Schick, Bela (1877-1967)

Hungarian-born American physician

Bela Schick was a pioneer in the field of child care; not only did he invent the diphtheria test, which helped wipe out this disease in children, but he also formulated and publicized child care theories that were advanced for his day. Schick also defined the allergic reaction, was considered the leading pediatrician of his time, and made contributions to knowledge about scarlet fever, tuberculosis , and infant nutrition. Schick received many honors for his work, including the Medal of the New York Academy of Medicine and the Addingham Gold Medal, a British award. Schick was also the founder of the American Academy of Pediatrics.

Schick was born on July 16, 1877 in Boglar, Hungary, the child of Jacob Schick, a grain merchant, and Johanna Pichler Schick. He attended the Staats Gymnasium in Graz, Austria, graduating in 1894. He then received his M.D. degree at Karl Franz University, also in Graz. After a stint with the medical corps in the Austro-Hungarian army, Schick started his own medical practice in Vienna in 1902. From then on he devoted his ample energies to teaching, research, and medical practice at the University of Vienna, where he served from 1902 to 1923—first as an intern, then as an assistant in the pediatrics clinic, and finally as lecturer and professor of pediatrics.

It was in 1905 that Schick made one of his most significant contributions. While working with collaborator Clemens von Pirquet, Schick wrote his first research study describing the phenomenon of allergy, which was then called serum sickness. The study not only described the concept of allergy, but also recommended methods of treatment.

At age 36, Schick moved on to make one of the most important discoveries of the twentieth century—the test for diphtheria. The test, announced in 1913, was a remarkably simple one that could tell whether a person was vulnerable to the disease. It showed whether a patient had already been exposed to the diphtheria toxin, which would make him immune from getting it again. A tiny amount of the diluted toxin was injected into the patient's arm. If the spot turned red and swollen, the doctors would know whether or not the patient been exposed to the disease. The treatment was then injection with an antitoxin.

Diphtheria was a common disease in the early twentieth century and afflicted thousands of children in every city throughout the world. It was especially common in Europe, where the close quarters of many cities made infection more likely. At the time Schick embarked on his research, scientists had already isolated the microbe or toxin that caused diphtheria. A horse serum had also been developed that could prevent or even cure the disease. But the serum had so many side effects that doctors were unwilling to prescribe it unless they knew a patient was seriously in danger of catching diphtheria. Thus, Schick's discovery made it easier for them to treat those who were the most vulnerable.

In 1923, an antitoxin without side effects was developed and was then given to babies during their first year of life. Later on, the Schick test would show whether immunity persisted. Schick's test technique was also used years later to treat people with allergies , using the same technique of injecting small doses of an antitoxin.

Schick left Vienna in 1923 to become pediatrician-in-chief at Mt. Sinai Hospital in New York City. Schick became an American citizen that same year and two years later married his wife, Catherine C. Fries. He held his post at Mt. Sinai Hospital until his retirement in May 1943, when he became a consulting pediatrician. During his career, he also worked simultaneously at other hospitals, acting as director of pediatrics at Sea View Hospital in Staten Island, New York and consulting pediatrician at the Willard Parker Hospital, the New York Infirmary for Women and Children, and Beth Israel Hospital. He also taught as a professor of the diseases of children at Columbia University College of Physicians and Surgeons, starting in 1936.

Schick directed a private practice in New York City as well. His office held a collection of dolls and animals that he had acquired in travels throughout the world. He would often play the piano in his office, or take out one of his doll or animal figures to calm a child. He never displayed a stethoscope until he made sure a child was relaxed. At one time, he estimated that he had treated over a million children.

Childless himself, he had a great fondness for children and in 1932 authored a popular book titled Child Care Today that contained his firm beliefs about how children should be raised. Many of his ideas were advanced for his time. He advocated little punishment for children and no corporal punishment. He also said that trauma in a child's early life often had a lasting effect.

Schick and his wife lived in a large apartment in New York City and were frequent travelers around the world. On a cruise to South America with his wife during his later years, Schick fell ill with pleurisy. Eventually brought back to the United States to Mt. Sinai Hospital, he died on Dec. 6, 1967.

See also Allergies; History of immunology; History of microbiology; History of public health; Immune system; Immunology; Medical training and careers in microbiology