The Enduring Impact of the X-Ray

Today we have part two of a guest post written by Dr. Daniel S. Goldberg, 2016 recipient of the Audrey and William H. Helfand Fellowship in the History of Medicine and Public Health. Part one can be read here.

X-ray exhibitions were hugely popular all over the country, and the greater NY area was no exception.  At a February 1896 demonstration run by Professor Arthur Wright, director of the Sloan Laboratory at Yale University, a newspaper reported that despite the auditorium being literally jam-packed, students were still crawling through windows 30 minutes into the lecture — and all this despite the fact that none of the audience, save those in the first few rows, could even hear Wright’s discussion.  The deans of multiple Yale schools (Divinity, Law, and Science), the head of the Yale Corporation, and the chief medical examiner were all in attendance.

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Perhaps the first published X-ray in the United States of a clinical condition. In “Rare Anomalies of the Phalanges Shown by the Röntgen Process,” Boston Medical and Surgical Journal 134(8), February 20, 1896: 198–99.

The pressing question is “why”? Why did X-rays exert such tremendous power across a wide spectrum of social domains? (X-rays were a constant topic of conversation in sermons and religious journals, in women’s journals, in influential satirical periodicals like Punch, and were the subject of a seemingly endless number of political and non-political cartoons, to name but a few).  Although historians of the X-ray have offered a number of plausible answers, I believe there is a key element left unexplored in the historiography: the intellectual frameworks, or ideas, relating to changing ideas of truth, doubt, and objectivity in U.S. society at the time.

Two of these frameworks are most useful in unpacking the stunning impact of the X-ray: the rise of mechanical objectivity, and what can be called “somaticism” within medicine and science.  Historians of science Lorraine Daston and Peter Galison explain that a new model of ‘objectivity’ begins to take hold during the middle decades of the 19th century.  Under this new model, the truth-value of scientific knowledge is a function of the investigator’s ability to remove or eliminate human, subjective influence from the knowledge-making process.  The fact that this is more or less impossible, and that X-rays can be manipulated in all sorts of ways was well-known to contemporaries and remained a source of anxiety for some time.  The important point is the ultimate goal: to let the mechanical processes of nature speak for themselves and reveal their truths.  Ideas of objectivity, as Daston and Galison point out, have for over four hundred years been connected to scientific images, which makes media like photography and X-rays especially significant.

By the end of the 19th century, ideas of mechanical objectivity begin to fundamentally reshape ideas of what is known and what is certain.  This is especially crucial in a century that features so much intense change, including but not limited to governments, family and labor structures, migration patterns, and, of course, industrialization and urbanization.  Late Victorians were beset with anxieties connected to their changing world, and they were especially concerned with artifice and deception — that the world was not what it seemed.  As such, intellectual frameworks that shaped the criteria for truth were hugely influential, and traveled well beyond narrow networks of scientists and medical men.

Somaticism integrates in important ways with constructs of mechanical objectivity.  Historians of medicine have documented the influence of somaticism (or, “empiricism,” as it is also sometimes termed) within medicine over the long 19th century.  The core of the framework is that truths about disease and the body are to be found in pathological anatomical objects.  The existence of these objects can then be clinically correlated with the illness complaints the patient has, or more likely had given that pathological objects are most likely to be located precisely during a postmortem — until the X-ray.  The truths of the sick body are to be found in the natural objects of disease, which makes seeing those objects so essential.  Laennec himself explained that the point of the stethoscope was not to listen; listening was merely a means to an end.  The point, as Jacalyn Duffin explains, was “to see with a better eye.”

Collectively, these frameworks go a significant length in explaining the enormous and enduring social impact of the X-ray.

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Article from the New York Record. May 1896.

For example, Morton’s clippings contain a May 1896 article from the New York Record entitled “X Rays for a Consideration: Light in a Human Kidney.”  The article details what may be the first private X-ray laboratory opened in New York City, founded by Mrs. M.F. Martin, and located at 110 East 26th Street.  The lab was intended solely for the use of physicians and hospitals.  One of its first patients was a doctor named George McLane, who traveled from North Dakota to have his kidney X-rayed for evidence of a possible stone.  A surgeon removed McLane’s kidney, and Morton placed it on a plate and subsequently irradiated it with X-rays.  The procedure “revealed the absence of any stone in the organ, demonstrating the entire reliability of doctors to prove the absence of stone in the kidney.”

The X-ray shines its light into the hitherto dark spaces inside the human body, revealing the truth of a disputed question: whether McLane suffered from a kidney stone or not.  The truth resides in the natural object itself, and the mechanism of the X-ray supposedly insulates the production of medical knowledge from the whims and artifices of the investigator (as compared to illustrations and drawings, for example).

Or, as Dr. McLane himself stated at the Post Graduate Hospital (the primary hospital at which Morton cared for inpatients):

“Dr. McLane spoke modestly at the Post Graduate Hospital about the risk he had taken in the name of science . . . ‘Hitherto a great many mistakes have been made owing to the inability of doctors to prove the absence of stone in the kidney . . .’  Now, by a very simple process, the truth can easily be determined.”

It is difficult to imagine how powerful it must have been, in 1896, to witness an X-ray operator remotely anatomize the living body.  Seeing inside the body had been a dream of physicians for centuries prior, and there is every reason to believe that its achievement has not eroded much of its social power.  Americans still perform significantly more medical imaging procedures than virtually any of our comparator societies, and what is most interesting is the evidence that this utilization is driven both by supply and demand.  That is, it is not merely that we have expensive X-ray and medical imaging machines — so we use them.  Across a wide variety of illness paradigms, illness sufferers and patients request medical imaging; they want it to be performed on their bodies.  The history of the X-ray helps us understand the enduring power of these tools, of what it means to delve into the penetralium.

The Early Days of the X-Ray

Today we have part one of a guest post written by Dr. Daniel S. Goldberg, 2016 recipient of the Audrey and William H. Helfand Fellowship in the History of Medicine and Public Health. Dr. Goldberg is trained as an attorney, a historian, and a bioethicist.  He is currently on the faculty at the Center for Bioethics and Humanities at the University of Colorado Anschutz Medical Campus.

After news of Wilhelm Röntgen’s discovery of X-rays was cabled across the Atlantic late in 1895, evidence suggests X-ray experimentation was taken up eagerly all over the U.S. almost immediately.  While scientists and physicians scrambled to build their own X-ray machines, newspapers in major cities throughout the country eagerly reported on their progress, with stories small and large appearing in nearly every significant daily from New York and Philadelphia to Chicago and St. Louis to San Francisco and Los Angeles.  Historians of the X-ray estimate that within only a year of Röntgen’s discovery, literally thousands of articles had been published on the X-ray in both lay and expert periodicals.  Even in the fertile print culture of 1896, this is a significant accounting.

Therein lies the methodological difficulty for the historian of the X-ray.  So often, the craft of history is a tedious search for small scraps of information that may not even exist.  Yet, as to X-rays, the problem is one of feast, not famine.  With so much print material appearing in so many different sources in so many different places all at the same time, sifting through the morass to articulate coherent and important narratives is difficult.

What makes this task far easier is a remarkable collection held at the New York Academy of Medicine Library.  The William J. Morton Collection is a small holding, consisting of only two boxes.  The second box is the true treasure, containing a single folder, approximately six inches thick.  Inside is an unbound series of pages consisting solely of newspaper clippings related primarily to early X-ray use in the U.S.  These are Morton’s clippings, and as far as is known, the order and arrangement of the pages is original to Morton himself.  The collection is astounding, for it represents something of an index or a cipher for the ferment of X-ray use in NYC in the first half of 1896.

Clippings

Newspaper clippings from the William J. Morton Collection, New York Academy of Medicine Library.

There is no question that New York City played an important role in early X-ray use, if for no other reason than the enormous shadow cast by the inventor, Thomas Edison.  There were, however, many other important figures involved in early X-ray use in NYC, including Nikola Tesla[1], Michael Pupin[2], and Morton.  Morton, the son of William T.G. Morton of anesthesia fame, was a prominent physician, a fellow of the New York Academy of Medicine, and a respected neurologist and electro-therapeutic practitioner.

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A telegram dated January 2, 1896 from Dyer & Driscoll, attorneys for none other than Thomas Edison, indicated that Morton visited Edison’s workshop for the purpose of conducting experiments (almost certainly with X-rays) several days earlier.

Because Morton was unquestionably at the forefront of early X-ray experimentation in NYC, his curation is a reasonable index as to important events and moments in the early use of X-rays in NYC.  There are limitations to this approach, of course.  Morton was obviously interested in his own role in early X-ray experimentation, so there is something of a selection bias at work (although it should be noted that there are no shortage of clippings pertaining to Pupin’s important work).

The collection is full of interesting and significant stories in the early history of X-ray use.  For example, in March 1896, strongman Eugene Sandow, considered the father of modern bodybuilding, turned to Morton in an effort to locate the source of a frustrating pain he was experiencing in his foot.  Apparently Sandow had stepped on some broken glass, but even his personal physician could not specify the location of the glass in his foot.  The potential for the X-ray must have seemed obvious, and Sandow reached out specifically to Morton to see if he could be of help.  Morton was eager to oblige.  He turned the X-rays on Sandow’s foot and located the shard of glass disturbing Sandow’s equanimity.  A surgeon subsequently operated and removed the glass, and the story made national news.

How the photograph was made_watermark

The X-Ray of Eugene Sandow’s foot in process.

Interestingly, Sandow was apparently impressed enough with the powerful rays to send an unsolicited telegram to Edison, offering his services as a human subject for any X-ray experiments Edison wished to undertake.

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Letter to Thomas Edison from Eugene Sandow.

It is difficult to imagine how powerful it must have been, in 1896, to witness an X-ray operator remotely anatomize the living body.  Seeing inside the body had been a dream of physicians for centuries prior, and there is every reason to believe that its achievement has not eroded much of its social power.  Americans still perform significantly more medical imaging procedures than virtually any of our comparator societies, and what is most interesting is the evidence that this utilization is driven both by supply and demand.  That is, it is not merely that we have expensive X-ray and medical imaging machines; so we use them.  Across a wide variety of illness paradigms, illness sufferers and patients request medical imaging; they want it to be performed on their bodies.  The history of the X-ray helps us understand the enduring power of these tools.

Footnotes:
[1] Tesla was heavily involved in early X-ray experiments in his laboratory at 46 East Houston Street; much to Edison’s likely chagrin, given the frostiness of their relationship by the time. The New York newspapers constantly asked Edison about Tesla’s progress.
[2] Pupin, a Columbia University physicist, would in short order — in 1896, in fact —  go on to discover a way of substantially reducing the exposure time needed to produce an X-ray image from hours to minutes.  The basics of Pupin’s method are still used today.

The Architecture of Health Care (Part 2)

Today’s guest post is written by Bert Hansen, Ph.D., professor emeritus of history at Baruch College of CUNY.  He is the author of Picturing Medical Progress from Pasteur to Polio: A History of Mass Media Images and Popular Attitudes in America (Rutgers, 2009), and other studies of medicine and science in the visual arts.  He is presenting an illustrated lecture about historic New York City buildings, followed by two walking tours-Uptown (May 13) and Downtown (May 20).  His 6 pm talk on Thursday, May 11, is entitled “Facades and Fashions in Medical Architecture and the Texture of the Urban Landscape.”  To read more about this lecture and to register, go HERE.

Part 1 introduced readers to the architectural firm of Sawyer and York and two of their medical buildings.  Part 2 now looks at Charles B. Meyers, who was responsible for dozens of major buildings in New York City and farther afield, including more than a dozen hospitals just in the city.  Still, he remains largely unknown outside of architectural history circles.

Readers of this blog are likely to know the red brick Psychiatric Hospital at Bellevue and Manhattan’s towering Criminal Court Building and House of Detention (New Deal WPA, 1938-41), sometimes called “The Tombs,” taking the name of an earlier building in neo-Egyptian style.[1]  Less familiar will be Morrisania Hospital in the Bronx and the Baruch College administration building (originally Family Court, 1939) on 22nd Street and Lexington Avenue.[2]  Some will have seen or visited the giant cube on Worth Street that housed the City’s Department of Health until 2011.  But it’s unlikely many could connect any of these with an architect’s name.  Even fifty years after his death, the imprint of Meyers on the look of New York is enormous while his name and career remain obscure.  Readily familiar buildings are seldom remembered as his elegant work.

Charles Bradford Meyers (ca.1875-1958) was an alumnus of City College and of Pratt Institute.  Early he worked in the office of Arthur Napier.  By the 1910s, he had began to specialize in schools, hospitals, and other public buildings.  Among about a dozen New York City hospitals he built, the Psychiatric building at Bellevue (1931) is one of the most familiar, in the red-brick and white-stone Beaux-Arts style that McKim Mead and White had established in their master plan for the Bellevue campus.

Fig1

The original Bellevue Psychiatric Hospital building (462 First Avenue). Source: Wikipedia.

His headquarters building for the New York City Department of Health (1935) at 125 Worth Street, right near two be-columned neo-classical courthouses, is a sleek, if monumental Art Deco cube with the names of famous healers inscribed on all four facades.  This building was one of many supported by federal infrastructure funding through the New Deal.  Nearby is another monumental work of his, the Manhattan Criminal Court Building of 1938-1941).  It, too, was a New Deal effort, one of thousands of such projects that are being documented in a crowd-sourced web-site, The Living New Deal.[3]

Fig2

New York City Department of Health (125 Worth Street). Source: Bert Hansen.

The former Morrisania Hospital (1929) in the Highbridge section of the Bronx is now an apartment cooperative, not generally accessible to architecture buffs or the public in general.  But I had an opportunity to visit last October during the weekend of Open House New York, when hundreds of generally private spaces are opened to the curious.

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The former Morrisania Hospital (East 168th Street between Gerard and Walton Avenues in the southern Bronx). Source: New York Housing Conference.

In the mid 1970s, Morrisania Hospital was closed at the time of the city’s fiscal crisis of the 1970s, and the building sat empty for about twenty-five years.  During the time when its future was in doubt and it might have been demolished and lost to posterity, Christopher Gray wrote about it in his “Streetscapes” column in the New York Times (15 July 1990) with his characteristic blend of reportage and criticism:

“The façades are generally straw-colored brick, although they range from a light beige to a deep orange.  They are ornamented with delicately molded Renaissance-style terra cotta in acanthus leaf, egg and dart, Greek key and similar patterns.  Red roof tiles provide a final accent.  Although the main elevation, facing 168th Street, is fussy and over-decorated, the bulk of the complex is an educated, tasteful design—above the norm for municipal architecture in this period.”[4]

Fig3

Façade of the former Morrisania Hospital building. Source: Bert Hansen.

Gray wrote this column weekly from 1987 to 2014, offering such stimulating insights over more than twenty-five years.  I was one of his readers and, in retrospect, I now realize how much he shaped my awareness of the visual pleasures of the New York City’s historic architecture.  After Gray’s death earlier this spring, another New York Times writer on architecture and urban life, David W. Dunlap, called to mind Gray’s distinctive approach:  “Gray did not serve up conventional architectural assessments. . . .  His columns were narratives of creation, abandonment, and restoration that lovingly highlighted quirky design and backstairs gossip from decades past.”  And Gray himself, perhaps thinking of overlooked treasures like Morrisania Hospital, had once remarked, “I am much more interested in minor-league, oddball structures than in tour-bus monuments like the Woolworth Building.”[5]

Meyers was a prolific architect with a career of nearly sixty years.  His buildings exhibited a remarkable range of uses and aesthetic styles.  Because they are scattered around the city (and beyond), one can’t do a Charles B. Meyers walking tour.  But the historically curious can still visit former hospital buildings like Morrisania and Bellevue Psychiatry as well as the elegant downtown Art Deco cube that he built for the Health Department (since relocated to Queens) and that is now called the Health, Hospitals, and Sanitation Departments Building.

References:
[1] Norval White, Elliot Willensky, and Fran Leadon, AIA Guide to New York City, fifth ed. (Oxford University Press, 2010), p. 80.
[2]Alex Gelfand, “The Development and Evolution of the Baruch Campus,” (including photographs of architectural decoration on the Meyers building).
[3] The Living New Deal. “Manhattan Criminal Court Building-New York NY.”
[4] Christopher Gray, “Streetscapes: Morrisania Hospital; A Tidy Relic of the 1920’s Looking for a New Use,” New York Times, July 15, 1990, p. R8.
[5] David W. Dunlap, “Christopher Gray, Who Chronicled New York Architecture, Is Dead at 66,” New York Times, March 14, 2017, p. B15.

The Architecture of Health Care (Part 1)

Today’s guest post is written by Bert Hansen, Ph.D., professor emeritus of history at Baruch College of CUNY.  He is the author of Picturing Medical Progress from Pasteur to Polio: A History of Mass Media Images and Popular Attitudes in America (Rutgers, 2009), and other studies of medicine and science in the visual arts.  He is presenting an illustrated lecture about historic New York City buildings, followed by two walking tours-Uptown (May 13) and Downtown (May 20).  His 6 pm talk on Thursday, May 11, is entitled “Facades and Fashions in Medical Architecture and the Texture of the Urban Landscape.”  To read more about this lecture and to register, go HERE.

Even people who are not architecture buffs usually recognize big contemporary names in architecture like I. M. Pei (the Louvre pyramid) of Pei Cobb Fried and Partners (Bellevue’s new Atrium Pavilion, 2005) or Skidmore Owings and Merrill (New York University Medical School buildings in the 1950s and Mt. Sinai’s Annenberg Pavilion of 1976).  Most New Yorkers have also run into the firm of McKim Mead and White’s many New York City buildings and their master plans for Columbia University and the Bellevue Hospital campus.

But what about Charles B. Meyers and the firm of York and Sawyer—both from the early twentieth century?  New Yorkers certainly know several of their contributions to the architecture of health care and to the cityscape more widely, but usually without knowing the designers’ names.

This blog introduces York and Sawyer.  The work of Charles B. Meyer will appear in a subsequent installment.

Flower-Fifth Avenue Hospital

The former Flower-Fifth Avenue Hospital (1249 Fifth Avenue).  Source: © Matthew X. Kiernan/New York Big Apple Images.

In 1921, their handsome and stately Fifth Avenue Hospital in Beaux-Arts style was completed and dedicated.  It spanned the block between 105th and 106th Streets, facing the entrance to Central Park’s Conservatory Garden.  The lower parts of the facade were of light colored limestone blocks and the upper parts were stucco in the same color.  It had terra cotta trim and a tile roof.  Although its X-shape floor plan was traditional, this design broke new ground in being a hospital without wards—only private rooms.[1]  The hospital was later renamed Flower-Fifth Avenue Hospital, and the building is currently home to the Terence Cardinal Cooke Health Care Center.

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Flower-Fifth Avenue Hospital floor plan of the fourth and fifth floors. Source: Architecture Review (1920).

The principals of the firm were Edward York (1863–1928) and Philip Sawyer (1868–1949), who established their firm in 1898 after they met while both were employed at McKim Mead and White.  They continued the American version of Beaux-Arts principles exemplified by McKim Mean and White’s work even as they expanded classical and Renaissance style to high-rise buildings made possible by the invention of the Otis safety elevator.  Among their many New York City buildings, readers are probably familiar with the New York Historical Society on Central Park West, the Federal Reserve Bank on Liberty Street, the Bowery Savings Bank on East 42nd Street, and the Central Savings Bank on 73rd Street between Broadway and Amsterdam (now the Apple Bank for Savings).

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Federal Reserve Bank (33 Liberty Street). Source: Wikimedia Commons.

Just four years after the Fifth Avenue Hospital opened, the New York Academy of Medicine laid a cornerstone for its new home on Fifth Avenue at 103rd Street, also designed by York and Sawyer.  This building had a dedication on November 18, 1926, which the following day’s New York Times headlined “Medical Academy in $2,000,000 Home.”  (Adjusted for inflation that project would cost about $27 million today).  An Italianate palazzo with Romanesque and Byzantine elements and faced in large stone blocks of variegated greys, the Academy was quite different from the classical lines and the uniform light color of their nearby hospital.  But both were beautiful additions to a rapidly developing upper Fifth Avenue, now often called “Museum Mile.”  They were proud—and enduring—achievements for the architects and for the health care institutions they served so well.

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The New York Academy of Medicine (1216 Fifth Avenue).

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Entrance to the New York Academy of Medicine.

Reference:
[1] Anonymous, “The Fifth Avenue Hospital and Laura Franklin Free Hospital for Children, New York City: York & Sawyer, Architects, Wiley Egan Woodbury, M.D., Consultant,” The Architectural Review 11:5 (November 1920), 129-140 plus unnumbered glossy plates.

Crimson in Memory

By Emily Miranker, Events and Projects Manager

In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie
In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.

Canadian doctor John McCrae wrote this poem on a May morning in 1915 in Ypres, what had been a stunning Belgian medieval city then horribly bombarded in the ghastly slaughter of the First World War. The evening before McCrae wrote In Flanders Fields, he presided over the burial of his friend Lt. Alexis Helmer, who died by German shellfire on May 2.[1]

John_McCrae_in_uniform_circa_1914

John McCrae in uniform circa 1914.  Source: William Notman and Son – Guelph Museums, Reference No. M968.354.1.2x

McCrae was one of many soldiers serving in WWI who found writing poetry an outlet for the horrors and grief, hope and homesickness of the conflict; others include Wilfred Owen, Siegfried Sassoon, Rudolf Binding, and Laurence Binyon. In Flanders Fields may be among the best known poems from the era today, in part due to the power and symbolism of the poppy flowers he evoked.

The flowers McCrae was looking at that May were Papaver rhoeas, the corn poppy beautifully shown in The British Flora Medica by Benjamin Barton. The sensation caused by the publication of McCrae’s poem got the flower rechristened the Flanders poppy.

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Red or corn poppy. Source: The British flora medica: a history of the medicinal plants of Great Britain by Benjamin H. Barton and Thomas Castle (1877).

In the popular mind, the corn (or Flanders) poppy is often confused or conflated with its cousin, Papaver somniferum –bringer of sleep- the opium poppy. Papaver somniferum pods contains a resin that has morphine and codeine (the only flowering plant known to contain morphine).[2] Both species spread to Europe and across Asia from the Middle East, helped along by trade routes as well as the Crusades. Since ancient times the opium poppy was used as a pain killer, making it a constant companion throughout history to the battlefield wounded, to veterans, and to civilian populations. In high enough doses, it can cause death. By contrast, the corn poppy’s milky sap contains alkaloid rhoeadine, a sedative. From ancient times to the present, the corn poppy has been used to make soporific tea, a milder respite than that offered by its cousin.

Woodville_opium poppy_1793_watermark

Opium poppy. Source: Medical Botany by William Woodville (1793).

The corn and opium poppies have had a long relationship with people and war. Indeed, the opium poppy gave its name to conflicts over British trade rights and Chinese sovereignty in the min-19th century,  called The Opium Wars.

Poppies have been on many battlefields as relief from pain, a resource to fight over, and as a vivid, little sign of hope or remembrance. The flower as an official symbol for remembrance has roots in New York City.

University of Columbia professor and humanitarian Moina Belle Michael wrote a response to McCrae’s poem, We Shall Keep the Faith, in 1918. Inspired by McCrae’s imagery, she wore a silk version in remembrance of the war’s dead, and spearheaded the American movement to have the flower officially recognized as a memorial symbol, and for money from its sale to help veterans. Across the Atlantic, another Poppy Lady, Anna Géurin, campaigned for selling flowers particularly to aid the women and orphans of France.[3]

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Eastern poppy. Source: The Botanical Magazine, v2, plate 57 (1788).

Poppies grow most readily in churned earth, so they flourish around people who constantly disturb, till, and work soil for various reasons: to build, to garden, to bury the dead. Before the upheavals of trenches and bombardment, poppies grew in Flanders, but not to the extant described by American William Stidger working for the YMCA in French battlefields in WWI:

“a blood-red poppy…[by the millions] covering a green field like a blanket…I thought to myself: They look as if they had once been our golden California poppies, but that in these years of war every last one of them had been dipped in the blood of those brave lads who died for us, and forever after shall they be crimson in memory of these who have given so much for humanity.”[4]

A grisly fact underlay the profusion of poppies on the Western Front. The soil of Flanders had not been rich enough in lime to sustain massive numbers of poppies. The infusion the earth received from the rubble of towns and the calcium from human bones allowed the poppies to flourish in greater numbers than ever before; a fitting beacon of regeneration as well as an ever present sign of the dead and destruction.

References:
[1] David Lloyd. Battlefield Tourism: Pilgrimage and the Commemoration of the Great in Britain, Australia and Canada. Oxford: Berg; 1998.
[2] Nicholas J. Saunders. The Poppy: A History of Conflict, Loss, Remembrance & Redemption. London: One World; 2013.
[3] The Story Behind the Remembrance Poppy. The Great War 1914 – 1918. Accessed April 13, 2017.
[4] William Stidger. Soldiers Silhouettes on our Front. New York, Scribner’s Sons; 1918.

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Graduations and Congratulations

By Lisa O’Sullivan, Director

Graduation season is quickly approaching, which means students in medicine, nursing, and the allied health professions will soon be celebrating their accomplishments with family and friends. To help celebrate, we have designed a new collection for our online shop featuring medical symbols.

Some of the symbols of health and medicine are relatively new historically, while others have a long and complex history.  Perhaps the most persistent symbol of medical care is the caduceus, the snakes coiled around a staff. The origins of the symbol go back to the classical world, where Asclepius, the god of medicine, was generally depicted carrying a staff with a snake coiled around it.  Asclepius’s staff was gradually replaced by the caduceus, which shows two snakes entwined around each other and a central staff.[1]

Blue Cadu chocolates

An elegant caduceus drawn by renowned obstetrics pioneer, maternal health educator, and Academy Fellow, Dr. Robert Latou Dickinson.

Asclepius’s daughter, Hygieia, was the goddess of health, cleanliness, and sanitation. Hygieia was often symbolized by a snake drinking from a bowl , and was shown in sculptures and images with a serpent entwined around her. Her chalice and bowl remain a potent symbol of pharmacy around the world.[2]

Bowl of hygieia china cup

This Hygieia mug was made using an image of the brass inlay from the lobby floor of The New York Academy of Medicine.

The stethoscope, invented by René-Théophile-Hyacinthe Laënnec in 1816, only took on the binaural form familiar today in the mid-19th century after much experimentation. The double stethoscope, which allowed the physician to listen to the sounds of the body with both ears, relied on the incorporation of flexible materials such as rubber and gutta-percha to become truly practical.[3]

Scalpel & Stetho totebag

The scalpel and stethoscope” was a late 19th century monthly magazine for “the surgical and medical professionals, and all kindred branches.”

Some version of a professional oath in which health professionals pledge to conduct themselves along strict ethical lines is a standard feature in most medical graduations. The most common and well-known of these is the Hippocratic Oath. The Oath is commonly dated to the fourth century BCE. Its original form was modified in Christian Europe in the medieval period, and has been in use in one form or another ever since, becoming particularly prevalent in the post-World War II era.[4]

Oath Notebook

 An early 20th century illustration of the Hippocratic Oath.

You can find these and other symbols on a range of products in our online shop’s Graduation Collection.  All proceeds from the Library shop support the preservation of the Library’s collections and its public programming in history, the humanities and the arts.

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References:
[1] O’Sullivan L. Snakes in Medicine: Slippery Symbolism.  Books, Health and History. The New York Academy of Medicine, 29 Aug. 2012.
[2] History of the Bowl of Hygeia award. Drug Topics 2002;19. 
Accessed 6 Apr. 2017.
[3] Blaufox MD. An ear to the chest : an illustrated history of the evolution of the stethoscope. Boca Raton : Parthenon Pub. Group; 2002, pp41-62.
[4] Hulkower R. The history of the Hippocratic Oath: outdated, inauthentic, and yet still relevant. Einstein Journal of Biology and Medicine. 2016; 25(1):41-44

Preservation Week: Health Pamphlet Rehousing Project Moves Forward with Support from the National Endowment for the Humanities

By Yungjin Shin, Collections Care Assistant

To celebrate Preservation Week, sponsored by the ALA’s Association of Library Collections and Technical Services, we would like to highlight our work with our Health Pamphlet Collection.

One of the major preservation projects at the Gladys Brooks Book and Paper Conservation Laboratory is the Health Pamphlet Rehousing Project, which is funded in part by a grant from the National Endowment for the Humanities (NEH). The Health Pamphlet Collection includes approximately 50,000 health-related pamphlets dating from the 19th to the early 20th century.

The current process involves multiple steps: pulling the pamphlet boxes from the stacks — cleaning the pamphlets and assessing them for future treatment — transferring the pamphlets to envelopes with custom fitted supports — updating the bibliographic information in the online catalog — building custom designed storage boxes — labeling the envelopes and boxes— rearranging as needed —and re-shelving to the new location.

Here is a behind-the-scenes video that shows the overall process, start to finish.

 

The project is currently scheduled to be completed in January 2018.

Preservation week

Scent Track

Today’s guest post is written by Ann-Sophie Barwich, Ph.D., scholar in the Presidential Scholars in Society and Neuroscience program at the Center for Science and Society, Columbia University. Her work is on current and past developments in olfactory research (1600 to today). On Wednesday, April 26, Barwich will give her talk, “Scent Track: What can the History of Olfaction tell us about Theorizing in the Life Sciences?” To read more about this lecture and to register, go HERE.

Scientific interest in the senses has always been preoccupied with vision and its underlying mechanisms. In comparison, smell is one our least understood senses. This may sound surprising given the importance of smell in flavor perception. Human cuisine represents one of the most central elements of human culture. While the cultural history of scent has gathered sufficient attraction in the humanities and social sciences, its scientific history has yet to be told.

Many of the central research questions about the characteristics of olfaction remain unresolved even to date. How do we classify smells? How many smells are there, and is there such a thing as olfactory primaries? Modern research on smell was revolutionized with the discovery of the olfactory receptors by Linda Buck and Richard Axel in 1991. Their discovery presented the key causal entity to model the molecular basis of smell and granted them the 2004 Nobel Prize in Physiology of Medicine. Since then, olfaction started to emerge as a modern model system in neuroscience.

Nonetheless, records of scientific theorizing about the material basis of odor reach much further back. These hidden experimental records of research on smell offer us an intriguing, yet untold, history of creativity in scientific reasoning. For large parts of the history of science, scientific approaches to smell were faced with its apparent lack of testability. An inherent difficulty for odor description and classification is that sense of smell is incredibly hard to study in a controlled setting. How do you visualize and materialize odor to turn it into an object of objective measurement and comparison? In reply to these questions, several answers were developed from various disciplinary perspectives throughout the past centuries. These ideas present a hidden heuristic source for widening our theoretical understanding of smell even today.

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Linnaeus’ classification of odors in medicinal plants in his Clavis Medicinae (1766).

My talk reconstructs a conceptual history of materiality that has informed scientific approaches to smell, and I analyze this material history of olfaction by three stages. First, smells are investigated as “objects in nature,” drawing on 18th-century expertise in botany and horticulture that arranged odors according to their diverse plant origins. Botanical classifications, such as in Linnaeus’ Odores Medicamentorum (1752) and Clavis Medicinae (1766), conceptualized odors as objects in nature. Here, the affective nature of smell was investigated with regard to the medicinal powers of plants. Meanwhile, perfumers have always experimented with odorous plant substances but their knowledge was a well-kept secret. Some records, such as George William Septimus Piesse’s The Art of Perfumery (1857), illustrate that these practices addressed the various possibilities for the material manipulation of odorous substances (e.g., through mechanical force, solvent extraction, distillation). They further conceptualized the psychological effects of odor by analogy with other sensory qualities such as taste, color, and sound. Can we blend odors like colors? Can we understand the harmony between odor notes in parallel with musical chords?

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Analogy of odors with sounds to define harmonic chords in perfumery. Source: Piesse 1857, The Art of Perfumery.

Second, smells are framed as “objects of production” in light of the industrialization of perfumery after the rise of synthetic chemistry at the end of the 19th-century. In earlier chemistry, smells were modeled as immaterial spirits that represented vital forces, such as in the Spiritus Rector theory by Herman Boerhaave. This theory was soon abandoned by a more mechanistic causal understanding of odorous particles, especially after Antoine-François de Fourcroy’s extraction of urea as the ‘smelling principle’ of horse urine. This discovery of the chemical basis of odors and its subsequent exploration with the rise of synthetic chemistry presented a fundamental conceptual liberation of smells from their plant origins. New scents, sometimes even unknown in nature, were now produced in the laboratory.

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Vanillin was first synthesized by Ferdinand Tiemann and Wilhelm Haarmann in 1874. It’s synthesis, illustrated above, was further refined by Karl Reimer in 1874. Source: Wikipedia (Yikrazuul).

Third, the introduction of molecular visualization and computational techniques in the 20th century abstracted smells further from their natural origins, and this advancement laid the foundation for smells to turn into what Hans-Jörg Rheinberger calls “epistemic objects.” This transformation signifies the integration of smell into the growing scientific domain of biochemical science. Confronted with the sheer diversity of chemical structures responsible for odor qualities, the classification of smells now required the integration of two seemingly separate data sets: a stimulus classification of chemical similarity on the one hand and an ordering of perceptual classes on the other. In this context, the food scientist John Amoore proposed a classification of five to seven primary odors in the 1960s and 1970s.

While this classificatory strategy was soon rendered too simplistic, it provides one of the earliest expressions of a central question in modern olfactory research: How does the chemical basis of odors relate to their perceptual quality? Can we predict smells from the molecular structure of their stimuli? Notably, this question remains open but of central scientific interest today.

Join us on Wednesday, April 26 to learn more about this topic. To RSVP to this free lecture, click HERE.

 

Robert L. Dickinson: Doctor and Artist

Today’s guest post is written by Rose Holz, Ph.D., historian of medicine and sexuality at the University of Nebraska – Lincoln where she serves as the Associate Director of the Women’s & Gender Studies Program and Director of Humanities in Medicine.  She is the author of The Birth Control Clinic in a Marketplace World (Rochester, 2012). Her current project investigates the intersection of medicine and art by way Dr. Robert L. Dickinson (1861-1950) — gynecologist, sexologist, and artist extraordinaire — and his prolific ten-year collaboration with fellow artist Abram Belskie (1907-1988). Not only did it yield in 1939 the hugely influential Birth Series sculptures but also hundreds of medical teaching models about women’s and men’s sexual anatomies. On Thursday, April 13, Rose will give her talk, “Art in the Service of Medical Education: The Robert L. Dickinson-Belskie Birth Series and the Use of Sculpture to Teach the Process of Human Development from Fertilization Through Delivery.” To read more about this lecture and to register, go HERE.

My interest in Dr. Robert L. Dickinson began many years ago when I was in graduate school, working on my Ph.D. in history and writing my dissertation on the history of birth control clinics in America. And, as has been the case with so many other scholars who have written about matters related to women, medicine, and sexuality in the twentieth century U.S., Dickinson made his brief cameo entrance into my story, though not without leaving behind a lasting impression.

For me it was the images — because, like me, Dickinson was compelled to color and draw. Early on, while pouring over Planned Parenthood records, I remember chuckling over a letter he had written to a contraceptive manufacturer complaining about the poor quality of one of their products, to which he then attached a drawing to illustrate his case.

Then there were the birth control manuals Dickinson wrote in the 1930s. Not only did he illustrate all the contraceptive methods then available, but he also offered birds-eye-view, architectural-style drawings to visualize how best to lay out gynecological clinics. More intriguingly still was what he included at the center of this architectural drawing, a tiny woman lying on the gynecological table with her legs spread wide open as the doctor conducted the physical exam.

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Pages from “Control of Contraception (2nd edition)” by Robert L. Dickinson.

As somebody who also loves small things—especially miniature worlds populated by miniature people—I could not help but find myself be smitten by this unusual man. However, at the time I had a different story to tell, a Ph.D. to defend, and a new job as a professor to pursue. And as the years passed, Dickinson slowly receded into the background.

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Drawings of the location of Embryo and size of Fetus. Source.

But Dickinson is not one to be denied, and that he has remained in obscurity for so long somehow explains to me why he has resurfaced—with a glorious vengeance—into my imagination. Indeed, he has made it clear to me that his story will be told; his skills as a doctor and artist properly recognized. And he has made it further clear that this story will begin with what he created in the twilight of his life: The 1939 Birth Series sculptures.

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Dickinson and Belskie’s “Sculptured Teaching Models Collection.” From the unprocessed Abram Belskie Papers, Belskie Museum, Closter, NJ.

Join us on Thursday, April 13 to learn more about Dr. Robert L. Dickinson and his Birth Series sculptures. To RSVP to this free lecture, click HERE.

War Wounded

Paul Theerman, Associate Director

On April 6, 1917, the United States entered the Great War on the side of the Allied powers. By the following fall, those powers were victorious, in part due to the American presence, adding industrial might and men to the stalled conflict and making up for the Russian withdrawal after the October Revolution.

Combat is the most vivid part of war. Victory often depends, however, on maintaining the military effort, and this meant mobilization, training, logistics, supply, and above all, the “medical front.” Armies had to take the wounded soldier, help him heal, and return him to battle. For World War I, that front was where men’s wounds met the medical machine.

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From a training book for stretcher bearers. Image source.

How were men wounded in the war? The strain and the boredom of trench warfare are part of our collective memory; the drama of that war comes from two sources: mustard gas and machine guns. The use of chemical weapons and the mechanization of shooting brought horror to men’s lives at the front. Yet they were not the greatest source of casualties. By far, artillery was the biggest killer in World War I, and provided the greatest source of war wounded.

In his book Trench: A History of Trench Warfare on the Western Front (2010), Stephen Bull concluded that in the western front, artillery was the biggest killer, responsible for “two-thirds of all deaths and injuries on the Western Front.”[1] Of this total, perhaps a third resulted in death, two-thirds in injuries. Artillery wounded the whole body. If not entirely obliterated, the body was often dismembered, losing arms, legs, ears, noses, and even faces. Even when there was not superficial damage, concussive injuries and “shell shock” put many men out of action. Of course, shooting—in combat as well as from snipers—was another great source of wounding. Gas attacks were a third. Phosgene, chlorine, mustard gas, and tear gas debilitated more than killed, though many ended up suffering long-term disability. Overall the war claimed about 10 million military dead, and about 20–21 million military wounded, with perhaps 5% of those wounds life-debilitating, that is, about a million persons.[2]

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Moving the wounded. Image source.

Outcomes depended on getting treatment quickly. Evacuation and triage became watchwords of the war-wounded. For the British Army, for example, the Royal Army Medical Corps developed an extensive system to move the wounded from the front to the rear, with triage at each step. Stretcher bearers evacuated the wounded to Regimental Aid Posts (RAP)—or at least those that they had the means to move, for when stretcher-bearers were few, the worst cases were left on the field of battle.

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The path from the front to the hospital. Image source.

In one report of a man severely wounded in the abdomen, “Since ‘death awaited him with certainty . . . I gave him a hypodermic of morphia and we propped him up as comfortably as we could’ and left him there.”[3] Behind the RAPs were Advanced Dressing Stations, then further back Main Dressing Stations, and finally, Casualty Clearing Stations. Each move to the rear—always challenging in itself—was based on an assessment of the injury and the chances of survival. The lightly wounded—those likely to recover quickly—and the “moribund”—those likely to die—were kept, and the others sent on. Each station provided stabilization and immediate care, with some basic surgeries, such as amputation, at Casualty Clearing Stations. More advanced treatment occurred at hospitals, either back in Britain or in France. As the war wore on, more of the wounded were kept in France, at hospitals far back from the lines. This was to use less transport and to maintain military morale, with the goal of returning the men to the front as quickly as possible. And indeed, American medical entry into the war came first in the form of hospitals. “The first six [mobile hospitals] to arrive in France took over British General Hospitals and provided hospital level care for the British. Other American hospitals arriving later in the summer of 1917, remained assigned to the American forces.”[4] The Allied pattern of medical triage and evacuation became the model for American efforts.

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The fracture ward; the term “machine shop” likely refers to the frames and power belts that characterized such shops at the turn of the last century. Image source.

How well did the system work? “War is a matter of expedients.”[5] The medical operation was persistently understaffed and under-resourced. In the latter part of the war, as the static front changed to a dynamic one, some medical units had difficulty achieving the mobility needed. And inevitably, given the need continually to evaluate the severity of wounds, and the difficulty of transport, some men ended up in the wrong place, some facilities were too crowded, and others were underused. Finally, in 1918 the medical system began to be overrun with influenza cases. Overall, though, the magnitude of the challenge needs to be kept in mind. In just the American experience, for an army that numbered almost 2 million men in France at the end of the war, 1.2 million men passed through the medical system, with about quarter million military wounded.[6] That is an astounding number for which to provide medical services under severe stress.

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Surgery in a Belgian field hospital. Image source.

References:
[1]“Krilling for Company.” Mud Feud [Review of Trench: A History of Trench Warfare on the Western Front, by Stephen Bull (Osprey Publishing 2010)]. Papyrocentric Performativity. Published July 14, 2014. Accessed March 21, 2017.
[2] The total number of killed from the Allied Powers exceeded that of the Central Powers by over a million; the total wounded exceeded by perhaps 4 million. Accurate statistics are hard come by; these are based on Antoine Prost. War losses. 1914-1918-online: International encyclopedia of the First World War. Published August 10, 2014. Accessed March 21, 2017.
[3] Carden-Coyne A. The Politics of wounds: Military patients and medical power in the First World War. Oxford: Oxford University Press; 2014. P. 65.
[4] Jaffin J. Medical support for the American Expeditionary Forces in France during the First World War. Published 1990. Accessed March 31, 2017. Pp. 95–96.
[5] Helmuth Karl Bernhard Graf von Moltke. Wikiquote. Published October 7, 2006. Updated September 1, 2016. Accessed March 31, 2017.
[6] Jaffin J. P. 166.