ABSTRACT
In the spring of 1938 both Thomas Francis, Jr, then at the Laboratories of the International Health Division of the Rockefeller Foundation, and John Paul from Yale University’s Department of Internal Medicine called for a new approach to epidemiology, which they called ‘clinical epidemiology’. To issue their call they both chose important venues. Francis chose his DeLamar Lecture at the Johns Hopkins School of Hygiene and Public Health (Francis, 1938, p77; Francis, 1939, p915; Francis, 1953, p377). Paul included his call in his Presidential Address to the American Society for Clinical Investigation (Paul, 1938, p539). Francis’s definition was more concise. Clinical epidemiology, he wrote, was the ‘epidemiology in which the unit for study is broken down from the herd to actual observation and investigation of each individual in the herd by carrying the laboratory to the patient’ (Francis, 1938, p77). Francis’s and Paul’s visions of clinical epidemiology were remarkably similar, although the experiences that had brought them to issue their manifestos were quite different. John Paul had been investigating outbreaks of polio and rheumatic fever. Francis, on the other hand, was America’s leading student of the human influenza virus. This chapter explores the changing shape of influenza research reflected in Francis’s call for a new type of epidemiology. It will emphasize the work of Francis and other American researchers.
