Virtually every Canadian child today is protected from a host of deadly infectious diseases thanks to the bold vision of Dr. John G. FitzGerald, founder of Connaught Laboratories and a leading proponent of Canada's modern public health system.

When John FitzGerald began practising medicine in Toronto at the beginning of this century, impoverished parents of children stricken with diphtheria often made a tragic mistake. Unable to afford enough of the costly, imported diphtheria antitoxin to treat each child effectively, they would share the medicine among the children, thereby leaving all at risk to the deadly disease. In those days, one out of every six children infected with diphtheria died.
 

The humble birthplace of Connaught Laboratories: the Barton Ave. stable where Dr. John FitzGerald and his first employee, William Fenton (at doorway), began producing diphtheria antitoxin for the first time in Canada. The stable now stands at Connaught's research and manufacturing complex in North York. [Photo, courtesy Connaught Laboratories]

This tragedy inspired the young, University of Toronto-trained physician to search for a way of bringing these new disease-fighting medicines – vaccines and antitoxins – to the public at the lowest possible cost.

Graduating in 1903 as the youngest member of his medical class, FitzGerald began his career in psychiatry. A growing interest in the possibilities of preventive medicine drew FitzGerald to the emerging field of bacteriology pioneered by Dr. Louis Pasteur of France. In 1909, he began lecturing on the subject at the University of Toronto and travelling the world to learn more.

FitzGerald spent the summers of 1910 and 1911 studying at the renowned Pasteur Institute in Paris and Brussels. While there, he learned not only of the latest advances in "microbics," as microbiology was then known, but also of Pasteur's strong belief that scientific knowledge should be applied to public health to benefit all people, regardless of economics and geography.

In Pasteur's philosophy, FitzGerald found a focus for his own frustrations about the state of preventative medicine in his native country. At the time, only smallpox and typhoid vaccines were being produced in small quantities in Canada. And while products such as diphtheria antitoxin could be imported from the United States, their cost was often beyond the reach of poor families and there was little guarantee of supply.

Through his studies at the Pasteur Institute, the Lister Institute in London, England, and with New York City's Department of Health, FitzGerald also recognized that knowledge was as vital as medicine in the fight against disease. Learning about a disease and how it was spread was important not only to the finding of a cure, but also in teaching others how it could be prevented. In this combination of research, production, and teaching, FitzGerald believed he had found a formula for reforming public health services in Canada.

His opportunity came in 1913 when he was appointed associate professor in the University of Toronto's new Department of Hygiene. That summer, FitzGerald took the first step in his plan by producing Pasteur's rabies treatment for the Ontario Board of Health in a small University laboratory above a jewellery store in downtown Toronto. Until then, rabies treatments had to be imported from New York at an exorbitant price.

Later that year, he approached the University with a proposal to set up laboratories as part of its Department of Hygiene where high-quality antitoxins and vaccines could be man-ufactured at costs low enough for them to be widely available. Yet FitzGerald's ideas met with skepticism since they represented a somewhat radical departure from the University's strictly academic traditions. Without the University's approval, the impatient FitzGerald decided to plunge ahead anyway.
 

1.  In the summer of 1910, Dr. John FitzGerald began his lifelong association with the Pasteur Institute of France where he learned how Louis Pasteur's life-saving vaccines and antitoxins could be produced for public distribution in Canada. [Photo, courtesy FitzGerald Family]  2. A display at the Canadian National Exhibition in 1920 shows how diphtheria antitoxin had reduced the death rate from the disease.  The antitoxin was the first of many biological products prepared by Connaught at costs low enough to be distributed free by the Ontario Board of Health.

Using money from his wife's inheritance, he built a small stable on Barton Avenue west of the University where he began to inoculate four horses with diphtheria bacteria, the first step in preparing the life-saving antitoxin. Within months, he was producing it at one-fifth of the cost of the imported product. This led to a contract with the Ontario Board of Health, which then undertook one of the first free distributions of medicine by any government in Canada.

These successes finally convinced the University to back FitzGerald's plan and he was given laboratory space in the basement of the medical building. Issuing his first progress report on June 30, 1914, FitzGerald outlined the new laboratory's role:

The fundamental idea underlying the project was the production of all sera and vaccines of value in public health work and their distribution at cost. It was expected that the active cooperation of public health authorities in Canada would be obtained, and this has, in large measure, been realized.

In one bold, impetuous stroke, FitzGerald had given Canada the ability to develop and produce life-saving vaccines and antitoxins and helped set the stage for the nation's modern, publicly funded public health care system.

The outbreak of the war in August 1914 threatened to undermine the support for FitzGerald's project as the University began focusing on helping the war effort. Ironically, the war was to give a "shot in the arm" to the fledging laboratories. In 1915, FitzGerald was asked by Col. Albert Gooderham of the Canadian Red Cross to begin producing large quantities of tetanus antitoxin for the Canadian Army.

Also known as "lockjaw," tetanus was infecting troops wounded in France, adding the threat of death by disease to the perils of the battlefield. FitzGerald, who had already enlisted in the Canadian Army Medical Corps, agreed to begin providing the much-needed antitoxin at cost, significantly less than $1.35 per dose cost of imported product from the United States. Suddenly, FitzGerald's back street stable and basement laboratory were propelled to the front line of the war effort.

To help increase the laboratory's production capacity, Gooderham donated a 57 acre farm 15 miles north of Toronto where stables and a modern laboratory building were constructed. Officially opened in October 1917, the new facility was named the "Connaught Antitoxin Laboratories and University Farm" after the Duke of Connaught, third son of Queen Victoria and a recent Governor General of Canada. By the war's end in 1918, the expanded laboratories had supplied more than 250,000 doses of tetanus antitoxin to the army at 34 cents a dose and produced more than one million doses of smallpox vaccine and several other much-needed vaccines and sera.

Soon after the new laboratory opened, the ever-restless FitzGerald was on his way to the Western Front after obtaining a transfer to the British Army's Medical Corps. During the last six months of the war, he commanded a mobile laboratory and served as assistant advisor of pathology to the Fifth British Army. In the meantime, FitzGerald's close friend, Dr. Robert Defries, managed Connaught's activities – a role he would often fill while FitzGerald pursued new projects.

Returning from overseas, FitzGerald resumed his teaching post at the University and his position as the Director of Connaught Laboratories. In 1920, he was appointed to the Dominion Council of Health, a new agency responsible for coordinating federal and provincial health programs. The Council was patterned on an earlier scientific advisory body that FitzGerald had created at Connaught. Following a sabbatical year at the University of California in 1922, FitzGerald was made a member of the Rockefeller Foundation's International Board of Health.

With the Foundation's backing, FitzGerald was soon able to complete the third stage of his public health vision for Canada – research, pro-duction, and education. In 1925, the Foundation provided fund ing to the University of Toronto to establish a School of Hygiene. Opened in 1927 with FitzGerald serving as its first director, it was the first learning institution in Canada dedicated to public health and preventative medicine.

In the meantime, Connaught Laboratories had achieved worldwide recognition in 1922 as the first organization to produce insulin in large quantities. This breakthrough treatment for diabetes had recently been discovered by Dr. Frederick Banting and Charles Best at the University of Toronto. Soon afterward, thanks to FitzGerald's connection with the Pasteur Institute which had developed the new vaccine, Connaught became the first North American laboratory to field-test and produce an immunizing diphtheria toxoid.

Throughout the 1930s, FitzGerald assumed even greater responsibilities both at home and abroad. In 1932, he was appointed Dean of Medicine at the University of Toronto, a position he would hold for three terms. With Defries' steadfast support, he continued as Connaught's Director as the laboratories expanded their research and production of vaccines and sera against other infectious diseases. FitzGerald also served as member or Director of several medical and research organizations both in Canada and the United States. On the interna-tional scene, he was a member of the League of Nations Health Committee and travelled extensively as a scientific director of the Rockefeller Foundation's International Division.

Sadly, by the late 1930s the restless energy and infectious enthusiasm that had enabled FitzGerald to accomplish so much and attract others to his cause began to wane. Throughout his life, he had suffered from severe headaches brought on by restless work habits and a worsening manic-depressive condition. Worn out physically and mentally, in 1938 FitzGerald suffered a severe mental breakdown that brought an end to his brilliant career. Tragically, he ended his own life in June 1940.

A year after his death, FitzGerald was honoured by Donald T. Fraser in the Proceedings of the Royal Society of Canada with the following eulogy:

To few are given the qualities of executive ability, singleness of purpose, imagination and vision, combined with gentleness, modesty, and charm of character in such large measure as Dr. FitzGerald possessed.

The small Barton Avenue stable where FitzGerald produced his first batches of diphtheria antitoxin stands today among several modern research and manufacturing buildings at Connaught Laboratories' facilities on the northern edge of Metropolitan Toronto. Surrounded by suburban sprawl, the former Gooderham farm is now headquarters of the largest vaccine manufacturer in North America.

At Connaught, research scientists carry on FitzGerald's fight against such modern-day infectious diseases as AIDS, influenza, and whooping cough. His former stable has been replaced by high technology biofermentation plants that produce millions of doses of vac-cines annually for distribution around the world.

And in a final irony, the story of John FitzGerald and Connaught Laboratories has come full circle. In 1989, the company became a member of the Pasteur Merieux group of companies of France. Nearly 80 years had passed since an idealistic young doctor from Canada spent a summer in Paris learning how to bring Louis Pasteur's new life-saving vaccines and sera "within reach of everyone."

Richard Levick