Dr. William H. Stewart: Mistaken or Maligned?

To the Editor—Dr. William H. Stewart was the US Surgeon General during 1965–1969 [1]. Despite his significant accomplishments, Dr. Stewart is remembered primarily for his infamous statement: “It is time to close the book on infectious diseases, and declare the war against pestilence won” [2]. Depending on the source, the quote is dated to 1967 or 1969. Infectious diseases specialists, including myself [3, 4], have repeated this quote innumerable times to underscore how wrong it was. I have spent the past 5 years seeking the primary source for his often-maligned quote, with no success. And I am not the only one. The US Public Health Service Web site informs us that “Although this remark has often been cited in the literature, the Office of the PHS Historian has never been able to locate the source of the statement, or to confirm that Dr. Stewart actually made such a comment. We have asked Dr. Stewart about it, and he cannot recall whether or not he made this statement” [2]. Virtually every reference to the statement is a secondary citation, and many of these secondary citations are circular (i.e., they reference one another rather than a primary source). The only primary reference to this statement, listed in a book about emerging infections [5], regards a speech given by Dr. Stewart at the 65th Annual Meeting of the Association of State and Territorial Health Officers in 1967 [6]. However, the speech contains nothing even remotely resembling the alleged quote. Quite to the contrary, Dr. Stewart actually said, “Warning flags are still flying in the communicable disease field.... While we are engaged in taking on new duties...we cannot and must not lose sight of our traditional program responsibilities” (p. 4). It is difficult to believe that a Surgeon General who was concerned about the traditional public health responsibility to defend against communicable diseases would declare that the era of infectious diseases had come to a close. It appears that Dr. Stewart's now-legendary quote may be a medical “urban legend.” Nevertheless, Dr. Anthony Fauci has assured us that the belief that infectious diseases had been conquered was widespread in the 1960s and 1970s [7]. Furthermore, in 1978, one of the world's leaders in infectious diseases, Dr. Robert Petersdorf, commented that, “Even with my great personal loyalty to Infectious Disease, I cannot conceive of the need for 309 more [graduating trainees in] infectious disease...unless they spend their time culturing each other” [8, p. 630]. As late as 1985, Dr. Petersdorf had not changed his mind; at the Infectious Diseases Society of America's annual meeting that year, he stated that “the millennium where fellows in infectious disease will culture one another is almost here” [9]. If anyone is aware of a real primary citation to Dr. Stewart's quote, I and others would be extremely interested in hearing from you. Failing that, perhaps it is time to replace Dr. Stewart's possibly apocryphal quotation with citations from verifiable sources, such as Dr. Fauci [7] or Dr. Petersdorf [8, 9]. Potential conflicts of interest. B.S.: no conflicts.