James Alexander Miller was an American physician. He was a professor of clinical medicine.
Background
James Alexander Miller was born on March 27, 1874, in Roselle Park, New Jersey. He was the second of seven children of Charles Dexter Miller and Julia Muirhead (Hope) Miller. His father was in the New York Cotton Exchange. His paternal grandfather, James, came from Belfast, Ireland, to New York in about 1830, lived on a farm near 86th Street, became a colonel in the Union Army, and was killed in battle. His mother was a descendant of Samuel Fuller, a physician in the Plymouth Colony. His one sister, Helen Clarkson, was an educator and author.
Education
The parents' Presbyterian and Puritan heritage imbued their children with firm and religious discipline. James's brother, Kenneth Dexter, a clergyman, directed the New York City Mission Society. James entered Princeton at fifteen after preparation at Pingry School. He received his B. A. in 1893 and M. A. in chemistry in 1894. After graduation from Princeton and a short stint as a chemist for the New Jersey Zinc and Iron Company, Miller was appointed by William H. Park as the research chemist in the Research Laboratory of the New York City Department of Health. There, Hermann M. Biggs urged him to study medicine and, while holding his job, he enrolled in the Columbia University College of Physicians and Surgeons. He received the M. D. with high honors in 1899 and was appointed intern at the Presbyterian Hospital.
Career
After finishing his internship in 1901, Miller became associated with A. A. Smith in private practice in New York and spent his summers in the Adirondacks, where he assisted Edward Livingston Trudeau, who, despite his own debilitating symptoms of tuberculosis, was conducting research in that disease and developing his sanatorium at Saranac Lake. Trudeau's ideals and lasting friendship influenced Miller's career deeply. The conquest of tuberculosis, then the leading cause of death, was still a dream, although Robert Koch had discovered the tuberculosis bacillus in 1882. The communicability of the infection became recognized and the prevention of its transmission was seen to be the key to control. Against opposition, the reporting of discovered cases of tuberculosis to the public health authorities became law, and a more humane attitude toward the patients followed. In 1903, Miller organized a separate tuberculosis clinic in the outpatient department of Bellevue, New York's largest public hospital; he was appointed adjunct assistant visiting a physician and delegated to look after patients who were housed in tents on the hospital grounds. Miller felt that more intensive education of medical students and researchers in tuberculosis was needed and, in 1927-1928, he proposed the building of a specialized hospital in the new Columbia Presbyterian Medical Center where he was a professor of clinical medicine. The cost was pledged and plans were drawn, but the idea perished in the economic crash of 1929. He then saw an alternative in the Bellevue Tuberculosis Service (later the Chest Service), long used as a Columbia teaching facility. Later, with the help of Harry Hopkins, a former tuberculosis worker, and a presidential advisor, Miller explained the need to President Franklin D. Roosevelt, who responded by arranging for federal funds to build a new tuberculosis pavilion at Bellevue. When this was opened in 1938, Miller retired as director of the service. As a Columbia teaching facility, the Chest Service staff, covering special fields of pathology, physiology, surgery, and clinical medicine, became distinguished for the scope and quality of its work. Miller lived to see the discovery of specific drug therapy, the most powerful weapon against tuberculosis. He died of cancer of the pancreas at his summer home in Black Point, Connecticut After a funeral service in the Brick Presbyterian Church, New York, he was buried in Fairview Cemetery, Westfield, New Jersey.
Achievements
James Alexander Miller conceptually outlined the objectives: medical attention; investigation and amelioration of the patients' unsanitary home conditions; hygienic education to avoid the spread of infection; material relief of patients and their families when needed. At Bellevue, he pursued these objectives undeviatingly, gradually building a staff of dedicated physicians, nurses, and social workers. In 1908, he organized a ladies' auxiliary, an effective philanthropic group that helped meet the social needs of the sick.
Throughout his career, Miller was active in many organizations. In 1904, he helped to found the National Association for the Study and Prevention of Tuberculosis, the first voluntary health organization in the United States. He also headed the tuberculosis committee of the Charity Organization Society of New York and in 1919 became president of its offspring, the New York Tuberculosis Association; in 1921, he became president of the national association. His experience was broadened during World War I by his service as associate medical director of a special commission of the International Health Board in helping to launch the tuberculosis program of France (1917 - 1918). A major in the American Red Cross, he was decorated Chevalier of the Légion d'Honneur. His extraordinary abilities as a policy-maker and leader drew him into various offices: he was president of the American Climatological and Clinical Association (1915), the American College of Physicians (1935 - 1936), the New York Academy of Medicine (1937 - 1938), and the Trudeau Sanatorium (1927 - 1945), and alumni trustee, Columbia University (1945). His influence on medical practice and public health was often exercised through the public health committee of the Academy of Medicine, of which he was a leader from the beginning (1911). The recommendations of this committee were often accepted with salutary effects, for example, examination of immigrants in the country of origin to prevent the importation of communicable disease, replacement of the political office of the coroner with that of a professionally competent chief medical examiner in New York, child health surveys, and industrial health studies. During its centennial celebration in 1947, the academy honored Miller as its "most distinguished and beloved fellow and one of the greatest benefactors of mankind. " Miller was held in high esteem not only because he entered an unpopular and limited field of medicine and succeeded beyond expectation but also because he had a vision, administrative and clinical skill, and great humanity. This underlay his concern for his patients and their devotion to him.
Personality
In college, James was tall, good-looking, cheerful, athletic, and healthy.
Connections
In his junior year, Miller met Marion Clifton Hunt. They became engaged but did not marry until ten years later, on June 4, 1902. During the interval, she worked in New York as a kindergarten teacher. They had two daughters, Constance and Marion.
