The middle-class plague: epidemic polio and the Canadian state, 1936-37.

During the pre-Salk era, paralytic poliomyelitis was one of the most feared diseases of twentieth-century North America. This perception, held most strongly by the middle class-- polio's principal target--shaped a unique Canadian response to it based on comprehensive, standardized, and unconditional programs of "state medicine" at the provincial level. Of Canada's four major waves of provincial polio epidemics, the second struck Ontario to an unprecedented degree in 1937, generating a similarly unprecedented response from the Ontario government in its control, treatment, hospitalization, and aftercare measures. As this article discusses, the severity of this epidemic led the provincial, and other Canadian public health authorities, to face a central question: How far should governments be compelled to go to ensure the advantages of modern treatment for their people? This article helps place the social impact of, and political and scientific response to, epidemic polio within the context of Canada's evolving public health and state medicine infrastructure at the time.