The Michael M. Davis Papers and Economics in Medicine

By Carrie Levinson, Reference Services & Outreach Librarian

Recently, the Academy hosted a talk between Paul Krugman and Tsung-Mei Cheng, entitled “Priced Out: The Economic and Ethical Costs of American Health Care.” This event focused on Uwe E. Reinhardt’s latest book, which discusses today’s U.S. healthcare system. Krugman and Cheng delivered lively and nuanced explanations of why our system is so expensive, especially compared with other similar countries, the morality involved in having costs so high, and some potential solutions.

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A photograph of Michael M. Davis from Michael M. Davis: A tribute, by Alice Taylor Davis and Gertrude Auerbach (1972?). NYAM Collection.

The debate about healthcare in the United States is not a new one, however. One notable medical economist whose collection is one of the most interesting in the Academy’s library, Michael Marks Davis, advocated for comprehensive medical care and national health insurance, and worked in many prominent organizations and committees throughout his career, including the Rockefeller Foundation, the Julius Rosenwald Fund, the Committee for Research in Medical Economics, and the Committee for the Nation’s Health (New York Academy of Medicine, n.d.).

Davis donated his collection of papers and reports in 1962. This collection is important because, among other things, it provides source material for studying some of the most significant historical legislative advances in the United States, as well as social trends of the 1920s through the 1960s, aspects of medicine and health in other countries, and confidential and other unpublished reports that likely are not duplicated elsewhere. Below is a short description of the kinds of material that can be found within these papers, originally compiled by Lee Ash (1967).

Series 1: Medical Economics and Medical Sociology

  • Material on medical care costs and studies by, for, and about the Committee on the Costs of Medical Care, including confidential reports; also material on state, industrial and cooperative medical plans, comprehensive group medical plans, and union health programs.

Series 2: Medical Care in the United States

  • Materials including confidential reports made for foundations in the United States; material on rural economic conditions from the 1930’s through the 1950s, and on rural health problems and programs, material on medical education, hospitals, and medical personnel.

Series 3: Legislation and Legal Aspects

  • Materials on legislation since 1950, and publications, reports, correspondence, and ephemera relevant to legislation prior to 1950, public assistance and child welfare, mental health, and state legislation, including sickness and disability insurance programs to be paid for by the state, and original texts of bills.

Series 4: Organizations

  • Samples of special reports, annual reports, and letters to and from Dr. Davis concerning the work of various organizations, grouped into the following sections: Professional Organizations, General Organizations, International Organizations, and Political Organizations.

Series 5: Medical Care in Foreign Countries

  • Public documentation and correspondence with leaders and private physicians concerned with social medicine and public health abroad; a good deal of material focusing on the National Health Service Act; published and unpublished reports from many other countries.

Series 6: Personalities

  • Correspondence, notes, comments, clippings, personality evaluations, and memorabilia to, from, and about all of the leaders Dr. Davis associated with in his work.
Article with graphs looking at illness and income

Article with graphs looking at illness and income in Volume 21 of the Michael M. Davis papers. NYAM Collection in Public Health in Modern America, 1890-1970 .

These short descriptions don’t even begin to cover the richness of the Davis collection. With over 400,000 pieces (Ash, 1967), it might seem insurmountable to researchers, but that’s not the case. We have an excellent finding aid that goes into more detail about the materials and how to find them, as well as giving detailed biographical information on Dr. Davis. Not enough for you? You may recall our blog post about our partnership with Gale to digitize material related to public health in America. Well, this entire collection can be found in Gale’s new database Public Health in Modern America, 1890-1970! If your institution doesn’t subscribe to it, you can make an appointment to view it at our library.

Conversation and arguments about healthcare costs and structure are unlikely to stop anytime soon, but with collections such as Davis’s available to those who are interested, we can understand the history of such discussions in going forward.

References

Ash, L. (1967). The Michael M. Davis Collection of Social and Economic Aspects of Medicine. Bulletin of the New York Academy of Medicine, 43(7), 598–608. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1806900/

New York Academy of Medicine (n. d.). Library of social and economic aspects of medicine of Michael M. Davis [Finding aid]. New York, NY: Author. Retrieved from https://www.nyam.org/library/collections-and-resources/archives/finding-aids/ARM-0003.html/

Monstrosity and Motherhood in Seventeenth-Century English Print

By Hannah Johnston, Library Volunteer 

While today many of us would relegate monsters to fantasy books and Halloween decor, to people in seventeenth-century England, monsters were very real. Fantastical beasts were thought to inhabit the far corners of the world, but perhaps more astonishing were the “beasts” born right at home.[1] Narratives of “monstrous births” could be found in pamphlets, balladry, and even medical books, and the infants in question ranged in these texts from frightening spectacles to prodigal symbols. Of course, many of the babies deemed “monstrous” were not, in fact, monsters. For every “actual” monster – serpents, flying infants, rabbits birthed by a human woman – there was a birth which in the modern era could be explained by numerous common as well as rare conditions.[2]

Nevertheless, this fascination with abnormal births can tell us quite a bit about the many ways early modern people conceptualized and dealt with bodies that defied categorization; among these was the child’s relationship with its mother. The placing of blame on mothers for their own monstrous births reflects a frustration with the lack of understanding of the female body, as well as an interest in encouraging “proper” behavior in women.

False Lover Rewarded

The False Lover Rewarded, 1760? Huntington Library 289786, EBBA 32528. Licensed under CC BY-NC 4.0.

Most people in the 17th century would learn about a monstrous birth from cheap print sources such as pamphlets and broadside ballads. Broadside ballads in particular were incredibly popular, affordable, and widely available to the public. Often sold by female “hawkers” on the street, broadside ballads could be bought by just about anyone and were written to entertain as well as inform.[3] While some ballads were based on true (if exaggerated) events, many were entirely works of fiction. Ballads overall were more concerned with entertainment and moral policing than exploring the functional causes of abnormal births. Sensationalist in nature, they often focused on the spectacle of a single birth, and were often framed as a divine punishment for the mother’s sins or flaws.

The Lamenting Lady

The Lamenting Lady, 1620? Magdalene College – Pepys Ballads 1.44-45 EBBA 20210. Licensed under CC BY-NC 4.0.

While many ballads focused on the physical aspects of infants’ bodies, the way some births occurred were seen as monstrous in and of themselves. “The Lamenting Lady,” published circa 1620, was one such ballad, focusing on the story of a “[lady] of degree” who, despite having beauty and a comfortable lifestyle, could not bear a child.[4] One day, a “poore woman” came to her door with her two children to beg for money. The woman could not fathom why “Beggers [sic] have what Ladies want,” and became irate with the beggar, asserting that she had had her children as a result of being unfaithful to her husband.[5] To punish the woman for her jealous behavior, the beggar woman promptly cursed her:

And for these children two of mine

heaven send thee such a number

At once, as dayes be in the yeare,

to make the world to wonder.

For I as true a wife have beene,

unto my husbands love:

As any Lady on the earth,

unto her Lord can prove.[6]

Because of her unkindness towards the poor woman, the wealthy woman was cursed to give birth to three-hundred and sixty-five children in succession.[7] “The Lamenting Lady” was, of course, a fictional account. However, this chastising tone is common to even the true (or at least more believable) accounts of monstrous births. Balladry, while interested in the causes of monstrous births, was centered on using them both to entertain and to discourage the behavior that was thought to cause them.

While pamphlets and ballads were focused mostly on the spectacle aspect of monstrous births, many books, in particular medical or midwifery manuals, sought to explore their cause. Aristotle’s Masterpiece was one of several works to try to answer the pressing question of where monstrosity came from. An amalgam of earlier works by various authors, the book was first published in 1684 and remained widely popular among curious readers through the early 20th century.[8] The author (or compiler) of the work is unknown, having used “Aristotle” as a pseudonym, likely to invoke authority.[9]

Example of a "monster" in Aristotle’s Masterpiece

Example of a “monster” in Aristotle’s Masterpiece, or The Secrets of Generation displayed in all the parts thereof… London, 1684. NYAM Collection.

Among many topics pertaining to sex, pregnancy, and childbirth, included in the Masterpiece was a chapter on the causes of “monstrous conceptions.”[10] Many people believed that a monstrous conception could be caused by a birth ill-timed with the stars, or a flaw in the “seed” of either parent.[11] The Masterpiece, while acknowledging these to be true, noted another important factor in an abnormal birth – the thoughts of the parents, particularly of the mother.[12] Already a popular concept by the Masterpiece’s publication, the theory of maternal imagination stated that the pregnant mother’s feelings, experiences, and thoughts could impact the development of her child.[13] While in line with the representations of monstrous births in balladry, the theory of maternal imagination sought to explain how the mother’s actions could physically alter her unborn child’s body. In particular, an infant could become “monstrous” if its mother were to wish for, think about, or look upon a thing or person to excess. The theory of maternal imagination would have supported the interpretations of monstrous births seen in cheap print, where mothers’ sins marked the bodies of their children.

Together, the representations of monstrosity in cheap print and in books suggest an interest in finding someone to blame for the curiosity, fear, and occasional tragedy associated with abnormal births. Seventeenth-century English print constructed a connection between the actions of mothers and the bodies of children that served to entertain, inspire fear, and encourage moral behavior in mothers-to-be.

References

[1] Lorraine Daston and Katharine Park, Wonders and the Order of Nature (New York, NY: Zone Books, 1998), pp 173–214.

[2] For flying: “The False Lover Rewarded” (London, UK: 1760), EBBA; For rabbits: See the well-known case of Mary Toft, who (falsely) claimed to have given birth to rabbits. Glennda Leslie, “Cheat and Impostor: Debate Following the Case of the Rabbit Breeder,” The Eighteenth Century 27, no. 3 (1986): 269–86.

[3] Patricia Fumerton and Anita Guerrini, ed. Ballads and Broadsides in Britain, 1500–1800 (Oxon, UK and New York, NY: Routledge, 2010).

[4]The Lamenting Lady, Who for the wrongs done to her by a poore woman, for hauing two children at one burthen, was by the hand of God most strangely punished, by sending her as many children at one birth, as there are daies in the yeare, in remembrance whereof, there is now a monument builded in the Citty of Lowdon, as many English men now liuing in Lowdon, can truely testifie the same and hath seene it,” 1620? EBBA.

[5] Ibid.

[6] Ibid.

[7] Ibid.

[8] Mary Fissell, “Hairy Women and Naked Truths: Gender and the Politics of Knowledge in ‘Aristotle’s Masterpiece,’” The William and Mary Quarterly 60 No 1, “Sexuality in Early America,” Jan 2003, pp 43–74; Pseudo Aristotele, and John How, Aristotle’s Masterpiece, Or The Secrets of Generation displayed in all the parts thereof  (London, England: 1684).

[9] Fissell 47.

[10] Aristotle’s Masterpiece 51.

[11] Ibid 52.

[12] Ibid 51.

[13] Daston & Park 192.

Opium in the Library: Remedy & Reverie in the 18th and 19th Centuries

By Hannah Johnston, Library Volunteer

Writing on opium and opioids in the 20th century, particularly in the United States, was often characterized by an interest in the mechanisms of addiction, a growing concern for public health, and a widespread and a deep-rooted fear of the “dope evil.”[1] Only two centuries earlier, however, the “dope evil” was instead “a safe, and noble Panacea.”[2] While there was certainly an understanding of the addictive nature of opium and, to some extent, concern over its safety, many writers in the 18th and 19th centuries were simply fascinated by the drug.

Two works in particular, The Mysteries of Opium Reveal’d by Dr. John Jones (1645–1709) and The Seven Sisters of Sleep by botanist Mordecai Cubitt Cooke (1825–1914), showcase this interest in the origins, nature, and various uses of the drug. While differing in their goals and their opinions on the primary benefits of opium, both works demonstrate some of the ways eighteenth- and nineteenth-century writers grappled with a substance unlike any they had previously encountered. In conversation with each other, The Mysteries and The Seven Sisters can reveal how changing ideas in medicine, culture, and politics influenced the perception and use of opium in the 18th and 19th centuries.

Considered one of the first comprehensive works on the effects and mechanisms of opium, The Mysteries of Opium Reveal’d aimed to demonstrate how, when used effectively, the drug could be a reliable and incredibly useful medicine.[3] Dr. John Jones first explained the origins, nature, uses, and possible misuses of opium.[4] Jones’ book was what one might expect from an eighteenth-century English medical book—while he did devote time to discussing the history and recreational use of opium, he was most deeply invested in unearthing the mechanisms by which opium “lulls, sooths, and, as it were, charms the Mind ….[5]

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A table of opiate dosages to give to various populations of men and women from John Jones’s Mysteries of opium reveal’d (1701). NYAM Collection.

More than a hundred years later, in the mid-19th century, Mordecai Cubitt Cooke wrote a very different kind of opium book. The Seven Sisters of Sleep focuses on seven narcotic drugs – opium, tobacco, cannabis, betel nut, cocaine, datura (a genus of hallucinogenic plants), and fly agaric (a psychoactive mushroom) – allegorically described as the “sisters” of the Queen of Sleep, who each ruled over different portions of the world.[6] Six of Cooke’s twenty-six chapters were devoted to opium in various respects, and the appendix of the book included tables and information on the use and trade of opium on a global scale.[7] While Jones was more concerned with the proper way of producing opium, dosage for various ailments, and outlining the drug’s exact effects on the body (he noted that opium primarily impacted the stomach), The Seven Sisters was primarily focused on recreational or regular use of the drug, and offered personal accounts of experiences with opium as well as comprehensive reports of opium use, particularly in China.[8]

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A table of opium and its substitutes, from Mordecai Cubitt Cooke’s The seven sisters of sleep: Popular history of the seven prevailing narcotics of the world (1860). NYAM Collection.

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A table estimating the amount of people taking narcotics around the world, from Mordecai Cubitt Cooke’s The seven sisters of sleep: Popular history of the seven prevailing narcotics of the world (1860). NYAM Collection.

Writing on the possible pitfalls of opium use, Jones argued that opium “does not diminish or disable the Spirits by any means whatsoever… when duely and moderately used. Cooke, however, addressed several rather terrifying side effects of the drug.[9] He devoted his twelfth chapter to the dangers of opium, describing in vivid detail the horrifying dreams had by some opium users and noting the occurrences of violent psychotic breaks fueled by opium use.[10] While both works discuss the “noxious principle” of the drug, Cooke devotes far more discussion to its potential for misuse, perhaps reflecting a growing understanding and worry about opium’s addictive nature.[11]

Both works made a point to discuss the place of opium on the global stage; the differing ways each author approached the subject, however, reveal the rapidly increasing role of opium in British imperial activities around the world. Jones’ discussion of this subject is limited mostly to the origins of opium, where he notes the relative quality of opium sourced from different countries.[12] Cooke’s work, on the other hand, was published after the Opium Wars between Britain and China of the previous two decades, and reflects the importance of opium in British imperial growth. He described the ways that different ethnic groups used opium, particularly in Asia, and included reports on the rates of opium use throughout different parts of China.[13] Although largely refraining from the demonizing Chinese opium users, which often happened in late 19th century Britain and the United States, Cooke’s writing suggests a British fascination with opium as a cultural import as well as a recreational drug.

The Mysteries of Opium Reveal’d and The Seven Sisters of Sleep reflect the many ways in which views on opium have changed over the last three hundred years. All in all, both writers were invested in defending the use of opium, and noted the many pleasurable effects the drug had on mind and body. However, the ways in which these effects were described by each writer show how the changing political and cultural climate altered the place of opium in the public mind and on the global stage. These works can offer us a glimpse into the worldviews and events that informed the evolving understanding of opium, its uses, and its dangers.

This blog post was written to complement The New York Academy of Medicine’s  Opioid Symposium, held on Friday, September 20th, 2019. You can also “adopt” The Mysteries of Opium Reveal’d, featured in this blog post, and other related works, to help ensure their care and preservation. See more information about this here

References

[1] Several articles in [Lawrence Boardman Dunham clippings and correspondence albums], Dec 1926 to Sept 1932, Volume 1, Manuscripts, New York Academy of Medicine Library, New York, NY.

[2] Dr. John Jones, The Mysteries of Opium Reveal’d (London: 1701), 1. All emphasis original unless stated otherwise.

[3] Ibid; Richard J. Miller and Phuong B. Tran, “More Mysteries of Opium Reveal’d: 300 Years of Opiates,” Trends in Pharmacological Sciences 21 (August 2000), 299–304.

[4] Jones, 1.

[5] Jones, 216.

[6] Mordecai Cubitt Cooke, The Seven Sisters of Sleep: Popular History of the Seven Prevailing Narcotics of the World (London: 1860), 1–5.

[7] Ibid, 357–371.

[8] Ibid, 163–180, 357–371.

[9] Jones, 81.

[10] Cooke, 163–180.

[11] Jones, 1; Cooke.

[12] Jones, 6.

[13] Cooke, 132–148, 366–368.

Get Your Primary Sources! Public Health in Modern America & Archives of Sexuality & Gender, Part III

By Robin Naughton, PhD

The New York Academy of Medicine Library has closed stacks, and as such, the serendipitous nature of browsing the shelves and discovering a gem stuck between two unlikely neighbors is limited to the librarians working in the Library. Thus, it is important that we provide patrons with access to the material in ways that they too can explore. This is a major goal of the Digital team, and it is made possible through a variety of digitization projects. Most recently, the Library partnered with Gale, a Cengage company, to digitize materials for two mass digitization projects: Public Health in Modern America, 1890-1970 launched in June 2019 and Archives of Sexuality & Gender, Part III: Sex and Sexuality, Sixteenth to Twentieth Centuries launched in February 2019.  Within the past year, the collaboration with Gale has helped the Library to digitize over 6,600 items, which represents almost a million images created.

Contributions

The Library contributed archival collections, and rare and historical materials for each project, providing users with access to major primary sources.

PHIAF0004-C00000-B0209700-00020

Bouton, S. M. (n. d.). Old Doc Politics is back again. New York: Public Relations Bureau Medical Society of the State of New York. Pamphlet in New York Academy of Medicine Library collection; digitized for Public Health in Modern America database.

Public Health in Modern America includes:

  • The Committee on Public Health of the New York Academy of Medicine – a collection of correspondence, reports, minutes, and documents on the significant work of the committee with New York’s health department and leading figures in public health. It is a collection about the New York Academy’s contribution and role in public health at the time.
  • Library of Social and Economic Aspects of Medicine of Michael M. Davis – a collection of the work of Dr. Davis in the early twentieth century, covering topics such as healthcare, medical economics, social security, legislation, and more.
  • Selected Public Health Pamphlets – over 2,200 pamphlets on various aspects of public health from the late nineteenth century to the mid-twentieth century.
Sanger_cover_cropped

Sanger, M. (1913?). What every girl should know. Reading, PA: Sentinel Printing Co. Book in New York Academy of Medicine Library collection; digitized for Archives of Sexuality & Gender database.

Archives of Sexuality & Gender includes:

  • Monographs – over 1,500 monographs on a variety of topics dealing with sex, sexuality, and gender.
  • Mary Ware Dennett Case Collection – an archival collection of the court case against Dennett for writing “The Sex Side of Life,” a pamphlet about sex for young people.
  • Correspondence between Eugen Steinach and Harry Benjamin – a collection of over forty years of correspondence about rejuvenation, including letters, postcards, diagrams, and photographs.

Together, these two products represent significant digitization making rare and unique materials available. Researchers can now go deep in ways not possible prior to digitization. For example, the material has optical character recognition (OCR), which means that researchers can search for a term and discover all the places where that term exists within a text, across the collection, or across the product, which includes collections from other collaborators. In addition, the products offer options to jump to diagrams, photographs, and other material types within a given item.  Thus, researchers now have direct access to substantial databases of primary source materials that they can analyze in novel ways.

External Digitization Process

Creating these products took tremendous amount of collaboration among multiple organizations and people.  For the Library, these products required the external digitization process, which was one process out of many that made it possible to seamlessly digitize this material. The external digitization process included an intricate tracking of each item digitized from the moment it was identified and taken off the shelf to moment it was returned to its place on the shelf.

The external digitization process workflow describes the steps involved.

Gale Production Process

External digitization process flowchart, created by the author.

Green indicates start and end.  White indicates steps in the process.   Yellow indicates that there are additional processes involved with their own workflows. Red indicates that there is an issue that needs to be resolved.

External digitization projects make it possible for the Library to digitize materials on a large scale and make the content available to universities and research institutions from Gale. It also makes the products created available to patrons in the Library. Thus, patrons visiting the Library can have access to these databases while in the Library.

Interested in using these databases in the Library? Click here to find out how to make an appointment to visit.

“Alas, Poor Daft Jamie’s Pickled!”: Poetry Concerning the Resurrectionists

By Carrie Levinson, Reference Services and Outreach Librarian

You may have heard about “Resurrection Men” – people who robbed graves and even killed people to fill the unprecedented demand for cadavers in medical schools in the nineteenth century. You may have even heard the names William Burke and William Hare: two of the most notorious body-snatchers and murderers who ever lived. But did you know that there is poetry about these bizarre and tragic events?

 The New York Academy of Medicine Library has a digital collection, The Resurrectionists, which contains broadsides, ballads, pamphlets, poetry, and other literature concerning Burke and Hare, their accomplices, and their victims. Since it is National Poetry Month, we’ve decided to feature some of the poetry contained in this collection.

First, however, a little bit of background. William Burke and William Hare were two ne’er-do-wells in 1820s Scotland who enjoyed drinking and working as little as possible (Barzun, 1974). When another occupant in their lodging house passed away from natural causes, they sold the body. Soon they found that bodies for the medical schools (particularly, the anatomy and physiology class in Edinburgh taught by Dr. Robert Knox) were in high demand, but not in ready supply. To capitalize on this newly-discovered stream of funds, the group quickly turned to murder. Their first victim was likely a miller by the name of Joe, and more followed (Barzun, 1974).

Unfortunately for them, Burke, Hare, and their accomplices made a number of mistakes resulting in their capture: they murdered a prostitute by the name of Mary Paterson, who was a client of one of the doctors and whom he recognized (though he kept quiet at the time); they also killed a well-known and -liked young man known in town as Daft Jamie, whose disappearance was immediately noted and speculated upon (bringing suspicion upon Dr. Knox as well); and they also began to quarrel amongst themselves. Their arrest came after a couple who knew their last victim, Mrs. Docherty, went to the police (Barzun, 1974).

 

 

 

Hare was offered immunity to testify against Burke and Helen MacDougal, Burke’s mistress. After the trial, deliberations took less than an hour: Burke was declared guilty, while MacDougal went free. Burke’s punishment: he was to be publicly hanged, his skin to be tanned and sold in strips, and his body to be dissected and then lectured upon, much like the bodies he had murdered for profit (Barzun, 1974). Burke was hanged on January 28, 1829, and his skeleton is still on view in the Anatomical Museum of the Edinburgh Medical School. Hare left Edinburgh in disguise and soon disappeared. One enduring legacy was a new verb, to burke, originally meaning to kill by smothering (in order to leave a good body to dissect!), and now broadened to mean to suppress.

 

A huge amount of literature was generated from these morbid events, including, arguably, the genre of crime fiction (Barzun, 1974). Here are a few examples of the poetry: one, an elegy for William Burke, and two poems lamenting the death of Daft Jamie (Jamie Wilson).

Elegy__page_2

We hope you will peruse this collection and marvel at the many effects Burke and Hare’s dastardly deeds had on the law, medicine, and literature. Perhaps you’ll be inspired to write a poem of your own!

  References

Barzun, J. (1974). Murder for profit and for science. In J. Barzun (Ed.), Burke and Hare: Resurrection men: A collection of contemporary documents including broadsides, occasional verses, illustrations, polemics, and a complete transcript of the testimony at the trial (pp. v-xii). Metuchen, NJ: Scarecrow Press.

Finding Cause in Street Cleanliness:  The Citizens’ Association of New York Report of 1865

By Anne Garner, Curator, Rare Books and Manuscripts

It’s 1863. New York’s streets are dismal.  Downtown, the scents of manure, garbage and chemicals permeate the air.  The streets are littered with debris, and in some places, are navigable only by wading through standing water. The gaps between cobblestones catch sewage and other dirt discharged from nearby tenements.

Public health statisticians estimate that New York has upwards of 200,000 cases of preventable and needless sickness every year. The Board of Health, controlled by corrupt politicians, is ineffective.  In newspapers like Frank Leslie’s Illustrated News and Harper’s Weekly, the condition of New York’s thoroughfares is a punchline. Editorials, cartoons and newspaper stories blame immigrant populations, the poor, and an indifferent municipal government. [1]

1BoardofHealth

T. Bernhard Gillam, “The Streets of New York,” Harper’s Weekly, February 26, 1881.

What to do?  In December of that same year, a group of citizens met with Mayor Gunther, the recently elected reform candidate to consider the city’s social problems. The following year, these concerned citizens formed the Citizens’ Association of New York, dedicated to a cause they describe in simple terms: “public usefulness.” [2]  The organization quickly determined that physicians should play a prominent role in sanitary reform, and organized the Association’s Special Council of Hygiene and Public Health. [3]

In May of 1864, the Council embarked on a street-by-street sanitary inspection of New York City. Medical inspectors – all physicians—were assigned to 31 districts throughout the city in an attempt to gather detailed information about New Yorkers and their living conditions. For seven months, the inspectors visited every household in Manhattan and used a nine-page survey as their guide. [4]

​​During the course of the survey, the inspectors filled seventeen volumes of observations and notes comprising the most “precise and exacting account of a city’s health and social conditions ever compiled.” Many of these notebooks, including some remarkable hand-drawn maps, are available at The New-York Historical Society. The image below is taken from the Society’s archives and shows a tenant house for 200 people at 311 Monroe Street, in the 9th District. [5]

7thward-NYHS

Record of Sanitary Inquiry, 7th ward, 9th District, {BV Citizens’ Association}. Reposted with permission of the New-York Historical Society.

This survey, presented by medical inspector William Hunter to former New York Academy of Medicine President Joseph M. Smith, records the living conditions of a family of three recent Irish immigrants living in a three-story tenement on W. 14th Street in late October of 1864. The unit was comprised of David, age 30, described in the survey as an “intelligent but uneducated” gardener, Ellen, age 28, and Margaret, age 6. The survey suggests that all three family members had typhoid fever, likely contracted on their journey to America from Ireland just a few months before.  Though the family’s living conditions were described as “good,” Hunter notes that the six families in their apartment were living in close quarters in just six rooms, with only two windows as a source of light and ventilation, and in such proximity to the horse stable that the horse could freely wander into their hallway. [6]

Surveys of this depth and length were kept for every household throughout the city’s 31 wards.  Wards were frequently assigned to physicians who knew the neighborhoods and the residents.  Most of the residents were given a thorough medical exam, and the nuisances of their environment were recorded in detail. [7]  Each ward’s physician contributed a district report, summarizing their findings. Ezra Pulling, who was the sanitary inspector for the fourth ward, contributed a report on his district and his data was poured into the making of this extraordinary map, published along with the report in 1865.  ​

2CANY_reportcouncilhygiene_sanitarychartfourthward_ca1865_watermark

Map of the Fourth Ward of the City of New York. Report of the Council of Hygiene and Public Health of the Citizens’ Association of New York. New York:  Appleton, 1865.

3CANY_reportcouncilhygiene_sanitarychartfourthward_ca1865_watermark

Fourth Ward map, detail of Gotham Court

The long, rectangular building that you see here at the center of this detail is a tenant house called Gotham Court.  The stars here indicate that outbreaks of typhus and smallpox have occurred in the house.  Privies in the basement were discharged into subterranean drains or sewers that run through each alley and then outside through grated openings, blocking much of the waste. Inside, each individual has an average of 275 cubic feet.  If these dimensions are difficult to picture, imagine a closet 5 feet square and 11 feet high, allotted per person, for their body and for everything they own as well. Nineteen children were recorded as unvaccinated for smallpox (the only vaccine available at this time) here, and it was also noted that clothes were being manufactured in the building as well—clothes that were exposed to cases of typhus and measles. [8]

In another section of the map, we see a number of tenant houses north of the Bowery surrounded by stables, with a brewery and a coal yard at the east.  Less than 30 percent of the privies in this district are connected with drains and sewers, and at least ten of these, as marked on the map by black squares, are in extremely offensive condition. A number of these are indicated on the map below.

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Fourth Ward map, detail of the Bowery

The impact of the publication of the Citizens’ Association report and the map itself was mixed. The report led to higher sanitation standards throughout the city, and forced the attention of government officials, who passed a law to create the Board of Health.[9]  Under this law, at least three of the Board’s nine commissioners needed to be physicians. Though the Council went to great lengths to visually and verbally document the city’s housing conditions, the Council didn’t investigate wage equity or the frequency and rate of unemployment. Historian Elizabeth Blackmar has argued that “the surveys fueled the movement for developing building codes and sanitary inspection as a means of guaranteeing better housing, but they also erased from discussion reflection on the larger economic relations that produced them.” [10]  In some cases, the report’s writers unfairly drew a line of causation directly from better living conditions to economic security, implying that given the right housing, the poor could flourish, independent of employment opportunities, fare wages, and access to healthcare.

In spite of its shortcomings, the report offered keen observations about the city’s conditions, and was instrumental in inspiring great reform in the city.  Today, IMAGE NYC, a project launched by the Academy with the CUNY Mapping Service at the Center for Urban Research / CUNY Graduate Center earlier this year, embraces the methodology the Citizens’ Association deployed over 150 years ago, and largely for the same reason: to better understand the social determinants of health.  The site has an interactive map of New York City’s current and projected population, 65 and older.  Much like the Citizens’ Association map, the idea is to determine environmental risks and benefits to certain populations.  Here, instead of physicians canvassing the neighborhoods to note conditions, community members can use the 311 app to take pictures and send them to the city.

The Fourth Ward Map, published as part of the 1865 Report of the Council of Hygiene and Public Health, as well as the 1864 survey form documenting the household of the Irish immigrants living on 14th street, are on view in Germ City: Microbes and the Metropolis, until this Sunday, April 28th.

References

[1] Bert Hansen. “The Image and Advocacy of Public Health in American Caricature and Cartoons from 1860 to 1900.”  American Journal of Public Health. Nov. 1997, v. 87, no. 11.

[2] Report of the Council of Hygiene and Public Health of the Citizens’ Association of New York. New York: Appleton, 1865, P. vii.

[3] John Duffy.  A History of Public Health in New York City 1625-1866.  New York: Russell Sage, 1968. Pp. 553-556.

[4] Report of the Council of Hygiene and Public Health of the Citizens’ Association of New York. New York:  Appleton, 1865.

[5] See also the excellent blog by Reference Librarian Mariam Touba of The New York Historical Society, here.

[6] Citizens’ Association of New York: Council of Hygiene and Public Health. Report of pestilential diseases and insalubrious quarters. New York: n.p., 1864.

[7] Duffy, p. 556.

[8] Report of the Council of Hygiene and Public Health…1865. P. 49-54.

[9] Duffy, 557.

[10] Elizabeth Blackmar.  “Accountability for Public Health: Regulating the Housing Market in Nineteenth-Century New York City.” In Hives of Sickness, edited by David Rosner. Rutgers University Press, 1995. Pp. 42-64.

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)!

Consumers_BehindtheScenesinaRestaurant_1916_diag5_watermark

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.

Consumers_BehindtheScenesinaRestaurant_1916_movie_watermark

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.

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).

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“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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No Spice More Superior: Pepper

By Emily Miranker, Events & Projects Manager

The marvelous thing about libraries (well, one on an infinite list of marvels…) are the remarkable rabbit holes of investigation and imagination you fall into. Recently,  I ran into a kitchen staple in an old medicine book:

Black Pepper is a remedy I value very highly. As a gastric stimulant it certainly has no superior…

Black pepper as a cure for anything, except perhaps bland food, was news to me. The above passage comes from the 19th century John Milton Scudder’s 1870 book Specific medication and specific medicines. In the 19th century “specific medicine” referred to a branch of American medicine, eclectic medicine, that relied on noninvasive practices such as botanical remedies or physical therapy.[i] As an eclectic practitioner, Scudder’s work was not mainstream, regular medicine, so I wondered if perhaps that was why pepper should come up as a remedy. Surely, pepper only belongs in the pantry not the medicine cabinet. But doing more research, it turns out that black pepper, Piper nigrum, originally from India, has been used by people for medicinal purposes for centuries.

Black Pepper_Bentley_1880

A member of the Piperaceae family of plants, black pepper is a tropical vine. Its berries (the dried berries are the peppercorns we’re familiar with from the kitchen), were known to the Egyptians, Greeks, and Romans long before it became one of the most sought-after spices in Europe during the Age of Exploration, the 15th-18th centuries. Depending on when it’s harvested, a vine produces four kinds of peppercorn. Green peppercorns are unripe berries that are freeze-dried. White pepper is almost ripened, the berries are harvested and soaked in water which washes off the husk leaving the gray-white seed. Red peppercorns are fresh, ripe berries. Black peppercorns are harvested when the spike of berries is midway ripe; these unripe berries are actually more flavorful than a fully ripe berry. The black peppercorns are blanched or left to ferment a few days and then dried in the sun. The drying process turns the husk black.[ii]

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A detail of a page of recipes calling for pepper by the Roman gourmand Apicius, the oldest cookbook in West. Author’s favorite: #31 Oenogarum in Tubera, a wine sauce for truffle mushrooms calling for pepper, lovage, coriander, rue, broth, honey and oil.

Pepper came to the tables and pharmacies of Europe via trade from the west coast of India. It was coveted enough to be part of the ransom demand Alaric the Goth made of Rome when he invaded in 408 C.E.[iii] With its strategic location on the Adriatic, Venice dominated the spice trade in Europe in the Middle Ages. The Portuguese were the first to break the Venetian hold by finding an all-ocean route to India. By the 17th century the Dutch and English were players in the spice trade. Innocuous-seeming dark grains in shakers on tabletops now, pepper was once more valuable than silver and gold. Sailors were paid in pepper. The spice was also used for paying taxes, custom duties, and dowries.[iv] In their quest for pepper, among other spices such as cinnamon, cloves, and nutmeg, the Europeans brutally pursued spice monopolies regardless of the upheaval and violence they wrought on the peoples of India, Sumatra and Java.

 

Dating back to 6,000 B.C.E. the Materia medica of Ayurveda advocates using pepper for a number of different maladies, especially those of the gastrointestinal tract.[v] To this day in India, a mixture of black pepper, long pepper, and ginger, known as trikatu, is a common Ayurvedic medicinal prescription. Trikatu is a Sanskrit word meaning “three acrids.” In the Ayurvedic tradition “the three acrids collectively act as ‘kapha-vatta-pitta-haratwam’ which means ‘correctors of the three doshas of the human.’”[vi] Doshas are energy centers in the body in the Ayurvedic tradition.

Pepper figured in Western medicine from antiquity onwards as well. Writing in the 7th century, Byzantine Greek physician Paul of Aegina quotes the 2nd-century Greek Galen on pepper’s’ medical properties, “it is strongly calefacient and desiccative.”[vii] Warming and drying, thus very good for stomach problems in his estimation. Side note: Galen’s office was in the spice quarter of Rome, underscoring the connections between health, spices, and food. Peppers’ use as a “gastric stimulant” persisted through the centuries. In our collection’s The elements of materia medica and therapeutics (1872), Jonathan Pereira states pepper “is a useful addition to difficult-to-digest foods, as fatty and mucilaginous matters, especially in persons subject to stomach complaints.” The illustrations of pepper plants in this post come from Robert Bentley’s Medicinal Plants (1880) which includes their medical properties and uses along with descriptions of habitats and composition.

Black pepper medicinal properties_Bentley_watermarked

Scientific studies on pepper coalesce around its compound piperine. The stronger—more pungent—the pepper, the more piperine it contains. The argument of studies on pepper’s properties is that adding pepper to a concoction increases its efficacy and digestibility. Research suggests “this bioavailability enhancing property of pepper to its main alkaloid, piperine…. The proposed mechanism for the increased bioavailability of drugs co-administered with piperine is attributed to the interaction of piperine with enzymes that participate in drug metabolism.”[viii]

I hadn’t looked to black pepper for any health benefits. I look to it for that delicious heat and spicy pungency it brings to my meals. But that’s the great thing about researching in our library; you always find delights beyond what you’re looking for.

References
[i] Eclectic Medicine. https://lloydlibrary.org/research/archives/eclectic-medicine/ Copyright 2008. Accessed August 30, 2018.
[ii] Sarah Lohman. Eight Flavors: The Untold Story of American Cuisine. New York: Simon & Schuster, 2016.
[iii] Majorie Schaffer. Pepper: A History of the World’s Most Influential Spice. New York: St. Martin’s Press, 2013.
[iv] Schaffer. Pepper. 2013.
[v] Muhammed Majeed and L. Prakash. “The Medicinal Uses of Pepper.” International Pepper News. 2000. Vol. 25, pp. 23-31.
[vi] Majeed & Prakash. 26.
[vii] Paulus Aegineta. La Chirurgie. Lyons: 1542.
[viii] Majeed & Prakash. 28.