Revisiting the Fabrica Frontispiece

Posted on September 26, 2014 by nyamhistorymed

Jeffrey M. Levine, MD, AGSF, author of today’s guest post, will present “Revisiting the Frontispiece: Vesalius’s Jewish Friend and the Impact of the Inquisition” with Michael Nevins, MD, at our October 18th festival, Art, Anatomy, and the Body: Vesalius 500.

Between the first edition in 1543 and the second edition in 1555, the frontispiece of Andreas Vesalius’ classic masterpiece, De humani corporis fabrica, was recut with many subtle variations in both style and content. I am thrilled to be presenting “Revisiting the Frontispiece: Vesalius’s Jewish Friend and the Impact of the Inquisition” at Art, Anatomy, and the Body: Vesalius 500 with my colleague and mentor, Dr. Michael Nevins. Together we will examine and compare the frontispieces and offer theories as to why differences appear. We propose, for example, that some changes to the second edition were in reaction to the Inquisition, which was revived by Pope Paul III.¹

Today’s guest post introduces selected features of the frontispiece of the Fabrica’s first edition. This intricate and multilayered composition features the master Vesalius dissecting a young female corpse, her abdomen flayed open. They are surrounded by a multitude of spectators crowded into a three-tiered wooden scaffold built into a semicircular amphitheater of Corinthian columns. At top-center is the decorative escutcheon that bears the name of the book and the author. Above is the family coat-of-arms of Andreas Vesalius flanked by two putti, the chubby male children who were often a feature of Renaissance art, and two gargoyles. Below is the face of Jupiter, the Roman king of gods.

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

The frieze sitting atop the columns contains symbols including a bucranium, or ox skull with garlands hanging from its horns, which was the symbol of the University at Padua,² and a winged lion representing the evangelist St. Mark, the symbol of neighboring Venice.³ The columns are flanked by two men, one naked with tense muscles and a worried look, the other relaxed and smartly dressed.

To the right of the skeleton bearing a risus sardonicas, a man in a truncated conical hat recoils as if in terror, squinting and raising his left hand in a defensive gesture. In his 1964 biography of Vesalius, Charles O’Malley identifies this figure as Vesalius’s Jewish friend, Lazaro de Fregeis, who assisted with the Hebrew nomenclature in the Fabrica.⁴ The only woman other than the corpse appears as a mysterious figure peeking between the columns. There are two Franciscan Monks among the spectators, neither exhibiting much interest in the dissection. Below right is a pickpocket caught in the act. On the opposite side, a leashed monkey screams in protest, and under the table two men fight over the dissecting tools.

There is much more to learn about the frontispiece of the first edition of the Fabrica, and even more when compared to the second edition. To find out more about the changes to the second edition frontispiece, and how they may have contained coded messages reflecting tensions of 16^th-century Italian society, particularly in the context of the situation of European Jewry, come to our presentation at the New York Academy of Medicine’s Vesalius 500 celebration on October 18.

References

1. Historical overview of the Inquisition. 2001. Available at: http://galileo.rice.edu/lib/student_work/trial96/loftis/overview.html. Accessed September 23, 2014.

2. Padova Terme Euganee. University of Padua – Palazzo Bo. Available at: http://www.turismopadova.it/en/university-padua-palazzo-bo. Accessed September 23, 2014.

3. Imboden D. Winged Lion of St. Mark. Durant Cheryl Imboden’s Venice Visit. Available at: http://europeforvisitors.com/venice/articles/winged_lion_of_st_mark.htm. Accessed September 23, 2014.

4. O’Malley C. Andreas Vesalius of Brussels, 1514-1564. Berkeley: Univ. of California Press; 1964.

A Lifetime of Healthiness? The Golden Health Library’s “Seven Ages of Man” (Item of the Month)

Posted on September 24, 2014 by nyamhistorymed

Cara Kiernan Fallon, this post’s guest author, is a history of science PhD candidate at Harvard University.

“The seven ages of man.” From The Golden Health Library. Click to enlarge.

Childhood can be full of “vigor and zest” but “Middle age is the time when our sins against the laws of health find us out,” warned physicians writing for The Golden Health Library’s inaugural volume. Published in the late 1930s, The Golden Health Library offered readers five volumes of advice on the “principles of right living” so they could secure health throughout their lifespans.¹ Authors included physicians, nurses, professors, and even birth control advocates like Margaret Sanger. September, Healthy Aging Month, is the perfect time to revisit this publication.

Part of the New York Academy of Medicine’s extensive collection of health guides, public health pamphlets, and medical magazines, The Golden Health Library highlights the growing health concerns associated with longer lives and an emerging notion of the elasticity of health in later life. Although originally published in the United Kingdom, people on both sides of the Atlantic expressed concerns over health into old age as they were living longer than ever before. Between 1901 and 1931, the population over age 65 nearly doubled from 1.8 to 3.5 million in the United Kingdom, and went from 3 million to 6.6 million in the United States.² Life expectancy at birth, a figure largely affected by infant and childhood mortality, grew dramatically along with the expanding older population. With more people surviving childhood and living decades longer, a new wave of health concerns—and health advice—came with it.

“Healthy womanhood.” From The Golden Health Library. Click to enlarge.

“The wrestlers.” From The Golden Health Library. Click to enlarge.

In a section directly addressing health throughout the life course—“The Seven Ages of Man”—The Golden Health Library provided a series of articles on maintaining health in each of seven stages of life: infancy, childhood, adolescence, maturity, middle age, elderly age, and old age. Physicians identified “the elderly age” as a “very elastic” time between middle age and old age (87). Rather than following an arc of growth to decline, “The Seven Ages of Man” presented the elderly age as an expandable period of potential health, one determined by physical condition rather than a particular chronological period. Men who followed the rules of health and hygiene, and who had “lived wisely…may feel justified in expecting to live for the full period of life free from disease… and to die of old age” (88). Moderate diet, exercise, rest, and regular medical examinations would also ensure a “healthy elderly age for all women—the best antidote to old age” (91).

“On skis at 63.” From The Golden Health Library. Click to enlarge.

The idea of a healthy and elastic elderly age reflected important new concepts emerging in the 20^th century. As people around the globe reached sixty, seventy, and eighty years of age in quantities never before seen, later life became a period of great diversity in physical, mental, social, and economic conditions. Readers were told that the “vigour and ability to do physical or mental work efficiently varies enormously in different people” but the “idea that advanced age in man must necessarily involve an arm-chair existence…is obsolete” (87, 89). Instead, it argued that “men are now never too old to lead an active life” (89). To demonstrate this new ideal, images of athleticism filled the pages of the elderly age. Fitness guru J. P. Muller was shown skiing in his undergarments at 63, and Lord Balfour was shown swinging for a tennis ball at the age of 80, both depicting the possibilities of health and vigor.

“Lord Balfour at eighty.” From The Golden Health Library. Click to enlarge.

Yet, the mid-century concept of a healthy elderly age also narrowly imagined health through a masculine body with physical freedom and strength. Despite women’s greater longevity—the article reminded readers that women lived on average five years longer than men at the time—the article offered no images of women living actively in the elderly age. Could no women be found to depict an ideal of healthy aging? Or did notions of health and age have different meanings for women than for men? Women may have been told they could achieve a healthy elderly age, but none could be found in these pages.

While the idea of healthy habits leading to a healthy older age offered a new optimism for the aging process, it also overlooked the powerful social and cultural influences on the biology, ability, and mobility of individuals. Recommendations throughout the lifespan for clean milk, sunny outdoor play, access to healthy foods, exercise, and regular physical exams reflected not merely physiological processes but more complex social and economic opportunities. Although the authors indicated that health throughout life was a matter of willpower, they acknowledged that few reached a disease-free old age. Were the ideals too lofty or were the challenges too great? Had their model failed to account for the complexities of health beyond a controllable regimen?

“A fine old age.” From The Golden Health Library. Click to enlarge.

“The Seven Ages of Man” offers an intriguing look into the early notions of healthy aging in the mid-20^th century. While it responded to the growing population of older individuals, offering opportunities for self-determination and responsibility, it also reduced healthy aging to a matter of knowledge, willpower, and habit.

Decades later, efforts to improve the quality of life of older individuals continue to grow with the expanding population. Through its healthy aging initiatives and participation in Age-friendly NYC, the New York Academy of Medicine aims to address not only the physical components of aging but also issues of employment, housing, social inclusion, community health services, and many other social, psychological, and economic concerns for seniors. Looking back to The Golden Health Library allows us to explore the formative stages of important themes today – the growing belief in the elasticity of later life, the new emphasis on “healthy” and “active” aging, and the changing understandings of the powerful social and cultural influences on biology.

References

1. Browning, E., Stanford Read, C., Williams, L. L.B., Crawford, B. G. R., Arbuthnot Lane, W., Somerville, G. (193?). The seven ages of man. In W. Arbuthnot Lane (Ed.), The golden health library (pp. 48–96). London: William Collins Sons & Co. All parenthetical page numbers refer to this publication.

2. For the United Kingdom, see the Office for National Vital Statistics, Chapter 15 Population: Age distribution of the resident population, 15.3(a). For the United States, see the Center for Disease Control and Prevention, National Vital Statistics System, Population by Age 1900 to 2002, No. HS-3.

A Medical Symphony: Celebrating African Americans in New York Medicine

Posted on September 22, 2014 by nyamhistorymed

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

The Knick’s Dr. Algernon Edwards struggles for acceptance as a medical professional, even when his expertise and knowledge outstrips many of his colleagues. How unusual was his experience as an African American practicing medicine in turn-of-the-century New York? As medical training and practice became more heavily regulated in the latter half of the 19^th century, access to the professions was constrained by issues of ethnicity, gender, class, and religion.

Gerald Spencer. From A Medical Symphony.

A slim green volume in our collections gives a small glimpse into some of the many stories of pioneering African American medical professionals. Our copy of the 1947 book Medical Symphony: A Study of The Contributions of The Negro to Medical Progress in New York is signed by author Dr. Gerald A. Spencer, a fellow of the New York Academy of Medicine. The volume brings together lectures and articles in which Dr. Spencer explores the attempt by African Americans to, in his words, join in “striving for medical symphony in which all races and creeds will be given the fullest opportunities to study and to make their unhampered contributions.”¹

As Dr. Spencer describes, in the last quarter of the 19th century, around 12 African American physicians had graduated from schools in New York and other northern states. Together, they founded the McDonough Memorial Hospital, which commemorated David McDonough. McDonough, born a slave, was selected for an education by his owner as part of a bet to establish the potential of African Americans for learning. McDonough not only succeeded in his studies, but went on to gain his freedom and practice on the staff at the New York Hospital and New York Eye and Ear Infirmary. While it only operated between 1898 and 1904, McDonough Memorial Hospital established itself as being open to physicians, nurses, and patients of every background and nationality. Also established in 1898, the Lincoln Hospital Training School for Nurses in the Bronx was the only place for African American nurses to train after the closure of the McDonough Memorial Hospital until the opening of the Harlem Hospital School of Nursing in 1923.

Lincoln Hospital Training School for Nurses, Class of 1907. From A Medical Symphony.

Integration in New York hospitals, public health agencies, and medical societies was limited in the first decades of the 20th century, but by the 1940s, when Dr. Spencer wrote his volume, integration was making inroads in the city’s institutions. Dr. Spencer wrote Medical Symphony to emphasize the many African American physicians rising to positions of prominence within the hospital system, the enormous public health impact of trained nurses, and acceptance into learned societies.

Dr. Aubre De L. Maynard’s recommendation letter of Dr. Spencer. Click to enlarge.

Dr. Spencer was from St. Lucia in the British West Indies and studied at the College of the City of New York before receiving a medical degree from the University of Lyon, France, in 1932. Many students of African descent found the barriers to an education less intractable in European medical centers. Dr. Spencer became a resident physician at the Skin and Cancer Hospital in New York, and visiting dermatologist at Harlem Hospital. He also became a fellow of the New York Academy of Medicine in 1942, described by one of his referees as a “man of excellent character, scholarly and profound.”²

Disparities in access to health care, and access to the health professions, have not disappeared over time. However, Medical Symphony reminds us of the many stories of success that can be celebrated. For those interested in learning more about who became a doctor in New York over time, join us at “Who Becomes a Medical Doctor in New York City: Then and Now – a Century of Change” on December 11.

References

1. Spencer GA. Medical symphony: a study of the contributions of the Negro to medical progress in New York. New York: 1947.

2. Spencer, GA. Application for fellowship form. Letter from Aubre de L Maynard, MD, March 10, 1942. New York Academy of Medicine Archives.

Introducing Graphic Medicine

Posted on September 18, 2014 by nyamhistorymed

Ian Williams and MK Czerwiec, authors of today’s guest post, co-run the website GraphicMedicine.org. They will present “Graphic Medicine and the Multiplanar Body” at our October 18th festival, Art, Anatomy, and the Body: Vesalius 500.

The 2010 Comics & Medicine gathering before Senate House.

In the summer of 2010 a group of scholars, health care professionals, and comics artists gathered in Senate House, London. This brutal-looking art deco building, said to have inspired George Orwell’s “Ministry of Truth,” represented Gotham City Courts in the films Batman Begins and The Dark Knight. Those gathered, however, were not particularly interested in superheroes. They focused on graphic memoirs of illness, a modern phenomenon born of the counterculture in the 60s and 70s that has gathered momentum over the last 20 years.

Among the 75 delegates from around the world were the authors of this blog entry. The lead organizer of the conference was Ian Williams, a doctor and comics artist, creator of The Bad Doctor (2014, Myriad Editions). MK Czerwiec (pronounced sir-wick), aka Comic Nurse, has been making comics about her work in HIV/AIDS and hospice care since the late 1990s as a way of processing these caregiving experiences. We have now worked together for four years, talking and writing about the interplay between the comics and health care. We make comics, collaboratively and separately, and will give a talk on October 18th at “Art, Anatomy, and the Body: Vesalius 500” about Graphic Medicine, the field we helped pioneer.

The Bad Doctor. Cover by Ian Williams.

MK Czerwiec teaching at Northwestern Feinberg Medical School. Still from BBC story by Katie Watson.

Often when we describe Graphic Medicine, people say that comics must make an excellent educational medium for patients, especially those with poor literary skills and marginalized groups such as drug addicts, teenage mothers, or the mentally ill. While comics have certainly been used to reach these audiences, the idea behind this response is freighted with assumptions about comics, their target demographics, and the literacy skills or aesthetic proclivities of the social groups so named.

Stack of medically-themed graphic novels. Photo by Ian Williams.

We regard comics as a sophisticated, rich, and adaptable system through which to explore the complex issues of health care. Our primary interest has been the use of graphic illness narratives to provide new knowledge about the illness experience and commentary on the pervading cultural conceptions of disease and health care. We are also interested in the psychological process of making comics. We have also been teaching using comics—both making them and reading them—in medical schools in the US and UK.

Binky Brown Meets The Holy Virgin Mary cover by Justin Green

In 1972 Justin Green became the first comics artist to unburden his psychological troubles onto the page, creating Binky Brown Meets the Holy Virgin Mary. This inspired subsequent generations of artists to articulate their corporeal experiences in words and pictures, a process that Elisabeth El Refaie refers to as “pictorial embodiment.”¹ More than 40 years later, the myriad comics titles that appear each year include stories of disease or trauma, known as “graphic pathographies,”² in which the authors give highly subjective accounts of their own illnesses or caregiving experiences. The production of these works involves the repeated drawing of the author’s or subject’s body over a prolonged period, which may have interesting effects on how the artist perceives the body. The relentless decision-making process forces the artist to examine fears, suffering, anger, disgust, disappointment, and grief and distill the whole into a succinct series of sequential panels through which to transfer the narrative to the reader.

2014 Comics & Medicine poster. Art by Lydia Gregg.

Since the London gathering, we have held international conferences in Chicago, Toronto, Brighton, and Baltimore. The movement is growing and what was initially viewed by some as a novelty interest is gaining respect in academia. As the nature of literacy changes, moving from the textual towards the image, comics is once again in ascendance, gaining new readers who might have previously dismissed the medium.

References

1. El Refaie, E. (2012). Autobiographical comics: Life writing in pictures. Jackson: University Press of Mississippi.

2. Green, M. J., & Myers, K. R. (2010). Graphic medicine: Use of comics in medical education and patient care. BMJ, 340, c863.

More Music From Your Cash Register: American Pharmacy at the Turn of the Century

Posted on September 15, 2014 by nyamhistorymed

By Johanna Goldberg, Information Services Librarian

This is part of an intermittent series of blogs featuring advertisements from medical journals. You can find the entire series here.

Ad published in The Practical Druggist and Review of Reviews, volume 35, number 5, May 1917. Click to enlarge.

By the late 1800s, a pharmacist (or druggist) stood at an interesting intersection in the marketplace. Both business person and medical professional, the pharmacist had to balance the responsibilities of dispensing medicine with the need to keep a business afloat.

This was in part due to changes in the field. As Gregory Higby explains in a Bulletin for the History of Chemistry article, “With most basic preparations now available from drug companies, anyone with enough courage and capital could open up a drugstore. The number of pharmacists grew enormously, and the quality of prescriptions dispensed declined accordingly.”¹ Fortunately, this decline led to increased industry regulation.

The first pharmacy school in the United States, the Philadelphia College of Pharmacy, opened in 1821, a year after the formation of the U.S. Pharmacopeia.² By the end 1870s, state laws began regulating pharmacy throughout the Unites States, including state licensing exams for pharmacists.¹ Not everyone attended a pharmacy school before taking the exam; a correspondence course option existed, as advertised in The Practical Druggist in 1917.

Ad published in The Practical Druggist and Review of Reviews, volume 35, number 2, February 1917.

Ad published in The Practical Druggist and Review of Reviews, volume 22, number 2, August 1907. Click to enlarge.

Drugs, too, came under closer scrutiny. In 1848, Congress passed the Drug Importation Act, which aimed to prevent the importation of tainted drugs from abroad. In 1906, Congress passed the Food and Drug Act, setting up the regulatory charge of the Food and Drug Administration and requiring the listing of alcohol and opiates on ingredient labels.^3,4 In 1912, the Sherley Amendment prevented drug labels from including false health claims.³ Cocaine was available over-the-counter until 1916; heroin and other opiates could be sold legally in the United States until 1920.^5,6

The pharmacy had “developed the warmth and hospitality of a country store,” with tobacco counters, home goods for sale, and, beginning in 1835, soda fountains.⁷ The soda fountain business turned pharmacy shops into social centers; as they grew in popularity, store owners added seats and tables, devoting large parts of the store to the soda fountain business (a trend that lasted into the 1960s).⁷

Enjoy these ads showing the wide variety of merchandise available to pharmacists, presented chronologically. Click on an ad to enlarge the image.

Ad published in Omaha Druggist, volume 7, number 1, January 1894.

Ad published in Omaha Druggist, volume 7, number 4, April 1894.

Ads published in Omaha Druggist, volume 7, number 4, April 1894.

The cover of The Practical Druggist and Review of Reviews, volume 3, number 1, January 1898.

Ad published in The Practical Druggist and Review of Reviews, volume 5, number 5, May 1899.

Ad published in American Druggist and Pharmaceutical Record, volume 36, number 2, January 25, 1900.

Ads published in American Druggist and Pharmaceutical Record, volume 36, number 2, January 25, 1900.

Ad published in American Druggist and Pharmaceutical Record, volume 36, number 6, March 25, 1900.

Ad published on the cover of American Druggist and Pharmaceutical Record, volume 36, number 6, March 25, 1900.

Ad published in American Druggist and Pharmaceutical Record, volume 36, number 6, March 25, 1900.

Ad published in American Druggist and Pharmaceutical Record, volume 45, November 7, 1904.

Ad published in The Practical Druggist, volume 22, number 2, August 1907.

Ads published in The Practical Druggist and Review of Reviews, volume 22, number 2, August 1907.

Ad published in The Practical Druggist and Review of Reviews, volume 22, number 4, October 1907.

Ad published in The Spatula, November 1910.

Ad published in The Practical Druggist, volume 35, number 1, January1917.

Ad published in The Practical Druggist and Review of Reviews, volume 35, number 1, January 1917.

Ad published in The Practical Druggist and Review of Reviews, volume 35, number 2, February 1917.

Ad published in the Omaha Digest, volume 32, number 4, April 1919.

Ad published in Omaha Druggist, volume 32, number 4, April 1919.

References

1. Higby GJ. Chemistry and the 19th-century American pharmacist. Bull Hist Chem. 2003;29(1):9–17. Available at: http://www.scs.illinois.edu/~mainzv/HIST/bulletin_open_access/v28-1/v28-1%20p9-17.pdf. Accessed August 21, 2014.

2. pharmacy. Encycl Br. 2014. Available at: http://www.britannica.com/EBchecked/topic/455192/pharmacy/35617/History-of-pharmacy. Accessed August 21, 2014.

3. Food and Drug Administration. A history of the FDA and drug regulation in the United States. 2006. Available at: http://www.fda.gov/downloads/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/UnderstandingOver-the-CounterMedicines/ucm093550.pdf. Accessed August 21, 2014.

4. Baker PM. Patent medicine: Cures & quacks. Available at: http://www.pilgrimhallmuseum.org/pdf/Patent_Medicine.pdf. Accessed August 22, 2014.

5. Miller RJ. A brief history of cocaine. Salon. 2013. Available at: http://www.salon.com/2013/12/07/a_brief_history_of_cocaine/. Accessed August 27, 2014.

6. Narconon International. History of Heroin. Available at: http://www.narconon.org/drug-information/heroin-history.html. Accessed August 27, 2014.

7. Richardson LC, Richardson CG. The pill rollers: A book on apothecary antiques and drug store collectibles. Harrisonburg, Va.: Old Fort Press, 1992.

Registration Open for Vesalius 500 Workshops

Posted on September 11, 2014 by nyamhistorymed

Registration is now open for our hands-on art and anatomy workshops, presented as part of our Vesalius 500 celebrations on October 18, 2014. Create your own articulated anatomical figure or “exquisite corpse” at the Gladys Brooks Book & Paper Conservation Laboratory; learn Renaissance drawing techniques with medical illustrator Marie Dauenheimer; or explore the anatomy and art of the hand with physical anthropologist Sam Dunlap.

Spaces are strictly limited so register soon. Registration at one of the workshops includes free entry to the Festival. You can register for the Festival (without workshop attendance) here.

From the Cradle to the Grave: Session One: The Cradle

Moveable baby and female pelvis from one of NYAM’s 19th century obstetrics texts, Dr. K. Shibata's Geburtschülfliche Taschen-Phantom, or the Obstetrical Pocket-Phantom.

Moveable baby and female pelvis from one of NYAM’s 19th century obstetrics texts, Dr. K. Shibata’s Geburtschülfliche Taschen-Phantom (Obstetrical Pocket-Phantom).

Working with NYAM’s conservation team, celebrate Vesalius’s life with a hands-on workshop producing your own articulated anatomical figures in the Gladys Brooks Book & Paper Conservation Laboratory.

Time: 11am-1pm
Cost: $55
Includes: All materials, and free entry to the Festival.
Maximum participants: 12
Register here

During the morning’s Cradle workshop, we will construct paper facsimiles of a moveable baby and female pelvis from one of NYAM’s 19^th century obstetrics texts, Geburtschülfliche Taschen-Phantom (or the Obstetrical Pocket-Phantom). The book was written by Dr. K. Shibata, a Japanese author studying in Germany, and was published first in German before being translated into English and Japanese.

Participants will have time to make at least one paper baby and pelvis, which can be produced as paper dolls or magnets.

From the Cradle to the Grave: Session Two: The Grave

An exquisite corpse made by staff of the Gladys Brooks Book & Paper Conservation Laboratory.

Working with our conservation team, celebrate Vesalius’s life with a hands-on workshop producing your own “exquisite corpse” in the Gladys Brooks Book & Paper Conservation Laboratory.

Time: 2:30pm-4:30pm
Cost: $55
Includes: All materials, and free entry to the Festival.
Maximum participants: 12
Register here

During the afternoon’s Grave workshop, we focus on producing a Vesalian-themed exquisite (or rotating) corpse. Loosely based on the surrealist parlor game in which a picture was collectively created by assembling unrelated images, this workshop will employ a special, rotating binding structure and mix-matched facsimile images from NYAM’s rare book collections to allow students to create their own unique, moveable pieces of art.

Renaissance Illustration Techniques Workshop with Marie Dauenheimer, Medical Illustrator

Students at medical illustrator Marie Dauenheimer’s workshop at last fall’s Festival.

Time: 10am-1pm
Cost: $85
Includes: All materials, and free entry to the Festival.
Maximum participants: 15
Register here

Artists and anatomists passionate about unlocking the mysteries of the human body drove anatomical investigation during the Renaissance. Anatomical illustrations of startling power vividly described and represented the inner workings of the human form. Leonardo da Vinci’s notebooks were among the most magnificent, merging scientific investigation and beautifully observed drawing.

Students will have the opportunity to learn and apply the techniques used by Renaissance artists to illustrate anatomical specimens. Using dip and technical pens, various inks and prepared paper students will investigate, discover, and draw osteology, models, and dissected specimens from various views creating an anatomical plate.

Understanding the Hand, physical anthropology workshop with Sam Dunlap, Ph.D.

Dr Sam Dunlop leading a workshop at last year’s Festival.

Time: 2:30pm-5:30pm
Cost: $75
Includes: All materials, and free entry to the Festival.
Maximum participants: 15
Register here

The hand as an expression of the mind and personality is second only to the face in the Renaissance tradition of dissection and illustration that continues to inform both art and science. Basic anatomical dissection, illustration, and knowledge continue to be fundamental in many fields from evolutionary biology to surgery, medical training, and forensic science. This workshop will offer participants the opportunity to explore the human hand and its anatomy, which will be demonstrated with at least three dissections. Opossum (Didelphis virginiana) and orangutan (Pongo pygmaeus) forelimbs will be available along with other comparative skeletal material. We will discuss hand evolution, embryology, and anatomy, and the artistic importance of the hand since its appearance in the upper palaeolithic cave art. We will also analyze the hand illustrations of da Vinci, Vesalius, Rembrandt, and artists up to and including the abstract expressionists.

Aseptic Surgery: Innovation circa 1900

Posted on September 8, 2014 by nyamhistorymed

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

In the middle of the 19^th century, the greatest surgical innovation was anesthesia. In the time that the television show The Knick is set, around 1900, the greatest surgical innovation was aseptic, or sterile, surgery. Anesthesia allowed for longer and steadier operations; aseptic surgery allowed for more successful ones. It changed surgical techniques, training, procedures, and equipment alike.

Sterile dressings. From Charles Truax’s The Mechanics of Surgery, ed. James M. Edmonson (1899; reprint ed., San Francisco: Norman Publishing, 1988). Click to enlarge.

The Knick shows first the techniques not of aseptic surgery, but of antiseptic surgery—that is, surgery under conditions designed to combat germs. Spraying the operating room with carbolic acid, and dipping beards in the same chemical, were two such techniques. Aseptic surgery went farther, creating surgical conditions without germs. Thus aseptic surgery led to sterilizing instruments; swabbing down patients; robing, masking, and gloving surgeons; and dressing wounds with sterile dressings. Such procedures began in the 1880s, and by the early 1900s were becoming more and more standard.

Our colleague Jim Edmonson of the Dittrick Museum of Medical History in Cleveland, Ohio, has explored the effect of aseptic surgery on medical instruments and instrument making. Aseptic surgery led to the sale and use of instrument sterilizers, of sterile gauze and cotton, and most especially of instruments designed to be readily and effectively sterilized, as well as inexpensively made. Thus metal soon replaced the wooden and ivory handles of surgical instruments. Jim quotes a Chicago surgeon, Nicholas Senn, in 1902:

All attempts at ornamentation have been abandoned . . . . The modern surgical instruments are made as plain and smooth as possible. Knives and retractors are made of one piece of steel, all niches and crevices being avoided wherever possible. Scissors and forceps are made so that the two parts may be readily separated and joined again.¹

Scalpels. From Charles Truax’s The Mechanics of Surgery, ed. James M. Edmonson (1899; reprint ed., San Francisco: Norman Publishing, 1988). Click to enlarge.

To take care of scissors and forceps, German instrument makers developed the “Aseptic Pin Lock,” patented in the United States by Paul Henger of Stuttgart in 1892.² This design allowed the device to be easily disassembled, sterilized, and then reassembled. Since the pieces could also be mass-produced rather than handcrafted, these instruments swept through the market, dominating from the 1890s to the 1930s. The idea of aseptic surgery pushed innovation throughout the whole of the surgical enterprise.

We show here images of the equipment of aseptic surgery, taken from Charles Truax’s The Mechanics of Surgery, ed. James M. Edmonson (1899; reprint ed., San Francisco: Norman Publishing, 1988). One of the images is of “Halsted’s Plain Hemostatic Forceps,” developed by William Halsted, the surgeon on whom The Knick’s Dr. Thackery is based, and designed to clamp blood vessels to control the loss of blood during surgery.

Thermal sterilization. From Charles Truax’s The Mechanics of Surgery, ed. James M. Edmonson (1899; reprint ed., San Francisco: Norman Publishing, 1988). Click to enlarge.

Sterilizers. From Charles Truax’s The Mechanics of Surgery, ed. James M. Edmonson (1899; reprint ed., San Francisco: Norman Publishing, 1988). Click to enlarge.

Forceps. From Charles Truax’s The Mechanics of Surgery, ed. James M. Edmonson (1899; reprint ed., San Francisco: Norman Publishing, 1988). Click to enlarge.

Sterilized gauze. From Charles Truax’s The Mechanics of Surgery, ed. James M. Edmonson (1899; reprint ed., San Francisco: Norman Publishing, 1988). Click to enlarge.

References

1. James M. Edmonson, American Surgical Instruments: The History of Their Manufacture and a Directory of Instrument Makers to 1900 (San Francisco: Norman Publishing, 1997), p. 14, quoting Nicholas Senn, Practical Surgery for the General Practitioner.

2. Idib, p. 137, and figure 170. U.S. Patent 474,130, issued May 3, 1892. You can also see this at the U.S. Patent and Trademark site: http://www.uspto.gov/patents/process/search/

Postures of Childhood: A Conversation

Posted on September 5, 2014 by nyamhistorymed

This blog post presents a discussion between Riva Lehrer, artist and anatomist and our “Art, Anatomy, and the Body: Vesalius 500” festival guest curator, and Sander Gilman, distinguished professor of the liberal arts and sciences and professor of psychiatry at Emory University. Dr. Gilman will present “STAND UP STRAIGHT: Toward a History of the Science of Posture” at our October 18^th festival. Register here.

Riva Lehrer:

Sander, when reading a scholar’s work, I often wonder whether it relates to personal experiences that set them on the path of intellectual obsession. For me, your work is so empathetic on the subject of difference it’s as if you’ve lived in the bodies of those you’ve written about. It’s fascinating to find out where that path started for you.

Riva Lehrer as a young child. Photo courtesy of Riva Lehrer.

It seems that both of us were confronted with the problem of difference beginning in elementary school. Mine began right away. From kindergarten through eighth grade, it didn’t matter whether I was in math class, or English, or social studies; I knew at some point an aide would show up at the classroom door and call my name. All us kids knew this; twice an hour, someone would get pulled out of class and sent to the big open room on the third floor. There, we’d get down on one of the vinyl mats on the floor and start following orders.

These were our daily physical therapy sessions. Almost every student at Randall J. Condon School for Handicapped Children went through this same routine. Most of us had some variety of orthopedic impairment. Condon punctuated our academics with treatments for these perceived aberrations. My brothers were not disabled. They went to regular schools, where their growing bodies were exercised in gym class. This may have been wretched on its own terms but was at least somewhat communal, being arranged around games and team sports. Here, in PT, it was isolating.

Sander Gilman:

Why is gym always the horror! When you are in third grade gym is a horror in most cases any way—except for the two guys you always get chose first for ALL the teams — but when you wear high boots with VERY long laces that had to be cross tied all the way to the top and those boots had metal braces in them, even going into the locker room was a horror. Last one in (on purpose) and last one dressed. And then gym itself—jump, climb, run. But you run like a duck, the gym teacher shouted: STAND UP STRAIGHT!

RL:

A class at the Condon School. Photo courtesy of Riva Lehrer.

A class at the Condon School, with Riva Lehrer kneeling, second from left. Photo courtesy of Riva Lehrer. Click to enlarge

Well, we never played any games together. Whenever I showed up, there’d be 8 or 10 kids already in the PT suite, mired in separate islands of exercise mats, or on high tables that put them at arm’s level with the physical therapists. We half-ignored each other, though if someone let out a loud enough squawk that faux-privacy would end. As a rule, we were an obedient lot; splaying like starfishes on huge medicine balls, lifting our knees, doing wobbly push-ups, clutching squishy objects to build up our hand strength. In the 1960s, most disabled children weren’t even given basic academic instruction; Condon was unusual in its goals to give us some kind of mainstream education. But it was clear that in the battle between teaching disabled children how to read and pushing our bodies towards normalcy, the toss would always land us back on a vinyl mat.

In that room, every weakness and failure of our bodies was brought to our attention, and then set upon by the therapists. I was told I walked as if I had a broken leg, dragging it a half-step behind me.

SG:

In truth, a duck was not wrong. I waddled without my shoes and indeed with them. Standing was hard, running was difficult and the worst part of it was being always the one who was different. I could never quite stand up the way the gym teacher or others wanted me to. Now I know that all third graders KNOW that they are too different, too visible, too comical, but somehow I knew I really was odd. STAND UP STRAIGHT! Still haunts me.

RL:

Kids at Condon used to be called abnormal. Condon was a refuge of sorts—at least we weren’t called the brutal names people used outside of school. The PT suite was the only place when I ever saw some of my friends out of their wheelchairs. If a kid could stand at all, the PTs made us watch ourselves walk. (it turned our most of my friends were taller than me; my assumption that I was one of the taller kids in class was an illusion). The room was divided by long metal poles that formed a narrow corridor ending in a tall mirror. I’d start at the far end, clutching the steel poles and trying to get my legs to regulate themselves as instructed. My reflection swayed and bounced as if I were on a ship in my own personal storm.

Riva Lehrer teaching at the School of the Art Institute of Chicago, circa 2008. Photo courtesy of Riva Lehrer.

Until I stopped growing (ending up at 4′ 9″), and my spine was less curved, my limp was most the obvious sign of my disability. Thing was, my limp didn’t hurt. I didn’t even feel it. I only saw it in that tall mirror, where I watched myself list and sway, buffeted by those invisible shipboard winds. I seldom thought about the way I walked at all, but my doctors did, and operated. Nothing made much difference. A year after surgery, my limp always came back, tenacious as malaria.

I am not one who thinks that impairments should not be treated, or that bodies should not be given the chance to experience individual interpretations of health. But health cannot take its bearings from the polestar of normal. Bodies should be supported and encouraged according to specific, idiosyncratic parameters. What was missing from those well-meaning treatments at Condon was any pleasure in the body itself. These were the bodies we’d had at birth. According to our parents, teachers, and doctors, we’d come ashore in broken vessels.

For us, posture regulation, gait repair, and physical therapy rested on a bedrock of shame. We were not given the option of simply loving our bodies as-is, and exercising those bodies out of delight and wonder for what our bodies could do.

SG:

The thing is that that sense of being odd never leaves you as, perhaps, we never stop being third graders when we look deep into our souls. When I started my new project on the history and meaning of posture, the title seemed obvious: STAND UP STRAIGHT! We all write autobiographies, even those who avoid writing autobiographies. That is true of artists as well as scholars.

RL:

Our early lives taught us both that crooked is a posture that tilts your head and gives you a most unexpected view of the world.

Patient Photographs and Medical Collecting

Posted on September 2, 2014 by nyamhistorymed

Heidi Knoblauch, the author of today’s guest post, is our 2014–2015 Klemperer Research Fellow. She is a Ph.D. candidate in the History of Science and Medicine Department at Yale University.

Tucked away in the New York Academy of Medicine’s special collections is a small green metal box, simply labeled “daguerreotypes.” The box contains twelve photographs and one painting. A few are images of doctors, but most are of patients.

The small green metal box, simply labeled “daguerreotypes.” Photo by Heidi Knoblauch.

The small green metal box, simply labeled “daguerreotypes.” Click to enlarge. Photo by Heidi Knoblauch.

You would not necessarily know these photographs were of patients unless you looked closely for a misshapen nose, outline of an excision, or nondescript facial scars. The subjects’ posing more closely resembles 19^th-century photographic portraits circulated between family members than the poses we currently associate with a clinical image. These poses are accentuated by the fact that most of the photographs are housed in hinged frames with gold matting.

These photographs straddle the line between the medical and the personal that was becoming more defined during the 19^th century. They blend intentional subjectivity with a new technology used to make what contemporary physicians described as a “more perfect record.”

During the 19^th century, medical men collected photographs of patients and pasted them into personal scrapbooks, case records, and put them on display. These personal collections of notable cases represent not only the use of photographic technologies in consultation, but also the continuation of an engrained practice of collecting that began long before the advent of the daguerreotype. Like all archives and collections, they highlight the inclusion of things meant to be remembered and exclusion of things meant to be forgotten.

Another view of the special collection. Photo by Heidi Knoblauch.

Another view of the special collection. Click to enlarge. Photo by Heidi Knoblauch.

Tracking the social practices associated with amassing medical collections is crucial for understanding this small box of photographs, almost all of which lack identifying information. These photographs have the potential to help us sketch out the formation of communities of collecting and exchange during the middle of the 19^th century and to think about how doctors interpreted their relationships with their patients.

The famed surgeon Valentine Mott was one of many physicians who collected surgical and pathological specimens—including the images in the small green box. His museum, which was located at the University Medical College, was composed mainly of pathological specimens from surgical operations, collected in part from his students, who submitted dissections through an annual competition. Like many of his contemporaries, Mott thought collecting would advance the surgical art. In 1858, he declared that his collection was “believed to be the largest that any American surgeon had the occasion to form.”

Mott also sought photographs from his students. Although most of the examples in the small box are unmarked, one of Mott’s students, Edward Archelaus Flewellen, labeled a photograph he sent Mott: “A.P Jackson, Thomaston, Georgia. A supposed case of subcutaneous aneurism by anastomosis. Referred to Dr. Mott by E.A. Flewellen.”

In 1856, Flewellen sent a letter with this daguerreotype to his instructor to obtain a consultation for his patient. Flewellen told Mott that he “did this reluctantly” because he was sure that Mott was “taxed by frequent consultation by many of the thousands of students who have had the pleasure and benefits of [his] instruction.” But, Flewellen added, he believed that Mott would find this an interesting and rare case.

Dr. Edward Archelaus Flewellen's note and photograph, sent to Dr. Valentine Mott. Photo by Heidi Knoblauch.

The note and daguerrotype Dr. Flewellen sent to Dr. Mott. Click to enlarge. Photo by Heidi Knoblauch.

Flewellen’s patient, A.P. Jackson, was a 33-year-old mechanic from Georgia who developed a tumor over his right eye when he was very young. Flewellen described the case in great detail, saying that he had watched the tumor grow for the past five years. Flewellen asked Mott what surgical treatment he would recommend to “rid this poor young man of this hideous deformity” and then promised to send Mott another daguerreotype of Jackson if the surgery was successful so Mott could contrast the before and after photographs. There is no record of Mott replying to Flewellen.

Patient photographs began to represent a new type of scientific aesthetic practice, aligned with graphs and charts, during the 1870s. Patients contributed photographs to their case records during the 19^th century, but by the 1890s patients became less willing to actively participate in creating a photographic record of their disease. Today, many patients—especially in genetics, plastic surgery, and dermatology departments—have their photographs taken by a physician or technician (with a digital camera of course) to include in their electronic medical record. Yet employing a professional photographer to take a photograph with the express purpose of mailing it to a physician would seem odd to most people today.

Concerns about privacy surfaced at the end of the 19^th century, which changed the way patients thought about photography in the clinic. Standards for clinical photography emerged during the 1920s and, because of this, we would find it strange to have a clinical photograph taken with a piece of bone or a bullet. Photographs are now more sterilized than they were in the 19^th century and, unlike in the case of Flewellen, patients are rarely told to dress up before being photographed. The culture of photography has changed and, with it, the way physicians use photographs has shifted.

Books, Health and History

The New York Academy of Medicine

Monthly Archives: September 2014

Revisiting the Fabrica Frontispiece

A Lifetime of Healthiness? The Golden Health Library’s “Seven Ages of Man” (Item of the Month)

A Medical Symphony: Celebrating African Americans in New York Medicine

Introducing Graphic Medicine

More Music From Your Cash Register: American Pharmacy at the Turn of the Century

Registration Open for Vesalius 500 Workshops

Aseptic Surgery: Innovation circa 1900

Postures of Childhood: A Conversation

Patient Photographs and Medical Collecting