Swimming from 1818 to 1918

By Johanna Goldberg, Information Services Librarian

Summertime is swimming time! Two books from our collection, published exactly 100 years apart, offer beach tips (some of which have aged better than others).

Title page, J. Frost, The Art of Swimming, 1818.

Title page, J. Frost, The Art of Swimming, 1818.

In The Art of Swimming (1818), J. Frost encouraged parents to teach their sons to swim:

“Some parents may object to their children being taught the art of swimming, from an apprehension that they would be more exposed to danger, on account of its inducing them more frequently to bathe: to them I would reply, that bathing produces very salutary effects, and expert swimmers are seldom in danger in the water; while, to those who are ignorant of the art, bathing is really dangerous.”1

Frost was ahead of his time. In the 19th century, New York and many other U.S. cities fined people for public swimming (no day swimming in the East River! It’s “‘extremely offensive to spectators.’”). As is evident from the male-oriented focus of Frost’s book, swimming only became acceptable for women with the availability of gender-segregated facilities. It was not until the mid-1800s—the age of a growing fitness movement—that upper and middle class Americans turned to swimming as recreation at seaside destinations and private fitness clubs. Public pools opened around the same time, but with a hygienic mission rather than a recreational one.2

In a footnote, Frost explains why learning to swim was so important:

“The writer, when young, had the happiness to rescue his brother from a watery grave; and he has lately had the pleasure to hear, that two of his pupils were the means of saving a person from drowning; and still more recently, that one of his pupils was preserved by swimming, when accidentally thrown from a ferry on the river Trent, though encumbered with his clothes.”1

In addition to 49 pages of swimming instructions, followed by the text of a swimming-related letter written by Benjamin Franklin, the book includes “twelve copper plate engravings comprising twenty-six appropriate figures, correctly exhibiting and elucidating the action and attitude, in every branch of that invaluable art.”1

Click on an image below to view a selection of these plates:

 

Cover of Dalton, Swimming Scientifically Taught, 1918.

Cover of Dalton, Swimming Scientifically Taught, 1918.

By 1918, when Frank Eugen Dalton published Swimming Scientifically Taught, America was on the cusp of a golden age of swimming. From 1920–1940, pools opened in more than 1,000 cities across the country as centers for recreation for men and women of all classes.2

Yet public pools were not Dalton’s focus, at least not in his introduction. He paints this evocative picture:

“When slaves of the desk and the counting-house are looking forward for an all too brief vacation and seek the mountains or seashore to store up energy for another year’s work, they should know how to swim. Poor indeed is the region which can not boast of a piece of water in which to take an invigorating plunge.”3

Dalton’s enthusiasm for swimming was limitless: “Most other forms of exercise, after they have been participated in for some time, are apt to become something like efforts, or even hardships. Swimming, on the other hand, continues to be exhilarating.”3

Dives. In  Dalton, Swimming Scientifically Taught, 1918, pp. 98-99.

Dives. In Dalton, Swimming Scientifically Taught, 1918, pp. 98-99.

Dalton believed that all but the most nervous person could “become a very fair swimmer” by reading his book.3 In addition to teaching basics, like the back stroke, breast stroke, and side stroke, the book also covers more advanced ground. Dalton shows a number of dives, a maneuver called “The Monte Cristo Sack Trick,” and includes instructions for learning to swim while clothed (“Practice first with a coat, then with a coat and waistcoat; next add trousers, and last the shoes and stockings”) and with hands and feet tied (a trick for advanced performers).3

The Monte Cristo Sack Trick.  Dalton, Swimming Scientifically Taught, 1918, p. 142.

The Monte Cristo Sack Trick. Dalton, Swimming Scientifically Taught, 1918, p. 142.

The final chapters focus on emergency response. Dalton describes two forms of resuscitation, Hall’s and Sylvester’s.3 Hall’s originated in 1856 as a method that did not require artificial respiration.4 Sylvester’s similar procedure followed two years later.5 Neither were very effective. It wasn’t until 1958 that mouth-to-mouth ventilation—a practice recommended by some medical societies as early as the 1770s—regained acceptance.4 Two years later, the American Heart Association developed CPR.6

Rule 1 of the Sylvester technique.  Dalton, Swimming Scientifically Taught, 1918, p. 191.

Rule 1 of the Sylvester technique. Dalton, Swimming Scientifically Taught, 1918, p. 191.

Whether you prefer Frost’s or Dalton’s instructions, swim safely this summer.

References

1. Frost J. The art of swimming: A series of practical instructions, on an original and progressive plan…to which is added, Dr. Franklin’s treatise, also some anecdotes respecting swimming. New York: P.W. Gallaudet; 1818.

2. Wiltse J. Contested waters: A social history of swimming pools in America. Chapel Hill: University of North Carolina Press; 2007.

3. Dalton FE, Dalton LC. Swimming scientifically taught: A practical manual for young and old. Fifth ed. New York; London: Funk Wagnalls Co.; 1918.

4. Fahey DG. The self-inflating resuscitator—evolution of an idea. Anaesth Intensive Care. 2010;38 Suppl 1: 10–5.

5. Liss HP. A history of resuscitation. Ann Emerg Med. 1986;15(1): 65–72. doi: 10.1016/S0196-0644(86)80490-5.

6. American Heart Association. History of CPR. Available at: http://www.heart.org/HEARTORG/CPRAndECC/WhatisCPR/CPRFactsandStats/History-of-CPR_UCM_307549_Article.jsp. Accessed June 24, 2015.

Dr. Evelyn Hooker and the Acceptance of Homosexuality

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

In the late 19th century, new legal, criminal, and scientific frameworks emerged seeking to understand, define, and in some cases control, human sexuality. In particular, homosexual activity between men became illegal in many countries, which opened up discussion about what counted as “normal” or “deviant” sexual expression. A significant body of research work began to be generated, such as Richard von Krafft-Ebing’s Psychopathia Sexualis (1886), seeking to understand the range of human sexuality and arguing that “deviancy” should be treated as a medical rather than criminal issue.1

Evelyn Hooker. Courtesy of UC Davis.

Evelyn Hooker. Courtesy of UC Davis.

By the 20th century, pioneering researchers like Evelyn Hooker (1907–1989) had begun to question whether homosexuality should be considered in medical terms. Hooker administered standard psychological tests to carefully selected groups of gay and straight men, who performed virtually identically. Her work was one in a series of investigations that eventually led to the removal of homosexuality from the list of mental disorders in the major official categorization of mental illness in the United States, the Diagnostic and Statistical Manual of Mental Disorders.

Born in Nebraska in 1907, Hooker went to the University of Colorado for her bachelor’s and master’s degrees in psychology. She undertook her Ph.D. work at Johns Hopkins, graduating in 1932. For the next eight years, she worked in a number of colleges, including Whittier College, was laid up with tuberculosis for two years, and had a fellowship year in Berlin. In 1940, she took up a research associate position at UCLA, where she remained for the next 30 years.2

Teaching was part of her purview. As the story goes, a friendship with a student who was gay, struck up in the mid-1940s, led to the student’s request that she research the gay community in Los Angeles. By 1953 she felt ready to do a controlled study, aided by a grant from the National Institute of Mental Health (NIMH). She assembled a group of 60 men, equal numbers of gay and straight, and matched for age, IQ, and education. In addition, the subjects had to be otherwise mentally healthy, that is, not in therapy nor showing any obvious mental disturbance. Finally, all were supposed to be “pure” in their orientation: purely heterosexual or purely homosexual. To this group, Hooker administered the Rorschach test, the Thematic Apperception Test (TAT), and the Make-A-Picture Story (MAPS) test, designed to measure personality, emotional stability, and coherence of thought. Recognized psychological experts evaluated the tests. After reviewing the results, Hooker found that they could not distinguish the tests completed by gay men from those by straight men. Any mental illness in this group was as likely to be found among heterosexual men as among homosexual ones.3

"Table II—Ratings on Overall Adjustment—Rorschach." In Hooker, “The Adjustment of the Male Overt Homosexual,” Journal of Projective Techniques 21 (1958): 18-31.

“Table II—Ratings on Overall Adjustment—Rorschach.” In Hooker, “The Adjustment of the Male Overt Homosexual,” Journal of Projective Techniques 21 (1958): 18-31. Click to enlarge.

Hooker presented her results at the 1956 meeting of the American Psychological Association. The editors of the Journal of Projective Techniques persuaded her to publish the results despite her wish to continue work until they were “incontrovertible.”4 In the following years, she continued to work and publish on the topic of gay men’s mental health—women were very little studied, the researchers themselves noted—with continued support from the NIMH. In 1967, the director of the NIMH, Dr. Stanley F. Yolles, appointed her the chair of the Institute’s Task Force on Homosexuality. Two years later, the task force finished its work. Its report concluded that “Homosexuality represents a major problem for our society largely because of the amount of injustice and suffering entailed in it, not only for the homosexual but also for those concerned about him.”5 It recommended establishing a Center for Study of Sexual Behavior within NIMH, to support research and training especially for mental health professionals, law enforcement personnel, and guidance and caretaking personnel.

 Hooker, “The Adjustment of the Male Overt Homosexual,” Journal of Projective Techniques 21 (1958): 18.

Hooker, “The Adjustment of the Male Overt Homosexual,” Journal of Projective Techniques 21 (1958): 18.

And yet . . . if gay people didn’t track differently than straight people on a whole range of mental disorders, they definitely did in one instance, according to the diagnostic standards of the times. Homosexuality itself was a mental disorder. And as jarring as it is to see, the same task force report from 1969 included as its final working paper “Treatment of Homosexuals,” detailing psychoanalytic, group, and drug- and electric shock–based aversion therapies, all intended to redirect sexual orientation.6 At the same time, though, countervailing political and cultural forces pushed towards acceptance of homosexuality, its normalization and de-medicalization. A recent New York Times article captures some of that flavor, expressed in the pre-Stonewall 1960s. As is well known, the Diagnostic and Statistical Manual included homosexuality as a mental disorder as late as its second edition in 1968; the American Psychiatric Association removed this designation in 1973, and the third edition of the DSM, published in 1980, included only the disorder “ego-dystonic homosexuality,” for those gay people uncomfortable with their orientation.7 By the 1987 revision of DSM, this condition was further downgraded to a “disorder not otherwise specified.”8

“Other Psychosexual Disorders. 302.00 Ego-dystonic Homosexuality,” American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (Third Edition) (Washington, DC: American Psychiatric Association, 1980), p. 281.

“Other Psychosexual Disorders. 302.00 Ego-dystonic Homosexuality,” American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (Third Edition) (Washington, DC: American Psychiatric Association, 1980), p. 281.

Evelyn Hooker went on to be a beloved mentor, especially for psychiatrists and psychologists interested in gay studies.9 She was the subject of a 1991 documentary, Changing our Minds: The Story of Dr. Evelyn Hooker,10 and the recipient of many awards, including the Distinguished Contribution in the Public Interest Award of the American Psychological Association. She passed away in 1996.

References

1. A brief introduction to the history of sexology can be found at The Kinsey Institute, which continues to explore sexual health and knowledge worldwide: www.kinseyinstitute.org/resources/sexology.html. See also APA Task Force on Appropriate Therapeutic Responses to Sexual Orientation, Report of the Task Force on Appropriate Therapeutic Responses to Sexual Orientation (Washington, DC: American Psychological Association, 2009), especially chapter 2, “A Brief History of Sexual Orientation Change Efforts,” pp. 21–25; Jonathan Katz’s Gay American History: Lesbians and Gay Men in the U.S.A. (1976; reprint ed., New York: New American Library, 1992) and The Invention of Heterosexuality (New York: Dutton, 1995); and Jennifer Terry, An American Obsession: Science, Medicine, and Homosexuality in Modern Society (Chicago: The University of Chicago Press, 1999).

2. Biographical material on Evelyn Hooker, here and below, comes from “Psychology’s Feminist Voices: Evelyn Gentry Hooker,” http://www.feministvoices.com/evelyn-gentry-hooker/, accessed June 10, 2015.

3. Evelyn Hooker, “The Adjustment of the Male Overt Homosexual,” Journal of Projective Techniques 21 (1958): 18-31.

4. Ibid., quotation from footnote on page 18.

5. National Institute of Mental Health Task Force on Homosexuality, Final Report and Background Papers, edited by John M. Livingood (Rockville, MD: U.S. Dept. of Health, Education, and Welfare, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, National Institute of Mental Health, 1972), quotation from page 2.

6. NIMH Task Force on Homosexuality, Final Report: Task Force Working Papers, “Treatment of Homosexuals,” by Jerome D. Frank, pp. 63–68.

7. APA Task Force, Report, p., 23; American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (Third Edition) (Washington, DC: American Psychiatric Association, 1980), pp. 281–83.

8. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (Third Edition–Revised) (Washington, DC: American Psychiatric Association, 1987), p. 296.

9. See in particular, Linda D. Garnets and Douglas C. Kimmel, eds., Psychological Perspectives on Lesbian, Gay, and Bisexual Experiences, 2nd ed. (New York: Columbia University Press, 2003), especially the chapter “What a Light It Shed: The Life of Evelyn Hooker,” by Garnets and Kimmel.

10. Changing Our Minds: The Story of Dr. Evelyn Hooker, directed by Richard Schmiechen, DVD, 75 mins. (San Francisco: Frameline, 1991).

Garbage and the City

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

This summer we are proud to present a new collaborative series, “Garbage and the City: Two Centuries of Dirt, Debris and Disposal.”

Together with our partners the Museum of the City of New York and ARCHIVE Global: Architecture for Health, “Garbage and the City” presents three moments in the city’s battle with sanitation and waste disposal challenges in a rapidly growing urban environment. Catherine McNeur will set the scene with “Hog Wash, Swill Milk, & the Politics of Waste Recycling in Antebellum Manhattan” on July 1. Julie Sze will discuss “Noxious New York: Race, Class and Garbage” on August 3, and finally, Robin Nagle, anthropologist-in-residence for New York City’s Department of Sanitation, will consider the daily practice of garbage collection and management in the city today with “Life Along the Curb: Inside the Department of Sanitation of New York” on August 17. All three events are free with advance registration.

New York City garbage truck, circa 1929. Photo from The New York Academy of Medicine Committee on Public Health Archive.

New York City garbage truck, circa 1929. Photo from The New York Academy of Medicine Committee on Public Health Archive.

The Academy has a long history tackling questions related to New York City’s sanitation infrastructure. Waste management and disposal was an ongoing concern as the city grew. Despite the creation of the Department of Street Cleaning in 1881, street cleaning and garbage removal contracts, like many other services enmeshed in the politics of city, included the trading of political favors, jobs for constituents, and the creation of slush funds. The threat or occurrence of epidemic disease triggered attempts to improve the situation, but at the turn of the 20th century, sanitation and waste disposal efforts remained haphazard and slow to change.

Many sanitation advocates of the late 19th century blamed disease on filth and refuse and the foul-smelling miasmas they produced. The emergence of new bacterial theories and techniques linked disease to the presence of specific pathogens. Whichever approach to disease was taken, the reality was clear: keeping the city clean from refuse was critical to minimizing the spread of infectious diseases such as cholera, making dealing with garbage a critical issue for the health of the city.

An open letter to mothers from the Committee of Twenty.

An open letter to mothers from the Committee of Twenty. Click to enlarge.

The Academy’s Committee for Public Health proposed new street cleaning methods periodically in the early 1900s. At this time, most of New York City’s garbage was carried out to sea in barges and dumped into the ocean. Collaborating with municipal officials and around a dozen civic organizations, the Academy appointed a Committee of Twenty on Street and Outdoor Cleanliness (a subcommittee of its Committee on Public Health). Its goal was public education, and included signage urging people to clean the sidewalks and curb their dogs, and a competition to design a more effective trash basket. The Committee reported on topics as varied as the effective design of dump trucks; conditions at the city’s open air markets and suggestions for their improvement; education campaigns instructing “every mother in this neighborhood” to teach their children to “refrain from this obnoxious practice” of throwing litter in street; and air pollution from fires on Rikers Island.1

Pamphlets reflecting the work of George Soper and the Committee of Twenty.

Pamphlets reflecting the work of George Soper and the Committee of Twenty.

In the 1930s, George Soper, the sanitation engineer best known for identifying Mary Mallon (“Typhoid Mary”) as a carrier of typhoid,2 was sent by the Committee of Twenty to take a trash tour of Europe. He attended the 1931 International Conference on Public Cleansing in London; measured the plowing capacity of German snow trucks; visited 14 incineration plants; and documented varied street sweeping methods during his extensive travels. The evidence he brought back all pointed in the same direction: whatever its successes, New York City was behind the times when it came to dealing with trash. The Academy used Soper’s reports to urge significant changes in the infrastructure of New York City’s garbage collection and disposal.

By 1933, politics struck again. The Committee chairman’s report stated that “the activities of the Committee of Twenty were considerably curtailed by the unexpected changes in City administration.”3 The Committee bemoaned the fact that despite better cooperation between the Police and Sanitation Departments, new ordinances and regulations were not systematically followed, and the “streets of New York City remain an untidy, if not disgraceful, condition.”4 Despite their concerns, the Committee concluded that the combination of political change and worsening economic conditions meant their attention would be better directed towards other efforts at a national level.

On a more positive note, the 1930s saw considerable resources expended, partly through New Deal projects, building new sanitation infrastructure, particularly sewage treatment.5 A 1934 law curtailed the dumping of municipal waste at sea, beginning a new era of sanitary landfills.6 Throughout the decade the Department of Sanitation (renamed from the Department of Street Cleaning in 1929) introduced new mass-produced garbage truck able to better compact and transport garbage. The winning entrant of the Committee’s competition for a more effective trash basket however, has sadly been lost to time.

New York City garbage truck circa 1930.

New York City garbage truck, circa 1930. Photo from the New York Academy of Medicine Committee on Public Health Archive.

The “Garbage and the City” series is presented in collaboration with the Museum of the City of New York and ARCHIVE GLOBAL and is supported by a grant from the New York Council for the Humanities. Any views, findings, conclusions or recommendations expressed in this program do not necessarily represent those of the National Endowment for the Humanities.

References

1. Committee of Twenty on Street and Outdoor Cleanliness, Committee on Public Health Archive, New York Academy of Medicine.

2. George A. Soper, “The Curious Career of Typhoid Mary,Bulletin of The New York Academy of Medicine, 1939 Oct; 15(10): 698–712.

3. Presumably a reference to Mayor John O’Brien, who served a one year term in 1933 before being defeated by Fiorello LaGuardia. O’Brien is now regarded as the last of the “Tammany Hall” mayors, criticized for his lackluster response to the impact of the Depression on the New York population. See: “Mayor John O’Brien: His Heart Is As Black As Yours!” Bowery Boys blog, February 25, 2010.

4. Report of the Chairman at the meeting of March 23, 1933, Committee of 20 on Street and Outdoor Cleanliness, New York Academy of Medicine Archives.

5. John Duffy, A History of Public Health in New York City 1866-1966 (Russell Sage Foundation: New York, 1968), 521.

6. George S. Soper, “Disposal of waste an urgent problem: Supreme Court order against dumping at sea points the need for incinerators,” The New York Times, March 18, 1934.

The Legacy of Aloysius “Alois” Alzheimer

By Danielle Aloia, Special Projects Librarian

Alois Alzheimer in 1884. In Maurer, Maurer, and Levi, Alzheimer: The Life of a Physician and the Career of a Disease, 2003.

Alois Alzheimer in 1884. In Maurer, Maurer, and Levi, Alzheimer: The Life of a Physician and the Career of a Disease, 2003.

Eminent German scientist Aloysius “Alois” Alzheimer was born on June 14, 1864. He considered himself a psychiatrist, because he “not only introduced the art of microscopy into psychiatry, but also contributed to psychiatry’s greatest interest in talking with patients.”1 His early work was at the Asylum for the Insane and Epileptic or “The Castle of the Insane,” where he spent hours listening to and examining patients, documenting each case.2 He also became a court-appointed forensic physician, treated private patients, and performed histological research.

While at the Asylum for the Insane and Epileptic, he met Auguste D., a 51-year-old wife and mother with symptoms of forgetfulness and jealously, whose husband could not take care of her anymore. Her case was curious because she was so young and had led a relatively healthy life. Senile dementia had been documented in patients in their 70s and 80s but none declined so rapidly as in Auguste D. in her last 4 years.

Emil Kraepelin circa 1910. In Kraepelin, Memoirs, 1987.

Emil Kraepelin circa 1910. In Kraepelin, Memoirs, 1987.

Alzheimer resigned from the asylum in 1903 and began work at the Psychiatric Clinic on Nussbaumstrasse in Munich under pioneering psychiatrist Emil Kraepelin. Much of Alzheimer’s early work focused on dementia caused by syphilis. Working with Kraepelin, he delved much deeper into the presenile dementia he first noted with Auguste D. at the asylum, what was to become the pinnacle of his career.

Together, Kraepelin and Alzheimer wanted to prove that psychiatric symptoms could be traced back to physical causes in the central nervous system.3 But when Kraepelin presented this hypothesis at the annual meeting of German Association for Psychiatry in 1906, they were not taken seriously. In April 1906, Auguste D. died and Alzheimer acquired her brain and clinical records. He began to compile his evidence of their “anatomical doctrine.”4

Left to right: Alzheimer and Kraepelin with psychiatrist Robert Gaupp and neuropathologist Franz Nissl, circa 1908.  In Kraepelin, Memoirs, 1987.

Left to right: Alzheimer and Kraepelin with psychiatrist Robert Gaupp and neuropathologist Franz Nissl, circa 1908. In Kraepelin, Memoirs, 1987.

With this doctrine, Alzheimer became the first person to describe the plaques and neurofibrillary tangles now known as indicators of Alzheimer’s disease.5 But the first article, published in 1906 in Zeitschrift fuer Psychiatrie und Psychisch-Gerichtliche Medizin, “Ueber eine eigenartige Erkrankung der Hirnrinde” [About a peculiar disease of the cerebral cortex], was not well received and garnered little attention. A second longer article published in 1911 in Zeitschrift fuer die gesamte Neurologie und Psychiatrie, “Ueber eigenartige Krankheitsfaelle des spaeteren Alters” [On peculiar cases of disease at higher age], drew much more attention. It included histological drawings of the tangles of the disease progression. Soon, other reports of similar cases started to appear in the literature.6

Drawings of histological preparations of Auguste D’s material, stained by Bielschowsky’s technique to demonstrate tangles, and their stages. Beginning of the disease. In Alzheimer, Ueber eigenartige Krankheitsfaelle des spaeteren Alters [On peculiar cases of disease at higher age]. Zeitschrift fuer die gesamte Neurologie und Psychiatrie 1911;4:356-385.

Drawings of histological preparations of Auguste D’s material, stained by Bielschowsky’s technique to demonstrate tangles, and their stages. Beginning of the disease. In Alzheimer, Ueber eigenartige Krankheitsfaelle des spaeteren Alters [On peculiar cases of disease at higher age]. Zeitschrift fuer die gesamte Neurologie und Psychiatrie 1911;4:356-385.

Drawings of histological preparations of Auguste D’s material, stained by Bielschowsky’s technique to demonstrate tangles, and their stages. 8. Advanced stage; and 9. Terminal state of the disease.. In Alzheimer, Ueber eigenartige Krankheitsfaelle des spaeteren Alters [On peculiar cases of disease at higher age]. Zeitschrift fuer die gesamte Neurologie und Psychiatrie 1911;4:356-385.

Drawings of histological preparations of Auguste D’s material, stained by Bielschowsky’s technique to demonstrate tangles, and their stages. 8. Advanced stage; and 9. Terminal state of the disease. In Alzheimer, Ueber eigenartige Krankheitsfaelle des spaeteren Alters [On peculiar cases of disease at higher age]. Zeitschrift fuer die gesamte Neurologie und Psychiatrie 1911;4:356-385. Click to enlarge.

Kraepelin named this new dementia after Alzheimer in the 1910 edition of his psychiatry textbook, Psychiatrie: Ein Lehrbuck für Studi[e]rende und Aerzte. They worked together from 1903 to 1912, when Alzheimer left to become chair of psychiatry at the Psychiatric Clinic in Breslau. Alzheimer died in 1915, at the age of 51, after a serious illness. During the course of his career Alzheimer made strides in the understanding of other diseases, such as epilepsy, and his work serves as the foundation for the continued development of a cure for the disease.7

References

1. Maurer K, Maurer U, Levi N (Trans.). Alzheimer: The Life of a Physician and the Career of a Disease. New York: Columbia University Press; 2003.

2. Ibid.

3. Ibid.

4. Ibid.

5. Hippius H, Neundörfer G. The discovery of Alzheimer’s disease. Dialogues in Clinical Neuroscience. 2003;5(1):101-108.

6. Zilka N, Novak M. The tangled story of Alois Alzheimer. Bratisl Lek Listy 2006;107(9-10):343-345.

7. Zilka N, Novak M. The tangled story of Alois Alzheimer. Bratisl Lek Listy 2006;107(9-10):343-345.

The Women’s Prison Association and “The Modern Way” (Item of the Month)

By Anne Garner, Curator, Center for the History of Medicine and Public Health

orange-is-the-new-blackHow do the experiences of the inmates of Orange Is the New Black’s fictional Litchfield Prison differ from those of incarcerated women a century before? “The Modern Way,” a pamphlet published in 1913 by the New York State Women’s Prison Association, offers a snapshot of the conditions in New York State prisons one hundred years ago. Today, as Netflix drops season three of the series, we thought it would be instructive to have a closer look at this remarkable feminist pamphlet, produced by New York’s oldest advocacy group for women.

Cover of "The Modern Way."

Cover of “The Modern Way.”

As with Orange Is the New Black, “The Modern Way” begins by telescoping the faces and stories of individual prisoners—in this case, the residents of an unnamed “Workhouse” 20 minutes from New York City’s Fifth Avenue.

It is 1913. There’s Maggie, “a strong sturdy woman of forty,”1 in and out of prison for public drunkenness for the last two years. She plans to drink again as soon as she’s released, even as she’s resigned to serving more jail time as a consequence. Jennie, age 37, has been in and out of Workhouse for two decades, incarcerated for the same cause. When interviewed, she says she’s done with jail. But without the guidance of a rehabilitating hospital, she claims she can’t stay away from the saloon.

And then there’s Mary, described by the warden as “one of the best dispositioned women [she] ever knew.” She’s the mother hen of the group, “stopping to comfort a sobbing prisoner, now scolding a vigorously quarrelsome one.” This model inmate keeps a medal in her cell, earned the day she was working on Riker’s Island in 1904 and brought in three drowning passengers from the steamship PS General Slocum (two survived). When interviewed, she’s back at the Workhouse again, after a trip to the saloon.2

Mary. In "The Modern Way," 1913, page 2.

Mary. In “The Modern Way,” 1913, page 2.

What binds together these three inmates is the impossibility of creating a new identity once they’ve served their sentences—which may remind OITNB fans of inmate Tasty’s plight. As Mary says, “A girl can’t do it once she has gone wrong. The plain clothes fellows remember you and they follow you up. There isn’t any use trying.”3

In 1912, New York State committed 20,616 women to correctional institutions.4 Unlike contemporary men’s prisons, prisons established for women in the late 19th and early 20th century were not philosophically bent towards reform.5 In most cases, as with the unnamed Workhouse featured in the pamphlet, prisons for women had no chaplain, physician, or teacher, unlike their male counterparts. Medical care was especially scarce. The Workhouse, a facility that accommodated 15,818 prisoners in 1911, had only thirty beds available for sick patients.6 With resources so limited, the Workhouse routinely discharged hundreds of women with no healthcare at all.

"Workhouse—Cell for Women." In "The Modern Way," 1913, page 11.

“Workhouse—Cell for Women.” In “The Modern Way,” 1913, page 11.

The inequitable treatment of male and female prisoners is a particular sticking point for the authors of “The Modern Way,” who are dismayed by the sexism inherent in the current penal system:

No crime which a man may commit excludes him from readjustment, rehabilitation. Alcoholism and immorality unless excessive are ignored and condoned, but the conviction by the Courts of a girl charged with loitering or a woman charged with intoxication places a ban upon her, ostracizes her from Society, is remembered against her through life no matter how correct her after life may be [italics theirs].7

They argue that female inmates need a setting hospitable to rehabilitation, a place “far-removed from temptation and made attractive by healthy employment and friendly supervision of [the prisoners’] moral and physical well-being.”

By 1908, the Women’s Prison Association had successfully lobbied for 315 public acres for such a place, the State Farm for Women Misdemeanants, in Valatie, New York.8 The site was planned in accordance with the early 20th-century trend of cottage-designed prisons, which placed inmates in small cottages scattered across a rural setting. The cottages were set up like small homes, with a dining room, kitchen, and sitting room. Household tasks were divided among the women. The idea was to engender self-esteem in the inmates, who then might be better positioned to take on these roles once released.9

"Cottage on State Farm for Women."  In "The Modern Way," 1913, page 14.

“Cottage on State Farm for Women.” In “The Modern Way,” 1913, page 14.

Bordered by the foothills of the Adirondacks, the Berkshires, the Matteawan Mountains, and the Catskills and Helderbergs, State Farm in Valatie offered tillable land, ample space, and a healthy environment. At completion, the farm was projected to have 27 buildings on the cottage plan, and would stress rehabilitation and careful supervision by an all-female staff (except for typically male roles, i.e. leadership roles like warden). Prisoners over 30 who had been convicted five times in two years qualified for accommodation.10

"Inmates' Room, State Farm for Women." In "The Modern Way," 1913, page 17.

“Inmates’ Room, State Farm for Women.” In “The Modern Way,” 1913, page 17.

When “The Modern Way” went to print, two cottages were ready for occupancy. Fifteen hundred New York women were eligible. According to the pamphlet’s writers, every farm implement had been purchased, and the grounds were populated with horses, cattle, and poultry.11 And yet, the pamphlet’s frustrated authors argued, the land remained vacant. Appeals to two different governors and the Senate Finance Committee to fund the opening of the cottages all stalled.12 At the close of “The Modern Way” we are left wondering what happened to State Farm. Was it ever operational?

"Cattle on State Farm for Women." In "The Modern Way," 1913, page 20.

“Cattle on State Farm for Women.” In “The Modern Way,” 1913, page 20.

The answer was yes. State Farm at Valatie was completed in 1914. But in total, the Columbia County facility accommodated only 146 inmates. These were mostly white women between the ages of 30 and 60, accused of public drunkenness. Funding was always scarce. By 1918, all the inmates had been paroled, and the grounds were turned over to a treatment center for women suffering from venereal disease.13 The efforts of the Women’s Prisoners’ Association to install State Farm as a viable alternative to the Workhouse model appears to have been only successful in the short term. Nevertheless, “The Modern Way” captures an important moment in the history of the Women’s Prison Association of New York, an organization still very active in lobbying for the rights of women prisoners today.

References

1. Women’s Prison Association of New York. “The Modern Way.” New York: The Association, [1913.] p. 14.

2. Women’s Prison Association of New York, p. 3-4.

3. Women’s Prison Association of New York, p. 9.

4. Women’s Prison Association of New York, p. 15.

5. Banks, Cyndi. Women in Prison: A Reference Handbook. Santa Barbara, CA: ABC-CLIO, 2003. p. 36.

6. Women’s Prison Association of New York, p. 12.

7. Women’s Prison Association of New York, p. 14.

8. Women’s Prison Association of New York, p. 16.

9. Dodge, L. (2005). Cottage system. In M. Bosworth (Ed.), Encyclopedia of prisons & correctional facilities. Thousand Oaks, CA: SAGE Publications, Inc. Accessed at http://dx.doi.org/10.4135/9781412952514.n77 on June 8, 2015. For more on the cottage model, see “Preparing Delinquent Women for the New Citizenship,” by Dr. Mary B. Harris, in The Delinquent Girl and Woman. New York: National Committee on Prisons and Prison Labor, 1919.

10. Women’s Prison Association of New York, p. 18 and Dodge, 2005.

11. Women’s Prison Association of New York, p. 22.

12. Women’s Prison Association of New York, p. 20-22.

13. Banks, 37.

An Eye for Conservation: William Clift, Fenwick Beekman, and John Hunter

By William Buie, MA (History), Rutgers University-Camden, Spring Intern

“After [John] Hunter’s death, his great rambling mansion, three blocks thrown into one, passed through many hands. Till 1806 the Museum was still filled with his collection. … And there is a tradition that Stevenson drew from them his picture of the house and museum of Dr. Jekyll.” (Paget 1897, 155)1

Author Robert Louis Stevenson’s description of Dr. Jekyll’s fictional residence caused some of his contemporaries to suspect that he had used the real home and museum of the pioneering 18th-century Scottish surgeon John Hunter as a model; whether or not this was really the case is up for debate.

Dr. Jekyll and Mr. Hyde. Color lithograph by National Printing & Engraving Company, 188?. Courtesy of the Library of Congress Prints and Photographs Division.

Dr. Jekyll and Mr. Hyde. Color lithograph by National Printing & Engraving Company, 188?. Courtesy of the Library of Congress Prints and Photographs Division.

Stevenson did not mention Hunter in any of his notes. Yet the rumor became so widespread that Stephen Paget casually referred to the “tradition” in his 1897 biography of John Hunter.2 Speculation continues well into the 21st century.3 We may never know for sure if Dr. Jekyll and Mr. Hunter both lived at No. 28, Leicester Square, but we can get a sense of what the residence looked like thanks to one of the few surviving design plans, in the library’s collection.

Pencil copy of William Clift's drawing of the "Ground plan of Mr. Hunter's Premises level with Street, or Parlour-Floor level."

Pencil copy of William Clift’s drawing of the “Ground plan of Mr. Hunter’s Premises level with Street, or Parlour-Floor level.” Click to enlarge.

Much of what we know about Hunter’s Leicester Square residence comes from a ground floor plan reproduced from memory by William Clift, Hunter’s assistant and the first conservator of the Hunter Museum. Clift was born 1775 in Bodmin, a town in Cornwall, England. He had a difficult upbringing. He lost his father, Robert Clift, at a very young age. According to Clift, his mother Joanna Courts occasionally “starved herself to save threepence a week” in order educate her son. She died when Clift was eight, leaving him “cast adrift on the wide wide world.”4 He eventually found work under a nurseryman named George King, a man given to occasional brandy-fueled outbursts. Out of the blue one day, an inebriated King chased Clift through the nursery. Clift managed to escape despite that fact that his pursuer was riding a horse. Clift drew a caricature of the incident sometime later and used it to entertain his coworkers. King became aware of the drawing and fired Clift.

Luckily, Nancy Gilbert of Priory, Bodmin became aware of Clift’s circumstance. Gilbert was a childhood friend of Anne Home, whom Hunter had married in 1771. Gilbert knew that the surgeon needed a new assistant and recommended Clift to Hunter, who gave him the job. On February 14, 1792, his and Hunter’s birthday, Clift arrived at the Leicester Square residence. In addition to the clothes on his back, he had only “four changes of shirts and neckcloths” to his name.4

Hunter was an accomplished anatomist, surgeon, lecturer, and a pioneer of evidence-based medicine.  During his lifetime, Hunter developed new methods for treating gunshot wounds and venereal disease. He stressed experimental research and encouraged his students to pay close attention to the way that the human body responded damage. Because of that approach, Hunter is now known as the pioneer of “scientific surgery.” He was also an avid collector of animal and plant specimens. His museum contained approximately 14,000 preparations of more than 500 different species.5

John Hunter, "engraved by W. O. Geller from the original picture by Sir Joshua Reynolds in the Royal College of Surgeons," 1836.

John Hunter, “engraved by W. O. Geller from the original picture by Sir Joshua Reynolds in the Royal College of Surgeons,” 1836.

Clift worked for Hunter for less than two years, but the days were full. Each morning, Clift assisted with dissection and the preparation of specimens for display. He put his  penmanship to use each evening when Hunter required he take dictation, copy his employer’s nearly illegible notes, and answer personal correspondence. The sudden death of Hunter on October 16, 1793 threatened to cast Clift adrift once more. Although Hunter’s income was steady and substantial, he borrowed from creditors to keep a ready supply of cash to cover household expenditures. Following his death, Mrs. Hunter left the house and rented out her room. She allowed only Clift and Elizabeth Adams, who worked as the Hunter’s housekeeper, to remain on staff. Clift was to look after the museum for a salary of £21 a year.6

Recognizing the intellectual value of Hunter’s manuscripts and collection of specimens, Clift set himself to the task of preserving them. He copied by hand nearly half of Hunter’s manuscripts. He also cared for the specimens in Hunter’s museum. Clift dutifully and quietly carried on for six years. His efforts were rewarded when the British government bought the collection in 1799 and transferred its care to the Royal College of Surgeons. A board of curators assembled by the RCS appointed Clift the official conservator of the museum. During his time as conservator, Clift cared for the physical condition of the collection and maintained its original order.7

Clift oversaw the Hunter Collection for the next 42 years, during which time the RCS transferred the materials from Leicester Square to a new building near Lincoln’s Inn Fields. Late one night after the move, as his time as conservator was coming to an end, Clift drafted the ground floor plan that we have today.8 Simon Chaplin, director of culture & society of the Wellcome Trust, has conducted extensive research into Hunter and the Leicester Street house and considers the drawing to be fairly accurate.9 Given that no complete plan exists for the Leicester Square property for the time when the Hunters lived there, Clift’s plan remains one of the best representations that we have today.

"Ground Plan of Mr. Hunter's Premisis, level with Street or Parlour-Floor level." Copied from original in Royal College of Surgeons.  Click to enlarge.

“Ground Plan of Mr. Hunter’s Premisis, level with Street or Parlour-Floor level.” Copied from original in Royal College of Surgeons. Click to enlarge.

Scholars typically describe the Leicester Square property as made up of two separate buildings that were originally separate structures. However, it may be helpful to think of the property as composed of four structures. There were two main buildings. Twenty-eight Leicester Square faced west. Thirteen Castle Street faced east. Situated between the two main buildings were two smaller structures. One building contained Hunter’s picture gallery. The other contained his “conversatione room,” lecture theater, and museum. The second and third floors of the Leicester Square building contained the Hunters’ private rooms. Mr. and Mrs. Hunter conducted many of their public affairs on the ground floor. It was there that Anne Home, a well-educated poet with connections in London’s literary and artistic scene, entertained guests. The Castle Street (now Charing Cross Road) building contained Hunter’s dissecting room, preparations room, a dining room for students, and a room for housekeeper Elizabeth Adams.10

Portrait of Dr. Fenwick Beekman. In Annan, G. L. (1961) "The Fenwick Beekman Collection." Bulletin of the New York Academy of Medicine 37(4):  277–280.

Portrait of Dr. Fenwick Beekman. In Annan, G. L. (1961) “The Fenwick Beekman Collection.” Bulletin of the New York Academy of Medicine 37(4): 277–280.

A guide to the Fenwick Beekman Collection of images is now available online here. Before I discovered who Beekman was, the images collected appeared to have been randomly assembled. Biographical research revealed that Beekman was the foremost private collector of material related to 18th-century Scottish physician John Hunter. Beekman spent years researching and writing about him. When Beekman donated his Hunterian collection in 1960 it was considered the best in private hands. Only the Royal College of Surgeons could boast of a superior collection of Hunter-related materials. It is thanks to Beekman that the New York Academy of Medicine came to own a copy of Clift’s ground plan, along with the other items related to Hunter. After researching Beekman, I began looking into the history of each item in the collection. Thematically, the images reflect the diverse interests of Beekman and Hunter. In addition to the various images, there are several handwritten letters by Hunter that shed light on the early days of his career. I came away from the collection informed and entertained. I have no doubt others will as well.

References

1. Stephen Paget, John Hunter, Man of Science and Surgeon, (London: T. Fisher Unwin, 1897), 155.

2. Simon David John Chaplin, “John Hunter and the ‘Museum Oeconomy’, 1750-1800” (PhD diss., University of London, 209).

3. Lloyd Axelrod, “Strange Case of Dr. Jekyll and Mr Hyde – and John Hunter,” The American Journal of Medicine 125 (2012): 618.

4. Arthur Keith, “The Dicary Lecture on the Life and Times of William Clift, First Conservator of the Museum of the Royal College of Surgeons of England. Given in the Theatre of the Royal College of Surgeons, Friday, December 7th, 1923,”The British Medical Journal 2 (1923): 1127, 1128.

5. “John Hunter,” The Royal College of Surgeons, accessed April 23, 2015, https://www.rcseng.ac.uk/museums/hunterian/history/johnhunter.html.

6. Keith, “Life and Times of William Clift,” 1127-29.

7. Ibid, 1129; Jessie Dobson, “William Clift, F.R.S., First Conservator of the Hunterian Museum,” Proceedings of the Royal Society of Medicine 48 (1955): 324-325.

8. Keith, “Life and Times of William Clift,” 1129.

9 Chaplin, “John Hunter.”

10. Ibid.

Did Corsets Harm Women’s Health?

By Johanna Goldberg, Information Services Librarian

“It is difficult to imagine a slavery more senseless, cruel, or far-reaching in its injurious consequences than that imposed by fashion on civilized womanhood during the past generation. Her health has been sacrificed, and in countless instances her life has paid the penalty; while posterity has been dwarfed, maimed, and enervated, and in body, mind, and soul deformed at its behests. … [T]he tight lacing required by the wasp waists has produced generations of invalids and bequeathed to posterity suffering that will not vanish for many decades. By it, as has been pointed out by the authorities cited, every vital organ in the body has been seriously affected.”1

The title page of

The title page of “Fashion’s Slaves,” 1892. Click to enlarge.

So writes Benjamin Orange Flower in “Fashion’s Slaves,” a 32-page pamphlet published in 1892 as an appeal for women’s dress reform. One of the many causes Flower takes up is the corset, expressing his concern that the undergarment causes damage to internal organs. He continues, “If women will continue this destructive habit, the race must inevitably deteriorate.”1

Certainly, many women felt fettered by their restrictive clothing or there would never have been a dress reform movement. But just how damaging were corsets?

Not all corsets were alike. Tight lacing—cinching a corset to achieve a very small, or wasp, waist—began in the 1820s and 1830s after the advent of corsets made with metal eyelets. Medical professionals came out strongly against the practice.2 As shown in dramatic X-ray images in Ludovic O’Followell’s Le Corset, tightly laced corsets could change the shape of the rib cage,3 but there is no evidence that women had lower ribs removed to decrease their waists.4

Click on an image to view the gallery from Le Corset.

By measuring 19th-century corsets and dresses, historians have determined that women probably did not cinch their waists below 20 inches.4 (By comparison, today many U.S. stores list their XXS waist size at 23.5 inches.5,6) While many waists were still quite small, they may never have gone to the 14-inch extremes reported in women’s magazines, regardless of what fashion drawings depicted.4

A tightly laced corset could reduce lung capacity, irritate skin, and weaken back and chest muscles used to being supported.2 Whether tight lacing caused long-term health issues, like reduced pelvis size, constipation and digestive issues, and reproductive problems ranging from miscarriage to uterine prolapse, is more difficult to assess and remains unclear.2,4,7

Dr. Warner trade card, inside and out. An 1883 article from Godey’s Lady’s Book and Magazine hailed Dr. Warner’s Coraline Corset as a model of comfort, superior to whalebone and horn corsets, and endorsed the model as a substitute for tight-laced models: “They have demonstrated that tight lacing is not essential to grace or beauty of form; and while impractical dress reformers have been preaching reforms which no one would adopt, Warner Brothers, by introducing properly fitting corsets, have given practical aid to the health and comfort of several million ladies.”8

Dr. Warner trade card, inside and out. An 1883 article from Godey’s Lady’s Book and Magazine hailed Dr. Warner’s Coraline Corset as a model of comfort, superior to whalebone and horn corsets, and endorsed the model as a substitute for tight-laced models: “They have demonstrated that tight lacing is not essential to grace or beauty of form; and while impractical dress reformers have been preaching reforms which no one would adopt, Warner Brothers, by introducing properly fitting corsets, have given practical aid to the health and comfort of several million ladies.”8 Click to enlarge.

Many health problems once blamed on the corset are now clearly not the fault of the undergarment. Death caused by postpartum infections, or childbed fever, became relatively rare with the advent and spread of antiseptic techniques. With the discovery of the tubercle bacillus in 1882, it became clear that corsets did not cause the disease. Incidence of breast cancer did not decrease after corsets that did not compress the breasts came into vogue. As Gerhart S. Schwartz wrote in a 1979 Bulletin of the New York Academy of Medicine article, “one disease after another found an explanation which was unrelated to the corset.”9

Many of the doctors against tight lacing, including O’Followell, did not condemn corsets as a whole. Instead, they championed designs less tightly laced. Several pamphlets in our collection feature what they claim to be medically sound corsets.

In one, “La Grecque Corset as an Aid to the Physician and Surgeon,” printed circa 1911, the van Orden Corset Company advertises corsets that pull in the abdomen while reducing strain on abdominal muscles.10

Incorrect and correct pressure applied by corsets. In

Incorrect and correct pressure applied by corsets. In van Orden Corset Company, “La Grecque Corset as an Aid to the Physician and Surgeon,” circa 1911. Click to enlarge.

The pamphlet also features a maternity corset, “designed for a natural change of figure.”10 Corsets for maternity came on the market in the 1830s, and were often tightly laced.11 Yet the medical literature of the period does not discuss dangers of maternity corsets to the fetus or the mother,11 either due to taboos of the time or because negative impacts were rare or unreported. The maternity corset advertised by the van Orden Corset Company, from the early 1900s, was not tightly laced, taking advantage of new elasticized fabrics to expand as needed.10

La Grecque Maternity Corset. In

La Grecque Maternity Corset. In van Orden Corset Company, “La Grecque Corset as an Aid to the Physician and Surgeon,” circa 1911. Click to enlarge.

Corsets from a Surgical Standpoint,” from H. W. Gossard and Company (still in business today as a lingerie company), describes to physicians the benefits of prescribing their pliable front-laced corsets. These corsets, they claimed, improved posture and “preserve[d] the lines demanded by fashion, but without discomfort or injury.”12

Figures 5 and 6 in

Figures 5 and 6 in H. W. Gossard and Company, “Corsets from a Surgical Standpoint,” 1909. Click to enlarge.

Both of these pamphlets were published at the end of an era. The advent of elasticized fabric paved the way for the creation of an early bra, displayed by Herminie Cadolle at the Exposition Universelle in 1889.13 The corset’s final death knell was World War I. Women could not work in factories or the field while wearing restrictive clothing. Once household staff went to work for the war effort, upper-class women had no one to help them dress. Girdles and bras took over the corset’s supporting role, about 20 years after Flower’s calls for the end of the “destructive habit” of corsetry.1,13

References

1. Flower BO. Fashion’s slaves. Boston: Arena Pub. Co.; 1892.

2. Starr M. Vintage X-rays reveal the hidden effects of corsets. CNET. 2015. Available at: http://www.cnet.com/au/news/vintage-x-rays-reveal-the-hidden-effects-of-corsets. Accessed May 14, 2015.

3. O’Followell L. Le corset; histoire, médecine, hygiène. volume 2. Paris: Maloine; 1908.

4. Davis L. No, corsets did not destroy the health of Victorian women. io9. 2014. Available at: http://io9.com/no-corsets-did-not-destroy-the-health-of-victorian-wom-1545644060. Accessed May 14, 2015.

5. LOFT: Size Chart. Available at: http://www.anntaylor.com/catalog/sizeChartPopup.jsp. Accessed May 18, 2015.

6. Gap – women’s size chart. Available at: http://www.gap.com/browse/sizeChart.do?cid=2081. Accessed May 18, 2015.

7. Klingerman KM. Binding femininity: An examination of the effects of tightlacing on the female pelvis. 2006. Available at: http://etd.lsu.edu/docs/available/etd-04072006-115441/unrestricted/Klingerman_thesis.pdf. Accessed May 14, 2015.

8. Coraline: Its discovery and use in the manufacture of corsets. Godey’s Lady’s B Mag. 1883:468–469. Available at: https://books.google.com/books?id=nXA-AQAAMAAJ&pgis=1. Accessed May 18, 2015.

9. Schwarz GS. Society, physicians, and the corset. Bull N Y Acad Med. 1979;55(6):551–90. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1807654. Accessed May 14, 2015.

10. La Grecque corset as an aid to the physician and surgeon. New York: van Orden Corset Co.; 1911?

11. Summers L. Bound to please: A history of the Victorian corset. Oxford, New York: Berg; 2001.

12. Corsets from a surgical viewpoint. Chicago: Gossard Co.; 1909.

13. Fontanel B. Support and seduction: The history of corsets and bras. New York: Abrams; 1997.

Aging Through Time

By Danielle Aloia, Special Projects Librarian

“Ah, but I was so much older then
I’m younger than that now”
– Bob Dylan, My Back Pages

May celebrates Older Americans Month, which this year focuses on promoting health and community engagement of seniors across the nation. Today, 14.1% of the U.S. population is aged 65 and older1 and by 2030, 20% of the population will be over 65.2 We are living longer, healthier, and more productive lives than ever before.

Over the years there has been investigation into aging and the life course, reflecting beliefs informed by the average lifespans of the time. The Art of Invigorating and Prolonging Life by William Kitchiner, published in 1821 in the U.K. and two years later in the U.S., suggested that life is divided into three stages, each stage requiring a different regimen of “food – clothes – fire – air – exercise – sleep – wine – &c.”3 Kitchiner cautions that people only realize the importance of these elements after they become enslaved to other, detrimental, habits. They may need to proceed gradually with his recommendations in order to correct the bad habits and form new ones.

The first stage of life is a period of preparation, from birth to 21. In this stage, people should take in as much healthful food as can be digested for the body to convert into Chyle (bodily fluids). The second stage, the period of active usefulness (ages 21-42), should include plenty of “hard exercise in the open air” to restore the body’s constitution. In the third stage, the period of decline, the rate of decline is based on the strength of the constitution built during the active stage of life. Without “due attention to Diet &c., the Third period of Life is little better than a Chronic Disease.”4

Pages 34-35 of Kitchiner, The Art of Invigorating and Prolonging Life, 1823 edition.

Pages 34-35 of Kitchiner, The Art of Invigorating and Prolonging Life, 1823 edition. Click to enlarge.

According to Kitchiner, by 42 years of age humans are on the decline; they are ancient by 63. Put in context, life expectancy in the 1900s for men was 46.3 in the U.S.and 44 in the UK.5,6 But still, Kitchiner believed it was never too late to make up for lost time.

Kitchiner incorporated William Jones’s andrometer,7 a chart intended as a tool for people to gauge their progress through life.8

William Jones' Andrometer, on pages 36-37 of Kitchiner, The Art of Invigorating and Prolonging Life, 1823 edition.

William Jones’ Andrometer, on pages 36-37 of Kitchiner, The Art of Invigorating and Prolonging Life, 1823 edition. Click to enlarge.

Unfortunately, Jones passed away in his late 40s and Kitchiner in his 50s. Sadly, neither got to experience “a glorious retirement” or the “universal respect” due after the age of 60.

More than 100 years later, in 1974, a new benchmark showed similarities to Kitchiner’s book while offering a 20th-century outlook. D. D. Stonecypher published Getting Older and Staying Young: A Doctor’s Prescription for Continuing Vitality in Later Life to give readers reliable and practical advice about aging, because “the quality of one’s later years grows out of the choices the individual makes.”9 In 1974 life expectancy in the United States was 68.2 for men and 75.9 for women.10

Stonecypher had specific audiences in mind for his work: middle-aged readers wondering about their aging bodies who may be modifying activities in order to preserve their vigor; older readers looking to gain insights into preserving mental and physical vitality; and younger readers who wished to assist the elderly and gain insight and perspective on their own aging process. He also notes another type of reader, the policy maker or community worker who “holds the key to the mounting social problems of aging.”

Stonecypher offered the following questionnaire as a way for readers to assess the probability of living a long life, but goes on to explain that medical science was advancing so rapidly it could be possible to double the life span to over 100 years. Citing that in classical Greece and Rome average life expectancy was 18 years, he writes that by the 1800s it had doubled to 35 years and between 1800 and 1970 it doubled again to 72 years.

In Stonecypher, Getting Older and Staying Young, 1974.

In Stonecypher, Getting Older and Staying Young, 1974.

In 2013, life expectancy in the United States was 76.4 for men and 81.2 for women,11 a substantial increase even from 1974. The longer one lives the more productive one may need to be: “a glorious retirement” may not be the answer to a healthy old age. Stonecypher tries to persuade his audience: “It is prejudice that has justified the compulsory retirement, inadequate pensions, the ostracism, and the other stresses which have come to seem a normal part of life after 65.”

This year, the Medicare, Medicaid and the Older American Act celebrates its 50th anniversary.12 The Act led to programs that have ensured access to health care, community services, and protections of the rights of elders. We have come a long way, but have even more work to do to support health and productivity of seniors as the population ages.

References

1. U.S. Census Bureau. State and County QuickFacts. http://quickfacts.census.gov/qfd/states/00000.html. Accessed May 21, 2015.

2. U.S. Census Bureau. An Aging Nation: the Older Population in the United States. Washington, D.C.: U.S. Census Bureau; 2014. http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_07.pdf. Accessed May 21, 2015.

3. Kitchiner William. The Art of Invigorating and Prolonging Life. Philadelphia : H. C. Carey & I. Lea; 1823.

4. Ibid.

5. U.S. Census Bureau. United States Life Tables, 2009.. Washington, D.C.: U.S. Census Bureau; 2014. http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_07.pdf. Accessed May 21, 2015.

6. England. Office for National Statistics. Mortality in England and Wales: Average Life Span, 2010. England: Office for National Statsitcs; 2012. http://www.ons.gov.uk/ons/dcp171776_292196.pdf. Accessed May 22, 2015.

7. Mental Floss. The Andrometer: an 18th-Century Measuring Stick for Success in Life. http://mentalfloss.com/article/58057/andrometer-18th-century-measuring-stick-success-life. Accessed May 21, 2015.

8. Jones, William. The works of Sir William Jones, Volumes 1-2, 1807. http://books.google.com/books?id=PW5KAAAAYAAJ&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false. Accessed May 21, 2015.

9. Stonecypher D. D. Getting Older and Staying Young. [1st ed.]. New York : Norton; 1973.

10. U.S. Census Bureau. United States Life Tables, 2009.. Washington, D.C.: U.S. Census Bureau; 2014. http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_07.pdf. Accessed May 21, 2015.

11. U.S. Census Bureau. Health, United States, 2014. Washington, D.C.: U.S. Census Bureau; 2014. http://www.cdc.gov/nchs/data/hus/hus14.pdf. Accessed May 21, 2015.

12. 2015 White House Conference on Aging. http://www.whitehouseconferenceonaging.gov/about/index.html. Accessed May 21, 2015.

Conan Doyle’s Poison Pen and “The Adventure of the Devil’s Foot”

By Anne Garner, Curator, Center for the History of Medicine and Public Health

“Upon my word, Watson!” said Holmes at last with an unsteady voice, “I owe you both my thanks and an apology. It was an unjustifiable experiment even for one’s self…A candid observer would certainly declare that we were [mad] before we embarked upon so wild an experiment. I confess that I never imagined that the effect could be so sudden and so severe.”

                                                –Arthur Conan Doyle, “The Adventure of the Devil’s Foot” (1910)1

Illustration from the 1910 publication of "The Adventure of the Devil's Foot" in The Strand magazine.

Illustration by Gilbert Holiday from the 1910 publication of “The Adventure of the Devil’s Foot” in The Strand magazine.

Nineteenth- and twentieth-century botanical dictionaries lack any mention of radix pedis diaboli. Curious readers will need to turn instead to fiction to find it, and to the Sherlock Holmes stories of Sir Arthur Conan Doyle. Conan Doyle’s short story, “The Adventure of the Devil’s Foot,” was published in 1910, and pivots on this fictional poisonous plant.

In the story, the plant—devil’s foot root—is little-known even in West Africa, its point of origin. Its transport to England is the work of the story’s lion-hunting physician, Dr. Leon Sternsdale.

The case involves the mysterious injuries sustained by four siblings (two are fatal). En route to the story’s solve, Holmes detects a strange brown powder on the smoke-guard of a lamp at the scene. Soon after, he proposes that he and Watson undertake a medical experiment to determine the powder’s effects on the body. The always accommodating Watson assents. Holmes then lights the lamp, burning the powder with the window and door ajar for ventilation.

The impact is immediate: Watson describes a “turmoil in his brains” and a mounting loss of control of both mind and body. At the last minute, Watson marshals his reason and tackles Holmes, pushing him out of the room, where the pair of them lie breathless on the grass outside as the fumes and the poison recede. Holmes’ suspicions are confirmed: the powder is toxic, and he’s able to link the deaths to the devil’s foot root, with the help of Sternsdale.

As a third-year medical student at the University of Edinburgh, Doyle embarked on his own experiment with a toxic root. Gelsemium (sometimes gelseminum), a dried rhizome of yellow jasmine, was rumored to have been discovered by a Mississippi planter who accidentally made a tea for his master using the root, and cured him of his fever (though with side effect—loss of muscle control).2

Doctor Conan Doyle in academic regalia for his graduation in August 1881. In Rodin and Key, Medical Casebook of Doctor Arthur Conan Doyle: From Practitioner to Sherlock Holmes and Beyond, 1984.

Doctor Conan Doyle in academic regalia for his graduation in August 1881. In Rodin and Key, Medical Casebook of Doctor Arthur Conan Doyle: From Practitioner to Sherlock Holmes and Beyond, 1984.

By the mid-19th century, gelsemium had gained a reputation with a handful of medical practitioners in the Midwest as a remedy for pneumonia, pleurisy, and other ailments. In 1879, Doyle, who had been taking a tincture of gelsemium for some time to combat neuralgia, began to experiment with it, incrementally increasing his dosage.3

Doyle published his findings in a letter to the editor in the September 20, 1879 issue of the British Medical Journal, under his initials, A.C.D. Doyle writes that he was “determined to ascertain how far one might go in taking the drug, and what the primary symptoms of an overdose might be.” He concludes that gelsemium, like opium, could be tolerated with increased exposure, though at 200 minims Doyle ceased his experiments because of debilitating stomach issues.4

Gelsemium. In  Millspaugh, American Medicinal Plants, 1887.

Gelsemium. In Millspaugh, American Medicinal Plants, 1887.

Holmes and Watson’s symptoms in the “Adventure of the Devil’s Foot” in some ways conjure the effects of the gelsemium described by Doyle in the BMJ. Watson reports a “freezing” loss of muscular control and partial paralysis as well as loss of the senses. Doyle recounted similar symptoms after ingesting gelsemium. At the highest dosages, Doyle reported severe depression. Watson, too, describes feelings of dread:

“A thick, black cloud swirled before my eyes, and my mind told me that in this cloud, unseen as yet, but about to spring out upon my appalled senses, lurked all that was vaguely horrible, all that was monstrous and inconceivably wicked in the universe.”5

Self-experimentation was common during Conan Doyle’s lifetime. And yet, it’s somewhat surprising that Conan Doyle endeavored to take on this project. As historians Rodin and Key note, Conan Doyle writes in his autobiography, “I had…no great interest in the more recent developments of my own profession, and a very strong belief that much of the so-called progress was illusory.”6 Why then, was Conan Doyle so determined to ascertain the limits of the drug, particularly when he knew of life-ending overdoses? (At peak dosage, Doyle took 2 1/2 times the fatal amount.)

Arthur Conan Doyle. In his Memories and Adventures, 1930.

Arthur Conan Doyle. In his Memories and Adventures, 1930.

The answer is not clear, but may suggest an early fascination with poisons, which decorate so many of Conan Doyle’s Holmes and Watson stories. As a medical student at the University of Edinburgh, Conan Doyle studied with several eminent toxicologists, including Sir Robert Christison and Sir Thomas Richard Fraser.7 Conan Doyle’s service as ship surgeon on a voyage to West Africa may also have familiarized him with poisons that inspired the “devil’s foot root” of the Holmes story.

Rodin and Key suggest that not only was Conan Doyle interested in poisons, but he was also a risk-taker. They write that the experiment was a “reflection of the bravado, the sense of the dramatic, and the spirit of adventure already noted in many of his endeavors—experiences as a ship’s surgeon and involvements in war and sports.”8 Conan Doyle bestowed these qualities on his crackerjack gumshoe. In “Devil’s Foot,” Holmes admits that testing the poison is somewhat reckless—and yet we can’t imagine him behaving otherwise.

a street where Arthur Conan Doyle had his first medical practice, where he created the character Sherlock. In Rodin and Key, Medical Casebook of Doctor Arthur Conan Doyle: From Practitioner to Sherlock Holmes and Beyond, 1984.

Southsea. No. 1. Bush Villas is the site of Doctor Arthur Conan Doyle’s practice, 1882-1890. He created Sherlock Holmes here. In Rodin and Key, Medical Casebook of Doctor Arthur Conan Doyle: From Practitioner to Sherlock Holmes and Beyond, 1984.

We recommend commemorating Arthur Conan Doyle’s birthday, May 22, 1859, with a story or three from Round the red lamp: Being facts and fancies of medical life, with other medical short stories, available online, originally published in 1894 and reissued in 1992.

References
1. Conan Doyle, Arthur. “The Adventure of the Devil’s Foot.” His Last Bow. 1910. Project Gutenberg 15 May 2015. http://www.gutenberg.org/ebooks/2349

2. Alvin E. Rodin and Jack D. Key. Medical Casebook of Doctor Arthur Conan Doyle: From Practitioner to Sherlock Holmes and Beyond. Malabar, FL: Robert E. Krieger Publishing, 1984. p. 82.

3. D[oyle], A[rthur] C[onan]. “Gelseminum as Poison.” British Medical Journal 2: 483, 1879.

4.D[oyle], A[rthur] C[onan].

5. Doyle, Arthur Conan. “The Adventure of the Devil’s Foot.” His Last Bow. 1910. Project Gutenberg. 15 May 2015. http://www.gutenberg.org/ebooks/2349

6. Rodin and Key, 82.

7. Billings, Harold. “The material medica of Sherlock Holmes.” Baker Street Journal 55: 2006. 37-44.

8. Rodin and Key, 82.

Damien the Leper (Part 3 of 3)

This is part three of a guest post written by Anna Weerasinghe, a graduate of Harvard Divinity School studying the history and theology of Hansen’s disease. Read part one and part two.

In March 1888, Damien received a visit from Dr. Prince A. Morrow, a prominent New York dermatologist and syphilologist best known today as an early proponent of sex education.1 Morrow, then a fellow at the New York Academy of Medicine, had written the month before requesting an account of the progression of Hansen’s disease from Damien’s earliest symptoms through to its (at the time) inevitable conclusion. Damien, who was now so far along in his illness that he could no longer hold a pen, dictated the full account.2

Damien weeks before his death, photographed by William Brigham.

Damien weeks before his death, photographed by William Brigham.” In Daws, Holy man: Father Damien of Molokai, 1973.

Damien described the beginnings of the illness as an itching on the skin of his face and legs. Then, in the early 1880s, he began to experience a dull, throbbing pain in his left leg that eventually gave away to numbness. In the beginning of 1885, Damien accidentally scalded his foot with boiling water. He felt nothing. One of the earliest signs of Hansen’s disease is loss of sensation in the extremities, and Damien began to suspect the worst. Examination by doctors confirmed his suspicions: he had Hansen’s disease.3

It was a devastating diagnosis. Being diagnosed with Hansen’s disease in Hawaii during the 19th and early 20th centuries was akin to being charged with a crime. Those afflicted with Hansen’s disease were legally required to turn themselves over to state incarceration at the Molokai settlement, leaving behind their families, friends, property, and livelihoods. The government enforced occasional sweeps of the island to ferret out ill people who were unwilling to turn themselves in.4

It is now known that Hansen’s disease is not a particularly contagious bacterial infection. About 95% of the population is naturally immune to Mycobacterium leprae, and most of the remaining 5% experience a relatively mild version of Hansen’s disease called tuberculoid leprosy. A small number of infected individuals, including Damien, are not so lucky. Due to a combination of genetic susceptibility and long-term exposure, possibly exacerbated by poor sanitation, Damien contracted the most serious form of Hansen’s disease: lepromatous. If left untreated, lepromatous Hansen’s disease causes large, insensate skin lesions eventually leading to extreme disfiguration of the extremities and face; nerve damage; breakdown of muscle tissue; and death.5

As if the disease weren’t terrible enough, the isolation of Hansen’s disease patients produced even more anguish. A 1907 government pamphlet on the Molokai settlement remarks, “the separation which the disease causes in families and among friends, is its most distressing feature.”6 By blaming the disease for the “distressing” practice of incarcerating victims of Hansen’s disease, Hawaiian policymakers and medical leaders abdicated responsibility for their actions. It was not the disease that separated sufferers from their healthy families, it was the tight grip of social mores and the law.7

Of course, the law did not affect the Hawaiian population equally. Even at the time of the Molokai settlement’s peak population (just over 1, 200 Hansen’s disease patients), only a tiny percentage was white.8 This disparity was most likely due to lower levels of genetic resistance among indigenous Hawaiians, compounded by poverty, as well as poor access to clean water, sanitation, and professional medical services.9 At the time, however, the high rate of infection among the native Hawaiian population was used to prop up colonialist bias and moral judgment.

Damien on his deathbed, photographed by the settlement physician, Sidney Bourne Swift. In Daws, Holy man: Father Damien of Molokai, 1973.

Damien on his deathbed, photographed by the settlement physician, Sidney Bourne Swift. In Daws, Holy man: Father Damien of Molokai, 1973.

Leprosy has had a moral dimension for almost as long as it has existed as a human disease. Like many illnesses, leprosy was often seen as a sign of divine displeasure and sinfulness. Throughout medieval and early modern times, leprosy was connected in particular to sexual deviancy and was even thought to be a venereal disease linked to syphilis.10

While the medical field had largely discarded this theory by the end of the 19th century, the close association between sexual immorality and leprosy was still a widely held belief among the white population of Hawaii. Indigenous Hawaiians, with their freewheeling approach to sex, were clearly at fault for their own sickness. Even Damien drew the connection: “It is an admitted fact,” he wrote, “that the great majority, if not the total number of all pure natives, have the syphilitic blood, very well developed in their system…as we are now, it developed it self [sic] in some instance in the way of what we called leprosy.”11

Damien was a man of his time, as this unflattering quote proves, but he was an extraordinary one. Others bemoaned the sorry state of leprous Hawaiians from a safe distance. Dr. Morrow’s interest in the Molokai settlement, for example, extended only as far as his scientific curiosity.12 But when someone asked Damien if he wanted to be cured of his leprosy, his answer was no: not if the price of the cure was abandoning Molokai and his work among his fellow sufferers.13 It was this very flawed, very human bravery—what some called recklessness—that made Damien a popular saint and martyr long before his canonization.

In previous posts, we have seen Damien through the eyes of his most vocal critics and poetic admirers, religious authorities, and now medical experts. He was a man who attracted the words of others, through his work, his circumstances, and his personality. But of himself, Damien typically had little to say. “As for me,” he wrote to his older brother during his 11th year as pastor of the Molokai settlement, “I am still almost the same, except for my beard which is beginning to turn a little grey.”14

References

1. For a full discussion of Morrow’s contribution to the early sex education movement in the United States, see Bryan Strong, “Ideas of the Early Sex Education Movement in America, 1890-1920,” History of Education Quarterly, 12 (1972): 129-61.

2.Gavan Daws, Holy Man: Father Damien of Molokai (New York: Harper & Row, 1973), 226-227.

3.Daws, Holy Man, 160-163.

4. Daws, Holy Man, 142-150.

5. Warwick J. Britton, “Leprosy,” Encyclopedia of Life Sciences, online ed. (John Wiley & Sons, Ltd., 2002), 1.

6. Hawaii Board of Health, The Molokai Settlement, Territory of Hawaii: Villages Kalaupapa and Kalawao (Honolulu, issued by the Board of Health of the Territory of Hawaii, 1907), 3. Emphasis added.

7. While segregation of Hansen’s disease patients has long been considered unnecessary and unethical, particularly with the development of effective antibiotic treatment, recent studies suggest that segregation may never have been a successful method for reducing the incidence of Hansen’s disease. New research has shown that the bacteria responsible for Hansen’s disease can survive for long periods of time inside amoebae that are commonly found in standing water and soil. This may explain why leprosy incidence in the Hawaiian Islands only began to decrease in the 1910s, when improvements in quality of life and sanitation began to trickle down to the wider Hawaiian population. See William H. Wheat, Amy L. Casali, Vincent Thomas et al. “Long-term Survival and Virulence of Mycobacterium leprae in Amoebal Cysts,” PL0S Neglected Tropical Diseases, Vol. 8, No. 12 (2014).

8. Daws, Holy Man, 250.

9. In addition, white sufferers of Hansen’s disease had greater mobility and often left the Hawaiian Islands to seek treatment in the U.S. or abroad. One government doctor even proposed setting up an official fund to pay the fares of diseased white men to leave Hawaii. Daws, Holy Man, 148.

10. Saul Nathanial Brody, The Disease of the Soul: Leprosy in Medieval Literature (Ithaca: Cornel University Press, 1974), 41; 60-61. See also Luke Demaitre, Leprosy in Premodern Medicine: A Malady of the Whole Body (Baltimore: Johns Hopkins University Press, 2007), 209.

11. Daws, 148-149.

12. Dr. Morrow ultimately advocated against the U.S. annexation of Hawaii from a sanitation perspective. See Prince A. Morrow, “Leprosy and Hawaiian Annexation,” The North American Review, Vol. 165, No. 49d2 (Nov. 1897).

13. Daws, Holy Man, 216.

14. Daws, Holy Man, 137.