Voices from the AIDS Epidemic

By Johanna Goldberg, Information Services Librarian

State of Florida Department of Health and Rehabilitative Services, 1987.

State of Florida Department of Health and Rehabilitative Services, 1987.

Today, health care professionals can use multiple tests to detect HIV infection. Where available, drugs therapies allow people to live with HIV for many years before developing AIDS. Of course, this was not always the case. In commemoration of World AIDS Day on December 1, we are revisiting some of the voices published in the early years of the epidemic.

In 1982, 14 doctors presented their front-line experiences at an international symposium, the proceedings of which were published in book form the following year. Their frustration with their inability to successfully treat their young patients rings out clearly.

“Thirteen of 42 patients in our series have already died. Nationwide, half of the patients have died.” Half of their patients with “Pneumicystis carinii pneumonia (PCP) , the most common infection,” responded to the administered drug . “However, excluding three who are still being treated, only two patients who had PCP are presently alive, even though six recovered from their initial infection.” In the ten patients with Cytomegalovirus (CMV) infection, eight died. “Only one, a 22-year-old man with CMV pneumonia, has recovered.” As the authors go on to say, “treatment remains a knotty problem.”

At another symposium, also published in book form, Dr. Kevin M. Cahill, the senior member of the New York City Board of Health, applauded the efforts of individual doctors and nurses, in addition to the “superb work” of the Gay Men’s Health Crisis.  But he chastised the inaction of the “organized medical community.”

“When a fatal infection had struck down veterans attending an American Legion convention, health professionals across the country joined in the search for a solution. When women using tampons became ill with toxic shock syndrome, medical societies and research centers immediately focused their enormous talents on that problem. But when the victims were drug addicts and poor Haitian refugees and homosexual men, their plight did not, somehow, seem as significant to those expected to speak for the health professions. No major research programs were announced, and until it became clear that the disease could spread to the general population through blood transfusions, organized medicine seemed part of the conspiracy of silence.”

Where are we today? Even with so much knowledge about prevention, the CDC estimates that 50,000 people in the United States become newly infected with HIV each year; about 33,000 people receive AIDS diagnoses. In the United States, HIV incidence in people aged 13-29 rose 21 percent between 2006 and 2009.

Prevention education remains essential. Visit the CDC’s Act Against AIDS page or World AIDS Day’s website to find out more about current prevention and testing measures.

For a year-by-year timeline of the HIV/AIDS epidemic in the United States, visit AIDS.gov.

Cahill, K. M. (1983). The AIDS epidemic.  New York: St. Martin’s Press.

Centers for Disease Control and Prevention. (2012). Basic Statistics. Retrieved November 28, 2012, from http://www.cdc.gov/hiv/topics/surveillance/basic.htm

Gold, J. W. M., Armstrong, D., Sears, C. L., Henry, S., Donnelly, H., Brown, A. E., …Wong, B.(1983). Acquired Immunodeficiency Syndrome: Infection and Neoplasia in Homosexual Men and Intravenous Drug Addicts. In C. S. F. Easmon & H. Gaya (Eds.), Second international symposium on infections in the immunocompromised host (pp. 105–113). London: Academic Press.

Skulls and Surgery

By Lisa O’Sullivan, Director

Row of plaster cast skulls

Plaster casts of skulls held in the NYAM Rare Book Reading Room, some showing signs of trepanation.

The practice of trepanning, or trepanation, which involved making a hole in the skull, is one of the oldest known surgical procedures. Skulls with holes have been found from the Neolithic period, and the technique continued to be practiced by cultures across the world. The surgeries relieved swelling of the brain and skulls showing bone regrowth indicate that the treatment was survived by many.  The reasoning behind such surgeries changed over place and time, and included questions of spiritual possession, convulsions, fractures and infections.

On Thursday, December 6, the fascinating history of such surgical procedures and the development of surgery, neuroanatomy and the other neurosciences will be explored by Dr. Eugene S. Flamm at the Augustus C. Long Health Sciences Library at the Columbia University Medical Center in a richly illustrated talk “Neurosurgery Before Neurosurgery.”

Image shows trepanning operation

John Browne, A Compleat Discourse of Wounds (London, 1678)

Dr. Flamm is the Jeffrey P. Bergstein Professor and Chairman of the Dept. of Neurosurgery at the Albert Einstein College of Medicine. He is an active researcher and clinician with in interest in cerebrovascular neurosurgery and spinal cord injury. Dr. Flamm is also an ardent book collector, the President of the Grolier Club, a NYAM Fellow and supporter and author of, among other works, From Skulls to Brains: 2500 Years of Neurosurgical Progress, which features many books from the NYAM collection.

More details about the event can be found here. Enquiries about From Skulls to Brains can be directed to NYAM at history@nyam.org.

Pox and Politics

By Rebecca Pou, Project Archvist

Arm with pustules

Edward Jenner. An Inquiry Into the Causes and Effects of the Variolæ Vaccinæ. London:1798.

Edward Jenner’s An Inquiry Into the Causes and Effects of the Variolæ Vaccinæ was published in 1798 and organizations encouraging inoculation were quick to form. In 1802, the New York Institution for the Inoculation of the Kine-Pock was established. The Institution issued documents on the advantages of inoculation with cowpox and created a clinic, “a main object whereof is to disseminate the blessings of this disease, free of cost, to the indigent members of the community.”

image of text

New York Institution for the Inoculation of the Kine Pock. Facts and Observations Relative to the Kine-pock. New York: 1802.

Despite massive efforts, smallpox persisted well into the 20th century. It took global vaccination to eliminate the disease in 1977. The story of vaccination programs is as much a political one as a medical, around balancing public health with individual choice. We are pleased to be welcoming Michael Willrich, PhD, to NYAM on Nov 29 to explore the tensions between compulsory vaccination and civil liberties brought into sharp focus in the smallpox epidemics of the late 19th and early 20th centuries. The lecture is free and open to the public. Register here.

In Pursuit of Pure, White, and Deadly

We were lucky enough to have the “Candy Professor,” Samira Kawash, visit the library earlier this year. She generously wrote the following post for us about the book she used in her research.

Poster with text "Sweet delicious but deadly" and image of man eating ice cream cone surrounded by different foods containing sugar.

Anti-sugar poster. Courtesy of the National Library of Medicine.

A few years ago, we started hearing that our current epidemic of obesity might be due to the rapid increase in consumption of high fructose corn syrup (HFCS) since the 1970s. The sharp upturn in both overweight and HFCS certainly suggest some relation, but what is the cause? Some have pointed to the excess calories, others to excess sugar, and some believe it is actually the fructose in HFCS that makes it uniquely “obesegenic.” Are sugar calories, or fructose calories, somehow different from other kinds of calories? Increasingly, advocates of the “carbohydrate hypothesis” are saying, yes, it’s the carbs, or the sugars that are making us not only fat, but sick as well: blame diabetes, heart disease, arthritis, and allergies on too much sugar.

I’m writing a book about the social history of candy, so of course I’m interested in these attacks on sugar. And one thing I’ve learned is that these worries about refined sugar are not new. In particular, back in the 1970s there was a wave of “sugar-phobia” that produced a raft of popular anti-sugar literature like William Duffy’s Sugar Blues. Food historians who have studied this period emphasize one especially influential book by a British biochemist named John Yudkin that summarizes and interprets scientific evidence implicating sugar in a broad range of diseases. So I definitely wanted to get my hands on this book, published as Pure, White and Deadly in Britain in 1972 and as Sweet and Dangerous in the U.S. the next year.

For months, I have been searching high and low for this book. The libraries I normally use didn’t have it. Google tantalized me with a “snippet” but coyly withheld the digitized (and still copyrighted) text. Could I buy a copy? Amazon could only tell me that it’s out of print; nowhere did there seem to be a used volume for sale at any price. And it turns out I’m not the only one who is trying to get their hands on this book. Bookfinder.com’s “Bookfinder Report 2012: Out-of-print and in Demand” ranked Pure, White and Deadly as the 5th most sought after out-of-print book.

And then I found Pure, White and Deadly, in the catalog of the New York Academy of Medicine Library. An email and a subway ride later, the book was in my hands. I couldn’t have been more excited with this uncovered treasure, and I was so thankful for the welcome and assistance offered by the library staff.

I’ve since learned that the NYAM library has been pulling this book off the shelf quite frequently at the request of all sorts of researchers and scholars. I doubt whoever acquired this volume back in the 1970s could have predicted its resurgent interest nearly a half century later. Thanks to the NYAM library, I and many others have been able to read this fascinating and provocative book.

About the author: Samira Kawash’s book on the social history of candy in the United States, titled In Defense of Candy, will be published by Faber and Faber in Fall 2013.

Mirroring Medicine: Of Mice and Men

Medal issued to commemorate Louis Pasteur’s 70th birthday, 1892.

Medal issued to commemorate Louis Pasteur’s 70th birthday, 1892.

Medals, amulets, badges and prizes play many roles, whether acknowledging significant figures in their fields, commemorating events, or giving insights into beliefs about health. Over 275 medical-themed items from the collection of Dr. Ira Rezak, currently on display at the Augustus C. Long Health Sciences Library at the Columbia University Medical Center, provide a rich and varied exploration of these roles. The objects in the exhibit range from a 70th birthday medal for Louis Pasteur (1892) to a 16th century German amulet used to ward off the bubonic plague, a Canadian medal from 1994 celebrating the role of white mice in medical science, and the New York Academy of Medicine medal by Harriet Whitney Frishmuth, among many other medals representing medicine in New York.

Round medal with female figure, for New York Academy of Medicine.

Medal of the New York Academy of Medicine, 1928, by Harriet Whitney Frishmuth.

The exhibition, Mirroring Medicine, is drawn from Dr. Rezak’s medal collection, formed over 50 years, and one of the most important in private hands. Dr. Rezak is a NYAM Fellow and Professor Emeritus of Medicine at the State University of New York at Stony Brook. The exhibition is on view until January 11, 2013 and is open from 7am to 9pm on Lower Level 2 of the Columbia University Medical Center’s Hammer Health Sciences Center. Individuals without Columbia University or New York-Presbyterian Hospital identification should make arrangements to visit the show by emailing hslarchives@columbia.edu.