Global Celebrations of Vesalius’s 500th Birthday

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

From the frontispiece of Vesalius’ Fabrica.

Not in New York? Plan a trip and attend our “Art, Anatomy, and the Body: Vesalius 500″ Festival on October 18! You can read our guest curator Riva Lehrer’s thoughts on the Festival here, and get a sneak peak of a virtual dissection demonstration by Kriota Willberg; and Brandy Schillace on Naissance Macabre; as well as more information about Vesalius and his Fabrica. Keep an eye out for more Vesalius 500 guest posts to come.

But, much as we’d like to see you here on October 18, you don’t have to be in New York to celebrate Vesalius’ 500th birthday.

We always welcome visitors to make an appointment to visit our rare book reading room and examine our copies of the Fabrica and its companion volume, the Epitome (in addition to the rest of our collection). Those elsewhere can find beautiful colored digital versions of the Fabrica from the University of Basel Library and the Epitome at University of Cambridge Library’s digital library. The publishers of the new English language edition of the Fabrica also have some wonderful material online.

In addition, there are multiple birthday celebrations for Vesalius across the globe this year. Travelers can visit Leuven for the Unravelling the Body. The Theatre of Anatomy at the Leuven Museum, or the international conference Towards the Authority of Vesalius: Representations of the Human Body in Antiquity, the Middle Ages and the Renaissance (Dec 3–5); join the Vesalius Continuum Conference on Zakynthos, the Ionian Island on which Vesalius died (Sept 4–8 ); visit Down to the Bones: Celebrating 500 Years of Innovation (Jul 11–Oct 9) at the University of Utah libraries; see Discovering the Human Body at Anatomical Museum in Basel, as well as the only existing skeleton known to have been dissected by Vesalius (Sept 12–Mar 2015) and explore Vesalius and His Worlds: Medical Illustration during the Renaissance at the Huntington library (Dec 12–13). Vesalius was born on Dec 31, 1514; if the events of 2014 were not enough, keep an eye out for the St. Louis meeting celebrating Vesalius in 2015 (Feb 26-28). (Apologies to anyone whose event we’ve missed! The Karger Fabrica site has a great, and constantly updated list of Vesalius 500 events.)

“The Pest at the Gate”: Typhoid, Sanitation, and Fear in NYC

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

The relationship between medicine and public health could be a complex one at the turn of the last century. In particular, the question of how to deal with infectious disease epidemics demanded that medical professionals and city officials grapple with sanitation and cleanliness, city infrastructure, water supplies, and garbage and sewage. Epidemics also raised questions of individual autonomy and the proper role of government. In response to these issues, Boards of Health emerged in many American cities in the second half of the 19th century. The New York Metropolitan Board of Health was the first, founded in 1866 after a campaign by Dr. Stephen Smith and The New York Academy of Medicine.

Poultney Bigelow, The Pest at Our Gates, ([New York] : Merchants’ Association of New York, [1908])

Bigelow Poultney, The Pest at Our Gates, (New York: Merchants’ Association of New York, 1908)

Relations were often fraught between the different groups responsible for the city’s health. Many physicians resented the interference of city-nominated health officials (many of whom they considered corrupt and/or incompetent) into the medical domain; health officials blamed doctors for failing to report cases of infectious diseases; and families regarded hospitals with suspicion and did their best to keep their ill relatives out of them.

The diseases most feared by New Yorkers included cholera, typhus, and typhoid fever. Between 1898 and 1907, at least 635 New Yorkers died from typhoid, with cases of the disease in the thousands.1 Typhoid spreads through water supplies contaminated with infected fecal matter. It can be transmitted via contaminated food or water, and more rarely, through direct contact with someone infected with the disease. As such, sources of the illness in late 19th-century New York were many and largely invisible, as the investigative journalist and author Poultney Bigelow described in 1908 in “The Pest at Our Gates”: typhoid sources ranged from the “placid, perilous Potomac” to “the deadly house fly,” “the fish and oyster menace” and the “perils that lurk in ice.”2 Fear of typhoid pushed public health initiatives and legislation to ensure safe water and food, adequate plumbing, and proper sewage control.

The specters of cholera, yellow fever, and smallpox recoil in fear as their way through the Port of New York is blocked by a barrier on which is written "quarantine" and by an angel holding a sword and shield on which is written "cleanliness." Courtesy of the National Library of Medicine.

Cholera, yellow fever, and smallpox recoil in fear as a quarantine barrier and an angel holding bearing a shield of cleanliness blocks their way through the Port of New York. Image courtesy of the National Library of Medicine.

Fear of infectious disease often overlapped with fears about the changing face of the city and nation. As Alan M. Kraut explores in Silent Travelers: Germs, Genes and the Immigrant Menace, the relationship between immigration and public health in the United States has historically been informed by nativist debates about the identity of the nation and its ethnic makeup, fears about the potential limitations of scientific medicine, and the public health impact of immigration.3 As the gateway to America for hundreds of thousands of new immigrants, New York City became a focus for questions of quarantine and infectious disease. Epidemics, particularly of cholera, prompted many public health reforms in the city, especially increased scrutiny of immigrant arrivals at quarantine stations, including Ellis Island, where officials assessed arriving immigrants for their physical and mental health between 1892 and 1924.

In the case of typhoid, the specter of the foreigner as the reservoir of disease came to be personified by the Irish-born Mary Mallon, so-called “Typhoid Mary.” Mallon was a cook whose employment history in the kitchens of wealthy New Yorkers matched a spate of typhoid outbreaks in those same households in 1906. Mallon was a healthy carrier of typhoid, and was put under enforced quarantine by the Board of Health, which she vigorously resisted. On her release in 1909 she took multiple aliases and continued to work as a cook until 1915, when she was again detained and kept in isolation until her death in 1932. To some, Mallon was “the most dangerous woman in America”; to others, she was a symbol of the undermining of individual liberties by the government.4

In the case of typhoid fever, a combination of new vaccine technology and improved sanitation measures (particularly water chlorination) saw cases in the United States drop dramatically in the early 20th century. However, as is the case for many preventable infectious diseases, typhoid remains a problem in parts of the world with less developed public health infrastructure. On a global scale, medical and governmental responses to public health issues continue to exist in an uneasy tension with broader political and social concerns.

References

1. John Duffy,  A history of public health in New York City (New York: Russell Sage Foundation, 1968), p566

2. Poultney Bigelow, The Pest at Our Gates, (New York: Merchants’ Association of New York, 1908)

3. Alan M. Kraut, Silent Travelers: Germs, Genes and the Immigrant Menace (New York: Basic Books, 1994), pp 1-9

4. Judith Walzer Leavitt, Typhoid Mary: captive to the public’s health (Boston: Beacon Press, 1996); Alan M. Kraut, Silent Travelers: Germs, Genes and the Immigrant Menace (Baltimore: Johns Hopkins University Press, 1995), 97-104.

 

The Fabrica of Andreas Vesalius: Object of the Month

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

This year we are celebrating the 500th anniversary of the birth of Andreas Vesalius with our fall festival, “Art, Anatomy, and the Body: Vesalius 500” on October 18. So much has been written on the Fabrica and its importance that it can be difficult to know where to begin. Why do Vesalius and his work remain so important to contemporary scholarship and anatomical study? The answer lies in his first and most famous book, De humani corporis fabrica. The title is translated as On the Fabric of the Human Body, although the “fabrica” in the original title can be best understood in terms of “craft”, “workings,” or “fabrication.”1 In other words, in this book Vesalius is interested in the functions of the body as a living system. Seven “books,” or sections, lay out the different systems and functions of the body, beginning with bones and ligaments and ending with the brain and sensory organs.

The frontispiece to the 1543 Fabrica in our collection.

The frontispiece to the 1543 Fabrica in our collection. Click to enlarge.

As the frontispiece makes clear, Vesalius wanted the Fabrica to demonstrate the importance of reviving hands-on anatomy as central to medical knowledge and practice. The Fabrica was a landmark publication, representing a turning point in the European understanding of the body and a new level of beauty and accuracy in its depiction in anatomical texts. At the time of its publication in 1543, Vesalius was a professor at the University of Padua, one of Europe’s best known medical schools. Only 28, Vesalius came from a long line of physicians. Like many of his forebears, he subsequently entered the service of the Imperial Court of Charles V, to whom he dedicated the Fabrica. He worked closely with his printers, wood carvers, and artists to ensure the accuracy and beauty of the over 300 woodblock images in the book.2 The Fabrica was exceptional in terms of both production and content, and its iconography, principles, and pedagogical approach were rapidly incorporated into medical thinking and teaching.

While the Fabrica is now remembered as the point at which a new, “modern” emphasis on direct observation and experimentation replaced deference to ancient authorities, Vesalius was careful to ensure that his erudition in the classical tradition was on display. Quotations of Greek, Arabic, and Hebrew texts point both to his determination to show the breadth of his knowledge and to the expertise of his typesetters. Vesalius used such authorities to place himself in an established tradition, even as he questioned aspects of accepted Galenic thought.

The frontispiece to the 1555 Fabrica in our collection. Click to enlarge.

The frontispiece to the 1555 Fabrica in our collection. Click to enlarge.

Along with his systematic exploration of all aspects of human anatomy, Vesalius’s demonstration that authorities such as Galen had made errors in their claims about human anatomy (in part due to reliance on animal dissection) was one reason the book rapidly assumed such extraordinary significance (although not universal acceptance). Despite its detractors, the Fabrica had an immediate impact; even with Vesalius’ best efforts, it was plagiarized and copied throughout Europe.3

Covers of the two Fabricas in our collection. The 1543 volume, left, has alum-tawed pigskin over wooden boards with elaborate decorative tooling and stamped designs and two brass fore-edge clasps. The 1555 edition, right, is bound in a contemporary parchment binding over stiff pasteboards with a single panel stamp. Click to enlarge.

Covers of two Fabricas in our collection. The 1543 volume, left, has alum-tawed pigskin over wooden boards with elaborate decorative tooling and stamped designs and two brass fore-edge clasps. The 1555 edition, right, is bound in a contemporary parchment binding over stiff pasteboards with a single panel stamp. Click to enlarge.

We are in the enviable position of owning multiple copies of the Fabrica as well as its companion piece the Epitome, a briefer volume designed for students with enlarged illustrations to aid the identification of individual features. In addition, we also hold multiple copies of the Icones Anatomicae, an extraordinary 20th-century artifact created in 1934 by The New York Academy of Medicine and the University of Munich, using the original 1543 wood blocks to reproduce illustrations from the Fabrica and Epitome (this was the last time images were taken from the woodblocks; returned to Munich, they were subsequently destroyed by Allied bombing during WWII). All of these volumes will be available to view at the festival on October 18. You will also be able to learn more about Vesalius and his work: Daniel Garrison will discuss translating the Fabrica for the new English-language edition, Arlene Shaner will explore the story of the Icones Anatomicae, and Drs. Jeff Levine and Michael Nevins will provide a guide to the possible stories hidden in the changes made to the Fabrica frontispiece between the first and second editions.

References

1. Harvey Cushing, A Bio-Bibliography of Andreas Vesalius (New York, Schuman’s, 1943), p73; Daniel Garrison, “Why Did Vesalius Title His Anatomical Atlas “The Fabric of the Human Body”?” http://www.vesaliusfabrica.com/en/original-fabrica/inside-the-fabrica/the-name-fabrica.html

2. The identity of the artist responsible for the wood blocks remains unclear, although many have argued that Jan Stephan Calcar, a student of Titian, was responsible. See Vivian Nutton’s introduction at http://vesalius.northwestern.edu/books/FA.aa.html.

3. More details about the life and impact of Vesalius can be found online in Vivian Nutton’s introduction and other essays at Northwestern’s Annotated Vesalius project: http://vesalius.northwestern.edu/ and in C. O’Malley, Andreas Vesalius of Brussels, 1514-1564 (Berkeley: University of California Press, 1964).

Calculating Lifetimes: Life Expectancy and Medical Progress at the Turn of the Century

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

“We now live in a time of endless possibility. More has been learned about the treatment of the human body in the last five years than was learned in the previous 500. Twenty years ago, 39 was the number of years a man could expect from his life. Today, it is more than 47.”1

So says the fictional character Dr. John Thackery on the first episode of Cinemax’s The Knick, a show set in New York in 1900. So the years and ages are thus: in 1880 newborn boys could expect a life of 39 years; in 1900, 47 years. And that’s about right. The technical term is life expectancy—the number of years that one could expect to live, with no substantial change of conditions. Dr. Thackery refers, grandiloquently, to those substantial changes of conditions that caused a dramatic increase in life expectancy in the developed world in the late 19th and early 20th centuries, and a steady increase thereafter. By 2010 U.S. life expectancy at birth stood at about 76 years for men, 81 years for women, with an average of 79 years overall.2

William Farr. Courtesy of the John Snow Archive and Research Companion.

William Farr, circa 1850. Courtesy of the John Snow Archive and Research Companion.

The individual who put such statistical work on a firm footing, institutionally and intellectually, was William Farr (1807–1883), statistician in Great Britain’s General Register Office from 1839 to 1879. The British government set up the Register Office in 1837 as part of a reform agenda to provide for civil—rather than parish-based—registration of births, marriages, and deaths. Farr was a medical doctor of modest background who found statistics fascinating. Three times Farr prepared life tables for England and Wales, providing life expectancies divided along gender and geographical lines, and basing his work on the burgeoning data collected in his office and through the expanded decennial censuses beginning in 1841. He was also instrumental in checking and confirming John Snow’s famous geographical detection of the source of the London cholera outbreak of 1853, based on mortality statistics.3

Farr was not the first to determine how to calculate life expectancy: that feat is general accorded to Edmond Halley, the early modern astronomer who predicted the return of the comet that bears his name. But while not the first to approach the topic, Farr may have been the most serious and articulate advocate of life expectancy as a measure of national health:

Since an English life table has now been framed from the necessary data, I venture to express a hope that the facts may be collected and abstracted, from which life tables of other nations can be constructed. A comparison of the duration of successive generations in England, France, Prussia, Austria, Russia, America, and other States, would throw much light on the physical condition of the respective populations, and suggest to scientific and benevolent individuals in every country—and to the Governments—many ways of diminishing the sufferings, and ameliorating the health and condition of the people; for the longer life of a nation denotes more than it does in an individual—a happier life—a life more exempt from sickness and infirmity—a life of greater energy and industry, of greater experience and wisdom.4

A life table from Vital Statistics.

A life table from Vital Statistics. The table, published in 1843 as part of the fifth report, refers to the year 1841.

Farr expected “a noble national emulation,” that is, a competition for best life expectancy, to generate as much enthusiasm as “victories over each other’s armies in the field.” His vision—at least of comparative data—came true: today the World Health Organization provides life expectancies for 194 countries.5

The cover of the NYAM edition of Vital Statistics.

The cover of the NYAM edition of Vital Statistics.

The centrality of Farr’s work to the mission of The New York Academy of Medicine led to NYAM’s reprinting Vital Statistics: A Memorial Volume of Selections from the Reports and Writings of William Farr (1885) in 1975.

As for Dr. John Thackery’s paean to modern medicine: it is a bit misplaced. He was right in stating that medical treatments, and especially surgical techniques, made great advances in his time. But that fact didn’t account for the change in life expectancy. Instead, “old knowledge” was more important: people fell ill and died due to poor sanitation, inadequate diet, dangerous working conditions, and the risks of childbirth and infancy. For example, in 1850 life expectancy in Massachusetts for newborn boys was 38, while 20-year-olds could expect to live to 62, 40-year-olds to 68, and 60-year-olds to 76. By 1900, the comparable figures are: newborns, 48; 20-year-olds, 61; 40-year-olds, 67; and 60-year-olds, 74.6 The situation for newborns improved greatly over the course of 50 years, but for older cohorts, little changed. Over time, the great dangers in childbirth and the first years of life had been ameliorated, and better obstetrics was part of the story, but public health made the difference.

References

1. “The Knick,” Cinemax, Series 1, Episode 1 (aired August 8, 2014), as quoted in NPR, “A New Show about Doctors of Old,” broadcast August 3, 2014, http://www.npr.org/2014/08/03/337531248/a-new-show-about-doctors-of-old, accessed August 14, 2014.

2. The Henry J. Kaiser Foundation, “State Health Facts: Life Expectancy at Birth (in years), by Gender” http://kff.org/other/state-indicator/life-expectancy-by-gender/, accessed August 14, 2014.

3. This and other information on Farr are from the editors’ “Introduction” (pp. iii–xiv), and the original “Biographical Sketch” (pp. vii–xxiv, separately paginated), in Vital Statistics: A Memorial Volume of Selections from the Reports and Writings of William Farr, with an Introduction by Mervyn Susser and Abraham Adelstein, The History of Medicine Series Issued under the Auspices of the Library of the New York Academy of Medicine, no. 46 (1885; reprint ed., Metuchen N.J.: The Scarecrow Press, 1975).

4. Vital Statistics, 453, quoting the Registrar General’s Fifth Annual Report (August 1843).

5. World Health Organization, Global Health Observatory Data Repository, http://apps.who.int/gho/data/view.main.60080?lang=en, accessed August 14, 2014.

6. Historical Statistics of the United States, 1789–1945: A Supplement to the Statistical Abstract of the United States (Washington: United States Department of Commerce, Bureau of the Census, 1949), page 45, Series C 6 21. “Vital Statistics—Complete Expectation of Life: 1789 to 1945.” http://www2.census.gov/prod2/statcomp/documents/HistoricalStatisticsoftheUnitedStates1789-1945.pdf, accessed August 14, 2014.

Virtual Dissection

Kriota Willberg, the author of today’s guest post, explores the intersection of body sciences with creative practice through drawing, writing, performance, and needlework. She will present at our October 18th festival, Art, Anatomy, and the Body: Vesalius 500.

Artistic and clinical examinations of the body share many of the same processes. The artist and the clinician study the body’s mass, look for irregularities in its shape and color, locate bones, joints, and muscles, take notice of the breath. They watch the body and its parts move through space, assess joint alignment, and determine if their subject’s physical parts and relationships are assembled or functioning in a desirable form. The languages for and techniques of analysis vary by discipline but the object of exploration is the same.

"Dhanurasana illustration" by Kriota Willberg

“Dhanurasana illustration” by Kriota Willberg. Click to enlarge.

My careers are grounded in the exploration of the body. There was a time when I would take a morning ballet class, teach anatomy in the afternoon, and in the evening either work a shift as a massage therapist or go to a dance rehearsal. To relax on the weekends I would draw musculoskeletal anatomy illustrations for my class handouts.

Drawing, dancing, and massage all require skills in postural assessment. As a massage therapist I also palpate deeper structures, locating them under skin, fat, and other layers of muscle. As a dancer I learned to feel my musculoskeletal structures via movement exercises that isolate muscle groups or coordinate the body as a whole. Through years of building experiential and objective understanding of the body, physical assessment has become second nature to me.

Friction “…Bundle of Fibers” by Kriota Willberg.

“Friction” by Kriota Willberg. Click to enlarge.

Anatomy entertains and delights me everywhere I go. I study the foot and ankle alignment of strangers as they climb the subway steps. I monitor my two amputee cats for the development of functional scoliosis. I measure and palpate the skin and adipose of my husband, or myself, or the cats, as we sit on the couch and watch the Bond film Tomorrow Never Dies. I comment on Pierce Brosnan’s resemblance in the film to a dissected human subject illustrated in an Albinus anatomy text from 1749.

Tomorrow Never Dies from “The Anatomy of 007” by Kriota Willberg. Click to enlarge

Tomorrow Never Dies from “The Anatomy of 007” by Kriota Willberg. Click to enlarge

The world is an anatomical wonderland. Anatomy is all around us and all we have to do is see it and feel it.

"Pictorial Anatomy of the Cute" by Kriota Willberg. Click to enlarge.

“Pictorial Anatomy of the Cute” by Kriota Willberg. Click to enlarge.

I’m not unique in my perspective of the world of anatomy. There are many people in arts, sciences, and health professions who are skilled at virtual dissection. We can look at you, through your clothing, and through your skin and fat to see the muscle and bone beneath. We share the same skills and sometimes we share the same sense of humor. But our cohort is somewhat rarified. I intend to bring more people into the knowledge and skills that will enable them to join our “club.”

I train others in methods of seeing the body as a clinical or artistic tool. As a part of this instruction, I draw the body on a body. Using a live model, I locate bones and joints, tracing bony landmarks in rinseable ink. Then I locate a muscle’s attachment sites, connect them, and “flesh out” the muscle’s contours and fiber direction.

Willberg anatomy drawing. Model: Wendy Chu

Willberg anatomy drawing. Model: Wendy Chu

Willberg anatomy drawing. Model: Wendy Chu

Willberg anatomy drawing. Model: Wendy Chu

We watch levator scapula lengthen with upward rotation of the scapula. Or the hamstring elongate to seemingly impossible length as the model moves through deep hip flexion. The upper pectoralis major shortens as the lower part lengthens when the model brings her arms overhead. After 27 years of teaching, I am still entranced by these simple movements.

At the Vesalius 500 celebration on October 18, we will look at the body with the double vision of the anatomist. Part live-drawing performance, part slide show/lecture, part conversation, we will explore the (kin)esthetic relationships of our anatomy. I’ll present a narrated slideshow of artworks from A(lbinus) to V(esalius) to enhance and define actual and fanciful relationships of our parts to our whole. A live model and I will create associations between these illustrations and the living body by tracing superficial and deep connections of muscle to movement. The presentation will include opportunities for you (the audience) to ask questions and comment on your own experiences with the study of anatomy.

See you there!

Beard Dipping: New York Medicine 1900 Style

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

After episode one of The Knick, the question on everyone’s lips is of course: what was going on with the beard dipping? A commitment to getting the historical details right is the answer (although we hope for the actor’s sake the liquid wasn’t completely true to life).

Dr. Christiansen (Matt Frewer) preps his beard for surgery, assisted by Nurse Elkins (Eve Hewson). Courtsey of HBO-Cinemax.

Dr. Christiansen (Matt Frewer) preps his beard for surgery, assisted by Nurse Elkins (Eve Hewson). Credit: HBO-Cinemax.

The surgeons performing the emergency Caesarean early in the episode ran an operating theater following Listerian principles of cleanliness and antiseptic surgery. Joseph Lister (1827–1912) was a professor of surgery at the University of Glasgow in Scotland, who, influenced by Louis Pasteur’s germ theory, looked for methods to remove microorganisms from the environment during surgery. The introduction of chloroform and ether as anesthetic agents in the mid-19th century meant that surgery had become a much less painful process for patients (and allowed surgeons to focus on longer and more complex procedures). However, surgery remained dangerous, with postoperative infection continuing to be a serious, often fatal, problem.

Carbolic steam spray used by Joseph Lister, England, 1866-18. Courtesy of the Science Museum, London, Wellcome Images.

Carbolic steam spray used by Joseph Lister, England, 1866-1870. Courtesy of the Science Museum, London, Wellcome Images.

In 1867, Lister published an article in which he proposed using carbolic acid (already used to treat sewage) to sterilize the operating room, surgical instruments, bandages, and wounds. Surgeons were encouraged to dip their hands—and yes, their beards!—into carbolic acid before operating.

Working in the midst of a pungent yellow spray that smelled like tar was not ideal and inhaling too much carbolic acid could be dangerous. Lister continued experimenting throughout his career with new sterilization techniques. However he never embraced the idea of gowns, face masks, or gloves.

The use of gloves in surgery was introduced by William Stewart Halsted (on whom Clive Owen’s character Dr. Thackery is based) in the 1890s. A pioneer of antiseptic surgery, one of his surgical nurses (whom he later married) had a bad reaction to the mercuric chloride used as a disinfectant, so he commissioned Goodyear rubber to make her some gloves. The early use of gloves in surgery was not about patient safety, but protecting the medical team. Like any new innovation, reactions were mixed. Some individuals embraced the idea of gloves, while others continued to operate bare-knuckled.

We’re looking forward to the next episode. Let us know in the comments if you have any questions about what’s going on in the hospital and we will get back to you in a future post.

It’s All in the Details

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

"Male Ward E" at Hahnemann Hospital, from the Hospital's May 1901 Report.

“Male Ward E” at Hahnemann Hospital, from the hospital’s May 1901 report. Click to enlarge.

Advertising for The Knick, the HBO Cinemax series that begins tonight, is everywhere right now. The show, which centers on the world of a fictional New York hospital, The Knickerbocker, right at the turn of the 20th century, has been in our sights here in the NYAM Library for months.

Long before the episodes of any historical drama are ready to air, a tremendous amount of research goes into making sure that the settings, costumes, and stories display a level of historical accuracy that will make the show believable. It is part of our mission as a library devoted to the history of medicine to help the show’s researchers discover where the information they need can be found. We don’t do our jobs alone, though, and colleagues at many other area institutions such as the Archives and Special Collections at the Health Sciences Library at Columbia University, the Museum of the City of New York and the Mount Sinai Archives, to name just a few, offered plenty of assistance as well.

There are lots of resources in our collections that Knick researchers explored while the show was under development. A particularly rich source for images and descriptions of hospitals in 1900, the year in which the show begins, are the annual reports produced by medical institutions here in the city. Illustrations of operating theaters, like this one from the Presbyterian Hospital, help designers build accurate sets in which the drama can unfold.

Presbyterian Hospital's operating theater, an image from its 1901 annual report. Click to enlarge.

Presbyterian Hospital’s operating theater, an image from its 1901 annual report. Click to enlarge.

In some instances, written descriptions help answer questions that come up when the photographs themselves don’t provide enough information. The Hahnemann Hospital operating room in the picture below is quite distinctive in appearance, but the actual descriptions of the rooms from the Hospital Souvenir offer lots of extra details: room dimensions; lists of equipment along with information about what everything is made from and where it sits in the space itself; and explanations of how the different rooms are physically connected to each other or separated from other spaces.

A Hahnemann Hospital operating room, from its May 1906 report. Click to enlarge.

A Hahnemann Hospital operating room, from its May 1906 report. Click to enlarge.

Descriptions of Hahnemann Hospital rooms, from the hospital's 1900 Souvenir.

Descriptions of Hahnemann Hospital rooms, from the hospital’s 1900 Souvenir. Click to enlarge.

A group of nurses from the May 1901 Hahnemann Hospital report.

A group of nurses from the May 1901 Hahnemann Hospital report. Click to enlarge

Some of the photographs also show us how doctors and nurses dressed. The nurses with their long white pinafores and puffy hats certainly look more dated than the surgeons in their doctors’ whites. And if you look back at the 1901 image of the operating theater from the beginning of this post, you’ll note that even though the doctors are performing surgery that no one is wearing a mask or gloves. In the Hahnemann Hospital operating room image from 1906, only a few people have gloves on.

We’ll be posting more about early 20th century medical practice on all of our social media platforms as The Knick gets underway, so be sure to follow us on Twitter and Facebook. And check our blog on Monday to learn more about the medical history behind The Knick.

Naissance Macabre: Birth, Death, and Female Anatomy

Brandy Schillace, PhD, the author of today’s guest post, is the research associate and guest curator for the Dittrick Museum of Medical History. She will speak at our October 18th festival, Art, Anatomy, and the Body: Vesalius 500.

The dance of death: Death emerges from the ground and is greeted by a group of allegorical women, symbolizing the vices. Woodcut after Alfred Rethel, 1848. Credit: Wellcome Library, London

The dance of death: Death emerges from the ground and is greeted by a group of allegorical women, symbolizing the vices. Woodcut after Alfred Rethel, 1848. Credit: Wellcome Library, London. Click to enlarge.

The danse macabre, or dance of death, features whirling skeletons and other personifications of death stalking the living. These images appeared regularly in the medieval period, particularly after outbreaks of bubonic plague. One of the salient features was death and life pictured together, frequently in the form of a young and beautiful woman. The juxtaposition symbolized how fleeting life could be, and served as a warning against vice and vanity. While death and the maiden might remind viewers of their own mortality, another set of images became far more instructive to the preservation of life: death and the mother—the anatomy of the pregnant womb.

From Jacob Reuff’s The Expert Midwife. Image courtesy of the Dittrick Museum.

From Jacob Reuff’s The Expert Midwife. Image courtesy of the Dittrick Museum.

The 1500s saw the proliferation of full-figure anatomy. Jacob Reuff’s The Expert Midwife (and other texts like it) displayed women with their torsos peeled back, daintily displaying their inner organs. Plenty of scholarship has focused on the near-wanton and sexualized poses of these and of the “wax Venus” figures, some of whom appear to be in raptures despite being disemboweled. Male figures also appeared in full and sometimes opened—many of Vesalius’ plates in On the Fabric of the Human Body provide these interior views. The male gaze is often directed at the viewer or at the anatomy, while female figures tend to look askance (perhaps with modesty or shame at the revelation of their innards). By the 18th century, however, the whole had been replaced by sectioned and partial anatomies. No longer were the figures walking, dancing, or—in the case of women—curtseying. Instead, only the relevant bits appear in the pages of the atlas, which meant (in pregnant women) only the womb.

Easily the most famous works on pregnant anatomy in the 18th century, William Smellie’s A Sett of Anatomical Tables and William Hunter’s Gravid Uterus provide a portal for viewing key developments in the practice of 18th-century midwifery. In Tables, Smellie set out to demonstrate technique, but, as historian Lucy Inglis explained in a recent talk at the Dittrick Museum, Hunter was more interested in ensuring his fame by making scientific discoveries on the causes of maternal death in childbirth. In fact, the title Gravid Uterus suggests just how primary the womb had become; the women to whom they belonged are depicted headless, limbless, with bloodied cross-sections of stumped legs.

From Hunter’s Gravid Uterus. Image courtesy of the Dittrick Museum.

From Hunter’s Gravid Uterus. Image courtesy of the Dittrick Museum. Click to enlarge.

Neither anatomist provided entire forms—there was no expectation that they should. But Smellie’s models often included sheets of cloth to hide, but also to suggest, extremities. There is some debate about whether Hunter deliberately tried to achieve artistic or visceral impact,1 but unlike the birthing sheet, which hid the woman’s body from the midwife, the atlas rendered the female form more than denuded: It was naked of flesh, severed in places, the internal matter laid open for observation. At the same time, these female anatomies, like silent muses, were invaluable to the practice of midwifery, particularly as it pertained to difficult and dangerous cases. So what was gained—or lost—by these piecemeal renderings?

In February 2013, I worked with Lucy Inglis on a temporary gallery at the Dittrick that showcased both atlases, not for the sake of their authors, but to exhibit the work of the artist. Jan Van Rymsdyk—the artist behind the majority of figures in both atlases—had a “forensic eye.” He attended when Hunter obtained a new corpse and sketched as the dissections took place. Once, he watched a stillborn baby, more suited to the illustration, substituted within a dead woman’s womb. Lucy and I pondered the ramifications of this, the strange artificial quality of these posed cadavers. Enlightenment ideals required strict adherence to evidence, to the “real.” And yet, even here, anatomies were constructed by doctor and artist, a “dance” that renders plain the problems and process of birth at the moment of death.

In Dream Anatomy, historian Michael Sappol suggests that mastery over the dead body was akin to mastery over oneself, and even a kind of mastery over death.2 He notes, too, the attempts of early anatomy texts to shock the reader, and even the pleasure of shock; the sense that anatomists and anatomy artists wielded an erotic power in undressing the body.2 The detachment necessary to the task (and feared by a public concerned that dissection rendered doctors inhuman) cannot be universally applied to all, however. Van Rymsdyk suffered something akin to a breakdown from the hours spent hovering over dead women and their children with his palette of chalks—and Smellie turned his anatomical information into instruction for saving the lives of women and children. Even so, in the naissance macabre, artist and author reduce female anatomy to constituent parts: woman becomes womb, objectified as teaching tool…a mute muse, but a muse none the less.

References

1. McCulloch, N.A., D. Russell, S.W. McDonald. “William Hunter’s casts of the gravid uterus at the University of Glasgow.” Clinical Anatomy 14, no. 3 (2001): 210-217.

2. Sappol, M. (2006). Dream Anatomy. Washington, D.C.: Government Printing Office, 34.

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.