Looking Out for the Health of the Nation: The History of the U.S. Surgeon General

By Judith Salerno M.D., M.S., President; and Paul Theerman, Ph.D., Director of the Library

It is widely recognized that the role of the U.S. Surgeon General is to set the national agenda for health and wellness. In describing the position, the Surgeon General’s website states that: “As the Nation’s Doctor, the Surgeon General provides Americans with the best scientific information available on how to improve their health and reduce the risk of illness and injury.”

The position, and the role of today’s U.S. Public Health Service, evolved from very modest beginnings. The story begins in 1798, during President John Adams’ term, with the passage of a law that created a fund to provide medical services for merchant seamen. The following year military seamen were included as well, with the cost of their care paid through a deduction from the seamen’s wages. Over the next 60 years, the government built hospitals in the country’s seaports and river ports.

Fast forward to the Civil War, in the course of which the Federal marine hospitals almost ceased to function. In the aftermath of the War, the Marine Hospital Service was established in 1870 to revitalize them as a national hospital system. Administration was centralized under a medical officer, the Supervising Surgeon, who was later given the title of Surgeon General. The first Supervising Surgeon, Dr. John Woodworth, set about creating a corps of medical personnel to run the Marine Hospital Service. In 1889, Congress officially recognized this new personnel system by formally authorizing the creation of the Commissioned Corps. These public health workers, all of whom initially were physicians, were organized along military lines, with the Surgeon General as their leader. The Surgeon General was given a rank equivalent to a three-star Admiral.

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“Aerial View U.S. Marine Hospital Stapleton, Staten Island, N.Y.” From the collection of Dr. Robert Matz, New York Academy of Medicine Library.

In the decades following the Civil War, the federal government began to assume many duties and responsibilities that heretofore had been undertaken by the states. The Marine Hospital Service took over the administration of quarantines and the health inspection of immigrants. It established a bacteriological lab on Staten Island (the “Hygienic Laboratory”) to better understand infectious diseases, and it ran a hospital on Ellis Island. The Service also coordinated state health efforts and standardized and published health statistics. In 1878, it began the publication of Public Health Reports (the official journal of the U.S. Surgeon General and the U.S. Public Health Service).

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“Doctor’s Examination.” From Quarantine Sketches.

At the turn of the previous century, as part of the progressive era reforms, the Service was given responsibility for controlling the quality of newly developed vaccines. And in 1912, the Service was given a new name—the U.S. Public Health Service (USPHS). Its mission was to:

“Investigate the diseases of man and conditions influencing the propagation and spread thereof, including sanitation and sewage and the pollution either directly or indirectly of the navigable streams and lakes of the United States.”

Throughout the first half of the 20th century, the Public Health Service took on an increasingly important role. Its staff grappled with the Spanish Flu Pandemic of 1918 and, for a time, it attended to the needs of injured veterans who were returning from World War I. It also undertook research into endemic diseases. For example, a USPHS physician, Dr. Joseph McMullen, did pioneering work in controlling trachoma (an infectious eye disease) and another USPHS doctor, Joseph Goldberger, made the discovery that a dietary deficiency causes pellagra.

The Service set up hospitals for the treatment of narcotics addiction in Lexington, Kentucky, and Fort Worth, Texas. Its efforts to control malaria in the American South led to the establishment of the Centers for Disease Control and Prevention, and the move of the Hygienic Laboratory from New York to Washington was the precursor to the establishment of the National Institutes of Health. USPHS also assumed responsibility for providing medical services to Native Americans and federal prisoners and, regrettably, it also oversaw shameful medical experiments in Tuskegee, Alabama, and in Guatemala.

From the 1930s onward, the role of the Surgeon General became more and more public. In 1964, Surgeon General Dr. Luther Terry took the campaign against tobacco use to the American public with the publication of Smoking and Health. This led in due course to major changes in the way cigarettes were advertised and eventually to tobacco regulation.

Prior to 1968, the Surgeon General was the head of the USPHS and all administrative, program, and financial responsibilities ran through this office, with the Surgeon General directly reporting to the Secretary of Health, Education and Welfare (HEW). Following a departmental reorganization that year, the USPHS’s responsibilities were delegated to HEW’s Assistant Secretary for Health (ASH) and the Surgeon General became a principal deputy and advisor to the ASH. In 1987, the Office of the Surgeon General was reestablished and the Surgeon General again became responsible for managing the Commissioned Corps.

Over the past 40 years, the Surgeon General has increasingly become the public face of health for the country. In the 1980s, Dr. C. Everett Koop made information about AIDS available to every American—in the form of an unprecedented direct mail campaign—as he sought to frame the disease as a public health threat demanding public health measures. In recent years, the Surgeons General have sought to publicize and address disparities in health care and outcomes among the nation’s increasingly diverse population. As the Commissioned Corps itself has become more diverse, so too have those holding the position of Surgeon General, with the appointment of the first female, African American, and Hispanic Surgeons General.

The New York Academy of Medicine was honored to host four illustrious former U.S. Surgeons General, Drs. Joycelyn Elders, David Satcher, Antonia Novello, and Richard Carmona, in conversation with Dr. Freda Lewis-Hall on October 15. They shared their reflections on what it takes to ensure the health of the nation. Above they are exploring with Curator Anne Garner our current exhibition on public health, “Germ City: Microbes and the Metropolis,” co-curated with the Museum of the City of New York, on view through April 2019.

References:
Parascandola, John. “Public Health Service,” in A Historical Guide to the U.S. Government, ed. George Thomas Kurian (New York: Oxford University Press, 1998), pp. 487–93.
Quarantine sketches : glimpses of America’s threshold. New York: Maltine Co., 1903.
 “The Reports of the Surgeon General,” Profiles in Science, https://profiles.nlm.nih.gov/NN/, accessed September 14, 2018.

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The First Yellow Fever Pandemic: Slavery and Its Consequences

Today’s guest post is by Billy G. Smith, Distinguished Professor in the Department of History, Philosophy, and Religious Studies at Montana State University. He earned his PhD at University of California Los Angeles. His research interests include disease; race, class and slavery; early America, and mapping early America.

Bird flu, SARS, Marburg, Ebola, HIV, West Nile Fever.  One of these diseases, or another, that spread from animals and mosquitoes to humans may soon kill most people on the planet.  More likely, the great majority of us will survive such a world-wide pandemic, and even now we have a heightened awareness that another one may be on the horizon.  This blog focuses on these issues in the past, outlining a virtually unknown voyage of death and disease that transformed the communities and nations bordering the Atlantic Ocean (what historians now refer to as the Atlantic World).  It traces the journey of a sailing ship that inadvertently instigated an epidemiological tragedy, thereby transforming North America, Europe, Africa, and the Caribbean islands.  This ship helped to create the first yellow fever pandemic.

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The Hankey. From “Ship of Death: The Voyage that Changed the Atlantic World.”

In 1792, the Hankey and two other ships carried nearly three hundred idealistic antislavery British radicals to Bolama, an island off the coast of West Africa, where they hoped to establish a colony designed to undermine the Atlantic slave trade by hiring rather than enslaving Africans.  Poor planning and tropical diseases, especially a particularly virulent strain of yellow fever likely contracted from the island’s numerous monkeys (through a mosquito vector), decimated the colonists and turned the enterprise into a tragic farce.

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 From “Ship of Death: The Voyage that Changed the Atlantic World.”

In early 1793, after most colonists had died and survivors had met resistance from the indigenous Bijagos for invading their lands, the Hankey attempted to return to Britain.  Disease-ridden, lacking healthy sailors, and fearing interception by hostile French ships, the colonists caught the trade winds to Grenada.  They and the mosquitoes in the water barrels spread yellow fever in that port and, very soon, throughout the West Indies.  This was only a few months before the British arrived to quell the slave rebellion in St. Domingue (now Haiti).  The British and subsequently the French military had their troops decimated by the disease—one reason why the slave revolution succeeded.  The crushing defeat in the Caribbean helped convince Napoleon to sell the vast Louisiana territory to the United States.  He turned eastward to expand his empire, altering the future of Europe and the Americas.

A few months after the Hankey arrived in the West Indies, commercial and refugee ships carried passengers and mosquitoes infected with yellow fever to Philadelphia, the nation’s capital during the 1790s.  The resulting epidemic killed five thousand people and forced tens of thousands of residents, including George Washington, Thomas Jefferson, and other prominent federal government leaders, to flee for their lives.  The state, city, and federal government all collapsed, leaving it to individual citizens to save the nation’s capital.  Meanwhile, doctors fiercely debated whether “Bulama fever” (as many called it) was a “new” disease or a more virulent strain of yellow fever common in the West Indies.  Physicians like the noted Benjamin Rush fiercely debated the causes of and treatment for the disease.  They mostly bled and purged their patients, at times causing more harm than good because of the rudimentary state of medicine.

Among those who stepped forward to aid people and save the city were members of the newly emerging community of free African Americans. Led by Absalom Jones, Richard Allen, and Anne Saville, black Philadelphians volunteered to nurse the sick and bury the dead—both dangerous undertakings at the time.  Many African Americans and physicians, exposed to yellow-fever infected mosquitoes, made the ultimate sacrifice as both groups died in disproportionately high numbers.  When a newspaper editor subsequently maligned black people for their efforts, Jones and Allen wrote a vigorous response—among the first publications by African Americans in the new nation.

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For one of the first times in American history, blacks responded in print; Revd.s Allen and Jones published a pamphlet answering the charges; Courtesy of the Internet Archive.

During the ensuing decade, yellow fever went global, afflicting every port city in the new nation on an annual basis.  Epidemics also occurred in metropolitan areas throughout the Atlantic World, including North and South America, the Caribbean, southern Europe, and Africa.  Among other consequences, this disaster encouraged Americans to fear cities as hubs of death.  The future of the United States, as Thomas Jefferson argued, would be rural areas populated by yeomen farmers rather than the people in teeming metropolises.  The epidemics also helped solidify the decision of leaders of the new nation to move its capital to Washington D.C. and away from the high mortality associated with Philadelphia.

After the Hankey finally limped home to Britain, its crew was taken into service in the Royal Navy; few of them survived long.  More importantly, the image of Africa as the “white man’s graveyard” became even more established in Britain and France, thereby providing a partially protective barrier for Africa from European invasion until the advent of tropical medicine.  The “Bulama fever” plagued the Atlantic World for the next half century, appearing in epidemic form from Spain to Africa to North and South America.  The origins and treatment of the disease drew intense debates as medical treatment became highly politicized, and the incorrect idea that Africans enjoyed immunity to yellow fever became an important part of the scientific justification of racism in the early nineteenth century.

Join Billy Smith along with epidemiologist Michael Levy on October 24 for Sickness and the City for a conversation that uses both science and history to understand the intersection of urban development and the spread of contagions.

References
Billy G. Smith. Ship of Death: The Voyage that Changed the Atlantic World. New Haven, CT: Yale University Press, 2013.

Dr. David Hosack, Botany, and Medicine in the Early Republic

Today’s guest post is written by Victoria Johnson, author of  American Eden (Liveright, 2018). On October 9, Dr. Johnson will give a talk at the Academy on David Hosack (1769–1835), the visionary doctor who served as the attending physician at the Hamilton-Burr duel in 1804. Hosack founded or co-founded many medical institutions in New York City, among them nation’s first public botanical garden. The following is adapted from American Eden, which is on the longlist of ten works nominated for the National Book Award in Nonfiction for 2018.

David Hosack’s twin passions were medicine and nature. As a young medical student he risked his life to defend the controversial practice of corpse dissection because he knew it was the best chance doctors had to understand the diseases that killed Americans in droves every year. He studied with the great Philadelphia physician Benjamin Rush and went on to become a celebrated medical professor in his own right. He drew crowds of students who hung on his every word and even wrote down his jokes in their notebooks. He performed surgeries never before documented on American soil and advocated smallpox vaccination at a time when many people were terrified of the idea. He pioneered the use of the stethoscope in the United States shortly after its invention in France in 1816. He published one innovative medical study after another—on breast cancer, anthrax, tetanus, obstetrics, the care of surgical wounds, and dozens of other subjects. In the early twentieth century, a medical journal paid tribute to Hosack’s many contributions by noting that “there is perhaps no one person in the nineteenth century to whom New York medicine is more deeply or widely indebted than to this learned, faithful, generous, liberal man.”[i]

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David Hosack’s admission card to Andrew Marshal’s anatomy course in London, 1793/94. Courtesy of Archives and Special Collections, Columbia University Health Sciences Library.

Yet although Hosack found surgery vital and exciting, he was certain that saving lives also depended on knowing the natural world outside the human body. As a young man, he studied medicine and botany in Great Britain, and he returned to the United States convinced that it was at their intersection that Americans would find the most promising new treatments for the diseases that regularly swept the country. Hosack talked and wrote constantly about the natural riches that blanketed the North American continent. The health of the young nation, he argued, would depend on the health of its citizens, and thus on the skill of its doctors in using plants to prevent and treat illness.

In 1801, Hosack bought twenty acres of Manhattan farmland and founded the first public botanical garden in the young nation. He collected thousands of specimens and used them to teach his Columbia students and to supervise some of the nation’s earliest pharmaceutical research.

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David Hosack with his botanical garden in the distance. Engraving by Charles Heath, 1816, after oil paintings by Thomas Sully and John Trumbull, Collections of the National Library of Medicine.

Because of his garden, Hosack became one of the most famous Americans of his time. His medical research there cemented his reputation as the most innovative doctor in New York. When Alexander Hamilton and Aaron Burr needed an attending physician for their 1804 duel, they both chose David Hosack. Thomas Jefferson, Alexander von Humboldt, and Sir Joseph Banks sent Hosack plants and seeds for his garden and lavished praise on him. In 1816, he was elected to the Royal Society of London, an extraordinary honor for an American.

Today, though, few people know Hosack’s name, and his botanical garden grows skyscrapers year-round. It’s now Rockefeller Center.

Learn more about this luminary individual; join us for Losing Hamilton, Saving New York: Dr. David Hosack, Botany, and Medicine in the Early Republic at the Academy on Tuesday October 9th at 6pm.

References:
[i] Dr. David Hosack and His Botanical Garden,” Medical News 85, no. 11 (1904): 517-19 [no author], p. 517.

 

No Spice More Superior: Pepper

By Emily Miranker, Events & Projects Manager

The marvelous thing about libraries (well, one on an infinite list of marvels…) are the remarkable rabbit holes of investigation and imagination you fall into. Recently,  I ran into a kitchen staple in an old medicine book:

Black Pepper is a remedy I value very highly. As a gastric stimulant it certainly has no superior…

Black pepper as a cure for anything, except perhaps bland food, was news to me. The above passage comes from the 19th century John Milton Scudder’s 1870 book Specific medication and specific medicines. In the 19th century “specific medicine” referred to a branch of American medicine, eclectic medicine, that relied on noninvasive practices such as botanical remedies or physical therapy.[i] As an eclectic practitioner, Scudder’s work was not mainstream, regular medicine, so I wondered if perhaps that was why pepper should come up as a remedy. Surely, pepper only belongs in the pantry not the medicine cabinet. But doing more research, it turns out that black pepper, Piper nigrum, originally from India, has been used by people for medicinal purposes for centuries.

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A member of the Piperaceae family of plants, black pepper is a tropical vine. Its berries (the dried berries are the peppercorns we’re familiar with from the kitchen), were known to the Egyptians, Greeks, and Romans long before it became one of the most sought-after spices in Europe during the Age of Exploration, the 15th-18th centuries. Depending on when it’s harvested, a vine produces four kinds of peppercorn. Green peppercorns are unripe berries that are freeze-dried. White pepper is almost ripened, the berries are harvested and soaked in water which washes off the husk leaving the gray-white seed. Red peppercorns are fresh, ripe berries. Black peppercorns are harvested when the spike of berries is midway ripe; these unripe berries are actually more flavorful than a fully ripe berry. The black peppercorns are blanched or left to ferment a few days and then dried in the sun. The drying process turns the husk black.[ii]

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A detail of a page of recipes calling for pepper by the Roman gourmand Apicius, the oldest cookbook in West. Author’s favorite: #31 Oenogarum in Tubera, a wine sauce for truffle mushrooms calling for pepper, lovage, coriander, rue, broth, honey and oil.

Pepper came to the tables and pharmacies of Europe via trade from the west coast of India. It was coveted enough to be part of the ransom demand Alaric the Goth made of Rome when he invaded in 408 C.E.[iii] With its strategic location on the Adriatic, Venice dominated the spice trade in Europe in the Middle Ages. The Portuguese were the first to break the Venetian hold by finding an all-ocean route to India. By the 17th century the Dutch and English were players in the spice trade. Innocuous-seeming dark grains in shakers on tabletops now, pepper was once more valuable than silver and gold. Sailors were paid in pepper. The spice was also used for paying taxes, custom duties, and dowries.[iv] In their quest for pepper, among other spices such as cinnamon, cloves, and nutmeg, the Europeans brutally pursued spice monopolies regardless of the upheaval and violence they wrought on the peoples of India, Sumatra and Java.

 

Dating back to 6,000 B.C.E. the Materia medica of Ayurveda advocates using pepper for a number of different maladies, especially those of the gastrointestinal tract.[v] To this day in India, a mixture of black pepper, long pepper, and ginger, known as trikatu, is a common Ayurvedic medicinal prescription. Trikatu is a Sanskrit word meaning “three acrids.” In the Ayurvedic tradition “the three acrids collectively act as ‘kapha-vatta-pitta-haratwam’ which means ‘correctors of the three doshas of the human.’”[vi] Doshas are energy centers in the body in the Ayurvedic tradition.

Pepper figured in Western medicine from antiquity onwards as well. Writing in the 7th century, Byzantine Greek physician Paul of Aegina quotes the 2nd-century Greek Galen on pepper’s’ medical properties, “it is strongly calefacient and desiccative.”[vii] Warming and drying, thus very good for stomach problems in his estimation. Side note: Galen’s office was in the spice quarter of Rome, underscoring the connections between health, spices, and food. Peppers’ use as a “gastric stimulant” persisted through the centuries. In our collection’s The elements of materia medica and therapeutics (1872), Jonathan Pereira states pepper “is a useful addition to difficult-to-digest foods, as fatty and mucilaginous matters, especially in persons subject to stomach complaints.” The illustrations of pepper plants in this post come from Robert Bentley’s Medicinal Plants (1880) which includes their medical properties and uses along with descriptions of habitats and composition.

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Scientific studies on pepper coalesce around its compound piperine. The stronger—more pungent—the pepper, the more piperine it contains. The argument of studies on pepper’s properties is that adding pepper to a concoction increases its efficacy and digestibility. Research suggests “this bioavailability enhancing property of pepper to its main alkaloid, piperine…. The proposed mechanism for the increased bioavailability of drugs co-administered with piperine is attributed to the interaction of piperine with enzymes that participate in drug metabolism.”[viii]

I hadn’t looked to black pepper for any health benefits. I look to it for that delicious heat and spicy pungency it brings to my meals. But that’s the great thing about researching in our library; you always find delights beyond what you’re looking for.

References
[i] Eclectic Medicine. https://lloydlibrary.org/research/archives/eclectic-medicine/ Copyright 2008. Accessed August 30, 2018.
[ii] Sarah Lohman. Eight Flavors: The Untold Story of American Cuisine. New York: Simon & Schuster, 2016.
[iii] Majorie Schaffer. Pepper: A History of the World’s Most Influential Spice. New York: St. Martin’s Press, 2013.
[iv] Schaffer. Pepper. 2013.
[v] Muhammed Majeed and L. Prakash. “The Medicinal Uses of Pepper.” International Pepper News. 2000. Vol. 25, pp. 23-31.
[vi] Majeed & Prakash. 26.
[vii] Paulus Aegineta. La Chirurgie. Lyons: 1542.
[viii] Majeed & Prakash. 28.

 

Germ City: Microbes and the Metropolis Opens

By Anne Garner, Curator of Rare Books and Manuscripts and Rebecca Jacobs, Andrew W. Mellon Postdoctoral Fellow, Museum of the City of New York

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Typist wearing mask, New York City, October, 16, 1918. Courtesy of the National Archives.

On certain October mornings during 1918, masks like the one in the above photograph would have been a common sight on New York’s streets. Men and women wore them on their commutes to work, or even while doing their jobs, as office workers, postal carriers, and sanitation workers. Over 30,000 New Yorkers died during the 1918 influenza pandemic. And yet, because the city had learned from other contagious disease outbreaks and adjusted its public response and infrastructure accordingly, these numbers were comparatively low side-by-side with other American cities.

A hundred years later, Germ City: Microbes and the Metropolis, opening today at the Museum of the City of New York, explores New York City’s history of battles with contagious disease. The exhibition is co-presented with The New York Academy of Medicine, in collaboration with the Wellcome Trust as part of their Contagious Cities project. Contagious Cities encourages local conversations about the global challenge of epidemic preparedness.

Germ City tells the very personal stories of New Yorkers’ experiences and their responses to the threat of contagious disease over time using historical objects, oral histories, and artwork. Artist Mariam Ghani’s film, inspired by Susan Sontag’s Illness as Metaphor, invites audiences at the main gallery’s entrance to engage with the themes of metaphor and disease. Ghani’s work leads into the main gallery, where the stories of the some of the city’s many microbes—flu, cholera, diphtheria, the common cold, cholera, smallpox, TB, polio, HIV, and others —are explored through scientific models, historical objects, and contemporary artworks.

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Orders for hospitalization for Mary Riley, August 29–31, 1854.

During the 1854 cholera epidemic, physicians visited the homes of the sick and issued orders for hospitalization, most hastily written on scrap paper. According to these notes, this patient, Mary Riley, delayed going to the hospital and died the following day.

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Letter from Mary Putnam Jacobi to Sophie Boaz, February 27, 1884.

The impact of diphtheria, another devastating disease of the 19th and early 20th century, is crystalized in the compelling story of Ernst Jacobi, the son of Abraham Jacobi, the father of pediatrics and himself a committed diphtheria researcher. An 1884 letter in the New York Academy of Medicine’s collections, written by Abraham Jacobi’s wife, the physician and activist Mary Putnam Jacobi, documents the devastating death of Ernst from diphtheria.

While this first section of the exhibition establishes just some of the contagious diseases that have hit New York over time, the remaining four sections of the exhibition probe the responses of the government, medical professionals, and ordinary citizens to the threat of epidemics. A common first response to contagion is to contain it. Visitors learn about New York’s man-made quarantine islands, Hoffman and Swinburne, and the exile of “Typhoid Mary” to nearby North Brother Island. These islands, now covered in overgrowth and closed to the public, are still visible from Manhattan’s shores.

Jordan Eagle’s Blood Mirror, a sculpture created with the blood of gay, bisexual, and transgender men to protest the U.S. government’s ban on their donating blood, provokes viewers to consider the potential consequences of linking particular identities with disease and thus isolating populations.

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Jordan Eagles, Blood Mirror, 2015–present Artwork on gallery floor. On loan from the artist.

The exhibition also explores the ways researchers, public officials, and ordinary New Yorkers have attempted to gather information in an effort to fight contagion. The Citizens’ Association of New York’s map of lower Manhattan illustrates the 1864 survey of New York households, conducted by physicians going door-to-door recording instances of typhoid, cholera, and other deadly diseases.

A copy of one survey, conducted by Dr. William Hunter, records the living conditions of a family of three recent Irish immigrants living on West 14th Street—all with typhoid fever. Science journalist Sonia Shah’s “Mapping Cholera” project illuminates the similarities between nineteenth-century New York’s vulnerability to cholera and more recent outbreaks in Haiti.

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Sonia Shah, Excerpt from Mapping Cholera: A Tale of Two Cities, 2015. Designed and built by Dan McCarey. Courtesy of the Pulitzer Center on Crisis Reporting.

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Postcard, Harlem Hospital. From the collection of Dr. Robert Matz.

Over time, New Yorkers have been reliant on medical research, medicine, and family and professional caregivers to provide respite from disease. A collection of postcards from the Academy Library donated by retired physician Dr. Robert Matz depict key institutions where epidemiological research, treatment, and care were given in an effort to save the lives of the city’s sickest. Many of these facilities—hospitals, sanitaria, and health resorts—have been torn down or transformed over time, becoming another invisible layer in the city’s architectural history.

New Yorkers sought care from old family recipes, as with Selma Yagoda’s recipe for chicken soup, and from patent medicines, cheap formulas widely available over the counter, which claimed to cure many ailments, including malaria and the Spanish flu.

 

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Diphtheria pamphlets

Germ City also engages with the ways cities create infrastructure and policies that support health. Public officials sometimes used creative delivery methods to communicate health information to wider audiences. In 1929, The Diphtheria Prevention Commission inundated the city’s subways and streets with placards and brochures in Spanish, Polish, Yiddish, and Greek, directing New Yorkers to get immunized for diphtheria.  David Lynch’s 1991 “Clean Up” video offers a dark and at times surreal look at the city’s rat problem, illustrating the importance of public hygiene. A number of private and public organizations mobilized to minimize disease outbreaks through outreach and education.

Following the main gallery, visitors are invited to engage hands-on with copies of collections materials in the “Reading Room,” in a range of formats (visual, audio, video). People can share their own family stories of disease through our public collecting initiative.

Germ City will be on view until April 28th, 2019. In coordination with the exhibition, the Academy is offering a slate of programming in partnership with the Museum of the City of New York. The first of these, “The World’s Deadliest Pandemic: A Century Later,” will take place at the Museum on September 27th. We hope to see you there (register here.)

The Red Cross Institute for Crippled and Disabled Men and the “Gospel of Rehabilitation”

Today we have a guest post written by Ms. Julie M. Powell, 2018 recipient of the Audrey and William H. Helfand Fellowship in the History of Medicine and Public Health. Ms. Powell is a PhD candidate at The Ohio State University, her dissertation topic explores the growth of wartime rehabilitation initiatives for disabled soldiers and the rhetoric that accompanied and facilitated this expansion. 

In May 1917, one month after the United States joined the First World War, the American Red Cross created the Institute for Crippled and Disabled Men to “build up re-educational facilities which might be of value to the crippled soldiers and sailors of the American forces.”[1] To this end, Director Douglas McMurtrie (1888–1944) collected approximately 3,500 separate books, pamphlets, reports, and articles from the European continent, North America, and the United Kingdom and its Dominions. He and his research staff pored over the documents, authoring reports, news articles, and lectures that were subsequently fed back into circulation both in the United States and abroad. A look at the collection and the work of the Institute provides a window into the development of rehabilitative care in the early twentieth century, demonstrating that transnational medical networks operated and expanded throughout the war and that the transmission of information and ideology often went hand in hand.

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The Red Cross Institute for Crippled and Disabled Men, 1918.

The proliferation of literature on rehabilitation (including surgical amputation, orthopaedics, prosthetic design, physical therapy, and vocational re-education) can be attributed both to a sense of urgency—20 million men were wounded in the war—and to the relative newness of the field. The first orthopaedic institute was created in Munich in 1832 and the next in Copenhagen in 1872 but these, and others that followed, focused exclusively on care for disabled children. The first significant moves toward the retraining of adults were taken up in the two decades before the war. In 1897, in Saint Petersburg, disabled men began to be trained in the manufacture of orthopaedic devices and in 1908, with the founding of a school in Charleroi, Belgium, the industrially maimed were taught bookbinding, shoe repair, basket making, and more. The first retraining school for invalided soldiers was created in December 1914 in Lyon, France, four months after the outbreak of hostilities. The school provided the inspiration for over 100 similar schools throughout France. The period 1915–1917 saw a proliferation of orthopaedic and re-education institutions throughout Europe and the western world. It was on these models that the Red Cross Institute was founded.

The first institution of its kind in the United States, the Red Cross Institute for Crippled and Disabled Men resided at 311 Fourth Avenue (now Park Avenue South) in New York. Disabled men, either funded by the U.S. Army or attending through no-interest loans, trained in four trades: welding, mechanical drafting, printing, and the manufacture of artificial limbs. McMurtrie and his staff hosted meetings of disabled men—punctuated by cake and ice cream—wherein testimonials from the recently rehabilitated served as recruitment tools for the Institute.

But the broadest impact of the Institute came from its crusade to spread what McMurtrie referred to as the “gospel of rehabilitation”—an insistence on returning the disabled man to independence and self-sufficiency that he might eschew charity and compete fairly in the labor marketplace. Such notions were deeply rooted in classical liberalism, a foil to large-scale social welfare programs that would only emerge in the wake of the Second World War. In The Disabled Soldier, McMurtrie wrote plainly:

When the crippled soldier returns from the front, the government will provide for him, in addition to medical care, special training for self-support. But whether this will really put him back on his feet depends on what the public does to help or hinder, on whether the community morally backs up the national program to put the disabled soldier beyond the need of charity… In light of results already obtained abroad in the training of disabled soldiers, the complete elimination of the dependent cripple has become a constructive and inspiring possibility. Idleness is the great calamity. Your service to the crippled man, therefore, is to find for him a good busy job, and encourage him to tackle it. Demand of the cripple that he get back in the work of the world, and you will find him only too ready to do so.[2]

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A reproduction (right) of part of McMurtrie’s poster exhibit for the Institute featuring the liberal “gospel of rehabilitation”: self-sufficiency, competition, and independence from charity.

McMurtrie’s gospel sounded the same notes as the works of U.S. Allies across the pond, whose material he’d spent years collecting. In 1918, famed novelist, advocate of the war wounded, and editor for the rehabilitation journal Reveille, John Galsworthy warned against the perils of charity, of “drown[ing] the disabled in tea and lip gratitude” and thereby “unsteel[ing] his soul.” Rather, he wrote:

We shall so re-create and fortify…[the disabled soldier] that he shall leave hospital ready for a new career. Then we shall teach him how to tread the road of it, so that he fits again into the national life, becomes once more a workman with pride in his work, a stake in the country, and the consciousness that, handicapped though he be, he runs the race level with his fellows, and is by that so much the better man than they.[3]

Such rhetoric was of a piece with appeals from British Minister of Pensions, John Hodge, for the restoration of men to “industrial independence,” that they might “hold their own in the industrial race.”[4]

When McMurtrie invited the world’s newly-minted experts in rehabilitation to New York in 1919, they shared—as they had through pamphlets, pictures, and films—not just information but ideology. Discussions on war surgery and the organization of rehabilitation schemes unfolded side-by-side with talks on public education and encouragement of the disabled to train.

Such propaganda efforts were critical. According to McMurtrie: “The self-respect of self-support or the ignominy of dependence—which shall the future hold for our disabled soldiers?” The credit or blame, he held, would rest with a public that either demanded self-sufficiency or patronized its men with charity.

References:
[1] Douglas C. McMurtrie, The Organization, Work and Method of the Red Cross Institute for Crippled and Disabled Men (New York: The Red Cross Institute for Crippled and Disabled Men, 1918).
[2] Douglas McMurtrie, The Disabled Soldier (New York: The Macmillan Company, 1919), 37.
[3] John Galsworthy, “Foreword,” The Inter-allied Conference on the After-Care of Disabled Men: Reports Presented to the Conference (London: His Majesty’s Stationary Office, 1918): 13–17. Reprinted in his book of essays Another Sheaf (New York: Charles Scribner’s Sons, 1919).
[4] John Hodge, “The Training of Disabled Men: How We Are Restoring Them to Industrial Independence,” Windsor Magazine no. 281 (1918): 569–571.
[5] McMurtrie, The Disabled Soldier, 75.

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Side Effects May Include

By Emily Miranker, Events & Projects Manager

You’re curled up on your couch watching the latest episode of a favorite show when a commercial break comes along. An actor with amazingly white teeth goes from an unhappy to a happy face suddenly able to go about their regular life without discomfort, all thanks to Some Medication. As the ad spot wraps up, a soothing and fast-talking voice rattles off a litany of side effects: dizziness, loss of appetite, dry mouth, nausea, indigestion, insomnia, and so on.

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Finding and Learning About Side Effects, FDA.gov.

I grew up used to the recitation of possible side effects and long lists of them stapled to prescriptions from the pharmacy. “Yeah, yeah; might get a headache…” But there is huge importance in a regular headache and a headache that presages something medically serious. Mrs. Anne St. C. of Buffalo, NY was not used to these warnings in the 1960s. Because they didn’t exist.

The inclusion of side effects, also called adverse events by the Food and Drug Administration, was an incredibly important milestone for patients and informed consumer choice. We owe these warning labels to another milestone event in public health; the oral contraceptive, the first of which was Enovid, approved for prevention of pregnancy in the United States in 1960.[1] This was a game changer for American women, and within two years 1.2 million women were taking the pill.[2]

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Advertisement for Enovid. American Journal of Obstetrics and Gynecology, Vol. 83 No. 3, February 1, 1962.

One of those women was Anne St. C.

Wife of a professor at a local [Buffalo, NY] university, mother of three and a user of the pill, [she] called her gynecologist and asked, “Is the pill safe? Should I be taking it?” Dr. K. snapped, “Of course, it’s all right for you to take the pill. If it weren’t, I’d never have prescribed it.” Anne did not tell the doctor the real reason why was she calling. In the preceding two weeks she had experienced several attacks of dizziness and double vision. She had also suffered from stiffness in the neck. If she had not been cowed by her doctor’s brusqueness, she might have detailed her symptoms. In that case, the doctor’s reaction might have been quite different. As it was, Anne had a stroke exactly eight days later.[3]

In that Anne survived her stroke, she was lucky. For other women, the side effects were fatal.

Two points about the world in which the oral contraceptives came to market. First, in assessing the safety of the pill, regulators focused on its “ability to prevent pregnancy because pregnancy and delivery were inherently medically risky”[4] and since the pill was effective in that objective, it met the law’s safety requirement. Second, the pill was approved before the dangers of thalidomide‑ discovered to cause birth defects in children whose mothers took it for morning sickness‑ were known and the consequent Kefauver Harris Amendment (“Drug Efficacy Amendment”) of 1962 passed.[5]

When Anne St. C. was taking the pill, doctor-patient relationships existed in the context of the 1938 Federal Food, Drug, and Cosmetic Act. That act required pharmaceutical companies to make information about drug safety available to physicians. When patients got information it was “through the filters of the prescribing physicians and the dispensing pharmacist.”[6] The balance of power rested with the medical practitioner. Come the late 1960s, the burgeoning feminist and consumer rights movements challenged the status quo of the doctor-patient relationship. The balance of power was  questioned and began to shift.

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Barbara Seaman, Alliance for Human Research Protection.

Journalist Barbara Seaman, exposed the dangers of the pill in her 1969 book The Doctors’ Case Against the Pill. She wrote that “a typical package insert that is supplied with one of the most popular oral contraceptives…lists more than 50 side effects of the pill, including a number that can be fatal…Relatively few women ever see these warnings because they are written for physicians; doctors or pharmacists usually remove them from the pill packages,” advocating that it was the patient’s privilege to decide. A woman was “entitled to know the risks and give her informed consent.”[7]

Seaman’s book brought the issue to the attention of Wisconsin Senator Gaylord Nelson (organizer of the first Earth Day). In January 1970 Nelson instigated Congressional hearings on the safety of the pill and the sufficiency of information about its side effects.[8] Attending the hearings, Seaman and fellow activist Alice Wolfson (both future founders of the National Women’s Health Network) were struck by “the fact that there were no women testifying and that there are no women on panel.”[9] Wolfson’s collective, D.C. Women’s Liberation, organized women to position themselves in the hearings’ audiences and outside the Capitol to voice their twofold concerns; the dangers of the pill and the exclusionary structure of the hearings. The feminist activists’ strategic interruptions at the hearings and protests outside the Capitol captured media attention.

Policeman Approaching Young Feminists

D.C. Women’s Liberation demonstrators at the Nelson Hearings, 1970

Amid the media coverage the feminists brought, FDA Commissioner Dr. Charles Edwards announced on the final day of the hearings “that his agency planned to require a … package insert in every package of birth control pills … written by the FDA in lay language and directed to the patient.”[10] While compromise about the writing and scope of the inserts continued, the activists’ efforts laid the groundwork for the warnings that come with all prescription packages today. And today’s pills contain lower doses of hormones than the first Enovid pill.[11]

We continue this important work in increasing the public health literacy and access at the Academy with our Language Access in Chain Pharmacies project, which supports multilingual medication labels. Being able to understand firsthand how to use and any risks or side effect is immensely empowering for a patient and goes a long way to fostering trust in the healthcare system.

Special thanks to Allison Piazza for research assistance with this post.
References:
[1] Suzanne White Junod. FDA’s Approval of the First Oral Contraceptive, Enovid. Update. 1998, July-August. https://www.fda.gov/downloads/AboutFDA/WhatWeDo/History/ProductRegulation/UCM593499.pdf Accessed July 9, 2018.
[2] Alexandra Nikolchev. A brief history of the birth control pill. Need to Know on PBS. http://www.pbs.org/wnet/need-to-know/health/a-brief-history-of-the-birth-control-pill/480/ Published May 7, 2010. Accessed July 10, 2018.
[3] Barbara Seaman. The Doctors’ Case Against the Pill. New York: Peter H. Wyden, Inc., 1969: 109.
[4] Junod. https://www.fda.gov/downloads/AboutFDA/WhatWeDo/History/ProductRegulation/UCM593499.pdf Accessed July 12, 2018.
[5] Sam Peltzman. An Evaluation of Consumer Protection Legislation: The 1962 Drug Amendments. The Journal of Political Economy, Vol. 81, No. 5. 1973 Sept-Oct.
[6] Elizabeth Siegel Watkins. Expanding Consumer Information: The Origin of the Patient Package Insert. Advancing Consumer Interest, Vol. 10, 1. 1998.
[7] Seaman, 9 & 15.
[8] Nikolchev. A brief history of the birth control pill. http://www.pbs.org/wnet/need-to-know/health/a-brief-history-of-the-birth-control-pill/480/ Accessed July 10, 2018.
[9] National Women’s Health Network. https://nwhn.org/pill-hearings/ Accessed July 12, 2018.
[10] Watkins. Expanding Consumer Information. 1998.
[11] Pamela Verma Liao. Half a century of the oral contraceptive pill. Can Fam Physician, Vol. 58, No. 12. 2012 December. Accessed August 24, 2018.

 

Summer Reading Suggestions – Part II

By Emily Miranker, Events & Projects Manager

Our last post suggested foundation and fictional summer reading along the theme of contagion, especially the infectious influenza epidemic of 1918, to whet your appetite for our forthcoming exhibition Germ City: Microbes and the Metropolis (opening September 14, 2018). Read on for more not-your-usual summer reading ideas.

Cities are concentrated hubs of peoples’ movements and interactions; for better or worse, the perfect location for populations and infections to collide. And, perhaps more than any other modern metropolis, the fabric of New York City has been shaped by responses to epidemic disease.

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Cities and Sickness

  • Hives of Sickness: Public Health and Epidemics in New York City, edited by David Rosner
  • Epidemic City: The Politics of Public Health in New York, James Colgrove
  • Smell Detectives: An Olfactory History of Nineteenth-Century Urban America, Melanie A. Kiechle
  • The Ghost Map: The Story of London’s Most Terrifying Epidemic and How It Changed Science, Cities, and the Modern World, Steven Johnson

Rosner’s Hives of Sickness is a great work to start with for looking at disease through the lens of urbanism; it’s a collection of nine essay the reader can dip and in out of. It’s fascinating to see how many of NYC’s public health initiatives were assigned to government agencies besides or along with the Dept. of Health, demonstrating how creating a health city is not an issue to be siloed. Follow that theme of health’s importance across civic agencies to James Colgrove’s Epidemic City, an analysis of the perspectives and initiatives of the people responsible for the city’s health since the 1960s.

Illustrated Newspaper August 1881_cholera_watermark

Another thing that cities mean is lots of people crowded together; which can smell bad. Bad smells and foul air (malaria, anyone?) were believed to be a cause of disease in the 19th century. Smell Detectives shows how hard it proved to find the sources of those dangerous odors and explores the larger tension between evolving scientific knowledge and people’s common, olfactory senses.

 

From across the pond in London is the story of the 1854 cholera epidemic; Dr. John Snow and Rev. Henry Whitehead’s use of interviews and mapping to identify the source as a contaminated water pump—not foul air—and with this the birth of the field of epidemiology and the power of visualizing data. The Ghost Map is a riveting, multidisciplinary tale.

 

Don’t be so Literal:

  • Illness as Metaphor and AIDS and Its Metaphors, Susan Sontag
  • In Sickness and in Health: Disease as Metaphor in Art and Popular Wisdom, by Laurinda S. Dixon
  • Contagious: Cultures, Carriers, and the Outbreak Narrative, Priscilla Wald
  • Punishing Disease: HIV and the Criminalization of Sickness, Trevor Hoppe

Disease is more than a clinical fact. It’s a concept. Trends go viral. Something cool is sick. There are cancers in the body politic. A cancer survivor herself, author Susan Sontag challenges victim-blaming in her seminal and intense work Illness as Metaphor and its follow-up AIDS and its Metaphors. In Sickness and in Health is a good counterpart, its concentration being on figurative illness through the visual arts and imagery. Many people with AIDs belonged to stigmatized minorities which led to society to link sickness to ‘badness,’ and the criminalizing of illness is not specific to AIDS alone as Trevor Hoppe’s Punishing Disease reveals. In Contagious, Priscilla Wald uses history, journalism, literary and cinematic depictions of disease to describe the “outbreak narrative,” and how getting stuck in this particular storyline and mode of thinking might limit our approach to the next big pandemic.

Bonus book

The Plague, Albert Camus

It’s on every other high school required reading list for a reason; Camus’ masterfully written tale of the town of Oran beset by plague is about death by disease but it’s also a powerful allegory about how we choose to live.

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Summer Reading Suggestions – Part I

“There is a narrative power to epidemics … these events typically unfold dramatically and contain elements of discovery, reaction, suspense, conflict, illness, perhaps death, and one hopes, resolution.” -Howard Markel, When Germs Travel

 

This September we open an exhibition with our partners (and next door neighbor) The Museum of the City of New York; Germ City: Microbes and the Metropolis. This year marks the 100th anniversary of the influenza pandemic of 1918 which infected an estimated quarter of the world’s population and caused the death of more people than the First World War.

Germ City exhibit graphic_ltblue

Prompted by this centenary, the exhibition and its related programs are the New York City site of the exploration of germs living in people the way people live in cities, along with sister sites in Hong Kong and Geneva. This international collaboration, Contagious Cities, was developed by the Wellcome Trust. Inspired by the Reading Room at the Wellcome Trust’s home in London, our exhibition will include a reading room of books and articles visitors can read.

If you just can’t wait till September to dig deeper into tales of cities’ roles in causing and controlling disease or the stories of human ingenuity, fear, and compassion in the face of sickness; pick among these titles for not-your-usual summer reading. Please bear in mind titles suggested below may not be in the exhibition’s reading room, but that’s where your local library steps in: find yours here.

Hear them Here: Authors Speaking at our Programs

  • The Great Influenza: The Story of the Deadliest Pandemic in History, John M. Barry
  • Silent Travelers: Germs, Genes, and the Immigrant Menace, Alan M. Kraut
  • Infectious Fear: Politics, Disease, and the Health Effects of Segregation, Samuel Kelton Roberts
  • After Silence: A History of AIDS Through its Images, Avram Finkelstein
  • Pandemic: Tracking Contagions, from Cholera to Ebola and Beyond, Sonia Shah

Many people aren’t aware of the 1918 influenza pandemic or how widespread and deadly it was in New York, the United States, and globally; so John Barry’s account of the pandemic’s history in The Great Influenza and connecting it to current day challenges like avian flu is a good foundation read. Readers can attend on Sept. 27th [coming soon to our events page] to hear Barry in panel discussion on the legacy of the 1918 flu and how surviving future pandemics may be as much a political issue as a medical one. Moderating that conversation will be Alan Kraut, author of Silent Travelers, a look at the medicalized prejudice that so often targets immigrants.

Infectious Fear Cover_RobertsGerms themselves may be blind when it comes to who infect; but outbreaks don’t strike populations with equity. We tackle the fraught intersection of disease and disparity in a discussion on Nov. 28th  [coming soon to our events page] and give the thumbs-up to our moderator Professor Samuel Roberts’ thought-provoking book Infectious Fear. For a closer look at the lived experiences of disease and how those infected are remembered or all too often forgotten join us in February 2019  [coming soon to our events page] for Remembering the Dead; you’ll have plenty of time to check out panelist Avram Finkelstein’s unflinching look at the AIDS crisis and the responses of artist-activists; After Silence. We face our future with infectious diseases in a discussion in April 2019 lead by journalist Sonia Shah. She weaves an amazing story with history, reportage and personal narrative in Pandemic: Tracking Contagions about how we are making predictions about the next major pandemic.

If you’d like a nonfiction read for a younger audience pick up Jim Murphy’s An American Plague. This is a dramatic retelling of the yellow fever epidemic in 1793 Philadelphia, a survival challenge to the city’s inhabitants as well as the young nation itself with a good spotlight on the incredible role of the Free African Society in caring for the sick. An American Plague pairs nicely with Laurie Halse Anderson’s fictional Fever 1793, also intended for the middle-school reader but from the point of view of its 15-year old heroine Mattie.

Which brings us to works of fiction more generally …

Fiction: Disease as a way to Explore the Body and Self; the Individual and Society

  • Fever: A Novel, Mary Beth Keane
  • The Last Man, Mary Shelley
  • Blue Pills a Postive Love Story, Frederik Peeters
  • The Andromeda Strain, Michael Crichton

For a change of pace from incisive facts and socio-scientific trends, delve into the highly personal story of Mary Mallon, an Irish immigrant to the United States better known as ‘Typhoid Mary,’ in Mary Beth Keane’s Fever. From Mary Shelley of Frankenstein fame, there’s an apocalyptic story of humankind brought face to face with its own destruction due to plague in The Last Man complete with thinly veiled versions of Lord Byron, Percy Shelley, and herself. Most of the English Romantics were deceased by the time Shelley wrote this, so an undercurrent of eulogizing comes through in her tone as she explores the failure of imagination to save society.

Translated from the French by Anjali Singh is Frederik Peeters’ graphic novel, Blue Pills – A Positive Love Story, the story of a man’s relationship with his girlfriend and her son who are both HIV+. The black and white artwork allows for an arresting depiction of what is literally happening to the protagonist and simultaneously what he is perceiving and coping with in the moment.

You didn’t think there wouldn’t be a Michael Crichton, did you? The Andromeda Strain is the kick-off novel of bio-tech thrillers with its deadly microbe brought back from space on a military satellite.

Bonus book:

Eleven Blue Men and Other Narratives of Medical Detection, Berton Roueché

One of the best writers from The New Yorker, Roueché’s short stories are superbly written vignettes of medical mystery solving.

Through The Grapevine: writing for Alcoholics Anonymous

By Anne Garner, Curator of Rare Books and Manuscripts

Alcoholics Anonymous first issued The Grapevine in June of 1944, seventy-four years ago this month.  In the journal’s inaugural issue, an uncredited author recounts the founding of the publication “in a big, smoke-filled room” where “six ink-stained wretches sipped at their Cokes … a cashier, a radio script writer: an author: a bookseller: an art director: a wife and mother of two.”  When questioned on the journal’s purpose, the mother of two explains.  It’s about “A.A.’s whole design of living.  There’s going to be a big, full-page on local group doings … and we’re planning to get all the big general stuff on alcoholism into the paper.  Best of all, we think, is the Servicemen’s Letter page…”[1]

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While managed by senior advisor and Alcoholics Anonymous founder Bill W., The Grapevine was conceived and established by a handful of New York “A.A.” women. In “–the story of your magazine – – ” published in the December 1948 issue, the initial idea for the serial publication was credited to “Lois K., a New York member,” who suggested a trial run. A preliminary meeting between Lois K. and three other women in the program, Priscilla P., Grace O. and Marty M. (the latter was the founder of the National Committee for Education on Alcoholism) solved initial questions about content and funding.  They also decided that male representation was needed, and added two men to their staff, Chase H. and Abbott T. Alcoholics Anonymous founder Bill W. gave the plan his blessing, and in his first editorial for the publication, called The Grapevine, “a lighted lamp.”[2]

The initial print run was 1,200 copies, and demand was steady. Members voted on October 3, 1945 to designate The Grapevine as the initial periodical of A.A.  In 1944 and 1945, the journal was produced entirely by non-paid volunteers; by 1948, The Grapevine was supported by four paid staff.  In September of 1948, a smaller, pocket format was conceived (the earliest editions bear a fruit-heavy vine on the cover with the issue information but no title, in an instance of design safeguarding anonymity.)

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The first edition of “Alcoholics Anonymous,” or “the Big Book,” (1939) included only one essay about a female in recovery.  But from the beginning, The Grapevine was more inclusive of women’s stories.  An early article by founding member Grace O. focused on female membership and the perceived challenges by men of women at meetings.  Here, she ticks out some of the complaints expressed by male members, who believed “women talk too much,” “many women form attachments that are too intense,” “women’s feelings get hurt too often,” and that they frequently “are attention demanders;” she concludes that the way forward is with patience and acknowledgement of common purpose.[3]  As Leslie Jamison writes in her 2018 book, The Recovering, “Describing the ‘traditional beliefs’ that inflect how male and female drinking have been understood differently, one clinical textbook puts it like this. ‘Intoxication in a woman was thought to signal a failure of control over her family relationships.’”[4]

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A selection of The Grapevine from 1948-1949.

4Grapevine_t_May1949_v5n2_WatermarkedPnina Levy demonstrates that in the earliest years of the organization men and women shared editorial and writing responsibilities for the serial, though the organization wasn’t always able to shake the entrenched cultural and social gender stereotypes of the early post-War period.[5] A May 1949 article, “Lady A.A.s Get Their Heads Together” acknowledged the challenges of “scurrying to fix dinner, wash dishes, prepare kids for bed, dress yourself and make the meeting across town by 8 o’clock.”[6]  In a “Vino Vignette” published in a 1946 issue, Esther E. tells of the difficulties of moving to her new town of San Antonio to kindle a regular meeting because she’s a woman. She’s successful assembling a group of three females and one male; eventually, as she says, “‘evah-thing’ caught fire.”  The December 1955 issue has no less than five articles by women, including articles about co-ed sponsorship, a narrative of a former female prisoner in recovery, and “My Son and I and AA,” written by a New York program mother.[7]

Today, The Grapevine is still in print, along with La Vina, for Spanish audiences.  Current information about subscriptions and excerpts from past issues can be found here.

References
[1] Anonymous. “Grapevine’ in Bow.” The Grapevine.  June 1944. Vol 1, No. 1.
[2] Anonymous.  “—the story of your magazine—“ The Grapevine. December 1948. Vol 5, No. 7; Bill W., “The Shape of Things to Come,” The Grapevine. June 1944. Vol. 1, No. 1.
[3] Grace O. “Women in A.A. Face Special Problems.” The Grapevine. October 1946. Vol. 3, No. 5, P. 1, pp 6 – 7, 10.
[4] Leslie Jamison. The Recovering.  New York: Little Brown, 2018.
[5] Pnina Levi. “Gender and Alcoholism: Pioneering alcoholic women’s contribution to Alcoholics Anonymous, 1937 – 60.”  Social History of Alcohol and Drugs. 2015. Vol. 29, pp. 112-35.
[6] Anonymous. “Lady A.A.’s Get Their Heads Together.” The Grapevine.  May 1949. Vol. 5, No. 12, p. 11.
[7]  See, “I’ve Changed My Tune,” “My Son and I and AA,” “Adding Up the Score,” “A Lady’s Gripe,” “I’ve Got What I Want for Christmas,” all from The Grapevine. December 1955.  Vol. 12, No. 7.Shop ad_book arts