Robert Hooke’s Micrographia (Item of the Month)

By Rebecca Pou, Archivist

The title page of Hooke's Micrographia.

The title page of Hooke’s Micrographia.

Robert Hooke was born on July 28 (O.S. July 18), 1635. To commemorate his birthday, we are featuring his book Micrographia as July’s item of the month.

Hooke published Micrographia in 1665 when he was 30 years old. At the time, Hooke was the curator of experiments for the Royal Society of London, which involved conducting several experiments a week and presenting them to the society. Hooke made many of the observations found in Micrographia through his activities for the society, and the Royal Society commissioned and printed the book.1

An extraordinary work, Micrographia details Hooke’s observations on objects as varied as the point of a needle, a louse, and the moon (he also utilized telescopes). The book includes 38 copperplate engravings of microscopic views based on Hooke’s drawings. Micrographia was not the first book of microscopic observations, but it was more successful and accessible than its predecessors. Who wouldn’t marvel at a close up shot of a flea?

Here is a selection of Micrographia’s plates (click to enlarge):

Fig. 1 shows a microscopic view of kettering-stone. In observation XV, Hooke notes, “We may here find a Stone by the help of a Microscope, to be made up of abundance of small Balls…and yet there being so many contacts, they make a firm hard mass…”

Fig. 1 shows a microscopic view of kettering-stone. In observation XV, Hooke notes, “We may here find a Stone by the help of a Microscope, to be made up of abundance of small Balls…and yet there being so many contacts, they make a firm hard mass…”

In his observation on cork, Hooke compared its structure to that of honeycomb and. He discovered plant cells, “which were indeed the first microscopical pores I ever saw, and perhaps that were ever seen…,” and coined the term “cell.”

In his observation on cork, Hooke compared its structure to that of honeycomb. He discovered plant cells, “which were indeed the first microscopical pores I ever saw, and perhaps that were ever seen…,” and coined the term “cell.”

For observation XXXIV, Hooke examined the eyes and head of grey drone-fly.

For observation XXXIV, Hooke examined the eyes and head of grey drone-fly.

Hooke seemed enamored with the white feather-winged moth, calling it a “pretty insect” and “a lovely object both to the naked Eye, and through a Microscope.”

Hooke seemed enamored with the white feather-winged moth, calling it a “pretty insect” and “a lovely object both to the naked Eye, and through a Microscope.”

The flea is one of several fold-out plates in the book. Again, Hooke has a scientist’s appreciation for the insect, commenting equally on its strength and beauty. He is particularly fascinated with the anatomy of its legs and joints, which “are so adapted, that he can…fold them short within another, and suddenly stretch, or spring them out to their whole length.”

The flea is one of several fold-out plates in the book. Again, Hooke has a scientist’s appreciation for the insect, commenting equally on its strength and beauty. He is particularly fascinated with the anatomy of its legs and joints, which “are so adapted, that he can…fold them short within another, and suddenly stretch, or spring them out to their whole length.”

In the last observations, Hooke turned his attention to celestial bodies. His study of the moon lead him to believe it might be covered in vegetation. He thought the hills seen in Fig. 2 “may be covered with so thin a vegetable Coat, as we may observe the Hills with us to be, such as the short Sheep pasture which covers the Hills of Salisbury Plains.”

In the last observations, Hooke turned his attention to celestial bodies. His study of the moon led him to surmise that the hills seen in Fig. 2 “may be covered with so thin a vegetable Coat, as we may observe the Hills with us to be, such as the short Sheep pasture which covers the Hills of Salisbury Plains.”

The National Library of Medicine’s Turning the Pages project has a selection of images from Micrographia available. It is well worth flipping through; you’ll find curator’s notes and you can even open the folded plates. If you are interested in looking at Micrographia in its entirety, contact us at history@nyam.org or 212-822-7313 to make an appointment.

Reference
1. Espinasee, Margaret. Robert Hooke. London: Heinemann, [1956].

Guest curator Riva Lehrer on Vesalius 500

Our “Art, Anatomy, and the Body: Vesalius 500″ festival guest curator, artist and anatomist Riva Lehrer, describes some of her thinking about bodies, anatomy and art.

In 1543, when Andreas Vesalius published his De humani corporis fabrica (On the fabric of the human body) many contemporaries refused to accept his results. They contradicted canonical texts passed down over millennia: belief and expectation trumped direct experience and observation.

It’s easy to smile condescendingly at such pig-headedness. Yet we can scarcely look in the mirror without being caught in a fog of distortion. Every day we’re overloaded with information about how we should look and how our bodies should work. There are still plenty of ways in which our biases form medicine, and medicine, in turn, forms us.

"Circle Stories #4: Riva Lehrer" 1998  self portrait

“Circle Stories #4: Riva Lehrer” (1998).

I was born with visible disabilities. My body has always been seen as lacking, in need of correction, and medically unacceptable. My parents and doctors pushed me to have countless procedures to render it more “normal” as well as more systemically functional. These were two different streams of anxiety—how I worked and how I looked— yet they became inextricably woven together. My life in the hospital gave me a tremendously intimate view of medicine, as does the fact that I come from a family of doctors, nurses, and pharmacists. It gave me an acute awareness of how medical choices control and shape our bodies.

I first studied anatomy at the School of the Art Institute of Chicago and later at the University of Illinois at Chicago, as a visiting artist in the cadaver lab. I often think about what my first anatomy professor told me, many years ago. She remarked that when she was a child, people grew into their original faces. Whatever oddities they were born with formed what they looked like, year after year. Faces were hard-won and unique. But modern dentistry, nutrition, grooming—all the large and small interventions of medicine—made people look much more alike than they did sixty years ago.

In the 21st century, medicine is not just about the “correction” of significant impairments; personal perfectibility is as much the point of modern medicine as the curing of significant diseases. We view our bodies as lifetime fixer-upper projects.

Yet, it’s that very fluidity that opens profound questions about the identities our bodies express. Technologies such as radical cosmetic surgery, cyborgian interfaces, and gender reassignment procedures raise and complicate our expectations. Medicine offers new options if the inside of our bodies does not match the appearance of the outside. We live in a state of wild restlessness, trying to see and feel who we are. We see chimeras of possibility.

"At 54" Riva Lehrer 2012 self portrait

“At 54″ by Riva Lehrer (2012).

My body was not normalized through all my surgeries; yet the original body I had would not have lived. It’s been changed so many times that I can’t even guess at what it would have been. My own mutability has given me a deep interest in the two-way relationship between one’s body and the course of a life.

I teach anatomy for artists at the School of the Art Institute and am a visiting artist in Medical Humanities at Northwestern University. My studio practice focuses on the intersection of the physical self and biography. I interview people in depth about the interweaving of their bodies and their stories. These interviews become narrative portraits, as I try to understand what can be known about a life in a single portrait image.

Join us as we explore the role of anatomy in identity formation through our celebration of the 500th anniversary of Vesalius’ birth. We’ve invited artists, performers, scholars, and historians to help us ask how our imaginations form our living flesh. Let’s all look in the mirror and ask, what are we really seeing, and what do we believe we see?

Some of the issues our speakers will explore include:

""Chase Joynt" by Riva Lehrer and Chase Joynt 2014

“”Chase Joynt” by Riva Lehrer and Chase Joynt (2014).

—How do we decide what is “lifesaving” and what is “elective” surgery when it comes to identity? Transgender performer Chase Joynt questions what it means to save a life, and how his dealings with the medical establishment led him to question such choices.

—How many of us were raised with the constant imprecation to stand up straight? Sander Gilman peers into the use of posture lessons in public schools to control the American body.

—Artist Steven Assael creates dramatic portraits of New Yorkers, from street performers to elderly eccentrics. His work shows us how identity travels from the inner self to the outer shell.  Assael is a long-time professor at New York’s School of Visual Arts, one of the last bastions of serious anatomical study in the U.S.

—Famed choreographer Heidi Latsky will discuss GIMP and how she creates dance for performers with a range of movements and morphologies. A performance and film excerpt bring us into the innovative strategies used by the GIMP collective.

—Many contemporary artists use anatomy in investigations of identity and formal exploration. Curator Ann Fox will present images from an international roster of artists. She will be joined by Taiwanese artist Sandie Yi, who will show work that deals with the intense difficulties of having a physically different body in China.

"Coloring Book" Riva Lehrer 2012

“Coloring Book” by Riva Lehrer (2012).

Graphic Medicine is a consortium of comics artists who explore medicine from the standpoint of doctor, nurse, patient and family member. The founders of Graphic Medicine, MK Czerwiec and Ian Williams, will discuss how the vulnerable body is rendered in comics form. Comics allow artists to move from the inside of the body to the outside in seamless transitions, to weave together objective perspectives and highly personal, subjective experiences.

Tracking the History of Cancer Drug Development

Lourdes Sosa, today’s guest blogger, is an associate professor in the department of management at the London School of Economics and Political Science.

Have new cancer drugs entered the market targeting ever-smaller portions of the total cancer patient population? If so, is this a symptom of a high-tech market phenomenon known to economists as submarket fragmentation?1 If we accurately answer these questions, we will better understand oncology drug discovery competition and thus will offer better strategic recommendations to enhance drug discovery efficiency.

My co-authors, Prof. Roberto Fernandez (MIT Work and Organization Studies), Prof. Andrew Lo (MIT Finance), and myself, Prof. Lourdes Sosa (LSE Department of Management), set about to answer these questions more than a year ago. As we began our research, our most important first step was to identify the anticancer drugs available in the US market since the birth of chemotherapy in the 1940s. A perfect data source became the Physicians’ Desk Reference (PDR®), an annual directory of approved drugs and full prescribing information that began publication in 1947.

Our next challenge came about immediately: where could we locate an accessible repository that held the entire collection to date? Although key local libraries offered us access to a large portion of the collection in print, we found in the New York Academy of Medicine Library full access to the entire collection. Furthermore, NYAM holds the collection in microfiche format, making it easy to browse from one year to another.

Starting a year ago, we began collecting data from the NYAM Library. We are now happy to report how our study is taking shape (we are also delighted to have an avenue to thank the support of Ms. Danielle Aloia and the team of expert librarians at NYAM).

The title page and an entry in from the 1949 Physician's Desk Reference.

The title page and an entry from the 1949 Physicians’ Desk Reference.

The figure below shows the oncology drugs available in the US market from 1947 until 2001 (data entry is still in progress). The process to identify these drugs started with the Product Category Index of the PDR®, where all cancer-related drugs can be found. We then read the full prescription information included in the product information section of the PDR® to extract the actual indications approved per drug. This latter step allowed us to make a precise decision on whether the drug was a treatment for cancer (as opposed to a treatment for a side effect or complication), and if so, to define for which cancer indications the drug was approved.

Courtesy of Roberto Fernandez, Andrew Lo, and Lourdes Sosa.

Courtesy of Roberto Fernandez, Andrew Lo, and Lourdes Sosa.

As can be seen in the figure, there is a big change in reporting in 1970. Starting that year the Product Category Index of the PDR® reported a category titled antineoplastics that made it straightforward to identify relevant drugs. In contrast, the categorization used in 1947–1969 has categories such as multiple myeloma and breast carcinoma listed separately. More importantly, during those earlier years a vast majority of drugs listed as cancer-related were in fact general-purpose drugs such as steroids, analgesics, and diuretics, which just happened to be novelties in the market.

As mentioned, we used the full prescription information to discern between the cancer-treating drugs that constitute the core of our study and those of either general application (e.g., steroids) or symptom-relief purpose (e.g., anemia treatments). The actual population of cancer-treating drugs for us to use is the black portion of the above figure shown with the legend “treating drugs.”

Our next step (after completing this exercise to year 2013) will be to calculate an index of coverage that proxies for the percentage of all cancer patients that each drug can treat. We will eagerly report on our progress as soon as we have preliminary results to share.

Reference

1. Sutton, J. 1998. Technology and Market Structure: Theory and Structure. MIT Press, Cambridge, MA.

Celebrate Andreas Vesalius’s 500th Birthday With Us on October 18

On October 18, our second-annual Festival for Medical History and the Arts, “Art, Anatomy, and the Body: Vesalius 500″ will celebrate the 500th birthday of anatomist Andreas Vesalius.

Vesalius’ groundbreaking De humani corporis fabrica (The Fabric of the Human Body) of 1543 is a key Renaissance text, one that profoundly changed medical training, anatomical knowledge, and artistic representations of the body, an influence that has persisted over the centuries. Our Festival is one of a global series of celebrations of his legacy.

Our day-long event will explore the intertwined histories of art and anatomy, illustration and medicine, performance and the body, body snatching and dissection, identity and intersexuality, disability and representation, and contemporary visual arts and the body. Speakers, performers, and artists will be joined by anatomical cartoonists, 3D printing demonstrations, workshops, and more. Artist and anatomist Riva Lehrer will be our guest curator. Speakers and presenters will include Daniel Garrison, Steven Assael, Sander Gilman, Brandy Schillace, Lisa Rosner, Ann Fabian, Bill HayesMichael Sappol, Chase JoyntProof X, and  Kriota Willberg (look for a full list of speakers later this summer).

Follow our blog over the summer for guest posts from Festival participants and more on the wonderful Vesalius holdings in our collection.

 

 

 

A Gallery of Gauzy Wings (Item of the Month)

By Arlene Shaner, Acting Curator and Reference Librarian for Historical Collections

Plate 8: Ephemera rupestris, the Rock Day Fly. Click to enlarge.

Plate 8: Ephemera rupestris, the rock day fly. Click to enlarge.

As we head into full summer, it seems appropriate to take a look at one of our many natural history books for this item of the month. Anyone who spends time outside at this time of year encounters insect life of many kinds.

While we mostly tend to avoid the bugs we encounter, many 18th century naturalists found them enticing subjects of study. John Hill (1714?-1775), the author of the charming A Decade of Curious Insects (1773), was no exception. Hill was an English apothecary and botanist with frustrated literary and theatrical aspirations. He also had a medical degree from the University of St. Andrews, but whether he actually studied to become a physician or just purchased the degree is unclear. He worked as an apothecary and created and dispensed many herbal remedies. He is most remembered now for his various botanical works, including the British Herbal (1756), a series of popular herbal medicine treatises, and the 26-volume Vegetable System (1759-1775).1,2

Hill_Title Page_watermark

Title page of A Decade of Curious Insects. Click to enlarge.

Hill had a longstanding interest in microscopic observation and revised an English translation of Jan Swammerdam’s heavily illustrated Book of Nature, or the History of Insects in 1758. In the little work that is the subject of this post, however, he made the observations himself, using a lucernal microscope probably much like the one pictured here.

All ten engravings in our copy are hand colored, although the illustrations could also be purchased separately and painted for personal education or enjoyment. As the verso of the title page notes, “Ladies who may chuse to paint these Insects themselves may have Sets of the Cuts on Royal Paper printed pale for that purpose.”

The text provides detailed descriptions of each insect, with particular attention paid to the colors of individual body parts. Sometimes Hill also offers his observations on their habits. Day-Flies, for example, “are an inoffensive race; born to pass thro’ their little stage of being, the prey to a thousand enemies; but hurtful to no creature.”

Plate 7, Ephemera culiciformis, the "white wing'd day fly." Click to enlarge.

Plate 7, Ephemera culiciformis, the “White Wing’d Day Fly.” Click to enlarge.

The Savages, Sphex and Sphex Spirifex, attack other insects with an unmatched intensity. In the case of the Comb-Footed Savage, “The number of other Insects these destroy, is scarce to be conceiv’d ; the mouth of their cave is like a Giant’s of old in romance ; strew’d with the remains of prey… he will kill fifty for a meal.”

Plate 3, Sphex pectinipes, the comb footed savage. Click to enlarge.

Plate 3, Sphex pectinipes, the comb footed savage. Click to enlarge.

A warning, though, that anyone who enjoys inhaling the fragrance of a bouquet of flowers might be in for a dreadful surprise if the either the Straw-Colour’d or the Tawny Chinch lurks inside. According to Hill, a gentleman who suffered from headaches sneezed onto a sheet of paper one day, and a microscopical examination of the “moving particles” revealed them to be Straw-Colour’d Chinches.

Plate 9, Allucita Pallida, "The Straw-colour'd Chinch."

Plate 9, Allucita Pallida, “The Straw-colour’d Chinch.”

Hill noted that both chinches inhabit a variety of popular flowers. “Many have this pain [headache] from the smell of Flowers,” he writes. “Some have been found dead, with quantities of violets, and other Flowers, in their chamber. Physicians have attributed these deaths to the powerful odour of those Flowers; but that they should be owing to these creatures, is much more probable.”

Plate 10, Allucita fulva, the tawny chinch.

Plate 10, Allucita fulva, the tawny chinch.

Perhaps you should think twice the next time you stop to smell the roses, just in case.

The book’s illustrations are too lovely not to share. Here are the remainder (click an image to view the gallery).

References
1. Barker, G. F. R. (1891). Hill, John (1716?-1775). In Dictionary of National Biography, 1885-1900, volume 26. London: Smith, Elder & Co. Retrieved from http://en.wikisource.org/wiki/Hill,_John_%281716%3F-1775%29_%28DNB00%29

2. Gerstner, P. A. (1972). Hill, John. In Dictionary of Scientific Biography, volume VI. New York: Charles Scribner’s Sons.

Brighten the Visit With Pepsi

By Johanna Goldberg, Information Services Librarian, with Jarlin Espinal, Technical Services Assistant

This is part of an intermittent series of blogs featuring advertisements from medical journals. You can find the entire series here.

From JAMA, volume 182, number 8, November 24, 1962.

From JAMA, volume 182, number 8, November 24, 1962.

Advertisements in the Journal of the American Medical Association (JAMA), have reflected food and diet trends from the start.

In the late 1930s and early 1940s, the journal normally had two pages of ads an issue, often related to food. By the late 1940s, advertising exploded. The May 3, 1947 issue of JAMA has 130 pages of ads, with food-related items amidst the publishers, medical devices, cigarettes, cosmetics, sanitariums, hospitals, and pharmaceuticals.

The advertising boom only increased—“In 1958 the industry estimated that it had turned out 3,790,809,000 pages of paid advertising in medical journals.”1 By this time, ads for pharmaceuticals far surpassed those for food- and diet-related items, a fitting trend as “between 1939 and 1959, drug sales rose from $300 million to $2.3 billion”1

The food- and diet-related advertisements presented here fall into several categories. There are promotions from industry groups—including my favorite, in which the National Confectioners’ Association attempts to convince doctors that candy has health benefits. There are beverages, ranging from baby formula to ovaltine to soft drinks. There are items that remain familiar today and items that seem totally foreign—if someone out there has tried Embo, please let us know. And of course, there’s the intersection of pharmaceuticals and diet, as claims of appetite suppression move from ads for apples and citrus to drugs like Desoxyn.

From JAMA, volume 106, number 20, May 16, 1936.

From JAMA, volume 106, number 20, May 16, 1936. Click to enlarge.

From JAMA, volume 134, number 1, May 3, 1947.

From JAMA, volume 134, number 1, May 3, 1947. Click to enlarge.

From JAMA, volume 134, number 2, May 10, 1947. Click to enlarge.

From JAMA, volume 134, number 2, May 10, 1947. Click to enlarge.

From JAMA, volume 154, number 3, January 16, 1954. Click to enlarge.

From JAMA, volume 154, number 3, January 16, 1954. Click to enlarge.

From JAMA, volume 154, number 5, January 30, 1954. Click to enlarge.

From JAMA, volume 154, number 5, January 30, 1954. Click to enlarge.

From JAMA, volume 154, number 6, February 6, 1954. Click to enlarge.

From JAMA, volume 154, number 6, February 6, 1954. Click to enlarge.

From JAMA, volume 154, number 9, February 27, 1954. Click to enlarge.

From JAMA, volume 154, number 9, February 27, 1954. Click to enlarge.

From JAMA, volume 182, number 7, November 17, 1962. Click to enlarge.

From JAMA, volume 182, number 7, November 17, 1962. Click to enlarge.

From JAMA, volume 182, number 7, November 17, 1962. Click to enlarge.

From JAMA, volume 182, number 7, November 17, 1962. Click to enlarge.

From JAMA, volume 234, number 2, October 13, 1975. Click to enlarge.

From JAMA, volume 234, number 2, October 13, 1975. Click to enlarge.

Reference

1. Donohue J. A history of drug advertising: the evolving roles of consumers and consumer protection. Milbank Q. 2006;84(4):659–699. Available at: http://facultynh.syr.edu/bjsheeha/ADV 604/History of Drug.pdf. Accessed May 30, 2014.

A History of Blood Transfusions

By Danielle Aloia, Special Projects Librarian

World Blood Donor Day 2014June 14 is World Blood Donor Day, a date selected to coincide with the birthday of Karl Landsteiner (1868–1943), the father of blood transfusions. Landsteiner discovered the A, B, AB, and O blood types in 1901, making blood transfusions safer. His work earned him the the Nobel Prize in Physiology or Medicine in 1930.1 The Word Health Organization (WHO) created this event to honor Dr. Landsteiner and to bring attention to the need for timely access to safe blood and blood products through voluntary donations.2

Recorded evidence of blood transfusions date back to the 16th century; there has been much speculation as to who first tried it and who first succeeded. Some tales are based on evidence and some seem to have been fabricated. Dr. Richard Lower is credited with performing the first successful blood transfusion from one animal to another in the 17th century. But it wasn’t until 1818 that Dr. James Blundell, a gynecologist, made a fairly successful attempt; after the procedure, patients who had been near death showed temporary improvement. Blundell continued to improve on the process and in 1829, he published the first report on a “human life being saved by transfusion” in the Lancet.3

Figure from Dr. Blundell's article in the June 13 ,1829 issue of The Lancet, "Observations on Transfusion of Blood."

Figure from Dr. Blundell’s article in the June 13, 1829 issue of The Lancet, “Observations on Transfusion of Blood.”

From the RAMC Muniment Collection in the care of the Wellcome Library. Credit: Wellcome Library, London.

From the RAMC Muniment Collection in the care of the Wellcome Library. Credit: Wellcome Library, London.

Even after Landsteiner’s 1901 discovery, the ability to safely store and preserve blood donations took several more decades of study. During the First World War, O. H. Robinson, an army doctor,  introduced an effective anti-coagulant for long-term human blood storage.4 Percy Oliver began the first blood donor service with the British Red Cross. In the 1920s, he was asked to help with the growing need for blood and developed the first system of a volunteer donation and screening process. It wasn’t until 1941 that the Red Cross in the US started actively collecting blood from donors on request of the US government.4

This year’s World Blood Donor Day campaign highlights the importance of safe blood and the prevention of unnecessary deaths during pregnancy. The loss of blood during childbirth has been studied throughout history5 and continues to be a medical concern. About 800 women, nearly all in developing countries, die of pregnancy- and childbirth-related causes every day.2 A 2006 WHO analysis identified hemorrhaging as the leading cause of maternal deaths in Africa and in Asia.6 In developing countries donated blood is most often used for pregnancy complications7 whereas only 2.2% of donated blood in the US is used for obstetrics.8

Blood donation is one of the single most important contributions a person can make in saving the lives of others. Every two seconds someone needs blood and every pint of blood can save several lives.9 The more donated blood, the more lives saved.

References

1. NobelPrize.org. Karl Landsteiner – Biographical. Available at: http://www.nobelprize.org/nobel_prizes/medicine/laureates/1930/landsteiner-bio.html. Accessed June 11, 2014.

2. World Health Organization. Campaign essentials: World blood donor day 2014.; 2014. Available at: http://apps.who.int/iris/bitstream/10665/112768/1/WHO_World-Blood-Donor-Day_2014.1_eng.pdf?ua=1&ua=1. Accessed June 11, 2014.

3. Walker K. The Story of Blood. London: H. Jenkins; 1958.

4. Duffin J. History of Medicine: A Scandalously Short Introduction. Toronto: University of Toronto Press; 2010.

5. Schorn MN. Measurement of blood loss: review of the literature. J Midwifery Womens Health. 55(1):20–7. doi:10.1016/j.jmwh.2009.02.014.

6. Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PFA. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367(9516):1066–74. doi:10.1016/S0140-6736(06)68397-9.

7. World Health Organization. WHO | 10 facts on blood transfusion. Available at: http://www.who.int/features/factfiles/blood_transfusion/blood_transfusion/en/index1.html. Accessed June 12, 2014.

8. Whitaker B, Hinkins S. The 2011 national blood collection and utilization survey report. Washington, D.C.; 2013. Available at: http://www.aabb.org/research/hemovigilance/nbcus/Documents/11-nbcus-report.pdf. Accessed June 12, 2014.

9. Blood Centers of the Pacific. 56 Facts About Blood and Blood Donation. 2005. Available at: http://www.bloodcenters.org/blood-donation/facts-about-blood-donation/. Accessed June 11, 2014.

Coloring Our Collections

Coloring books and oranges, waiting for the start of the Museum Mile Festival.

Coloring books and oranges, waiting for the start of the Museum Mile Festival.

At last night’s Museum Mile Festival, we were thrilled to offer a coloring book featuring images from our collections, along with the oranges seen here and packets of crayons.

NYAM also partnered with community organizations to engage the festival participants in healthy eating and active living activities. Harlem Seeds demonstrated how to cook a healthy and delicious kale salad and baked apple dessert. Harlem Hospital Center’s Walk it Out and Hip Hop Public Health programs got the crowd moving with high-energy kickboxing, line dancing, and break dancing lessons.

While we can’t give you crayons or break dancing lessons through our blog, we can offer you the coloring book in PDF format. You can color images from Leonhart Fuchs’ De historia stirpium commentarii insignes . . . (1542);  Ulisse Aldrovandi’s Serpentum, et draconum historiae libri duo (1640); and two works by Konrad Gesner, Conradi Gesneri medici Tigurini Historiæ animalium Lib. I. de quadrupedibus uiuiparis . . . (1551) and Thierbuch das is ein kurtze b[e]schreybung aller vierfüssigen thiern so/ auff der erdē und in wasseren wonend/ sampt irer waren conterfactur . . . (1563).

We’d love to see your colored pages—please share them with us!

War and Veterans Health: Some History for the 70th Anniversary of D-Day

By Paul Theerman, Associate Director, Center for the History of Medicine and Public Health

June is Men’s Health Month. As a concept, men’s health—a focus on the health and wellness issues particular to men—is still new, first arising in the men’s movements of the 1960s and 1970s. The emergence of AIDS sharpened the idea of men’s health, as gay men took the brutal first hits of the pandemic. By the 1990s, though, the idea of men’s health had become more mainstream. Congress first designated an official men’s health week in 1994, sponsored by Senator Robert Dole. By the early 2000s, the CDC began to include men’s health as a separate category in its consumer health site. In 2014, NYU’s Langone Medical Center opened the Preston Robert Tisch Center for Men’s Health, the counterpart to its Joan H. Tisch Center for Women’s Health of 2011.

The original men’s health movement, though, focused on war veterans. Each war brings up the issue—for Vietnam, for example, it emerged in such popular books as Peter Bourne’s Men, Stress, and Vietnam (1970; by the physician who became President Jimmy Carter’s drug czar). An escalating cycle of concern, growth, failure, and reform—so apparent in today’s veterans health scandal—has deep roots in American military history.

The federal government first extended general health and medical benefits to veterans in 1917 due to the large number of Great War veterans.1 In 1921, this led to a separate agency, the Veterans Bureau—which, joined with two other agencies, became the Veterans Administration in 1930. The VA ran a separate hospital system, with 74 facilities by the end of 1932.1

Photograph in: Armfield BB. Organization and Administration in World War II. Washington, D.C.: Office of the Surgeon General. Department of the Army; 1963.

Photograph in: Armfield BB. Organization and Administration in World War II. Washington, D.C.: Office of the Surgeon General. Department of the Army; 1963.

World War II led to a new crisis in veterans health. In 1945, the number of living veterans from all previous wars numbered some 4 million men; World War II immediately added 15 million more.2 This surge threatened to overwhelm the system, and led to major reform of veterans health care, undertaken by Major General Paul R. Hawley.

In World War II, Hawley (1891–1966) served as the theater surgeon for the European Theater of Operations. As such he was responsible for all medical care for American armed forces fighting in Europe, with 250,000 medical men under his command. Among other accomplishments, he planned the medical support for D-Day, June 6, 1944, arranging for the construction of field hospitals (with some 11,000 beds) in Normandy right after the invasion. These hospitals began as concrete slabs to hold tents, as there were almost no existing hospitals in the landing area. He called this work “one of the finest pieces of planning in the entire campaign.”3,4

Photograph in: Wiltse C. Medical supply in World War II. Washington, D.C.: Office of the Surgeon General. Department of the Army; 1968.

Photograph in: Wiltse C. Medical supply in World War II. Washington, D.C.: Office of the Surgeon General. Department of the Army; 1968.

Indeed, planning was Hawley’s strength. In 1945, the new head of the Veterans Administration was General Omar Bradley, who had commanded American invasion forces in Europe from D-day through to German surrender. Bradley brought in Hawley to reorganize the health services. To this task, Hawley brought a keen sense of what was possible and a reliance on improving health by raising the quality of the system’s doctors. The Veterans Administration began by engaging in hospital building—by the late 1940s, the number of VA hospitals has risen to almost 100—but as a first measure, Hawley advocated using private clinics to help veterans, and he looked to county medical societies to provide the services. His vision was to have “every physician in each community designated a veteran’s physician.”5 For, ultimately, he saw the nation’s physicians and surgeons as the backbone of the system. He had great confidence in physicians’ abilities; indeed, more than any other factor, he gave well-trained doctors the chief credit for the greatly reduced casualty rates in World War II.3

Armfield BB. Organization and Administration in World War II. Washington, D.C.: Office of the Surgeon General. Department of the Army; 1963.

Photograph in: Armfield BB. Organization and Administration in World War II. Washington, D.C.: Office of the Surgeon General. Department of the Army; 1963.

And so, after revitalizing local clinics, Hawley’s chief reform was getting good doctors into veterans hospitals. He loosened the employment structure, removing it from civil service system, and increased the top salaries to about $125,000 in today’s dollars. For board-certified specialties, there was a 25% premium above that—all free of office and support expenses, as he pointed out. He allied VA hospitals with medical schools as much as possible, allowing VA physicians to teach, and he provided for expansive professional development programs. He went out of his way to secure the best physicians—his February 1946 JAMA article on the Veterans Administration2 is really an extended recruitment notice. By the time he left the position in 1947—he went on to head Blue Cross/Blue Shield and then the American College of Surgeons—Hawley had substantially raised the level of care in veterans’ health.

The Veterans Health Administration has gone through successive periods of reform since the late 1940s. The last major period was in the 1990s under Kenneth Kizer, and included implementing one of first effective electronic medical records systems, VistA. By the 2010s, though, the Administration was again overwhelmed, overseeing care for war veterans going back to World War II as well as from recent U.S. wars and incursions—and now serving both men and women. Many of the same issues are there as Hawley faced: the challenge of providing increasing numbers of veterans with the care they need. New, and newly recognized, medical conditions have stressed the system as well. One is PTSD, a consequence in previous wars but not well understood; another are the injuries from IEDs. Neither was a major factor when Hawley reformed the Veterans Health Administration, and now both are huge. We await the next cycle of reform.

References

1. Weber GA, Schmeckebier LF. The Veterans’ Administration: Its History, Activities and Organization. Washington, D.C.: The Brookings Institution; 1934.

2.Hawley PR. New opportunities for physicians in the Veterans Administration. J Am Med Assoc. 1946;130:403.

3.Hawley PR. Advances in war medicine and surgery as demonstrated in the European theater of operations. Med Ann Dist Columbia. 1946;15:99–109.

4. Hall DE. “We were ready”: Health services support in the Normandy campaign. US Army Med Dep Off Med Hist. 1993. Available at: http://history.amedd.army.mil/booksdocs/wwii/Overlord/Normandy/HallNormandy.html. Accessed June 5, 2014.

5. Hawley PR. Medical care for veterans. Ill Med J. 1945;88:294–96.

2014–2015 Helfand and Klemperer Research Fellows

By Lisa O’Sullivan, Director, Center for the History of Medicine and Public Health

We are pleased to announce the 20142015 Helfand and Klemperer Research Fellows: Laura Robson (University of Reading) and Heidi Knoblauch (Yale University).

Rösslin, Eucharius. The byrth of mankynde, otherwyse named the womans booke. [London : Tho. Ray[nalde]], 1545.

The Audrey and William H. Helfand Fellowship in the History of Medicine and Public Health  focuses on the use of visual materials. Laura Robson will explore how medical works in the sixteenth century used images and texts from Andreas Vesalius’ anatomical treatise, the Fabrica. She will use Geminus’s Compendiosa (1545) and Raynalde’s translation of The byrth of mankynde (1545) to demonstrate the complex relationship between anatomical image and text and to unite the history of the book with the history of the representation of the body.

Louis A. Sayre Personal Casebook with multiple photographs, drawings, and ephemera of his patient, Aldoph Roussell ca. 1867

Louis A. Sayre Personal Casebook with multiple photographs, drawings, and ephemera of his patient, Aldoph Roussell ca. 1867

Our Paul Klemperer Fellow in the History of Medicine, Heidi Knoblauch, will use Lewis Sayre’s casebooks, the Photographic Review of Medicine and Surgery, and Bellevue Hospital Records. Looking especially at images and records from the Photographic Department at Bellevue Hospital (1868−1906), the first such department in a civil hospital in the United States, she will explore how 19th- and early 20th-century medical professionals in the U.S. used photographs of patients. What did physicians intend to do with photographs? What role did patients play in the collection of photographs? Her research will track how patients and physicians conceived the confidential nature of recording, collecting, and disseminating medical information (an ongoing question for medical archivists and historians).

Keep an eye out for guest posts from our fellows, who will also present their work at the end of their fellowships.