Highlighting NYAM Women in Medical History: Elizabeth Martha Cushier, MD

By Arlene Shaner, Historical Collections Librarian

Academy Fellows lead by serving, now during the COVID-19 crisis as in the past. This is the fifth entry in our series on early women NYAM Fellows and their contributions to society; for earlier posts, see Sara Josephine BakerMartha WollsteinDaisy Maude Orleman Robinson, and Sarah McNutt. Please also see our biographical sketch of Mary Putnam Jacobi, the first female Fellow of the New York Academy of Medicine.

When Elizabeth Cushier (1837–1931) was elected a Fellow of the New York Academy of Medicine in 1889, she was only the third woman to be invited into the Academy, joining two of her colleagues from the New York Infirmary for Women and Children, Dr. Mary Putnam Jacobi and Dr. Sarah McNutt.

Cushier was born in Jamaica, New York, on November 25, 1837, a daughter of John Henry and Martha Lumley Cushier. She was the sixth of eleven children, but three of her older siblings had died before she was born; five other younger siblings followed. In her autobiography, published as an appendix to Kate Campbell Hurd-Mead’s Medical Women of America, Cushier said this about her childhood: “We were brought up in the strictest economy, as my father’s income was a very limited one, but we were, as I remember, a happy, healthy lot, quite enterprising and consequently often trying.”[i] When she was sixteen, the family moved to Little Falls, New Jersey. Cushier quickly became friendly with the Hinton family, who had also relocated from New York, and forged a life-long friendship with Ione Hinton. The family’s wide-ranging intellectual interests, along with their support of abolitionism and women’s suffrage, resonated with her and encouraged her independent spirit.

After her mother died in 1859, Cushier took on much of the household responsibility, caring for her father and her four living younger siblings. His remarriage a year later freed her to go to New York, where she got a position singing with a church choir and gave private voice lessons. In the summer of 1868, she happened to read a medical article that sparked her interest, and she enrolled in the homeopathic New York Medical College for Women before transferring a year later to Elizabeth and Emily Blackwell’s Woman’s Medical College of the New York Infirmary, graduating in 1872.

Cushier’s 1872 graduation noted in the Annual Announcement of the Woman’s Medical College of the New York Infirmary, noting her thesis topic as “Endometritis.” Woman’s Medical College of the New York Infirmary (N.Y.). Annual catalogue and announcement. New York: S. Angell, 1871.

Cushier stayed on at the Infirmary, beginning as an intern before becoming a resident physician. Her practice was devoted to obstetrics and gynecology, but an interest in normal and pathological histology led to eighteen months of study in Zurich with a Professor Ebert, who offered her laboratory opportunities that were not yet available to women in the United States. Laboratory research, pathological and post-mortem study, lectures, and bedside clinics all enriched her knowledge before she returned to New York.

The Woman’s Medical College of the New York Infirmary on Stuvvesant Square. Woman’s Medical College of the New York Infirmary (N.Y.). Annual catalogue and announcement. New York: M.J. Rooney, 1891.

On her return, Cushier went right back to the Infirmary, and worked to expand the practice of gynecological surgery there. Thomas Addis Emmet and T. Gaillard Thomas, who were on the staff at the Woman’s Hospital (and both of whom were NYAM Fellows), allowed her to attend clinics there, and the Infirmary, in its larger home on Stuyvesant Square, eventually added a modern operating room for both gynecological and abdominal surgeries. As her work at the Infirmary and her private practice continued to grow, she published articles and case studies, mainly about gynecological and obstetrical subjects.[ii]

In 1882, Cushier’s personal life changed significantly when she and Emily Blackwell (1826–1910) began to live together in Blackwell’s home on East 20th Street. Cushier and Blackwell also bought a summer home, Seawold, near York Cliffs, Maine, in 1893. After the Woman’s Medical College closed its doors in 1899, both women retired from practice and headed to Europe, where they spent eighteen months. On their return, they gave up their city home, moving to Montclair, New Jersey, where Cushier’s niece, Dr. Emily Mercelis, also lived. When Blackwell died in September 1910, just a few months after her older sister Elizabeth (1821–1910) died in England, Cushier called the moment “an irreparable break in my life.”[iii]

Elizabeth Cushier and Emily Blackwell’s home in Montclair, NJ. Photograph by Elisa Rolle, originally published in her Queer Places: Retracing the Steps of LGBTQ People around the World. CreateSpace Independent Publishing Platform, 2017.

Cushier lived for another 20 years, going to Maine in the summers and living in Montclair for the rest of the year. No longer engaged in the practice of medicine, she felt her days were not useful, until the First World War brought the opportunity to do relief work for French and Belgian women and children and for servicemen through the Red Cross. She died on November 25, 1931, her 94th birthday, and is buried, alongside her parents, in Green-Wood Cemetery in Brooklyn.

________

Notes

[i] Kate Campbell Hurd-Mead, MD. Medical Women of America: A short history of the pioneer medical women of America and a few of their colleagues in England. Froben Press; 1933: 85.

[ii] A full list of Cushier’s publications can be found in Creese, Mary RS. Ladies in the Laboratory? American and British Women in Science, 1800–1900: a survey of their contributions to research. Scarecrow Press, 2000: 392.

[iii] Hurd-Mead. Medical Women of America, 92.

Living through COVID-19: What can we learn from typhoid epidemics of the past?

by guest contributor Jacob Steere-Williams, PhD, Associate Professor of History, College of Charleston.

Join us for Steere-Williams’ talk on typhoid on September 23. 

For decades, thinking about and learning from past pandemics has largely been an academic exercise, one for historians and archivists who specialize in public health. Now, in the midst of a generation-defining pandemic, COVID-19, there has been an explosion of public interest in epidemics and epidemiology. Before 2020, few Americans outside of infectious disease specialists routinely spoke the words “contact tracing” and “case fatality,” or knew the difference between isolation and quarantine.

The recent surge in popular understandings of epidemics has centered on some familiar examples, such as the 1918–1919 influenza pandemic, the mistakenly called “Spanish Flu.”[1] As this was the most significant pandemic of the 20th century, the comparisons make sense, and the public health struggle between individual rights and community health is as apt now as it was then. Other historians, seeing the rise of xenophobia as a cultural response to COVID-19 in the West, have perceptively turned our attention to 19th-century pandemics of cholera and bubonic plague. Then, as now, a uniquely durable, yet startlingly western approach to framing pandemics has been to blame Asian people and Asian cultural practices.[2] 

At a time when the cultural mileage of past pandemics is perhaps at its height in modern history, we might fruitfully turn to the history of a relatively unexplored disease, typhoid fever, to think about our current moment.

Typhoid fever is a food- and water-borne infectious disease, the most virulent of the Salmonella family. The disease continues to wreak havoc on the Global South, killing about 200,000 people each year. In the western world typhoid was at its height in the 19th century, when it was a ubiquitous and insidious reality in North America and Western Europe. In Britain, for example, typhoid annually struck up to 150,000 people, taking the lives of 20,000 each year.

Thomas Godart, “Head and Neck of a Patient Suffering from Typhoid Fever.” Courtesy of the Wellcome Library.

Typhoid’s patterns of distribution were erratic; it might spare a community for months or even years, then erupt as a local outbreak. Epidemiologists today discuss COVID-19 as a cluster disease, exploding in localized events not unlike the way that typhoid did in the past.

Interestingly, typhoid outbreaks continued after the introduction of early sanitary improvements such as toilets, pumped water, and sanitation systems. In the second half of the 19th century no infectious disease was as central to the rise of public health than typhoid. Typhoid was a model disease because the burgeoning group of public health scientists, the first to call themselves epidemiologists, saw that stopping typhoid’s different pathways—through food, water, and healthy human carriers—could transform the nation through preventive public health.[3]

“Avoid the Grip of the Typhoid Hand,” in G.S. Franklin, “Sanitary Care of Privies” (1899), from “Health and Sanitation: Disease and the Working Poor,” https://www.wm.edu/sites/wmcar/research/danvilledig/millworker-life/health-sanitation/index.php.

The story of typhoid in the 19th century is one deeply tied to the emergence of modern epidemiology, which George Buchanan, Chief Medical Officer of Britain’s central public health office, called “the minute observations of particular outbreaks.”[4] Epidemiological practice does not operate in a vacuum, then or now with COVID-19; it is inherently a political exercise. Everyday people, business owners, and politicians have to be convinced about the science of disease communication, requiring complex rhetorical strategies that tell us a great deal about the inherent struggles of public health.

“Transmission of Typhoid Fever,” in George Whipple, Typhoid Fever; Its Causation, Transmission, and Prevention (New York: John Wiley and Sons, 1908).

__________

Notes

[1] See, for example, a recent blog post in Nursing Clio: Jessica Brabble, Ariel Ludwig, and Thomas Ewing, “‘All the World’s a Harem’: Perceptions of Masked Women During the 1918–19 Flu Pandemic,” Nursing Clio. https://nursingclio.org/2020/09/08/all-the-worlds-a-harem-perceptions-of-masked-women-during-the-1918-1919-flu-pandemic/.

[2] Catherine E. Shoichet, “What historians hear when Trump calls coronavirus ‘Chinese’ and ‘foreign,’” CNN. https://www.cnn.com/2020/03/12/us/disease-outbreaks-xenophobia-history/index.html.

[3] Graham Mooney, “How to Talk About Freedom During a Pandemic,” The Atlantic. https://www.theatlantic.com/ideas/archive/2020/05/freedom-pandemic-19th-century/611800/.

[4] George Buchanan, “On the Dry Earth System of Dealing with Excrement,” Annual Report of the Medical Officer of the Privy Council for 1870. Parliamentary Papers. London: Eyre and Spottiswoode, 1871, 97.

Highlighting NYAM Women in Medical History: Sarah McNutt, MD

By Miranda Schwartz, Cataloger

Academy Fellows lead by serving, now during the COVID-19 crisis as in the past. This is the fourth entry in our series on early women NYAM Fellows and their contributions to society; for earlier posts, see Sara Josephine Baker, Martha Wollstein, and Daisy Maude Orleman Robinson. Please also see our biographical sketch of Mary Putnam Jacobi, the first female Fellow of the New York Academy of Medicine.

The interconnected medical interests of New York Academy of Medicine Fellow Dr. Sarah McNutt show deep curiosity, energy, and a dedication to service: “She trained as a pediatrician, gynecologist, and pathologist and developed a special interest in the study of pediatric neurologic disorders.”[1] During her professional life in New York City, she worked closely with prominent women doctors Emily and Elizabeth Blackwell and Mary Putnam Jacobi. With Jacobi and others she was key in founding the New York Post-Graduate Medical School and Hospital; with her twin sister Julia, also a doctor, she founded the Postgraduate Training School for Nurses and Babies’ Hospital.[2]

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Sarah Jane McNutt (July 22, 1839–September 10, 1930) was the second female Fellow of NYAM (admitted 1888). She was the first woman to be inducted into the American Neurological Association, and cofounded Babies’ Hospital in NYC. Portrait of Sarah J. McNutt, M.D., undated, From the National Library of Medicine.

McNutt was born in Warrensburg, New York, in 1839, to James and Adaline McNutt. She attended Albany Normal School and then continued her education at the Emma Willard Seminary in Troy, New York. She worked as a teacher before attending medical school at Woman’s Medical College of the New York Infirmary (founded by the Blackwell sisters). After her graduation in 1877, she did a two-year internship at the Infirmary’s hospital.[3]

In the mid-1880s McNutt saw the city’s clear need for more beds for pediatric patients; at the time New York had only a handful of beds for sick children under the age of 2.[4] With her sister and three other women, McNutt founded Babies’ Hospital at its first location at Lexington Avenue and 45th Street.[5] Babies’ Hospital also ran a “Summer Branch” in Oceanic, NJ, where the children went between June and October to recover away from the city heat and noise.[6] Babies’ Hospital existed as its own entity until 1943, when it became fully part of Presbyterian Hospital; today, its successor institution, Morgan Stanley Children’s Hospital of NewYork-Presbyterian, is one of the country’s most highly rated pediatric hospitals.

Babies Hospital NYHS cropped

Babies’ Hospital moved a few times. This Lexington Avenue building designed by York & Sawyer was its home from 1902 to 1929. (From the George P. Hall and Son Photograph Collection, New-York Historical Society, undated.)

McNutt also collaborated with Dr. Mary Putnam Jacobi and others to establish the New York Post-Graduate Medical School and Hospital on East 23rd Street, “an institution dedicated to the continuing education of male and female physicians, especially through the sponsorship of weekly lectures on medical topics.”[7] At this institution, “lectures by capable women were as acceptable as those by men”[8]; here, McNutt gave regular weekly lectures on pediatric diseases, one of her own special areas of study.

But it was not only in the lecture hall that McNutt imparted her knowledge: her use of morgue research in pediatric neurology was a key contributor to a fuller understanding of hemiplegia and its causes, as well as other conditions. “The idea of utilizing the material at the morgue for instruction in the pathological conditions of children was original with her, and thus her classes at the New York Post-Graduate Medical School had practical experience on all the operations performed on children, while she found here an excellent opportunity to perfect herself in gynecological surgery and abdominal work.”[9]

In 1884 Dr. R.W. Amidon, who knew McNutt from the New York Infirmary for Women and Children, nominated her for admission to the American Neurological Association. She had an excellent reputation as a gynecologist, pathologist, surgeon, and lecturer. The ANA required an original unpublished work for a candidate to be considered for admission and limited the number of active members to just 50.[10] McNutt’s thesis paper for admission, “Double Infantile Spastic Hemiplegia,” was “an important contribution to medical literature in the United States”[11] and she was admitted to the select group. Her 1884 achievement stands out even more in light of the fact that the ANA did not elect another woman member until 1935, with Dr. Lauretta Bender. In 1888, McNutt became NYAM’s second female Fellow.

Sarah McNutt helped establish leading local medical institutions, lectured on pediatric diseases, performed gynecologic surgery, contributed to prestigious professional organizations, and led the way in morgue research. Her desire to serve, her entrepreneurial initiative, and her hands-on approach to research, coupled with her close connections to other prominent female physicians, made her an integral part of the New York medical community.

________

Notes

[1] Stacy S. Horn, DO, and Christopher G. Goetz, MD. The election of Sarah McNutt as the first woman member of the American Neurological Association, Historical Neurology. 2002; 59: 113–117.

[2] Ibid, 114.

[3] Ibid, 113.

[4] Ibid, 114.

[5] Tom Miller. The 1902 Babies’ Hospital — 135 East 55th Street. http://daytoninmanhattan.blogspot.com/2016/03/the-1902-babies-hospital-135-east-55th.html. Accessed August 25, 2020.

[6] Robert J. Touloukian. Origins of Pediatric Surgery: Patient, Doctor and Hospital. John Jones Surgical Society. Summer 2007; volume 10 (number 1): 5–6.

[7] Horn and Goetz, 114.

[8] Kate Campbell Hurd-Mead, MD. Medical Women of America: A short history of the pioneer medical women of America and a few of their colleagues in England.  Froben Press; 1933: 38.

[9] The National Cyclopedia of American Biography, Volume XV. New York: James T. White & Company; 1916: 264.

[10] Horn and Goetz, 116.

[11] Ibid, 116.

References

Kate Campbell Hurd-Mead, MD. Medical Women of America: A short history of the pioneer medical women of America and a few of their colleagues in England.  Froben Press; 1933.

Stacy S. Horn, DO, and Christopher G. Goetz, MD. The election of Sarah McNutt as the first woman member of the American Neurological Association, Historical Neurology. 2002; 59: 113–117.

The National Cyclopedia of American Biography, Volume XV. New York: James T. White & Company; 1916.

Robert J. Touloukian. Origins of Pediatric Surgery: Patient, Doctor and Hospital. John Jones Surgical Society. Summer 2007; volume 10 (number 1): 5–6.

Reflections on Past Pandemics: A Bibliography of Historical Articles

By Hannah Johnston, Library volunteer

Danzig_1709 0001

The plague in Danzig (in what is now Poland) in 1709, giving the death tolls from within the city (24,533), the outskirts (8,066), and the total of the two (32,599). From “Abbildung von der groszen Pest in Dantzig, 1709

From July 2019 until March 2020, with few exceptions, I spent one day out of every week in the Drs. Barry and Bobbi Coller Rare Book Reading Room of the NYAM Library. As a volunteer, I wrote for this blog, Books, Health, and History, on various topics that utilized sources from the Library’s collections; I wrote about monsters, famous female physicians, and even libraries themselves. In March, as the threat of COVID-19 became clearer, the reading room closed, and I (among many others) could no longer consult the physical collections at the NYAM Library. After discussing with Library staff, I decided that my next project would use the digital resources and collections I am lucky to have access to as a student. I compiled a bibliography of historical literature on the topic du jour—pandemics. 

Awareness that one is living through a historical moment is relatively rare; this awareness has led many to look to the past for hints as to how the current COVID-19 pandemic might impact the world going forward. In compiling this bibliography, I hoped to curate a resource that historians and history enthusiasts alike could use for research on epidemic history, personal interest, or simply to try to place our present moment in a larger historical context. I searched through several databases, including JSTOR, Project MUSE, and the History of Science, Technology, and Medicine database, looking specifically for journal articles from the last two decades which used a historical perspective to discuss pandemic or epidemic diseases. 

 

Fasciculus Plague 1509

A plague visitation scene from a 1509 edition of Fasciculus Medicinae, one of the earliest illustrated medical books to be printed. Image from the NYAM Digital Collections.

I limited my search to only those articles which are available in full digitally. This choice was made in part out of necessity—during a pandemic, a person may not be able to visit a library to find and read the journal they are looking for. Since I was “volunteering from home,” I could only read through and write descriptions for articles to which I had full digital access. Of course, this is not a perfect solution. Many articles were omitted from this bibliography because they are not available online, and they would surely have been useful.  The digital articles are still for the most part only available to readers with either individual or institutional subscriptions to the relevant databases or journals.

 

My own experience compiling this bibliography taught me quite a bit about the long and ever-changing relationship between humanity and disease throughout history. Some diseases and disease events, such as the influenza pandemic of 1918, can provide an example (or a warning) of how different public health responses can affect long-term outcomes. Others, such as the Black Death, HIV/AIDS, and countless others, show us how disease has changed art, politics, the environment, and even the minutiae of human behavior. We have already seen many of the ways COVID-19 has changed our daily lives. While it is important not to underplay the devastation wrought by epidemic disease, reading about the impacts of other, similar disease outbreaks makes it clear that this pandemic will bring with it (and perhaps already has) significant cultural, social, and economic change, and perhaps offers us some guidance in navigating the “new normal.”

 

1918 flu pandemic

Red Cross volunteers wearing and making gauze masks at Camp Devens near Boston in 1918. From the Centers for Disease Control 1918 Pandemic Historical Image Gallery.

 

Compiling the bibliography was certainly a survey for me in the history of disease, but also highlighted several obstacles brought on or exacerbated by the modern-day pandemic. The biggest of these, at least in relation to this bibliography, is access—for all the work I did to collect and curate these digital articles, and despite the fact that many databases, journals, and other resources have made some or all of their articles free to read, many of them are still accessible only to a select few. The debate over who has or should have access to academic works is one that predates the pandemic, and is perhaps beyond the scope of a blog post. The COVID-19 crisis, however, impacts everyone, and the articles in this bibliography would almost certainly be of value to any reader. When the day finally comes that the coronavirus is no longer the threat it is today, it will still be important to read and write about it—work which everyone should have the resources to do.

I hope this bibliography can be a useful and informative resource for anyone who wishes to better understand how the coronavirus pandemic fits into a much larger historical context. The history of epidemic disease can inform how we interpret our experiences and plan our next steps in the current crisis. No less important, we can consider how our modern-day experience with a pandemic informs the ways we interpret the past.

Check out Pandemics in Historical Perspective: A Bibliography for Evaluating the Impacts of Diseases Past and Present .

 

Highlighting NYAM Women in Medical History: Daisy Maude Orleman Robinson, MS, MD

by Hannah Johnston, Library Volunteer

Academy Fellows lead by serving, now during the COVID-19 crisis as in the past. This the third entry in our series on early women NYAM Fellows and their contributions to society; for earlier posts, see Sara Josephine Baker, and Martha Wollstein. Please also see our biographical sketch of Mary Putnam Jacobi, the first female Fellow of the New York Academy of Medicine.

IMG_1380

A portrait of Daisy Orleman in her youth (date unknown). Photograph courtesy Paul Austin Orleman.

Widely lauded as the first female dermatologist in the United States and one of the first women to become a NYAM Fellow, Daisy Maude Orleman Robinson (1868–1942) had an illustrious career in patient care, public health, and health scholarship that spanned decades. Among her long list of achievements is being the first woman to publish scholarly work in the field of dermatology.[1] The work, an 1899 case report entitled “The Ill Effects of the Roentgen Rays as Demonstrated in a Case Herewith Reported,” was one of the first scholarly works to examine the harmful effects of X-rays, which at that time were being widely used as treatments for a variety of ailments.[2] The work is important in its own right, but is particularly interesting because the patient whose experience formed the case study was none other than Orleman herself.[3]

Orleman began her medical education at age 19 at the National Medical College of Columbian University in Washington, D.C. She was the only woman in her medical school class.[4] After her graduation in 1890, she spent several years continuing her education, eventually earning a bachelor’s degree and a master’s degree, as well as engaging in coursework on a wide range of specialties. In 1896 she obtained a medical license in the state of New York, and she was elected a NYAM Fellow in May 1897.[5]

IMG_1381

Orleman in her room at Peekskill Military Academy, where she was the resident physician from 1899 to 1903. Photograph courtesy Paul Austin Orleman.

That same year, Orleman suffered a fracture in her femur. Between January and May of 1898, she received three X-ray treatments intended to heal the fracture. She noted the first two as being “unsuccessful” but having no ill effects, and reported a “slight tingling sensation” upon her final treatment on May 14, 1898, with a similar lack of success.[6] Twenty-one days later, she noticed a small patch of inflamed and itchy skin where she had received the treatments. With each passing day, the inflamed area increased in size and became more and more uncomfortable. Eventually, the inflamed area became an ulcer, and over the course of several months continued to worsen. Only after ten months did the “severe injury” finally heal with the help of several doctors, various ointments, tinctures, and washes to heal the wound, and, eventually, a skin graft on the affected area.[7] She determined that, aside from the relief of pain (for which she occasionally used opium and morphine), “[maintaining] the limb in a perfect state of rest” was essential to her recovery.[8] She admitted to forgoing her doctors’ advice to rest early on in her treatment, noting that “[had she] given this precedence in the beginning … [she] might have had a more speedy recovery.”[9] Irritated by her ordeal, Orleman kept meticulous records of her symptoms and treatments, as well as the advice and theories of her medical providers. She published her case study—of herself—in 1899. In it, she lamented the lack of knowledge among physicians of the harmful effects of X-ray treatments and shared her experience in the hopes of both improving medical response to future cases and preventing them from developing in the first place.[10]

IMG_1631

Orleman’s paper in The Medical Record provides an overview of her injury and treatment.

Orleman’s painful experience with what would come to be known as radiation dermatitis likely sparked her interest in dermatology. In addition to pioneering female dermatological scholarship and providing us with an excellent example of a physician’s understanding of her own experience with injury and illness, “The Ill Effects of the Roentgen Rays” was, in fact, Orleman’s first scholarly publication.[11]

Orleman continued to innovate in the field of dermatology throughout the rest of her career. From 1908 until 1910, she worked with Hideyo Noguchi on developing more accurate diagnostic tests for syphilis. Her publication on what came to be known as the “Noguchi reaction test” earned her the Gold Palms from the French Academy of Science in 1910. During World War I, she joined the French Army’s medical corps and was decorated for her work there, becoming the first woman and the first American to receive a Gold Medal of Epidemics and Contagious Diseases from the French minister of war.[12] After the war, she turned her attention to public health and sex education, becoming an officer in the United States Public Health Service and focusing her work on the eradication of sexually transmitted infections such as syphilis. She was also invested in educating women’s groups, becoming one of the founding members of the Medical Women’s International Association in 1919.[13]

IMG_1374

Orleman wearing the Gold Medal of Epidemics and Contagious Diseases, awarded to her by the French minister of war at the end of World War I. Photograph courtesy Paul Austin Orleman.

Daisy Maude Orleman Robinson had a long, wide-ranging, and influential career, but her interest in using her own experience as a patient to inform her medical writing and practice makes her particularly extraordinary. With “The Ill Effects of the Roentgen Rays,” she used a fractured femur to cement her place in the history of her field.

__________
[1] David M. Pariser, “Daisy Maude Orleman Robinson: The first American woman dermatologist,” Clinics in Dermatology 33 (2015), 404.
[2] Daisy Maude Orleman, “The Ill Effects of the Roentgen Rays as Demonstrated in a Case Herewith Reported,” The Medical Record (1899), 8–10.
[3] Pariser, 399–400. As she did this work prior to her 1904 marriage to Andrew Rose Robinson, we refer to her as “Orleman.”
[4] Ibid., 397, 404.
[5] Ibid., 399; Bulletin of the New York Academy of Medicine 18/6 (June 1942), 430.
[6] Orleman, 8.
[7] Ibid., 10.
[8] Ibid., 10.
[9] Ibid., 8, 10.
[10] Ibid., 8.
[11] Pariser, 399.
[12] Ibid., 402.
[13] Ibid., 403.

Quarantine in Nineteenth-Century New York

By Lorna Ebner, Guest Contributor, Stony Brook University

As COVID-19 races through New York, we asked Lorna Ebner to tell us about previous attempts to mitigate disease in the city. Ms. Ebner is a PhD student in history at Stony Brook University, currently researching the 1858 destruction of the Staten Island Marine Hospital by residents upset at the presence of the quarantine hospital in their community.

As COVID-19 numbers continue to climb, the sounds of New York City are uncharacteristically muted. Many living in the city are understandably disquieted by the absence of the familiar soundtrack of city life, but this is far from the first time Broadway and Times Square have been silenced by an epidemic. Over the course of the nineteenth century, New York City officials have struggled to understand and alleviate the spread of disease. By the end of the century, one practice, when properly executed alongside sanitation measures, was proven to successfully stem the tide and save lives: Quarantine has conclusively mitigated the spread of disease for hundreds of years.

Throughout the long nineteenth century, New York City faced disease epidemics that felled thousands. Yellow fever (1795, 1798, 1804, and 1856) and cholera (1832, 1849, 1854, 1862) caused alarm through their high mortality rates. However, the number of deaths recorded is likely a vast underestimation as disease reporting was not kept up and counting was often skewed. From the early to mid-nineteenth century, limited medical knowledge combined with a lack of a standing public health authority limited the city’s reactions to contagious disease. Yellow fever, spread through mosquitoes, hit New York City in 1795, 1798, and 1804. In an effort to curtail the rising number of cases, a Health Committee made up of physicians was assembled and given authority by the City Council. Its first act sanctioned quarantine for all ships that carried any form of illness and those arriving from affected areas, particularly Philadelphia. In 1795, the quarantine was violated by a merchant vessel that denied incidences of sickness on board. This violation and blatant disregard for the dangers posed by yellow fever led to an outbreak in the city. Over 750 New Yorkers died, nearly 2 percent of the city’s population.[1] In 1805, New York City’s first Board of Health was appointed by the mayor and City Council. It was generally an apathetic government body with little power that met only at irregular intervals over the next six decades until called upon by a crisis.

The nineteenth century saw more devastating outbreaks as cholera swept through the city in 1832, 1849, and 1854. Cholera’s victims suffered from acute dehydration which caused patients to turn blue.

Cholera faces

Horatio Bartley. Illustrations of Cholera Asphyxia; In Its Different Stages. Selected from Cases Treated at the Cholera Hospital, Rivington Street. New York: Printed by S. H. Jackson, New-York, 1832.

The visceral sights relentlessly reminded New Yorkers of the disease’s dangerous presence. In 1832, a cholera pandemic approached New York City after leaving a destructive trail through Asia and Europe. After cases were reported in Quebec in late June, Mayor Walter Browne enacted a blanket quarantine on all incoming vessels. The Board of Health was called out of hibernation to enforce quarantine and enact efforts to clean up impoverished neighborhoods, such as the Five Points District. The board also commissioned special quarantine hospitals. These were either converted warehouses, taverns, and schools, or were hastily constructed on empty lots, as hospitals at the time did not accept patients with infectious diseases. New Yorkers of means fled the city in hopes that the country air and distance would deter cholera’s onslaught. Between June and September of 1832, 3,515 deaths were attributed to cholera, while 70,000 New York citizens fled for the country, spreading the disease unknowingly across the United States.[2] Cholera descended upon New York City again in 1849. The Board of Health quarantined all incoming vessels and made it illegal to keep hogs within city limits as part of its ongoing sanitation efforts. In this outbreak, the Board of Health reported 5,017 deaths over the course of the summer.[3] Preparedness and stringent sanitary measures during the 1854 epidemic led to a lower mortality rate, and the number of deaths attributed to cholera dropped by almost half, to 2,509.[4]

During the mid-nineteenth century, cholera was not the only disease for which public health officials demanded immediate quarantine for all contaminated incoming vessels. As yellow fever approached New York in 1856, the head physician of the Marine Hospital, which served as a quarantine hospital for both people and products, mapped the incoming quarantined vessels. Elisha Harris’s map indicates where in the harbor the quarantined ships anchored as well as areas along the coast that he believed were susceptible to contaminated paraphernalia.

New York Harbor

Map of quarantined vessels in New York City. Elisha Harris. The Annual Report of the Physician-in-Chief of the Marine Hospital at Quarantine: Presented to the Legislature February 4, 1857. Albany: Charles Van Benthuysen, 1857.

While public health officials and many in the medical field espoused the belief that yellow fever was indeed contagious and in need of strict quarantine, some expressed other concerns. “The restrictions laid upon commerce, with a view to prevent the introduction of yellow fever, are grounded upon the supposition of its contagious and infectious character; whereas, it is a disease of local origin, and incapable of propagation from person to person, or by emanations from the human body.”[5] Though restrictions on commerce continued, despite people’s belief that trading should continue, yellow fever ran rampant through Staten Island and the shores of Long Island. Fort Hamilton and Tompkinsville suffered dozens of cases. Because health was not prioritized by all and quarantine regulations were not strictly adhered to, New York again suffered loss of life.

The cholera epidemic of 1866 saw the advent of the Metropolitan Board of Health, which proactively enforced strict quarantine and sanitary measures prior to the outbreak. Unlike with the previous epidemics, the newly established board set out strict sanitary measures that applied to all businesses and tenement owners. While many New Yorkers vocalized their dissatisfaction with what they thought of as harsh and unnecessary measures, the numbers speak for themselves. Despite an exponentially growing population, the third cholera epidemic claimed the lives of 1,137 New Yorkers as compared to over 5,000 in 1849, and over 3,000 in 1832. As historian of medicine Charles E. Rosenberg wrote, “Physicians had tried to cure cholera; 1866 had shown them their duty was to prevent it.”[6]

The city’s measures proved effective in the late nineteenth century. A worldwide cholera pandemic began in 1881. For over a decade, cholera spread throughout Europe and Asia. After a century of battling the disease, most cities instituted precautions to mitigate loss of life. By the time cholera approached New York City in fall of 1892 in the form of a contagious vessel from Hamburg, Germany, city officials and public health authorities had already prepared strict quarantine procedures. As a result, the expected onslaught never arrived. It is estimated that 32 deaths occurred because of cholera in the fall of 1892, and that the majority of these occurred on quarantined vessels that arrived from contagious cities.[7] The century of experience definitively illustrated that preparation and preemptive quarantine proved effective in slowing or even stopping the spread of contagious disease.

New York’s resilience through nineteenth-century epidemics demonstrates the effectiveness of public health measures such as enforced quarantine and increased sanitation. Though the population of New York City continued to grow throughout the nineteenth century, the number of deaths from epidemic disease fell. The Board of Health, once a listless and irregular fixture, grew into a metropolitan medical authority whose public health measures alleviated the spread of contagion. A version of quarantine has always been employed during times of crisis. Public health in the twentieth century expanded the practice to include individual and self-quarantine. In late 2019, news broke of a novel, deadly, and extremely contagious virus Despite the developing information concerning COVID-19’s spread, the federal government did not have a consistent response to the possibility of a worldwide outbreak. And, unlike previous contagious threats, such as cholera in 1880 and smallpox in 1947, the city did not quarantine immediately and did not implement sanitary measures until after the coronavirus—unbeknownst to authorities—had already spread through the population. New York City’s history conclusively shows that basic public health measures, properly enacted, serve as New York’s most powerful weapon against epidemics. The consequences of ignoring and downplaying serious medical threats result in needless loss of life, a story shown over and over again in the nineteenth century, up to the great influenza pandemic of 1918, and now replayed in our current day.


[1] John Duffy, History of Public Health in New York City, 1625–1866: Volume 1 (Russell Sage Foundation, 1968), 104.

[2] J. S. Chambers, The Conquest of Cholera: America’s Greatest Scourge (New York: The Macmillan Company, 1938), 63.

[3] Charles E. Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866 (Chicago: University of Chicago Press, 2009), 114.

[4] Duffy, 588.

[5] “Yellow Fever and Quarantine—Letter from a Non-Contagionist,” New York Daily Times, September 9, 1856.

[6] Rosenberg, 212.

[7] Paul S. B. Jackson, “Fearing Future Epidemics: The Cholera Crisis of 1892,” Cultural Geographies, 2012, 43–65, 52.

Highlighting NYAM Women in Medical History: Martha Wollstein, MD

By Andrea Byrne, Digital Technical Specialist, Academy Library

Coming to terms with the COVID-19 pandemic needs the work of many skilled and dedicated physicians, researchers, and health professionals. With this essay, the Library adds to its series celebrating the sustained efforts for the public good of the Academy’s women Fellows, from the first, Mary Putnam Jacobi, to the present. 

A pioneer in pathology, New York Academy of Medicine Fellow Martha Wollstein (1868–1939) was the first North American specialist of pediatric perinatal pathology and developmental pathology.1 As one of the earliest women clinician-scientists, she published over 65 papers while acting as a pathologist at Manhattan’s Babies Hospital and a researcher at The Rockefeller Institute.

Martha Wollstein was born November 21, 1868, in New York City to Louis and Minna Cohn Wollstein, German-Jewish immigrants. She graduated from Woman’s Medical College of the New York Infirmary in 1889, where she studied with the first woman NYAM fellow, Mary Putnam Jacobi. Jacobi encouraged her research, and they published Wollstein’s first (and Jacobi’s last) paper together, on the myosarcoma of the uterus in 1902.2 Wollstein had become a NYAM Fellow the previous year, and she also held a teaching appointment at Woman’s College in the 1890s.
AmericanPediatricSociety_MarthaWollstein_1938
Portrait of Martha Wollstein. American Pediatric Society. Semi-centennial volume of the American pediatric society, 1888–1938. Menasha, Wis: Priv. print; 1938.

After graduation, Wollstein went on to be the first resident physician of Babies Hospital in 1890, where she worked until her retirement in 1935.3 Her focus was on infant diseases, including diarrhea, typhoid fever, malaria, and tuberculosis. In 1896, she opened the Heter Pathology Laboratory at Babies. The laboratory became integral to the work of the hospital.4 Babies Hospital’s affiliation with Columbia University connected Wollstein to pediatric and pathology departments at the College of Physicians and Surgeons, where she was an assistant professor of pathology and childhood diseases until her retirement.5

Wollstein was one of five women to be appointed as a researcher at The Rockefeller Institute in 1907. She worked with Simon Flexner, the noted pathologist and researcher, and made important discoveries that led to the treatment of meningitis and other serious illnesses. However, Wollstein never received a formal appointment and dropped her affiliation in 1921.6

The papers Wollstein published throughout her career embodied the pediatric pathology literature of North America.7 Her bibliography comprises over 65 papers, spanning research on descriptive and experimental pathology. Her research interests included bacteriology, diseases of the blood, and mumps, where her development of an experimental animal model became well known. While at Babies she wrote three extensive papers on tuberculosis. Using autopsy data and looking at the distribution of affected organs, she was able to demonstrate a decrease of the disease over time.8

In recognition of her authoritative work and groundbreaking research, Wollstein was nominated as the head of the pediatric section of NYAM in 1928. Two years later, she was the first woman to be elected to membership in the American Pediatric Society. After her death on September 30th, 1939, an obituary remarked that at the time of her retirement, Wollstein “had more extensive experience in the morphology of disease in infants than any other American living.”9

_______

1 James R. Wright Jr., Jeanne Abrams. Martha Wollstein of Babies Hospital in New York City (1868–1939)—The First North American Pediatric Pathologist. Pediatric and Developmental Pathology. 2017; 21 (5): 437–443.
2 Joy Dorothy Harvey, Marilyn Bailey Ogilvie. “Wollstein, Martha (1868–1939).” The Biographical Dictionary of Women in Science. Taylor and Francis; 2000. 1393.
3 R.M. Martha Wollstein, M.D. The American Journal of Diseases of Children. 1939; 58 (60): 1301.
4 Wright and Abrams, Martha Wollstein.
5 R.M. Martha Wollstein, M.D.
6 Jeanne Abrams, James R. Wright Jr. (2018). Martha Wollstein: A pioneer American female clinician-scientist. Journal of Medical Biography. 2018.
7 Wright and Abrams, Martha Wollstein.
8 Ibid.
9 R.M. Martha Wollstein, M.D.

Digitization Pilot: The Robert Matz Hospital Postcard Collection 

By Robin Naughton, Senior Digital Program Manager

The front of a postcard of Roosevelt Hospital.

The front of a postcard of Roosevelt Hospital. NYAM Collection.

matz_nycm_395v_watermark

The back of the postcard, with a message from a patient of the hospital. NYAM Collection.

We are excited to launch a new digital collection, The Robert Matz Hospital Postcard Collection.

Dr. Robert Matz donated about 2,000 hospital postcards to The New York Academy of Medicine Library in several installments between 2015 and 2019. Dating from the late 19th century to the mid-20th century, the postcards were organized into three sub-collections: New York City (NYC), New York State (sans NYC), and United States (sans New York).  To create metadata for the postcards, the Library started a project where volunteers researched and captured data about each postcard. New York City was the first sub-collection completed by the volunteers. It was the perfect sub-collection to use for an internal digitization pilot project.

A digitization pilot project is a great opportunity to showcase part of a much larger collection and to test innovative ideas.  For the pilot, 118 postcards were selected from the NYC sub-collection of 962 hospital postcards. Hospital postcards were selected representing all five boroughs (BronxBrooklynManhattanQueens, and Staten Island) to highlight the variety of hospitals, building architecture, and cultural value of the postcards.  The number of postcards selected for each borough is approximately 10 to 12 percent of the total number of postcards for that borough.  For example, Manhattan has the largest number of postcards of the five boroughs and the largest number of postcards in the pilot. The pilot offers an opportunity for users, researchers, potential funders, and the public to explore what has already been digitized, and to learn more about the collection.

Borough # of Postcards in Pilot
Bronx 15
Brooklyn 26
Manhattan 55
Queens 10
Staten Island 12
Total 118

The process of digitizing the postcards provides an opportunity to test new and innovative ways of imaging the collection. For this collection, the opportunity to capture four postcards at once was an innovative approach to digitizing the collection.

The postcard setup in the digitization lab.

The postcard setup in the digitization lab.

The software used for internal digitization was Capture One, which offered many opportunities to enhance the imaging workflow. One such opportunity was to divide the capture area into quadrants so that one shot could capture four objects and ultimately create four images. Rather than taking eight shots for four postcards (front & back), the process reduced the work to only two shots for all four postcards. To do this, variants (duplicates of the raw images) were created in Capture One and the settings applied to each shot.  This method improved the efficiency of digitizing the Matz postcards and provided a significant enhancement to the Digital Lab’s workflow for small, flat objects.

Image capture of four objects (front).

Image capture of four objects (front).

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Image capture of four objects (back).

The Robert Matz Hospital Postcards Collection pilot project provides a glimpse into what is possible and available if the entire collection were digitized. Digitizing 2,000 postcards and creating metadata so that users can explore the collection in multiple ways will take time and resources, but the Library is excited about the opportunity.

Take some time to explore the collection and learn more about each of the hospitals represented in the pilot.  If you’d like to explore additional postcards, reach out to the Library.

Explore the Matz Collection here.

The Public Health Origins of Census Data Collection

By Paul Theerman, Director

Every 10 years, the Federal census counts the country’s population. The count is mandated in the Constitution in order to distribute political power, as the census leads to deciding how many representatives a state will send to the House as well as to redrawing their district boundaries. Government resources flow according to population. And public health research uses census data, providing tools to better understand the conditions of people and their health.

Laidlaw_PopulationoftheCityofNY1890-1930_1932_10_watermark

Percentage of the Nation in New York City and Six Other Areal Groupings of Continental United States, 1790–1930, in Population of the City of New York 1890–1930 (New York: Cities Census Committee, Inc., 1932), 10. NYAM Collection.

Using census data for social purposes relies on a particular way of measuring things, though. To be useful, some “granularity” is needed: it’s not just at the state or county level that we need statistics, it’s rather at the block and neighborhood level. And there needs to be some sense of “commensurability”: a measure of a neighborhood in one part of a city, say, needs to be readily comparable to the measure in another part. And stability of the measuring unit is important; the geographical unit needs to stay the same over the years. For populations that are ever-changing, in place and age and origin, this is no mean feat. The fact that it works in the American context at all is largely due to one man, Walter Laidlaw, a statistician of the early 20th century who revolutionized the way that the Census Bureau carried out the New York census, a change that eventually was implemented for the whole country.

Walter Laidlaw (1861–1936), was a Canadian Presbyterian minister. As a child, he was adopted by his uncle, Robert Laidlaw, founder of a prominent lumber company in Esquesing Township, southwest of Toronto. After graduating from the University of Toronto in 1881, Princeton Theological Seminary in 1884, and going on for further study at the University of Berlin and again at Princeton Seminary, he was called to be pastor of the Jermain Memorial Church in Watervliet (now West Troy), New York, a post he held from 1886 to 1892.[1]

After a year as president of the new University of Fairhaven (which later became Western Washington University, Bellingham) from 1892 to 1893, he settled in New York City, at St. Nicholas Collegiate Reformed Church, part of the Dutch Reformed tradition, from 1894–1895. But a new opportunity called: in 1895, he was appointed the first executive director of the newly formed New York Federation of Churches and Christian Workers. He held this position for almost 30 years, until 1922. Along the way, Laidlaw earned a Ph.D. from New York University in 1896; the field has not been determined, but statistics was his passion.

From his position as executive director of the Federation of Churches, and as editor of its journal, Federation, Laidlaw sought to put the work of religion on a secure scientific basis. Who were the people of New York? What social and economic needs did these people have? Where were the (Protestant, at least) houses of worship and settlement houses? Data were needed, and the census seemed a good place to start.

Laidlaw_StatisticalSourcesforDemographicStudiesofGreaterNY1920_1922_NYandNeighborhood_watermark

New York and Neighborhood. In In New York City 1920 Census Committee, Statistical Sources for Demographic Studies of Greater New York, 1920 (New York: New York City 1920 Census Committee, Inc., 1922), xliv. NYAM Collection.

At this time, there were two: the Federal census, conducted in the years ending in “0,” the New York State census in the years ending in “5,” and they didn’t work the same way. As he details in a classic 1906 article in Federation, the counting principles differed between the Federal and state censuses, from one year’s census to the next, and even for different parts of the city within the same census. The Federal census of 1900 rolled up its data differently: for Brooklyn, Queens, and Staten Island, city council wards were used, and for Manhattan and the Bronx, New York State Assembly districts. And then the 1905 state census used New York State Assembly districts in all five boroughs. In Laidlaw’s words: “The ward is a fixed boundary, immobile as the orthography of a dead language,” he said; drawing out the metaphor, he continued, “the Assembly district is a changing boundary, a phonetic spelling arrangement which responds to the alien accents in the makeup of the city.” To get good data, the Federation found itself retabulating first the 1900 Federal census for 2 boroughs, and then, for the 1905 state census, for all 5 boroughs. At this point, Laidlaw called for a new system: “The scientific sociological study of Greater New York requires a ‘dead language’ boundary for tabulations. . . . Federation respectfully suggests a scheme which does away both with ward and Assembly district outlines, and which can be permanent.” [2]

The system he proposed was securely within the American tradition. It was, in fact, to use the system that was enshrined in law in the Land Ordinance of 1785: the “section” system set up to survey and sell the undeveloped lands west of the Appalachians. (An arial view of a Midwestern county, in Indiana, say,  would reveal the regularity of the system!) Laidlaw’s first unit of analysis was the quarter-section: a quarter of a square mile, or 160 acres.

The whole city could be mapped into 1,308 quarter section plots, . . . The “quarter sections” could not, to be sure, be invariably 160 acres. Blocks should not be broken. But well defined area of about 160 acres could easily be devised. . . . [The] designation . . . could become uniform in the Federal Census tabulations, perpetually, and in the work of every department of the city, not excepting even the tax office.[3]

The idea caught on. The U.S. Census Bureau adopted it the same year in preparation for the 1910 Federal census, but took the area down to 40-acre plots and called the basic units “census tracts.” By 1914, the city’s Department of Health had adopted census tracts as “‘sanitary areas’ to be followed in constructing new administrative districts in tuberculosis clinic work, baby health station districts, etc.” The sanitary areas were grouped together to form “Health Area Units.” [4]

Laidlaw_StatisticalSourcesforDemographicStudiesofGreaterNY1920_1922_SanitaryDistrict1_watermark

Sanitary districts of Manhattan. In New York City 1920 Census Committee, Statistical Sources for Demographic Studies of Greater New York, 1920 (New York: New York City 1920 Census Committee, Inc., 1922), 12A. NYAM Collection.

Laidlaw_StatisticalSourcesforDemographicStudiesofGreaterNY1920_1922_SanitaryDistrict2_watermark

Sanitary districts of Manhattan. Sanitary districts of Manhattan. In New York City 1920 Census Committee, Statistical Sources for Demographic Studies of Greater New York, 1920 (New York: New York City 1920 Census Committee, Inc., 1922), 12B. NYAM Collection.

Although eight cities ostensibly made use of census tracts in 1910 data gathering, New York remained the only one to analyze and publish the data to that granularity. The technique spread to 10 more cities for the 1930 census, and 42 more in 1940. The entire county was covered by census tracts by the year 2000. More importantly, the social service purposes that Laidlaw brought to his recommendations for the census came to fruition in governmental circles. Census tract data became a standard unit for analysis in public health, both for government and for academia.

As for Walter Laidlaw, he was deeply involved in every census from 1910 to 1930, often as a leader in the city census committees and as editor of the published compiled results. On May 20, returning from lunch at the Mayor’s Committee on City Planning, he died. His funeral, at Riverside Church, presided over by Harry Emerson Fosdick, attracted the notables of the City.[5]

References

[1] “Laidlaw, Walter.” Who’s Who in New York (City and State): A Biographical Dictionary of Contemporaries. 6th biennial ed. Ed. William H. Mohr (New York: Who’s Who in New York City and State, Inc., 1914), 434–435. https://archive.org/details/whoswhoinnewyor1914hame/page/n79/mode/2up]

[2] Laidlaw, Walter. “Federation Districts and a Suggestion for a Convenient and Scientific City Map System.” Federation 4(4) 1906: 2–6.

[3] Ibid.

[4] Godias J. Drolet and William H. Guilfoy, “Organization of Local Health Area Statistics in New York City,” American Journal of Public Health 20(4), April 1930: 380–386.

[5] New York Times, May 23, 1936; p. 15.

Highlighting NYAM Women in Medical History: Sara Josephine Baker, MD, DrPh

By Hannah Johnston, Library Volunteer

This the first entry in our series on female New York Academy of Medicine (NYAM) Fellows and their contributions to society. Please also see our biographical sketch of Mary Putnam Jacobi, the first female Fellow.

A pioneer in public health and champion of preventative medicine, New York Academy of Medicine Fellow Dr. Sara Josephine Baker (1873–1945) had a significant impact on the landscape of maternal and infant health outcomes in the early twentieth century in New York City. Throughout her long career as a physician and health inspector, Baker introduced and supported numerous measures to reduce maternal, infant, and child mortality and morbidity, particularly in immigrant and low-income communities within the city. Her work saved countless lives and had substantial influence within the larger structure of medicine and public health in New York and beyond.[1] Baker and her career were exceptional in many ways, but in particular, she engendered greater public trust in the medical profession by encouraging greater reliance on doctors while still allowing for and expecting continued trust in other sources of knowledge.

Portrait as director of the Bureau of Child Hygiene

Portrait of Sara Josephine Baker. In S. Josephine Baker, Fighting for life (1939). NYAM Collection.

Baker, who was often referred to affectionately as “Dr. Jo,” earned her medical degree from the Women’s Medical College at the New York Infirmary, which was founded by early female physicians Elizabeth and Emily Blackwell.[2] Following her graduation, she began practicing in New York while serving as a medical inspector for the New York Life Insurance Company and as a part-time medical examiner for the city. In 1907, she was appointed Assistant Commissioner of Health, and by the following year was named the first director of the Bureau of Child Hygiene.[3]

Baker_FightingForLife_1939_MyFirstStaff_watermark

The doctors and nurses of the Bureau of Child Hygiene in 1909. In S. Josephine Baker, Fighting for life (1939). NYAM Collection.

Among Baker’s chief concerns as director were those regarding the high infant mortality and morbidity rates in the city, especially in communities with low rates of access to sanitary medical care. In her 1939 autobiography Fighting for Life, she noted the high rates of infant blindness, illness, and deaths in the city, and attributed them to overreliance on the unqualified advice of neighbors and friends as well as a lack of sanitation of spaces and materials.[4] In 1913 she wrote a pamphlet for new mothers, in coordination with the New York Milk Committee, titled “Talks with Mothers,” instructing them on how to best prevent these and other issues, as well as urging them to consult with medical professionals whenever possible.[5] Additionally, Baker lamented high rates of infant, child, and maternal mortality in New York. Many of her public health and preventative care efforts were directed toward lowering these mortality rates, particularly by improving access to pasteurized milk and sanitary medical care. Sanitation was not Baker’s sole focus, however; she marveled at how babies living in tenements seemed to be doing better than foundlings living in sanitary hospitals, and concluded that “personal care from a maternally minded mother” was as important for a baby’s survival as sanitation.[6] She then implemented a program where “tenement mothers” fostered foundlings from the hospital, which led to a drastic drop in the mortality rate among these babies — from 50% to 33% generally, and from 100% to 50% among “hopeless cases.”[7]

A firm believer in social medicine, Baker formed her opinions and efforts regarding public health around the needs and circumstances of the communities she served. Her commitments to serving immigrant and low-income communities can be clearly seen in her considerations of the practice of midwifery in the city and of the needs of working mothers. Despite feeling that midwives in the U.S. were largely “very clumsy [practitioners] indeed who had got into the profession as [amateurs] and stayed in to make a living,” Baker recognized that many women, especially those who had grown up in countries where midwives were more widely respected and utilized, were uncomfortable with the “American” practice of (male) physician-attended birth.[8] Positing that without midwives women might put themselves at further risk by seeking the help of unqualified neighbors and friends before seeking a doctor (if they could even afford to), Baker became focused on implementing a system to regulate the practice of midwifery in the city to ensure higher standards of care. This stance put her at odds with many of her peers, and in Fighting for Life, she described a “hot discussion” with her colleagues at the New York Academy of Medicine over the matter.[9] In order to ensure the well-being of infants whose mothers were in the workforce, a common occurrence particularly in low-income households at the time, Baker developed the Little Mothers League to educate older children on the proper care of infants. Since older daughters were often tasked with caring for their siblings while their parents worked, Baker believed it was important to ensure that everyone caring for babies was prepared to do so. The education girls received from the Little Mothers League, Baker reasoned, also had the positive side effect of larger-scale understanding of the proper care of children, as the “Little Mothers” shared their new expertise with their parents, friends, and communities.[10]

Sara Josephine Baker’s long, wide-ranging, and impressive career saw significant improvements in the well-being of mothers and children in New York City and beyond. Aside from her efforts to improve the care of infants, she championed preventative healthcare for toddlers and school-aged children and mothers, and was instrumental—twice—in catching the first known asymptomatic carrier of typhoid, “Typhoid Mary” Mallon.[11] By the time she retired in New Jersey with her partner Ida Wylie and their friend Louise Pearce in the mid-1930s, New York City had the lowest urban infant mortality rate in the United States.[12] Sara Josephine Baker’s social and preventative approach to medicine engendered greater and more widespread public trust in medical professionals while respecting the need for other sources of knowledge and care, and made New York City a healthier place.

References

[1] Manon Parry, “Sara Josephine Baker (1873-1945),” American Journal of Public Health 96 No. 4 (2006), pp. 620–621.

[2] Ibid.

[3] Ibid.

[4] Sara Josephine Baker, Fighting for Life (New York, NY: The Macmillan Company, 1939), 116–119, New York Academy of Medicine Library, New York, NY, Special Collections, Call No. WZ 100 B168 1939, Film 8865 no. 5.

[5] Sara Josephine Baker, “Talks with Mothers” (New York, NY: The New York Milk Committee, for the Babies’ Welfare Association of New York City, 1913), New York Academy of Medicine Library, New York, NY, Pamphlet Collection, Box 97, Call No. 115239.

[6] Baker, Fighting for Life 119–121.

[7] Ibid. 120.

[8] Ibid. 112.

[9] Ibid. 114.

[10] Ibid. 132–137.

[11] Parry.

[12] Ibid.