Background note
Simon Flexner was born on March 25, 1863, in Louisville, Kentucky to Helen and Morris Flexner, a Jewish German-speaking couple
who'd arrived in the United States just 12 years prior. Morris Flexner had achieved moderate success with a wholesale hat
business until the depression in 1872 caused the business to fail, a financial setback from which the large family never fully
recovered. As a result, the Flexners were forced to move to increasingly marginal neighborhoods where the schools were inadequate
and the neighbors anti-Semitic, an experience that deeply affected young Simon. He did poorly in school and was considered
a failure in the Flexner family when he dropped out of school permanently at the age of 14, abandoning the eighth grade and
formal education for the remainder of his youth. No longer a student, Simon trudged from one menial job to the next in order
to make a contribution to the household.
Simon continued to disappoint his family with his failed efforts at keeping even the most menial of jobs. Simon managed to
get fired from even a photographer's studio owned by an uncle; he was then hired out to lowly shopkeepers who couldn't afford
to pay the boy more than a couple of dollars a week for his labor. Circumstances were dire; Flexner wouldn't attend school
and couldn't sustain any kind of worthwhile employment. Just when it seemed circumstances couldn't be more desolate, Flexner
contacted typhoid fever and death appeared imminent for the unfortunate youth. Far from killing him, however, the debilitating
illness seemed to give Simon a new lease on life. The illness left him introspective and serious and as the teenager convalesced,
he focused his attention on improving not only his health but also the course of his future. His new contemplative state
reinforced conviction and focus in the teenager and for the first time in his life, Flexner considered the possibility that
he could make a worthwhile contribution not only to his family but even to society.
The Flexner family happily supported the newly ambitious Simon and arranged for him to be apprenticed to a respected area
druggist. It was a fortunate pairing; the druggist, while not overly ambitious, was kind and encouraging and Simon flourished
under his tutelage. Part of his apprenticeship included a series of courses at the Louisville School of Pharmacy, where to
his surprise and to the delight of his family, Flexner excelled. It was a proud moment when Simon presented the gold medal
for scholastic achievement to his mother and dying father. In the evenings, Simon would take the store microscope home and
conduct his own studies under the single gaslight shared by the entire family. Once a poor student, Flexner now devoted himself
to learning.
In 1882, Flexner clerked at his eldest brother Jacob's drugstore where his thirst for knowledge grew. At the pharmacy, he
listened intently to the gathered physicians' shoptalk and spent his evenings poring over borrowed books to familiarize himself
with rudimentary medical principles. His interest in microscopy led Flexner to study histology and then pathology, an uncharted
discipline at that time especially in Louisville. Local doctors increasingly brought Simon specimens and sought his opinion.
It was soon apparent that Simon had learned all that he could from borrowed books; the time had arrived to pursue formal
education.
Flexner dreamed of pursuing a medical education which would facilitate his dream of opening and operating but brother Abraham's
course at Johns Hopkins altered his path. Abraham, who'd been attending classes at Johns Hopkins University for two years,
kept Simon abreast of university news. Upon hearing of university plans to open a medical college and, more importantly,
the recent faculty hire of a professor of pathology, Simon decided to attend Johns Hopkins but in order to be admitted to
the university he first would have to get a medical degree. This, as it turned out, was actually accomplished quite easily
with a little help from the physicians who'd gathered at Jacob Flexner's drugstore.
The Medical Institute of the University of Louisville had never established an academic department and was therefore staffed
entirely by a group of practitioners who conducted lectures - and granted degrees - rather casually. This same group, luckily
for Simon, agreed to take him on as a student at a reduced rate and allowed him to attend lectures during the spare hours
that he wasn't clerking at the drugstore. The physicians sympathized with Simon's familial financial obligations and since
Flexner insisted that he never planned to practice medicine, they were willing to be more lenient with him. In 1889, Simon
Flexner graduated from the University of Louisville with a medical degree. He immediately applied for a fellowship at Johns
Hopkins.
To his disappointment, Simon wasn't chosen for the fellowship. Adding to his regret was the realization that he simply couldn't
teach himself any further. Abraham offered to send Simon to Baltimore for a year of instruction as sibling Jacob had done
for him. While the family, which had grown dependent on Simon's salary, wasn't entirely supportive of the decision, Simon
nonetheless set off to make his mark at Johns Hopkins University with $500 from his brother Abraham.
Although Flexner had neither the benefit of a formal medical school education nor the financial stability of his classmate,
the autodidact nonetheless did remarkably well with his drugstore background and extraordinary sense of discipline. Finances
were Flexner's only setback. His funds were quickly running out and he faced an unwanted return to Louisville. His professors,
however, refused to let a lack of finances interfere with the young man's promising future; he was offered a fellowship at
the end of his first year and despite his family's fear that he would never return to Louisville, happily accepted.
In the fall of 1891, Flexner began his fellowship but under slightly different circumstances. Instead of rooming in a boardinghouse,
as he'd done the previous term, he now lived with the superintendent of the hospital, which meant that he constantly interacted
with clinical as well as pathology students. This proved to be a most stimulating environment for the young scientist. At
the same time, the fields of bacteriology and pathology were so new that nothing but groundbreaking research opportunities
awaited pioneering students. Although Flexner was slightly self-conscious about his lack of education and upbringing, for
the first time in his life, close relationships with his fellow students, some of whom would also go on to become quite famous
for their work in infectious disease research. Meanwhile, the medical school, which had been postponed due to lack of funding,
was now slated for a fall 1893 opening.
Flexner began his work on meningitis in early 1892 when an epidemic broke out in the coal-mining region of Cumberland, Maryland.
Flexner and another scientist performed an autopsy on a young girl and although the bereaved parents insisted that the body
remain intact, Flexner sneaked tissue samples out of the house in order to determine whether the epidemic was actually spotted
fever as originally believed or an outbreak of meningitis. Flexner determined that it was definitely an outbreak of meningitis
and set off on a course of study linking meningitis with pneumonia. While his theory eventually proved wrong, it launched
Flexner's lifetime research on the disease.
Simon completed his second year at Johns Hopkins and saw some of the pathology faculty leave the university for opportunities
elsewhere. Torn between leaving Johns Hopkins for a faculty position or staying and hoping for a promotion that might never
materialize due to his lack of experience, Flexner was uneasy about his prospects. He perceived stiff competition among his
fellow students but when his mentor and faculty member, William T. Councilman decided to leave for Harvard, Flexner received
the assistant in pathology appointment. Within two years of arriving at Johns Hopkins, Flexner became not only a faculty
member but also slated to succeed Councilman's successor as resident pathologist at the hospital. This time the entire Flexner
family supported Simon's appointment.
Flexner spent the next year doing autopsies, research, and lecturing and although he was confident in his abilities, he recognized
that he could benefit from a period of German study, standard for young medical students at that time. At the end of the
first semester in 1893, he set sail for Germany. It was a successful trip in the sense that although Flexner visited many
universities abroad, he returned with a deeper appreciation for the Johns Hopkins University, which employed a much more egalitarian
approach than the medical schools he'd seen in Eastern and Western Europe.
By the time Flexner returned from Europe in the fall of 1893, the eagerly awaited medical school was finally open but more
importantly, the pathology department had been expanded to twice the size. The medical school student body consisted of fourteen
men and three women; the inclusion of the latter was not included in the original plan but became a condition of funding.
Stringent admission requirements further reduced enrollment. Upon his return, Flexner resumed his exhausting schedule of
supervising the pathology laboratory and assisting with pathology courses. At the same time, he continued his research on
diphtheria and toxins, which introduced him to the new field of immunology. Flexner also managed to write extensively in
conjunction with his research, ultimately publishing more than seventy articles between 1893 and 1899.
Flexner conducted important research on toxins and diphtheria during 1893-1894, which contributed to the discovery of a cure
and led him to inadvertently stumble on the phenomenon of anaphylaxis. He was invited to speak before the Pathological Society
of Philadelphia on his toxin research; this presentation he later claimed established his reputation in Philadelphia, then
considered to be the capital of American medicine. Continuing to do autopsies also presented Flexner with valuable research
opportunities. A case of acute pancreatitis, for example, led Flexner to study the pancreas carefully and after thirty years
of continuous research ultimately led to the isolation of insulin.
Elected to the American College of Physicians in 1895, Flexner was also promoted to associate professor of pathology, a remarkable
feat for one who'd arrived at Johns Hopkins less than five years prior as a very inexperienced student. Other universities
offered Flexner, who was lamentably underpaid, faculty positions at higher salaries but with fewer research opportunities.
His mentor, William Welch, encouraged Flexner to be selective in light of his growing reputation as one of leading pathologists
in the country. Although uncertain about his future, Flexner decided to stay at "the Hopkins" when they offered him a slight
increase in salary; he felt comfortable there and his research benefited from the network he'd established with the other
researchers.
Even the appointment of full professorship didn't seem to assure Flexner of a secure future at Johns Hopkins. He decided
to resume negotiations with Cornell and also the University of Pennsylvania when he learned of the opening in pathology.
Flexner decided on the University of Pennsylvania despite the lower salary and rumors of anti-Semitism. While the negotiations
continued, he decided to go to the Philippines on a research expedition with his close friend and colleague, Lewellys F. Barker.
The University of Pennsylvania confirmed his appointment as the men prepared for their expedition giving Flexner reservations
about leaving just as the position of his dreams had finally opened. Eventually he decided to go and the trip proved a great
success, scientifically speaking.
The beauty of Japan, where the group decided to spend some time, enchanted Flexner but he found himself craving structure
and anxious to begin working. The group traveled to Tokyo, the center of infection disease research where Shibasaburo Kitasato,
a codiscoverer of the diphtheria antitoxin, invited them into the laboratories. Flexner's introduction to scientist Hideyo
Noguchi was most significant. Noguchi immediately expressed a desire to work with Flexner. Flexner's response was polite;
at the time, he had no idea of the impact Noguchi would have in his own personal life, his career, and even the history of
science itself.
The group traveled next to Hong Kong and then into the Philippine Islands. The "plague" and other infectious diseases were
on the rise in Manila, offering plentiful virology research opportunities. The commission studied typhoid fever, malarial
fevers, tuberculosis, and dengue fever, topical ulcers and dysentery, in which Flexner had the greatest interest. Aside
from the research opportunities, Flexner found Manila depressing and the group decided to leave early. Flexner took a long
voyage home and was back in Philadelphia with time to spare before his new position started.
Meanwhile there was an implosion in the tightly knit Flexner family, which left Abraham, the founder of a very successful
school for boys, trying to keep the family afloat. Jacob Flexner, the acting patriarch since the death of their father years
before, revealed that he was overextended financially and close to losing his drugstore. Abraham refused to let the family
declare bankruptcy and for a time managed to juggle the debt incurred by various Flexner family members. It was a losing
battle, however, and although he somehow saved the newly constructed family houses from foreclosure, Jacob lost his drugstore.
Jacob decided to try his hand at medicine. At Abraham's urging he joined Simon at Johns Hopkins. It was an uncomfortable
time for Simon. Jacob, never prone to humility even in the face of his financial failures, embarrassed the quiet Simon with
his overbearing and belligerent manner. Luckily, he attended the university for just a few months and then went on to New
York for further training. In the end Simon felt as if the declaration of bankruptcy had liberated the Flexner family; everyone
could now pursue desired careers without considering the family finances.
Flexner arrived in Philadelphia in 1899 to begin his professorship at the University of Pennsylvania. It was not smooth sailing.
The faculty resented Flexner and resisted change. Senior faculty members were cool towards Flexner and opposed his ambitious
plans to expand the pathology department. Flexner was barred from even hiring his own assistants. But students immediately
responded warmly and enthusiastically to Flexner who lectured three days a week.
Soon after he began in Philadelphia, Flexner was surprised by the arrival of Hideyo Noguchi, the bacteriologist from Japan.
Flexner had written to Noguchi that there wasn't a position available in Philadelphia but Noguchi had taken upon himself
to make the trip prior to Flexner's discouraging response. There was nothing to do but put Noguchi to work in the pathology
lab. Though Noguchi needed training, like Flexner he proved to be a quick study and an invaluable assistant. Noguchi went
on to do brilliant research work on syphilis and yellow fever. The two developed a close relationship and it is most telling
that when Flexner moved on to the Rockefeller Institute, Noguchi was the only member of his Philadelphia group who was chosen
to join the staff at the new facility.
Flexner's time at the University of Pennsylvania was perhaps the most social period of his life. Most of the faculty members
eventually warmed to the young man and included him in social gatherings. The salary increase also allowed him to go out
more often. It wasn't long after he'd arrived at Pennsylvania though that he met his future wife, Helen Thomas. The sister
of former Johns Hopkins colleague and friend Harry Thomas, she taught at nearby Bryn Mawr College where older sister Carey
was dean.
During 1900-1901, his second year at the University of Pennsylvania, Flexner gained a hospital pathologist position as well
as an appointment as director of the university's Ayer Clinical Laboratory which Flexner insisted should be used for research
in conjunction with medical school classes. His background in plague research led him to be appointed head of a federal commission
to investigate an outbreak in San Francisco that same year. At the same time, he continued with his own research on immunology
with Noguchi. They worked together to study the toxic effects of snake venom, a research project suggested by Dr. Weir Mitchell
who'd studied the effects of snake venom on humans and wanted Flexner to pursue experimental immunology.
That same year, 1901, Flexner received an appointment to the Board of Scientific Directors of the newly formed Rockefeller
Institute for Medical Research, endowed by John D. Rockefeller. The next year the Institute offered Flexner the opportunity
to direct laboratories and organize operations, a brilliant opportunity. To leave the university was risky because Rockefeller
had guaranteed funding for only ten years. Flexner agonized over leaving his prestigious position at Penn but in the end,
he accepted. By this time, Flexner and Helen Whitall Thomas were engaged.
Flexner and his new bride spent much of 1903, the first year of his appointment, visiting research laboratories in Europe
seeking a model for the Rockefeller Institute. Realizing that chemistry, physics, and experimental biology were increasing
becoming a central component of virology research, Flexner hired only scientists with a command of the basic sciences. When
the Institute opened in 1906, the staff included Samuel J. Meltzer, Phoebus A. Levene, Eugene L. Opie, Hideyo Noguchi, Alexis
Carrel, Jacques Loeb, Rufus I. Cole, and Peyton Rous.
Flexner's own research, meanwhile, rapidly gained attention and acclaim by the general public. This translated into winning
public support for the new Institution and assured Rockefeller's continued financial backing. When New York City suffered
a severe cerebrospinal meningitis epidemic during 1904 and 1905, Flexner studied the disease and by 1907 was able to develop
an antiserum that acted against the bacterial agent and reduced the mortality rate by fifty percent. The Institute developed
and distributed the serum to the general public free of charge. In 1907 Flexner took the same approach with polio and while
his conclusions proved to be incorrect, he nonetheless laid important groundwork for researching the disease.
John D. Rockefeller, completely confident in Flexner, agreed to finance a research hospital at the Institute in 1910. During
World War I, Flexner implemented a program to train medical officers and technicians and taught bacteriology himself. Serving
in the Army Medical Corps from 1917-1919, Flexner attained the rank of colonel and assumed responsibility for inspecting the
expeditionary forces laboratories in Europe.
While hired to just direct the laboratory, Flexner's superior administrative skill had essentially made him acting director
of the entire facility. In 1924, he was formally named Director of the Rockefeller Institute, an amazing accomplishment that
the entire Flexner family celebrated.
In addition to overseeing the daily operations of the Institute, Flexner worked tirelessly to aid other agencies in promoting
medical and scientific education. He served as a charter member of the Rockefeller Foundation, the largest medical education
and research benefactor, and helped the National Research Council secure funding for medical and mathematical research. He
served on the Johns Hopkins Medical School board of trustees and chaired the Public Health Council of New York State.
A participating member of many scientific organizations throughout his career, Flexner served as president of the Association
of American Physicians in 1914 and the American Association for the Advancement of Science and the Congress of American Physicians
and Surgeons in 1919. The National Academy of Sciences recognized his contributions with a membership in 1908.
Flexner acted as director of the Rockefeller Institute until his retirement in 1935. During 1937 and 1938, he traveled to
Oxford University as Eastman Professor acting as a consultant on medical professorships. During his time in England, Flexner
wrote The Evolution and Organization of the University Clinic. In 1942, Flexner and his son, James Thomas Flexner, co-authored a well-received biography, William Henry Welch and the Heroic Age of American Medicine. Simon Flexner died in New York City at the age of 83.
Scope and content
The Rockefeller Institute series, the first of two in the collection, is approximately 150 linear feet of mostly Institute-related
material. Flexner's early years at Johns Hopkins and the University of Pennsylvania are not documented in this collection
but there is, however, a substantial amount of material reflecting Flexner's early interest in virology, pathology and bacteriology
within his notes, notebooks and diaries.
Much of the correspondence in the collection is dated after his Rockefeller Institute appointment except for communication
between Flexner and Helen Whitall Thomas and various family members. Flexner's research and scientific interests led him
to form lifelong relationships with other scientists, researchers, and medical practitioners; therefore much of the correspondence
spans decades.
There is correspondence with Frederick Gates, business manager to John D. Rockefeller. Instrumental in convincing Rockefeller
of the impact that a medical research facility would have for all of mankind, he successfully persuaded Rockefeller to finance
a research facility. In 1901 a planning committee was formed. Persons involved in the early stages of the Rockefeller Institute
included William H. Welch, Hermann Briggs, Emmett Holt, Christian Herter, Theobald Smith, and Simon Flexner.
As director of the Rockefeller Institute, Flexner chose his staff carefully. Ultimately, the Institute staff included: Samuel
J. Meltzer, Phoebus A. Levene, Eugene L. Opie, Hideyo Noguchi, Alexis Carrel, Jacques Loeb, Rufus I. Cole, and Peyton Rous.
There is a great deal of correspondence between Flexner and his candidates that document the accomplishments of these men
and illustrate the role they filled within the Institute.
In 1909, the Rockefeller Hospital was completed with Rufus Cole named as director. The correspondence between Cole and Flexner
covers mostly administrative manners but also mentions some of the groundbreaking scientific research in the laboratories
by D. D. Van Slyke, A. E. Cohn and A. E. Mirsky. Theobald Smith headed the Institute's department of animal pathology in
Princeton opened in 1916 and mentions research at the department, particularly the work of pathologist John W. Gowen.
Between 1901 and 1913, the Rockefeller philanthropies established the General Education Board with Wallace Buttrick as its
President; the China Medical Board; the Sanitary Commission to Eradicate Hookworm Disease; the International Health Commission
with Wickliffe Rose as director. The Rockefeller Foundation was incorporated in 1913. Flexner became a trustee that same
year along with John D. Rockefeller, Frederick L. Gates, Henry Pratt Judson, Starr J. Murphy, Jerome D. Greene, Wickliffe
Rose, Charles O. Heydt and later, Charles William Eliot and A. Barton Hepburn. The collection is rich in correspondence concerning
individual Rockefeller boards and funding history both in the United States and abroad. Perhaps most significant is the work
of the General Education Board and the Rockefeller Foundation in supporting the development of medical education following
the publication of Abraham Flexner's report on North American medical schools.
The reorganization of the Foundation in 1928 led to the creation of the Division of Natural Sciences, first directed by Max
Mason and then Hermann A. Spoer and from 1932 on, by Warren Weaver. There is an abundance of material on the Foundation's
reorganization. Much of the material is devoted to the early 1930's when Weaver began to shift the funding direction from
financing the construction of research facilities to the actual practice of research.
The following is a short list of Flexner's correspondents mentioned primarily because the sheer amount of correspondence with
Flexner indicates a significant relationship in some aspect. It is by no means a comprehensive list. There is a substantial
amount of correspondence with Harold L. Amoss. Amoss, an American physician, worked with Flexner to develop a dysentery serum.
Other scientists who corresponded with Flexner were Swiss physiologist and biochemist, Emil Abderhalden; John J. Abel, American
physiological chemist; James Arthur Bain, American pharmacologist and Rockefeller fellow; Canadian physician and Nobel Prize
recipient, Frederick Grant Banting; Johns Hopkins colleague and longtime friend, Lewellys F. Barker; Hermann Michael Biggs,
American physician and bacteriologist, (Biggs wrote about tuberculosis and cholera; he also organized the bacteriology labs
of the New York City Health Department).
Carl Alfred Lanning Binger, American psychiatrist; Wade Hampton Brown, American pathologist; Carroll G. Bull, American immunologist;
Walter B. Cannon, American physiologist; Alexis Carrel; Rufus Cole; Frederick Fuller, American physician; Phoebus Aaron Theodore
Levene, American physiologist, Winthrop John Vanleuven Osterhout; Russian-born chemist; Richard Mills Pearce, pathologist;
F. Peyton Rous, American physician and virologist; Theobald Smith, American pathologist; Hans Zinsser, American bacteriologist.
There are 65 Simon Flexner folders and almost 170 subject files. There are many files on meningitis, poliomyelitis, and tryparsamide.
Administrative information
Restrictions
None.
Provenance
Acquired, 1964.
Preferred citation
Cite as: Simon Flexner Papers, American Philosophical Society.
Processing information
Recatalogued by A. Harney, June, 2003. Michael Miller incorporated the information from Margaret Miller's guide into this
finding aid in 2007.
Other finding aids
The Simon Flexner Papers are also described in Margaret Miller's Guide to Selected Files of the Professional Papers of Simon Flexner at The American Philosophical Society.
The Simon Flexner Papers are also described in Lilly Kay's
Molecules, Cells and Life.
Additional information
Separated material
Photographs were removed from the Flexner Papers for storage with the APS graphics collections.
Related material
Other related material at The American Philosophical Society include:
- The Simon Flexner Family Papers
- Francis Peyton Rous Papers
- Hans Thacher Clarke Papers
- Cyril Norman Hugh Long Papers
- Rufus Ivory Cole Papers
- Max Bergmann Papers
- Eugene Lindsay Opie Papers
- Winthrop John Van Leuven Osterhout Papers
- Peter K. Olitsky Papers
- Landsteiner-Mackenzie Papers
- Florence Rena Sabin Papers
- James B. Murphy Papers
- Oswald H. Robertson Papers
- Thomas M. Rivers Papers
- Leslie T. Webster Papers
- Charles Benedict Davenport Papers
- Leslie Clarence Dunn Papers
- Franz Boas Papers
- Harold Lindsay Amoss Papers
Related collections located at the Rockefeller Archives Center include:
- Records of the Rockefeller Institute for Medical Research
- Papers of the General Education Board
- Papers of the China Medical Board
- Records of the Rockefeller Foundation
- International Education Board Papers
- papers of the Rockefeller Sanitary Commission for the Eradication of Hookworm Disease, Washington, D.C.
Related materials also at the Library of Congress, Washington, D.C., Connecticut Agricultural Experiment Station, Marine Biological
Laboratories, Woods Hole, California Institute of Technology Archives and the National Library of Medicine, Bethesda, Maryland.
References
Flexner, James Thomas, An American Saga, The Story of Helen Thomas and Simon Flexner (Toronto: Little, Brown and Company, 1984). Call no. B F635 a
Flexner, James Thomas, Maverick's Progress, an Autobiography (New York: Fordham University, 1996). Call no. B F635 m
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