite the modern custom of building huge bibliographies, Dr. Armstrong had written only a modest number of research publications but that most of them were of original research that made major contributions to the knowledge of infections. Dr. Hewitt offered to arrange an interview for me with Dr. Armstrong at the National Institutes of Health in Bethesda, Maryland. Beeman, Charles Armstrong, M.D.: A Biography, 2007 7 At this juncture it is worthwhile to describe the historical evolution of the Division (later Laboratory) of Infectious Diseases (3). This organization was the most direct descendant of the original Marine Hospital Service research laboratory established in August 1887 at the Marine Hospital on Staten Island, New York. Its function was to assist the Public Health Service in diagnosing infectious diseases among passengers on incoming ships. Detached from the Hospital and moved to the Butler Building in Washington, D.C. in 1891, this “Laboratory of Hygiene” became known as the Hygienic Laboratory. Authorized in 1901 by Congress to investigate “infectious and contagious diseases and matters pertaining to the public health,” the research of the Hygienic Laboratory focused primarily on bacteriology and pathology, the two major fields of 19th century medical interest (3). In 1902 a reorganization of the Public Health Service divided the Laboratory into four divisions; infectious disease research became located in the Division of Pathology and Bacteriology. On February 1, 1937, the Division was renamed the Division of Infectious Diseases, becoming one of the eight Divisions and one Office (of Comparative Studies) defined in the National Institute of Health reorganization of that date. The NIH moved to the Bethesda campus from 1938 – 1941 as the construction of the buildings was being completed. During this period the Division had the assignment of administrative jurisdiction over the Rocky Mountain Laboratory in Hamilton, Montana. The Division incidentally carried on the heart and dental research of the Public Health Service (3). Almost coincidental with my arrival at NIH, in the reorganization of 1948 that created the (plural) National Institutes of Health, the Division became the Laboratory of Infectious Diseases, one of the four original components of the National Microbiological Institute (NMI) also established at that time (the other three Beeman, Charles Armstrong, M.D.: A Biography, 2007 8 were the Laboratory of Tropical Diseases, the Laboratory of Biologics Control and the Rocky Mountain Laboratory). The Rocky Mountain Laboratory received equal administrative status as part of new NMI, and the heart and dental activities were placed in their own newly created Institutes. In 1955 the NMI morphed into the National Institute of Allergic and Infectious Diseases (NIAID) with many resultant changes both in LID and NIAID. During the period of 1948 to 1952 when the organizational changes occurred or were in the process of occurring while I was at NIH, the only thing that penetrated to my level of awareness as a junior officer was just the changes in the office stationery. In January 1948 I was able to meet with Dr. Armstrong. I was then in rotation at the Forest Hills Hospital, part of the Massachusetts Memorial (Hospital) complex. This phase of my internship was a mix of medicine and surgery without obstetrics or pediatrics. I had to maneuver three days off continuously from a Thursday to a Saturday with a report back to duty on a Sunday. To compensate for this “vacation time”, I had to work three extra weekends. I took a roomette on the night train from Boston to Washington, D.C. Arriving at Union Station, and, ignorant of local geography and unacquainted with the local transportation system, I asked a bemused information clerk about “the train to Bethesda”. I finally made my way by taking the streetcar (long-since gone) from Union Station to Friendship Heights in Chevy Chase, Maryland and then the bus up Wisconsin Avenue through a semi-rural downtown Bethesda to the NIH-Naval Medical (Hospital) bus stop. Miss Virginia Burlingame, Dr. Armstrong’s gracious and efficient secretary, greeted me initially at the Laboratory. (She later confessed to me that she enjoyed greeting the young Beeman, Charles Armstrong, M.D.: A Biography, 2007 9 and “handsome” doctors who came to work in the Laboratory (1)). I met Dr. Armstrong shortly thereafter in his office in Building 7, The Memorial Building. He impressed me immediately with his warm, friendly but dignified and humble personality, especially so, since Dr. Hewitt had enlightened me about his multiple research accomplishments. After a cordial introductory conversation, Dr. Armstrong asked me about my interests and what I might want to do at NIH. I replied that I had no specific interests but that I wanted to acquire some laboratory skills working with rickettsias and viruses and to see what might develop. This answer was probably one that he found satisfactory. He suggested then that I meet with some of the other investigators in the Laboratory. I had very pleasant meetings with Drs. Robert Huebner, Karl Habel, Carl Larson and Dorland Davis, all with established research reputations. I ran into a “buzz saw” encounter with Dr. Byron J. Olson (opinionated and dogmatic) who castigated me for not knowing what line of investigation I wanted to pursue. Fortunately, we had no further exposure to one another, to the mutual advantage of each, during the time that I was at NIH. At the end of the day’s visit, Dr. Armstrong asked me with whom I should like to work. I was torn in my decision between Drs. Huebner and Habel. The research achievements of both men impressed me. Initially, I felt that I wanted experience working with rickettsial organisms, but on the other hand I thought I would learn more virology under Dr. Habel’s supervision. In view of Dr. Huebner’s recent successes with rickettsialpox and his current activities with Q fever, I opted to begin my work with Huebner and try to learn virological investigation on my own. Dr. Armstrong seemed pleased, and he approved of my decision. (Huebner was one of his favorite people, Beeman, Charles Armstrong, M.D.: A Biography, 2007 10