John E. Affeldt, MD

Born: May 26, 1918

Major Contribution:

Medical director at Rancho Los Amigos Hospital in Los Angeles County from 1957-1964, Dr. Affeldt was in charge of the polio respiratory center there (one of 13 in the US) and organized the first extensive home care system for significantly disabled polio survivors, who were up to that time "warehoused" in the hospital.

Other Information:

Brief Biography: John Affeldt was born in Lansing, Michigan, and named after his father and grandfather, both who owned grocery and meat markets. He, however, went to medical school at the College of Medical Evangelists in California (renamed Loma Linda University in 1961) and studied internal medicine.

In 1951, he was sent by the National Infantile Paralysis Foundation (NFIP) to evaluate the staffing, space and equipment needs of Rancho Los Amigos. (The NFIP was developing 13 regional respiratory centers across the country.) At that time, the hospital census averaged 85 polio cases with 65 of them as "respirator cases." Forty-one had tracheostomies requiring positive pressure and suctioning.

In 1953, the county opened its Home Care Department, a truly interdepartmental undertaking. The program included mechanics and electricians who were on call 24 hours a day. The cost of caring for a ventilator-assisted polio survivor at home was 1/3 to 1/2 the cost of hospitalization. Rancho's Home Care department- the most extensive attempted- became a model of how to return significantly disabled patients to the community and into society. When private companies began offering home care services, the program closed (1978).

Also, during Affeldt's tenure Clarence Dail, MD, noticed a paralyzed polio patient using a substitute method of breathing. It was eventually taught to others and was called glossopharyngeal, or "frog" breathing.

Affeldt had a very prestigious career as director of Los Angeles County Department of Health Services, the president of the American Hospital Association (AHA) and president of the Joint Commission for the Accreditation of Hospitals.

Location of Papers: Papers of John E. Affeldt are available at Papers of the Rancho Los Amigos Hospital, The California Social Welfare Archives, 2002. An oral history of John E. Affeldt was published in 1987 and is available from the American Hospital Association.

Major Articles: John E. Affeldt, MD

Mechanics of Glossopharyngeal Breathing. 1956. Clarence R. Collier, Clarence W. Dail, and John E. Affeldt. J Appl Physiol 8: 580-584.

Elective Surgery on Patients with Respiratory Paralysis. 1957. Vernon L. Nickel, Jacquelin Perry, John E. Affeldt, And Clarence W. Dail. J Bone Joint Surg Am.39:989-1001. Free Article

Ventilatory Aspects of Poliomyelitis . 1955. John E. Affeldt, Clarence R. Collier, Milton G. Crane, and Andrew F. Farr. Anesth Analg 1955 34: 41-53.

Noninvasive Mechanical Ventilation at Home Building Upon the Tradition. 2002. Allen I. Goldberg, MD, FCCP (Chicago, IL ) Full text available of (Chest. 2002;121:321-324.) © 2002 American College of Chest Physicians.

Polio Survivors Prove the Value of Home Care Services by Gini Laurie. Read at National Library of Medicine's Profiles in Science.

Companion book to the film, "A Paralyzing Fear: The Triumph Over Polio in America" (1998) Author(s): Seavey, Nina Gilden; Smith, Jane S.; Wagner, Paul Simon & Schuster ISBN10: 1575000709 Chapter 4 includes the voice of John Affeldt.

Articles found at HighWire Press® Standford University. (*Asterisk denotes article is free of subscription fee.)

Ventilatory Aspects of Poliomyelitis. John E. Affeldt, Clarence R. Collier, Milton G. Crane, and Andrew F. Farr Anesth. Analg., Jan 1955; 34: 41 – 53.

The Need For Supplemental Oxygen Therapy In Acute And Chronic Poliomyelitis. Stanley N. Rokaw, Mllton G. Crane, Clarncs R. Collier, John E. Affeldt, and Albert G. Bower. Anesth. Analg., May 1958; 37: 107 – 113.

In Defense of the JCAH. John E. Affeldt. Am J Psychiatry, Aug 1980; 137: 993.

The Use of Enzymes and Wetting Agents in the Treatment of Pulmonary Atelectasis. Samuel J. Camarata, Harry J. Jacobs, And John E. Affeldt. Chest, Apr 1956; 29: 388 - 401.

Quality Assurance: Its Origin, Status, and Future Direction a JCAH Perspective. John E. Affeldt, James S. Roberts, and Regina M. Walczak. Eval Health Prof, Jun 1983; 6: 245 - 255.

Articles Found at ScienceDirect.com

The rapid diagnosis of ventilatory failure with the carbon dioxide analyzer. Donald E. Griggs, Jack D. Hackney, Clarence R. Collier and John E. Affeldt. The American Journal of Medicine, Volume 25, Issue 1, July 1958, Pages 31-36.

Chronic poliomyelitic respirator deaths. Robert A. Blossom and John E. Affeldt. The American Journal of Medicine, Volume 20, Issue 1, January 1956, Pages 77-87.

Determination of alveolar CO2 with a portable rapid infra-red analyzer. Clarence R. Collier, John E. Affeldt and Andrew F. Farr. The American Journal of Medicine, Volume 17, Issue 1, July 1954, Pages 109-110.

The treatment of the anginose type of infectious mononucleosis with gamma globulin. Albert G. Bower, John E. Affeldt and Harold Wes. The Journal of Pediatrics, Volume 35, Issue 1, July 1949, Pages 58-62.

Articles found at JSTOR

To Prevent Helplessness and Deformities. Barbara Williams Madden, John E. Affeldt. The American Journal of Nursing, Vol. 62, No. 12 (Dec., 1962), pp. 59-61.

Voluntary Accreditation. John E. Affeldt. Proceedings of the Academy of Political Science, Vol. 33, No. 4, Regulating Health Care: The Struggle for Control (1980), pp. 182-191.

The Iron Lung: Halfway Technology or Necessary Step? James H. Maxwell. The Milbank Quarterly, Vol. 64, No. 1 (1986), pp. 3-29.

The dental profession’s new role. JCAH president sees improved communications with dentistry. JE Affeldt. J Am Dent Assoc, Nov 1980; 101: 762 - 763.

Air-Flow Patterns and Pulmonary Ventilation During Manual Artificial Respiration on Apneic Normal Adults. II Archer S. Gordon, John E. Affeldt, Max Sadove, Frank Raymon, James L. Whittenberger, and A. C. Ivy. J Appl Physiol, Dec 1951; 4: 408 - 420.

Mechanics of Breathing in Relation to Manual Methods of Artificial Respiration. J. L. Whittenberger, J. E. Affeldt, W. T. Goodale, and S. J. Sarnoff. J Appl Physiol, Dec 1951; 4: 476 - 485.

Ventilatory Efficiency of the Cuirass Respirator in Totally Paralyzed Chronic Poliomyelitis Patients. Clarence R. Collier and John E. Affeldt. J Appl Physiol, Mar 1954; 6: 531 - 538.

Glossopharyngeal Breathing: Ventilation Studies. John E. Affeldt, Clarence W. Dail, Clarence R. Collier, and Andrew F. Farr. J Appl Physiol, Jul 1955; 8: 111 - 113.

Alveolar Carbon Dioxide Levels in Acute Poliomyelitis. Milton G. Crane, John E. Affeldt, Elizabeth Austin, and Albert G. Bower. J Appl Physiol, Jul 1956; 9: 11 - 18.

Mechanics of Glossopharyngeal Breathing. Clarence R. Collier, Clarence W. Dail, and John E. Affeldt. J Appl Physiol, May 1956; 8: 580 – 584.

A Plastic Balloon for Recording Intraesophageal Pressures. Milton G. Crane, Donald A. Hamilton, and John E. Affeldt. J Appl Physiol, May 1956; 8: 585 – 586.

Elective Surgery On Patients With Respiratory Paralysis.* Vernon L. Nickel, Jacquelin Perry, John E. Affeldt, And Clarence W. Dail. J. Bone Joint Surg. Am., Oct 1957; 39: 989 - 1001.

From SAGE Journals

Quality Assurance: Its Origin, Status, and Future Direction, a JCAH Perspective. John E. Affeldt, James S. Roberts, and Regina M. Walczak. Evaluation & the Health Professions, Vol. 6, No. 2, 245-255 (1983) © SAGE Publications

From WorldCat™

Regulating Health Care: The Struggle for Control. Arthur Levin. 1980. New York: Academy of Political Science.

John E. Affeldt in Fist Person : An Oral History. John E Affeldt,and Lewis E. Weeks. American Hospital Association.; Hospital Research and Educational Trust. Ann Arbor, MI: L.E. Weeks, ©1987. Located at American Hosp Asn, Chicago, IL 60606 United States; National Library of Medicine, Bethesda, MD 20894 United States.

Dr. John E. Affeldt : An Oral History Interview 23 March 1976. John E Affeldt and Marcia Erickson. Thesis/dissertation/manuscript. Archival Material Located at California State University, Northridge, Northridge, CA 91330 United States.

Los Angeles County Hospital House Staff Manual. David Hamm. Los Angeles County Hospital (Los Angeles, CA). Los Angeles: The Hospital, 1950. Located at University of Alabama, Bham, Health Science Birmingham, AL 35294 United States; University of Cincinnati, Medical Center, Cincinnati, OH 45267 United States; Harvard University, Cambridge, MA 02138 United States; Harvard University, Medical School, Countway Library, Boston, MA 02115 United States.

Coordination of Planning for Health Program in Drug, Alcohol, Mental hHalth, and Development Disabilities. Affeldt, John E. Los Angeles County (Calif.). Dept. of Health Services. Language: English Type: Book Publisher: Los Angeles: Department of Health Services, 1975. Located at UCLA Library, Los Angeles, CA 90024 United States; University of California, S Reg Library Fac, Los Angeles, CA 90095 United States.

Vocational Rehabilitation Research in a Regional Respiratory Center for Poliomyelitis. John E Affeldt. 1960. Rancho Los Amigos Hospital Respiratory and Rehabilitation Center for Poliomyelitis. Microform Publisher: Downey, Calif : Rancho Los Amigos Hospital Poliomyelitis Clinical Study Center located at University of Northern Colorado, Greeley, CO 80639 United States; University of Central Oklahoma, Edmond, OK 73034 United States; Texas Woman's University Library, Denton, TX 76204 United States.

"Glassopharyngeal Breathing." Clarence W Dail, John E Affeldt. 1970s (film). Rancho Los Amigos Respiratory Center for Poliomyelitis.; College of Medical Evangelists (Los Angeles, CA). Dept. of Visual Education. The College, located at Veterans Admin Medical Center, Miami Miami, FL 33125 United States.

Status of mental health restoration monies. John E Affeldt. Los Angeles County (Calif.). Dept. of Health Services. Department of Health Services, 1975. Located at UCLA Library Los Angeles, CA 90024 United States; University of California, S Reg Library Fac, Los Angeles, CA 90095 United States.

Regulating health care the struggle for control. Arthur Levin. (videorecording) JSTOR (Organization) Computer File Internet Resource. New York: Academy of Political Science, 1980. Located at Colorado State University, Ft Collins, CO 80523 United States JCAH forum. American Hospital Association. Chicago, Illinois American Hospital Association, 1979. Located at Louisiana State University, Health Science Center, Shreveport, LA 71130 United States.

Muscle breathing patterns in poliomyelitis. Clarence W Dahl, John E Affeldt. (motion picture, film) Rancho Los Amigos Respiratory Center for Poliomyelitis. The Center.

Vocational rehabilitation research in a regional respiratory center for poliomyelitis. 1958. Rancho Los Amigos Hospital. Respiratory and Rehabilitation Center for Poliomyelitis. Publisher: Downey, CA. Located at University of Oregon Library, Eugene, OR 97403 United States.

Recognition from other agency professionals. William L Kempiners and John E Affeldt. 1981. (sound Recording: cassette tape) Arlington, VA; Instant Replay.

Primary care management of hypertension. John E Affeldt, Carroll J Wendland. 1975.(slides) Los Angeles County Medical Training Systems. Access to Primary Health Care.

Key word suggestions for additional publication searches: glossopharyngeal breathing, frog breathing, artificial respiration, muscle breathing, mechanical ventilation, pulmonary ventilation, respiratory paralysis, poliomyelitis.