Emma Broder is a Ph.D. Candidate in the History of Science Department at Harvard University and a 2024-2025 Consortium Research Fellow.
As a 2024-2025 Consortium Fellow, I visited three archives for research on my dissertation, a history of mysterious outbreaks now linked to chronic fatigue syndrome and long COVID. All these conditions are plausibly post-viral, yet they have sparked controversy over the role of the psyche in producing their many, variable symptoms. These outbreaks were labeled things like “atypical poliomyelitis” and “epidemic neuromyasthenia” and recorded across the (primarily) Anglophone world in the 20th century. I focus on five outbreaks which took place within American medicine and public health between 1934 and 1985. I visited the Yale University Library, The Rockefeller Archive Center, and the National Library of Medicine to uncover the actions of major figures in 20th century virology who each participated in the public health response, questioning whether the outbreak was caused by a familiar or new, unknown virus, often leaving unanswered the question of a psychological cause.
I ask how these conditions have been understood as epidemic threats and epidemiological objects to be studied at a population level, and how this intersects with individual patient and physician understandings in the past. I argue that this set of illnesses have been an influential yet marginal presence in US healthcare as it transformed over the twentieth century. Influential because major public health agencies and private foundations responded to outbreaks, attempting to uncover the viral cause behind the syndrome, while in the present day most patients in primary care have symptoms like fatigue and pain for which doctors can make no diagnosis; marginal because the mechanistic framework of biomedicine cannot manage such patients, who are therefore left without care.
At the Yale University Library’s Manuscripts and Archives I viewed the papers of virologist and epidemiologist John Rodman Paul. Paul was a founding member of the Yale Poliomyelitis Research Unit, which predated the March of Dimes in coordinating research on the virus. In the first decades of the 20th century, polio had begun to cause increasingly large, severe, and deadly outbreaks in the US and Scandinavia. In 1934, amidst an unusually mild but large poliomyelitis outbreak in Los Angeles, workers at the Los Angeles County General Hospital began falling ill with a similar, yet strangely distinct condition. They were often disabled for months after falling ill despite normal test results. Paul and several colleagues at the Rockefeller Institute traveled across the country to attempt to isolate a pathogen but were unsuccessful. Some doctors felt the hospital outbreak, suffered mainly by nurses, was hysteria in response to fear of polio. Paul himself was circumspect but remained interested in the condition for years after, as his correspondence shows.
Paul’s papers were essential for understanding his professional network, including scientists who had investigated other mysterious apparently viral outbreaks. I found that he placed much more emphasis than I had previously appreciated on social dimensions of medical practice, in line with his pioneering work in the field of clinical epidemiology. He admired the work of British social medicine doctor John Ryle and felt that epidemiological study was a necessary component of medical education. He also built connections with Icelandic scientists who studied their own strange outbreak a decade after the Los Angeles outbreak.
At the Rockefeller Archive Center, I viewed the papers of Richard Moreland Taylor. Taylor was an officer in the Rockefeller Foundation’s International Health Division who traveled to Iceland in 1949 to help Icelandic scientists attempt to identify the cause of their own polio-like outbreak. The RF was also interested in helping develop Iceland’s public health system with a virological and epidemiological laboratory, in line with their international health development agenda at this time. The archives contained Taylor’s diary, an official document with his travel notes, impressions of Iceland, and thoughts on the polio-like disease outbreak. Going into this archive, my main question was why and how the Foundation had become involved in the outbreak. A single news story alluded to their involvement and the outbreak report thanked collaborators at Johns Hopkins University. In the Rockefeller Foundation’s sources on the collaboration and in Taylor’s officer’s diary I saw a longer history of Rockefeller interest in Iceland as a semi-isolated country whose population could serve as a field laboratory for epidemiological research. This was tied to cold war geopolitical interests as well as the context of poliomyelitis.
At the National Library of Medicine, I focused on the papers of Alexis Shelokov. Shelokov was a Chinese-born Russian virologist who moved to the US to attend college. He spent most of his career at the National Institutes of Health, including as the founding director of the Middle America Research Unit in Panama. As part of the NIH Microbiological Institute, he was sent to yet another polio-like outbreak, this time among the nurses of the Chestnut Lodge psychiatric institute in the suburbs of Washington DC. Though he and his colleagues were unable to isolate a pathogen, Shelokov’s work on the outbreak brought him in contact with an epidemiologist who had seen and written about the Los Angeles outbreak and a group at the Communicable Disease Center who responded to their own outbreak of what was increasingly considered a new condition. Shelokov collaborated with the CDC’s D.A. Henderson to write up their two outbreak reports and co-author a review on the new syndrome they were calling “epidemic neuromyasthenia.”
Shelokov’s papers are especially valuable for leaving a decades-long trace of his research on and interest in epidemic neuromyasthenia, and what he saw as highly related—if not identical to—the later condition “chronic fatigue syndrome.” His correspondence with Henderson while they coauthored their review for the New England Journal of Medicine throughout the 1950s helped me contextualize their interest in these outbreaks and how it fit into the rest of their careers. Shelokov’s papers contain lecture notes from the 1970s through 90s which show him negotiating growing disbelief in the validity and reality of these conditions from his fellow physicians and researchers. His research files also attest to his search for various physical signs and mechanisms that characterized the condition, based on findings from past outbreaks. I haven’t seen much history of medicine engagement with Shelokov and highly recommend his papers to other researchers interested in the history of chronic fatigue syndrome (official name myalgic encephalomyelitis/chronic fatigue syndrome or ME/CFS). As his oral history with the Office of NIH History shows, he is a colorful figure whose career touched on many pivotal moments in the twentieth-century history of biomedicine.
I’m very grateful to the Consortium for this research funding, which transformed aspects of my project’s narrative and deepened my understanding of this history. The community of scholars that CHSTM brings together was another highlight of the fellowship and I look forward continuing to participate in this community.