Monthly Archives: November 2024

Researching Neuropsychiatry and Veterans Hospitals During the 1930s at the New York Academy of Medicine 

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By Dr. Michael Robinson, National Army Museum Research Fellow, University of Birmingham (UK), and the Library’s 2024 Paul Klemperer Fellow in the History of Medicine 

I spent one month working in the New York Academy of Medicine’s magnificent library and reading room in the autumn of 2024. This residency enabled me to look at a host of materials dedicated to the treatment of mentally ill American Army veterans of the First World War during the Great Depression (1929–1939). I undertook this research hoping to utilise the USA as an important comparative case study on my current research project dedicated to mental illness and British Great War veterans during the 1930s. By examining mental breakdown and psychiatric medical care during this decade, this research seeks to reveal the delayed traumatic after-effects of war service on ex-service personnel and the potential for additional psychosocial determinants to influence mental ill-health.  

I first became interested in the American experience of post-First World War disability and mental healthcare owing to its regular appearance in the archival records of Britain’s Ministry of Pensions, the government agency responsible for distributing veterans’ pensions and medical care. During the inter-war period, British policymakers regularly cited the US experience of veteran after-care as a deterrent and a case study to avoid replicating. They actively held up the US system as being unfairly exclusive, costly, and liberal owing to its incremental but costly expansion of veteran rights and facilities. Britain significantly reduced its liability on behalf of veterans during the 1920s and 1930s, including the closure of most veterans’ hospitals. Veterans’ medical care in Britain was primarily outsourced to broader public health facilities, the civilian welfare state, and the charity sector.  

By contrast, the US witnessed increased state liability, including a vast financial outlay in funding exclusive Veterans Administration (VA) hospitals and medical facilities. In 1936, owing to the two nations’ inversed approaches to veteran care, one Ministry of Pensions official described the UK and US responses as being of ‘opposite extremes.’1 The primary purpose of my time at the NYAM was to better understand why the British and US systems were the complete inverse of one another. I also sought to appreciate how these contrasting policy trajectories and medical infrastructures affected the lives of mentally ill veterans.  

Portrait of Thomas Salmon, from History of the Interurban Clinical Club 1905-1937, edited by David Riesman (1937).

This comparative approach first led me to NYAM records relating to Dr. Thomas Salmon (1876–1927). For those unfamiliar, Salmon was the American Expeditionary Forces’ chief consultant in psychiatry during the First World War. Before this important role, following the country’s entry into the global conflict in 1917, Salmon visited England to study how it dealt with mental wounds during the war to help inform his country’s approach.2 As a leading figure in the US National Hygiene Movement before and after his war service, the records of Salmon’s war experience reflect a relatively progressive military medical official. He regularly stressed the environmental causes of soldiers’ breakdown. In short, Salmon was more inclined to blame combat neurosis and stress on the dehumanising and brutalising effects of war service than citing faulty hereditary genetics, as was more apparent amongst British military officials. This more empathetic outlook continued into Salmon’s advocacy on behalf of veterans following his return to America. Unlike the more reclusive and disillusioned Dr. Charles Myers, the British Army’s leading psychiatric official, Salmon advocated for healthcare and welfare on behalf of the mentally disabled First World War veterans during the initial post-war years. Described by his biographer as a successful ‘spokesman for veterans,’ the force of Salmon’s personality and his effective collaboration with the American Legion help explain why the American mentally ill veteran stopped being admitted into larger public mental hospitals.3 Instead, the US Federal Government established exclusive medical facilities for veterans from the early 1920s onwards.  

Salmon died unexpectedly whilst sailing near Long Island in 1927. Reflecting his prestige amongst his contemporaries, the National Committee for Mental Hygiene, an advocacy organization founded in 1909 by Clifford W. Beers, set up the Salmon Committee on Psychiatry and Mental Hygiene at the New York Academy of Medicine in 1931.4 Regardless, the exclusive medical infrastructure he had helped establish continued to cater to mentally ill First World War veterans into the 1930s. In stark contrast to Britain’s minuscule and dwindling psychiatric infrastructure, the VA provided seventeen neuropsychiatric facilities across its national network of forty-nine hospitals. It offered 10,633 beds for mental ailments, marking a 467% increase over 1921’s availability. The number of beds would be set to increase for the rest of the decade.5 With this exclusive federal medical care program for veterans, the VA published its Medical Bulletin journal throughout the 1930s. Pouring through these issues reveals a lively forum of VA medical officials discussing the continued difficulties of treating veterans during this period.  

Regarding neuropsychiatry—I was struck by how hospital superintendents, nurses, vocational trainers, and social workers regularly articulated a holistic approach to mental healthcare. They cited the psychosocial determinants of health outside of hospital walls. This includes, for example, the detrimental impact of unemployment and poverty on an individual’s mental and bodily health, the emasculating stigma attached to male mental illness, and the potential for harmful self-medication practices such as alcoholism.  

United States Veterans’ Bureau Medical Bulletin (1931), a collection of articles by VA staff and associates dedicated to all aspects of veteran after-care. These various scans come from volume 7.

The materials I reviewed at the NYAM provide a complex and nuanced picture of the post-war treatment of mentally ill World War One veterans. On the one hand, they give an image of an expansive, caring and financially generous veterans’ system. On the other hand, however, they provide comparatively little insight into the personal perspectives of veteran patients to verify the progressive narrative offered by medical officials. In addition, contemporary medical journals reveal increasing resentment from American citizens regarding the spiralling costs of veteran medical care with little in return in terms of cure and recovery.6 This counter-narrative also appears worthy of further research.  

Before arriving in New York, I was unsure how exactly the USA would fit into my larger project of Great War veterans during the Great Depression. However, my time at the NYAM proved incredibly rewarding by revealing how fascinating and unique an American case study is. I look forward to continuing this research into 2025. 

Notes: 

1 Nineteenth Annual Report of the Ministry of Pensions, 1935-1936, 33. 

2 For a write-up of Salmon’s observations and recommendations, see Thomas Salmon, The care and treatment of mental diseases and war neuroses (“shell shock”) in the British Army (War Work Committee of the National Committee for Mental Hygiene, 1917). 

3 E. D. Bond, Thomas W. Salmon: Psychiatrist (W. W. Norton & Co, 1950), 160. 

4 For more information on the Salmon Committee on Psychiatry and Mental Hygiene and its records that are held in the NYAM, see https://www.nyam.org/library/collections-and-resources/archives/finding-aids/ARN-0006.html/ [last accessed 18 November 2024]. 

5 E. O. Crossman and Glenn E. Myers, ‘The neuropsychiatric problem in the US Veterans’ Bureau,’ Journal of the American Medical Association, vol. 94, no. 7 (1930), 473–478. 

6 For example, see the Crossman and Myers article cited above. 

Tracing the Transmission of Early Modern Recipe Knowledge in the New York Academy of Medicine Library

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By Sheryl Wombell, University of Cambridge, and the Library’s 2024 Audrey and William H. Helfand Fellow.

In seventeenth-century Europe, knowledge about health and healing was shared with family, friends, and acquaintances. In the case of printed books, wider audiences were reached. A significant subset of these communications took the form of recipes: sets of instructions telling one how to make something. These might be instructions for making medicines in the home, with a range of ingredients from the inexpensive and easily sourced, to the rare and exotic products available due to expanding trade. Or they could be instructions to make culinary formulations, which were interpreted as having an impact on the body’s condition due to the lasting influence of the ancient theory of the four humours. Individual recipes, which could be as short as a line or as long as tens of pages, were gifted, traded, and passed around early modern social networks.

A letter penned by the courtier and privateer Sir Kenelm Digby, likely to Sir Richard Grenville, 1st Baronet of Kilkhampton, demonstrates the mobility of recipes in the mid-seventeenth century.i In it, Digby thanks Grenville for sending him a recipe for ‘Sir Walter Rawleys great Cordiall’ but questions its provenance:

I beleive th[a]t it came from me, for it agreeth word for word with my Receipt that I had out of his owne originall book written with his owne hand; & whereof I made at one time as much as stood mee in above 500 [pounds] sterling; & stored the Court, Citty, & Country with it; But I add to it, the Magistery of Rubies, of Emeralds of granales of amethystes, of Saphyres, of each halfe an Ounce to the proportion that you sayth, also, magestery of Crabbs Eyes [3 oz], of Crabbs Clawes [2 oz]; of Contra yarva stone [1 oz], of snakweed of Virginia, of Contra yarva root, of each halfe an Ounce and of Tincture of gold made by spirite of Honey [1 oz]; and I finde this much more efficacious.

The circular path of recipes that Digby describes – when a recipe he believes to be his own is unwittingly returned to him – is testament to the lively early modern traffic in recipe dissemination and collection.

Fig. 1: Copy of a letter from K. Digby in MS ‘Old Doctor 1690’, f. 76, New York Academy of Medicine Library.

Manuscript collections of recipes survive in archives around the world, and the New York Academy of Medicine Library holds a rich cache of such volumes. Thanks to winning their Helfand Fellowship in 2024, I had the privilege of spending five weeks on a close reading of the early modern medical recipe collections at NYAM. This research forms part of my PhD project, which looks at the mid-seventeenth century production, management, and transmission of knowledge about health and healing amongst exiled and mobile elites, including Digby. While my work to date had focused on three key media – printed medical books, manuscript recipe collections, and consultation letters – somewhat in isolation from each other, at NYAM I had the time and resources to explore the relationships between these formats.

One such connection was the integration of transcribed letters into larger manuscript collections. Digby’s letter, for example, was copied into a large bound volume of recipes, letters, and transcriptions from printed books titled ‘Old Doctor 1690’. But in handling the manuscripts I was also confronted with material traces of transmission. In another manuscript, for example, is a recipe for ‘Costiveness to help’, that is, how to relieve constipation. Next to the instructions are two small, shiny blobs of dried red sealing wax. While this is not conclusive evidence that the recipes on the page were copied into a letter, it does indicate that the notebook lay open while a letter was sealed – and likely written – in its vicinity. Through this tiny physical sign, we learn something of the co-presence of writing and collecting practices across the distinct but interrelated media of letters and recipe books.

Fig. 2: Wax in ‘Pagett recipes for medical remedies: autograph manuscript signed, c. 1640–1650’, f. 73, New York Academy of Medicine Library.

The objects of transmission themselves also appear in these recipe collections. A notebook belonging to Owen Salesbury holds a loose paper slip with instructions ‘To Make Elder Claret’ and sent ‘To Mrs Longford att her hous in Wrexham’. Folded slips could be enclosed in a larger letter, or they could constitute the entire missive. The inclusion of the address on this example suggests the latter. The contents of the slip were not transcribed into the body of the notebook but containing it within the bound volume preserved its knowledge. We don’t know precisely how or when a slip sent – or intended to be sent – to a Mrs Longford ended up in Salesbury’s manuscript, but it offers further evidence of the close connections between ephemeral letter formats and the more durable objects of recipe collections.

Figs. 3 and 4: Paper slip in ‘Collection of medical recipes, poems, prayers, and charms: autograph manuscript signed, 1638–1642’, New York Academy of Medicine Library.

Spending time in the NYAM Library’s collections allowed me to get to grips with evidence of early modern recipe transmission. While digitised surrogates of manuscripts have been invaluable in my research, handling these collections has enriched my analysis by bringing their material qualities – size, varying durability, the spatial relationships between their contents, and signs of use – to the fore.

Further Reading:

Ken Albala, Food in Early Modern Europe (London: Bloomsbury Academic, 2003).

James Daybell, The Material Letter in Early Modern England: Manuscript Letters and the Culture and Practice of Letter-Writing, 1512–1635 (Basingstoke: Palgrave Macmillan, 2012).

Elaine Leong, Recipes and Everyday Knowledge: Medicine, Science, and the Household in Early Modern England (Chicago and London: University of Chicago Press, 2018).

Alisha Rankin, ‘Recipes in Early Modern Europe,’ Encyclopedia of the History of Science (2023), https://doi.org/10.34758/fvw2-w336.