About nyamhistory

The Center for the History of Medicine and Public Health, which includes the Library, promotes the scholarly and public understanding of the history of medicine and public health and the history of the book. Established in 2012, the Center aims to build bridges among an interdisciplinary community of scholars, educators, clinicians, curatorial and conservation professionals, and the general public. The Center’s Library is one of the largest medical collections in the United States open to the general public, to whom it has been available since 1878.

Women’s Work in “Behind the Scenes in a Restaurant”

By Carrie Levinson, Reference Services and Outreach Librarian

We tend to take labor laws for granted nowadays. There are limits in many jobs to how many hours one can work, minimum wage determinations, and other protections for those in the workforce. However, this was not always the case, particularly for certain kinds of workers. In the early twentieth century, for example, these laws had nothing to say about women in many professions, such as those working in restaurants. This resulted in long, grueling hours for many women, without respite or protection from exploitation.

Eight hours of work versus fifteen for restaurant workers

Fig. 1. Diagrams showing the normal working day versus a restaurant worker’s day. Consumers’ League of New York City (1916). Behind the scenes in a restaurant: A study of 1017 women restaurant employees. New York, NY: Author.

The Consumers’ League of New York City was alarmed by this, and decided to conduct a study, which turned into the pamphlet “Behind the Scenes in a Restaurant: A Study of 1017 Women Restaurant Employees.” The study had three aims: to find out the actual labor conditions in New York State restaurants; to determine whether these labor conditions led to a “wholesome, normal life” for the workers in these restaurants; and to see how these conditions impacted society as a whole (1916, pp. 3-4).

One thousand seventeen women were surveyed for this over the course of five months, in different locations such as their homes, their workplaces, and employment agencies. In New York City, all the interviews were given at the Occupational Clinic of the Board of Health (Consumers’ League of New York City, 1916, p. 3).  The workers came from all types of restaurants, allowing the League to get a representative sample of participants. Women of all ages were asked, as well as women of different nationalities (though women of color were noticeably absent). The largest group interviewed here was “Austro-Hungarian” (39%), followed by “American” (presumably meaning non-immigrants) (33%), German (8%), Irish (7%), Russian (4%), “Other”, (4%), English & Canadian (3%), and Polish (3%). While there is clearly an effort to be inclusive, there is still racist/ethnicist ideology that creeps in:

The largest single group is made up of Austro-Hungarians. The demand for cheap, unskilled labor in this occupation calls for the kind of service which these girls and others of the European peasant class can give. The outdoor life in the fields of their native land fits them for the hard labor required in a restaurant kitchen (Consumers’ League of New York City, 1916, p. 8).

Despite this language, the League was extremely concerned over the exploitation of these workers, noting that many worked 15-hour days (Fig. 1). Seventy-eight percent of workers exceeded a 54-hour week (Fig. 2), which was prohibited for women who worked in stores and factories. One of the participants, a 20-year old woman, worked 122 hours a week (Consumers’ League of New York City, 1916, p. 13)!

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Fig. 2. Weekly hours of labor of women employed in restaurants. Behind the scenes in a restaurant… (1916).

The long hours (Fig. 3) were not the only thing this report examined. Other issues included tipping, irregularity of work, and the low wages earned by many in the profession. Such practices prevented these women from having regular social or family lives and had deleterious effects on their health.

The Consumers’ League argued that because of these conditions, a regular working day for restaurant workers was “not only reasonable, but…essential to the best welfare of their people as a whole” (1916, p. 28). They recommended a legislative amendment under the already-existing Mercantile Law.

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Fig. 3. A movie of the restaurant worker. Behind the scenes in a restaurant… (1916).

Did restaurant workers in New York State get the protections they so desperately needed after this report was published? Not immediately. By 1933, a New York law limiting the amount of hours women could work was passed, but then it was struck down by the Supreme Court in 1936. Women restaurant workers had to wait until the federal Fair Labor Standards Act was passed in 1938 to have the right to a minimum wage and overtime (Hart, 1994).

Although it did not instantly better the situations of women working in restaurant positions, this report and others like it raised awareness of what it was like to be working in these conditions, and they remain as a testament to those who toiled for long hours to clean, prepare, and serve food to so many others.

This book and other recent acquisitions will be on display and available for “adoption” at the Celebration of the Library night, also featuring a lecture by New Yorker author John Colapinto. Join us on April 11th at the Academy!

References

Consumers’ League of New York City (1916). Behind the scenes in a restaurant: A study of 1017 women restaurant employees. New York, NY: Author.

Hart, V. (1994). Bound by our Constitution: Women, workers and the minimum wage. Princeton, NJ: Princeton University Press.

Death, Deformity, Decay: Memento Mori and the Case of the Colloredo Twins

This guest post is by Rach Klein. Rach is an art history Masters Candidate at McGill University whose research focuses on the early modern grotesque, medical illustration, and print. She is a current recipient of a Joseph-Armand Bombardier grant, as well as a Michael Smith Foreign Studies scholarship.

Throughout the last month I have had the privilege of working in the NYAM Library, looking directly at their remarkable collection of broadsheets and rare books.  The opportunity to closely examine the objects and images that I am studying is unparalleled. My research locates a framework for viewing 17th-century non-normative and “freakish” bodies in the memento mori traditions of the previous century. Memento mori, a Latin phrase meaning, “remember you will die,” became shorthand for a host of visual imagery and cultural objects rooted in medieval Christian theory, which permeated the European early modern.  With a specific focus on the culture of spectacle employed by early modern “shows of wonder” and touring freak shows, the research that I have been doing at NYAM combines visual analysis with medical history and disability studies to suggest that integral to the creation of early modern “freaks” is a manipulation of non-normative persons into objects that spark mortuary contemplation. Guiding this research is the case of Italian conjoined/parasitic twins Lazarus Colloredo and Joannes Baptista Colloredo (1617–1646). Their journey, which is remarkably well-documented in both text and image (for example, see Fig. 1), showcases the duality of the so-called “freak body” and its links to mortuary philosophy.

Historia Ænigmatica, de gemellis Genoæ connati

Fig. 1. Mylbourne, R. (Publisher). (1637). Historia Ænigmatica, de gemellis Genoæ connatis, [Engraving]. © The Trustees of the British Museum. Licensed under CC-BY-NC-SA 4.0.

In 1617, Lazarus and Joannes Baptista Colloredo were born into a life of spectacle and uncertainty. Protruding laterally from the breast of Lazarus was his twin brother, Joannes Baptista, whose malformed body lived partially inside him. Unable to speak or move independently, Joannes Baptista was deemed a “parasitic twin”.  As living persons that defy expectations of the “normative,” visual documentation of the Colloredo twins’ spectacular bodies/body provides insight into anxieties about the boundaries between animate/inanimate, normal/abnormal, beauty/ugliness, soul/body, and, ultimately, life/death. Jan Bondeson calls attention to how remarkable their story is, even within the history of conjoined twins. He says:

Conjoined twins are the result of imperfect splitting of a fertilized ovum and the site of conjunction depends on which part of the splitting has not occurred. Lazarus and Joannes Baptista Collerado represent one of the very few convincing cases of viable omphalopagus parasiticus twins (who lived).[1]

The words in parentheses here, “who lived,” iterate the challenges of piecing together a history of marginalized persons such as those who are disabled and deformed, and the gentle surprise provoked by the twins’ survival.

Perhaps the most interesting discovery found throughout my research is the nonlinear timeline in scholarship about these twins due to a misattributed/incorrectly labelled print from Giovanni Battista de’Cavalieri’s series of engravings, Opera nel a quale vie molti Mostri de tute le parti del mondo antichi et Moderni (Monsters from all parts of the ancient and modern world), published in 1585 (Fig. 2). This image, which is reprinted in Fortunio Liceti’s 1634 De Monstrorum Caussis (Fig. 3), is captioned with the twins’ names and place of birth, despite having been created thirty-years prior to their birth. As with many “freakish” bodies, the accuracy of their experience exists separately from its visual history.[2]

Although these contradictions of dates and attributions make reproducing a clean narrative difficult, they reflect a larger theme of teratology: that bodies are detached from persons, and imaginative ideals misaligned from lived experience. The image by de’ Cavalieri was likely a representation of an earlier set of conjoined twins in the 16th century, perhaps based on conjoined twins mentioned by Ambrose Paré in 1530. This image is subsequently reproduced in Liceti’s 1665 edition of his work, now titled De Monstris. Hence, the twins’ image has been collapsed into a narrative that took place well before their birth, and which frames them as simultaneously alive and dead.

 

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Fig. 3. Liceti, F. (1634). [Rueffo puer Amiterni natus uno brachio, fed pedibus tribus in hanc effigiem] (p. 117). De monstrorum caussis, natura, et differentiis libri duo … Padua, Italy: Apud Paulum Frambottum.

Worries and uncertainties over death and the body make themselves known in images and stories documenting the “freakish” body. Art that has been traditionally deemed “grotesque,” “macabre,” or more colloquially, simply “disturbing” is part of a symbolic system that expresses metaphysical anxieties about what lurks beneath the surface of the body. I am not attempting to medicalize nor romanticize the history of those who are or have been designated as disabled, deformed, monstrous, and freakish. Rather, my aim is to provide a critical and historical study of how non-normative bodies have been catalogued as a memento mori for its witnesses and used by able-bodied viewers as tools of self-reflection and meditation, a practice that actively erases personhood in favour of objectification.[3]

References

[1] Bondeson, Jan. The Two-headed Boy: And Other Medical Marvels. Ithaca, NY: Cornell University Press, 2000.

[2] Jillings, Karen. “Monstrosity as Spectacle: The Two Inseparable Brothers’ European Tour of the 1630s and 1640s.” Popular Entertainment Studies 2, no. 1 (2011): 54–68.

[3] My work is particularly indebted to the disability, feminist, and race scholarship of Tobin Siebers (Disability Aesthetics), Rana Hogarth (Medicalizing Blackness: Making Racial Difference in the Atlantic World, 1780-1840), and Elizabeth Grosz (Volatile Bodies).

Further Reading

Bates, A. W., Emblematic Monsters: Unnatural Conceptions and Deformed Births in Early Modern Europe. Amsterdam: Rodopi, 2009.

Benedict, Barbara M. Curiosity: A Cultural History of Early Modern Inquiry. Chicago, IL: University of Chicago Press, 2002.

Daston, Lorraine, and Katharine Park. Wonders and the Order of Nature, 1150-1750. New York: Zone Books, 2012.

Thomson, Rosemarie Garland. Freakery: Cultural Spectacles of the Extraordinary Body. New York: New York University Press, 2008.

Remembering the Syphilis Study in Tuskegee

This guest post is by Dr. Susan Reverby, the Marion Butler McLean Professor Emerita in the History of Ideas and Professor Emerita of Women’s and Gender Studies at Wellesley College. This year she is a fellow at the Project on Race and Gender in Science and Medicine at the Hutchins Institute for African and African American Research at Harvard University. Reverby is most recently the author of the multiple prize winning book, Examining Tuskegee: The Infamous Syphilis Study and its Legacy and the historian whose work on immoral U.S. led research in Guatemala in the late 1940s led to a federal apology in 2010. She is currently completing her latest book, The Revolutionary Life of Brother Doc: A 20th Century White Man’s Tale (University of North Carolina Press, 2020).

Conspiracy theories and myths, medical and otherwise, often reflect ways to cope with racism in its multiple nefarious forms.   Many such tales focus on destruction of the black body: from the fears that Church’s chicken, now Popeye’s, put something in their frying that caused Black men to become sterile to the beliefs in South Africa that the HIV virus was spread by false vaccinations funded by the C.I.A. and British intelligence. Did you hear the one about the U.S. government letting hundreds of black men in and around Tuskegee, Alabama with syphilis not get to treatment that went on for four decades between 1932 and 1972?  Or that the government actually gave the men the syphilis and you can see it in the photographs, especially if you cannot differentiate between a blood draw and an injection?

Photograph of Participant in the Tuskegee Syphilis Study

Centers for Disease Control: Venereal Disease Branch. (ca. 1953). Photograph of Participant in the Tuskegee Syphilis Study. Image from https://catalog.archives.gov/id/824612

Only the fact that the government tried to make sure the men who already had late latent syphilis did not get treatment for forty years is true among these tales, and horrendous enough. Now we have to consider the meaning given to this Study over the nearly fifty years since it became widespread public knowledge.

The exposure of the Study came at the end of the modern Civil Rights era and after the medical community was beginning to acknowledge that even the “good guys” did immoral work. Along with the unethical studies at Willowbrook [1] and the Jewish Chronic Disease Hospital [2], the experiment in Tuskegee led to the federal Belmont Report [3] and the modern era of institutional review boards and regulations surrounding informed consent.

Kenan Thompson Hugh Laurie

King, D. R. (Director).  (2006, October 28). Modern Medicine: Hugh Laurie/Beck [Television series episode].  In L. Michaels (Producer), Saturday Night Live. New York, NY: NBC.

For many in the health care community and general public the words “Tuskegee” became symbolic of racism in medical research and care, making its way into popular culture in songs, plays, poems, rap, and cultural imagination.   In 2006, Hugh Laurie (T.V.’s irascible Dr. House) hosted Saturday Night Live and played the wife in a skit with patient Kenan Thompson. When the doctor offers care to Thompson, Laurie and Thompson both look at one another and yell “We know what this is: Tuskegee, Tuskegee, Tuskegee.” Others have done academic studies that prove and disprove that it is the memory of Tuskegee that keeps African American patients from seeking care or participating in research trials.  What we do know is that the subtle, and not so subtle, forms of racism create an aura of distrust that affects the kind of health care African Americans both seek and receive whether they know the details of what happened half a century ago or not.

So can there be another Tuskegee?  If by this question we mean the misrepresentation in informed consent, the danger of scientific hubris, and the misuse of patients of color:  probably in some form. Just as importantly, we need to ask what meaning is given to these experiences once they become public? How can the health care and public health communities create what historian Vanessa Northington Gamble calls “trustworthiness.”  It is the meaning of the study in Tuskegee that needs to be assessed, taught and considered. For it is this meaning that reverberates long after the men caught in its grasp wandered in the medical desert for 40 years, and long after any knowledge of its facts actually fade.

Join Susan Reverby along with moderator Aletha Maybank and Monique Guishard for our panel on February 26th, Could Tuskegee Happen Today?, addressing the history and legacy of the study and why it remains relevant today.

Footnotes

[1] J.D. Howell, R.A.Haywood, “Writing Willowbrook, Reading Willowbrook: The Recounting of a Medical Experiment. In: J. Goodman, A. McElligott and L. Marks, eds. Using Bodies: Humans in the Service of Medical Science in the 20th Century (Baltimore: Johns Hopkins University Press, 2003), pp. 190-213.

[2] Barron H. Lerner, “Sins of Omission—Cancer Research without Informed Consent,” New England Journal of Medicine 351 (2004): 628-630.

[3] Office of the Secretary, The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research, April 18, 1979.

#ColorOurCollections 2019: Here Comes the Sun

Are you ready? Our fourth annual #ColorOurCollections week kicks off today! From February 4th through the 8th, libraries, archives, and other cultural institutions are showcasing their collections in the form of free coloring sheets. Follow #ColorOurCollections on Twitter, Instagram, Facebook, and other social media platforms to participate. If you’re a cultural institution, share your own coloring sheets to our website, colorourcollections.org.  And if you’re looking for pages to color you can join in too, by following the social media hashtag. Be sure to visit the #ColorOurCollections website for free, downloadable coloring books created for the campaign.

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Last year our coloring pages took their cues from the ocean, but this year’s especially cold January had us running to our botanicals.  Here, we found a respite from the cold in the pages of Willem Piso’s natural history of Brazil, the vibrant cacti of Johannes Burman’s eighteenth-century volumes on American plants, and the always evergreen pines of the early and important herbal, the Hortus Sanitatis, or Garden of Health.

The earliest illustrations in this year’s coloring book come from a French edition of the Hortus Sanitatus, first published in Mainz in 1485. The woodblocks used to make the book’s many illustrations of plants and animals were reused many times to depict different species. In some cases, fantasy takes over entirely, as with a pair of images depicting male and female mandrakes.

pruss_ortussanitatis_1497_mandrakes_watermark

Source: Verard, Antoine. Des herbis & tabulae… (1500).

Athanasius Kircher was also no stranger to fantasy, and his levitating lily pad, from his illustrated guide to China published in 1667, is no exception. Kircher, a Jesuit, never travelled to China, but relied on accounts by his fellow Jesuits for source material for his book. Kircher promised that his travelogue would distinguish between the real and the unreal, but offered illustrations of a number of incredible sights, including winged tortoises and this flower with a face, who graces this year’s coloring book cover:

Kircher_China_1667_lilypad_watermark.jpg

Source: Kircher, Athanasius. Athanasii Kircheri e Soc. Jesu China…(1667).

Other images this year were taken from the herbal of the Dutch botanist, Johannes Burman, published between 1755–1757. Burman studied under Herman Boerhaave at Leiden, and qualified in 1728 as a doctor of medicine. He later replaced Frederick Ruysch as Professor of Botany in Amsterdam, and was responsible for the botanical garden there. Many of the illustrations in Burman’s Plantarum Americanarum were drawn by the French botanist and artist Charles Plumier (1646–1704). The flowering plant plumeria was named in his honor.

burman_plantarumamericanum_1755_plumeria_watermark

Source: Burmann, Johannes. Plantarum Americanarum. (1755–1757).

Finally, two additional coloring images come from Willem Piso and Georg Markgraf’s astonishing Historia naturalis Brasiliae, published in 1648. The book contains 446 remarkable woodcuts illustrating local flora and fauna, and comprises the most important seventeenth-century catalog of zoology, botany and medicine in Brazil. The woodcuts are based on an original collection of paintings and sketches, now lost; many of these original depictions were likely done by Markgraf himself. Selected pages from the book are digitized here.

piso_brazil_1648_unknownplant_watermark

Piso, Willem & Laet, Joannes de. Historia naturalis Brasiliae. (1648).

We can’t wait to see what you’re coloring from our collections—and from others!  Don’t forget to share your work and use the hashtag #ColorOurCollections on social media.

 

Winter/Spring 2019 Upcoming Events

Happy New Year! After finishing off a wonderful array of programming for 2018, we’re looking forward to the events we have in store for 2019, and hope you are too!

Our winter/spring programming begins on January 26 with our Bibliography Week lecture, “‘The Horrors of My Secret Toil’: What Frankenstein Demands of Curators”, with speaker, Elizabeth Denlinger. She will consider Mary Shelley’s fictional experiment with dead bodies and their place in the scientific world of Shelley’s time, as well as exploring the ethical implications of making a spectacle of human bodies — in the novel, in movies, and in exhibitions.

Please join the Academy on January 30 for the “Tenth Annual History of Medicine and Public Health Night, Part I“. This special evening of selected short talks will address varied topics in the history of medicine and public health from milk pasteurization to the eradication of rinderpest in East Africa.

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February 4-8 is Color Our Collections Week! Begun by the Academy Library in 2016, Color Our Collections Week brings you free coloring sheets based on materials in our Library as well as other cultural institutions from around the world. Users are invited to download and print the coloring sheets via the website www.colorourcollections.org and share their filled-in images with hashtag #ColorOurCollections.

Who is remembered, commemorated, and forgotten? Join us on February 6 for “Remembering the Dead“, a Germ City event where activist and artist Avram Finkelstein and essayist Garnette Cadogan consider the complicated social and institutional responses to infectious disease with the Tenement Museum’s David Favaloro.

The “Tuskegee Study of Untreated Syphilis” was an unethical medical research study conducted by the U.S. Public Health Service on hundreds of African-American men from 1932-1972. “Could Tuskegee Happen Today?”, the inaugural event in the Academy’s Race & Health series, to be held on February 26, will share first-person accounts from survivors, combined with expert perspectives and audience discussion, to address the history and legacy of the study and why it remains relevant today. 

On April 3, we will be presenting “Facing the Future: Predicting and Preparing for Disease Outbreaks“. At this Germ City event, science reporter Sonia Shah will speak with experts Dr. Amy Fairchild, Dr. Larry Madoff, and Lauren Flicker about how prepared we are for future pandemics.

Save the date for April 11, our annual Celebration of the Library: “How the Voice Made Us Human”! This year’s speaker is award-winning journalist and author of As Nature Made Him John Colapinto, who will discuss his current book project on the history of the voice.

Lastly, be on the lookout: newly-added dates for our incredibly popular walking tours on Roosevelt Island and Ellis Island are coming soon!

Check back here for special guest posts by some of our speakers in the coming months, and we hope to see you soon!

If you’d like all this information in handy brochure form, click here.

Digitizing the William S. Ladd Collection of Prints

By Robin Naughton, Head of Digital

We are excited to launch a new digital collection: the William S. Ladd Collection of Prints!

In 1975, The New York Academy of Medicine accepted the gift of the William S. Ladd collection, which consisted of 671 prints dating from the 17th – 19th centuries, from Cornell University Medical College via Erich Meyerhoff, then Librarian of the Medical College Library.   Since receiving the Ladd Collection, the Library rehoused and conserved the material. In the Spring of 2018, the Library submitted a proposal for funding to the Metropolitan New York Library Council’s (METRO) New York State Regional Bibliographic Database Program to digitize the Ladd Collection.  The grant proposal was accepted, and the Library began the process to digitize the Ladd Collection and make it available to the public. METRO provided the funds to scan the collection and the Library provided the resources to build a digital collection website.

Because the Ladd Collection was already conserved and in a ready-to-digitize state, we sent the collection out for scanning soon after receiving funding.  While the collection was being scanned, we turned our attention to the metadata created during the conservation process. The metadata, created for a different purpose, needed to be enhanced for the digital collection.  For the launch, we decided on seven pieces of metadata that would provide users with enough information to understand each print.

Metadata Field Example
Title Aesculapius
Portrait Subject (LC) Asklepios (Greek deity)
Aesculapius (Roman deity)
Collection William S. Ladd Collection of Prints
Repository The New York Academy of Medicine
Genre Prints
Illustration Technique Engraving
ID ladd_010

“Title” is the most critical piece of information because it describes the subject of the portrait and is an easy way to identify the context of the image. Where possible, the Library of Congress (LC) subject is identified.

“Illustration Technique” is an additional piece of information that describes the story of the technology used to develop the portrait.  Researchers and general users can explore the collection by “Illustration Technique,” including etching, stipple, engraving, mezzotint, and lithograph. With each technique hyperlinked in the collection, users can click to see all the prints in the collection with that technique. The top three techniques are engraving (~339 prints), lithograph (~115 prints) and stipple (~61 prints).

Aesculapius. Example of engraving.

Aesculapius. Example of engraving. Image: William S. Ladd Collection of Prints, New York Academy of Medicine.

Récamier, Joseph Claude Anthelme. Example of a lithograph

Récamier, Joseph Claude Anthelme. Example of a lithograph. Image: William S. Ladd Collection of Prints, New York Academy of Medicine.

Widmann, Johann Wilhelm. Example of stipple technique.

Widmann, Johann Wilhelm. Example of stipple technique. Image: William S. Ladd Collection of Prints, New York Academy of Medicine.

As users explore the collection, it becomes clear that there are mostly prints of men.  However, there is a print of a woman in the collection who is described as the wife of Michel Schuppach.

Marie Flückigger

Flückigger, Marie. Image: The William S. Ladd Collection of Prints, New York Academy of Medicine.

There are also prints of a few hospitals, including Brooklyn City Hospital (now the Brooklyn Hospital Center).

Brooklyn City Hospital

Brooklyn City Hospital. Image: William S. Ladd Collection of Prints. New York Academy of Medicine.

Digitizing the Ladd collection provides broad access to the public and an opportunity for researchers, conservators, artists, and the general public to explore early print technology (17th to 19th centuries) from any web-enabled device.  So, take some time to read more about the history of the collection and the important figures in medicine and science, compare multiple printing techniques, and discover these amazing works of art in our new digital collection.

Click here to check out our new digital collection.

Charles Terry Butler: An American Doctor in World War I

By Paul Theerman, Ph.D., Director of the Library

A hundred years ago this week, medical doctor Lt. Charles Terry Butler (1889–1980) entered Germany with the Army of Occupation. Yes, the Armistice had been signed a full three weeks prior, but “Charlie’s war” was not yet over. He would remain in uniform for over four more months. Through his detailed memoir, A Civilian in Uniform [1], we have   insight into his war service and the work of Evacuation Hospital #3, which followed the American war effort across France and into Germany in 1918 and 1919.

1st Lt. Charles T. Butler, MRC, US Army Sept. 1917

Image: A Civilian in Uniform, b/t. pp. 124-125.

As detailed in a previous blog entry, in 1916, Butler, newly graduated from medical school, spent six months as a volunteer surgeon in a British-French military hospital outside Paris, the “war before the war” for Americans.  His experience at Ris-Orangis turned out to be crucial for his later war service. Three months after he returned home, the United States entered the war on the side of the Allies. Butler’s adventures over the next two years capture much of the American medical experience of the Great War.

Butler’s first “battle” was to avoid getting drafted into the infantry so that he could serve in the medical corps.  A draft started right upon declaration of war on April 6th, and as a young man of 27, Butler was likely to be called up. He instead volunteered for the Army Medical Reserve Corps, where, with a medical degree, he received a commission as a first lieutenant in August. He was directed to go to Camp Greenleaf in Fort Oglethorpe, Georgia, by September 15th for additional training. [2] Afterwards, Butler shipped from Hoboken on January 12, 1918, bound for Saint-Nazaire, France, at the mouth of the Loire River, arriving on the 27th. Within a few weeks, Butler’s medical contingent was sent up the Loire and was divided, half to a hospital in Tours and half to one in Blois, both well behind the lines. He would serve separately in these locations over the next five months.

In early July, as part of “Evacuation Hospital #3,” he was moved to Rimaucourt, in the département of Haute Marne, close to the front. On July 29th, the operation moved to La Ferté-Milon “70 K. from Paris, about 23 K. from the Front.” [3]

The sound of guns was plainly audible; the signs of war were everywhere about. The station was almost wrecked—one end blown to atoms by a shell that had come through the roof. Everywhere were shell holes; among the tracks, in the platforms, and in the fields.… Houses everywhere were gaping ruins—roofs knocked off, holes in the walls, windows smashed. For, until the first Allied counteroffensive started, the enemy were within 4K. of the town. [4]

Entire route of Evacuation Hospital #3, 1/27/1918-4/12/1919.

Entire route of Evacuation Hospital #3 in France, where Butler served, from St. Nazaire to Brest. Image: A Civilian in Uniform, b/t pp. 354 and 355.

That afternoon he and his comrades explored the devastated town; less than a week later, the hospital was moved to Château-Thierry and then Crezancy. Butler’s hospital formed part of the medical services supporting the first major American military action in the War. “The camp at Crezancy was the first at which the organization came face to face with all kinds of casualties straight from the front.” [5] His unit remained close to the fighting, treating the wounded of the many battles of the Meuse–Argonne offensive, up until the Armistice on November 11th that marked the War’s end. On that day, Butler wrote to his mother from behind the lines at Verdun:

Everyone is wild with joy! The war ended this morning at eleven. But it’s hard to realize. Automatically we camouflage our lights, but I don’t doubt will get out of that habit before long. . . . They had a big bonfire after supper [tonight] to celebrate with speeches, song, etc. . . . Now we are wondering what will happen to us. There is some talk of our going into Germany with the Army of Occupation, but we have as good chance of getting home fairly early. [6]

Home early was not to be: in December the unit moved north through Luxembourg to Trier, Germany. There it provided medical services for Allied soldiers held in a military prison hospital. For the first time, Butler noted the Spanish Flu in his war reminiscence:

Worn out by months of fighting, their resistance exhausted from the long march, hundreds fell easy prey to the virulent flu-pneumonia bug that was epidemic. While I was in charge of the pneumonia ward, of the 153 admissions, 50 died—one-third. A soldier would come in on his feet and be dead in 48 hours.  The work was utterly frustrating. . . . [7]

Charles Terry Butler July to December 1918 personal diary

Pages from Butler’s diary, which was written from July to December, 1918. Image: Charles Terry Butler papers, New York Academy of Medicine.

After four months, the unit was ordered home. It left Trier on March 27th and arrived in Brest, France, on the 31st, then embarked by ship on April 12th for Hoboken, arriving on the 20th. On April 27th, Butler was discharged from the military at Fort Dix. Between his volunteer service in 1916–1917, and his military service in 1917–1919, he had served over two years, or half of the war.

Charles Terry Butler in July 1975.

Charles Terry Butler in July 1975. Image: A Civilian in Uniform, p. 399.

After the war, Butler married, had children, and entered private practice, but by 1923 rheumatoid arthritis led him to retire. Moving to the Ojai Valley of Ventura County, California, he became a prominent civic and cultural leader. In 1975, after many years of work, he privately published A Civilian in Uniform as perhaps “the most complete account of one of the most active large mobile evacuation hospitals” in the First World War. Butler died in 1980.

Reading through A Civilian in Uniform one learns the reason for its writing: to combine the historical and the personal. Throughout the work, Butler mixed his letters and diary entries with understanding of the war and the official account of his hospital unit. He was justly proud of that unit:

This outfit, through trial and error and after many varying experiences in battle areas, had reached a state of efficiency in all departments that may have served as a useful guide for the structure and administration of evacuation hospitals in World War II. [8]

And of his role:

Yet when, from the multi-thousands of wounded who passed through the portals of these two hospitals, are sorted out the hundreds who owe much of their future physical well being to the professional performance of one single individual, and perhaps that man’s work during those years of bloodshed warrants, in philosophical perspective, a place a notch or two above the microscopic level. [9]

For many, the attraction of war may come from the desire to play a role in a venture of world-wide consequence. For Butler, this played out through his medical work in World War I.

The New York Academy of Medicine Library also houses Butler’s papers.

References:

[1] Charles Terry Butler, A Civilian in Uniform (Ojai, CA: “Private edition,” 1975).
[2] Butler was expected to outfit himself for his service, in the amount of $275.00 for uniforms, insignia, blankets, cots, and incidentals such as mirrors, electric lights, and candles. He received $2,000 a year in compensation, from which were deducted the premium for War Risk Insurance—life and disability insurance provided through the government—and $1.00 a day for officers’ mess! Butler, A Civilian in Uniform, 123–24.
[3] Butler, “Diary,” July 30, 1918, A Civilian in Uniform, p. 230.
[4] Butler, “Diary,” July 30, 1918, A Civilian in Uniform, pp. 230–31.
[5] Butler, A Civilian in Uniform, p. 248.
[6] Butler to “Mother” [Louise Collins Butler], November 11, 1918, in A Civilian in Uniform, pp. 312–13.
[7] Butler, A Civilian in Uniform, p. 332. There also Butler was assigned the task of writing the history of Evacuation Hospital #3, which formed much of the basis of A Civilian in Uniform.
[8] Butler, A Civilian in Uniform, p. 364.
[9] Butler, A Civilian in Uniform, p. 355–56.

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

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

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

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

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

MarineHospital_StatenIsland

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

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

QuarantineSketches_15watermarked

“Doctor’s Examination.” From Quarantine Sketches.

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

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

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

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

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

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

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

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

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

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The First Yellow Fever Pandemic: Slavery and Its Consequences

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

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

1-Hankey

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

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

1-Bulama

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

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

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

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

A Refutation_internetarchive

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

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

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

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

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

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

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

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

Andrew Marshal anatomy course

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

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

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

painting of David Hosack

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

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

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

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

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