By Mario Rubano, MPH, Center for Healthy Aging, NYAM
Today’s guest blogger is Mario Rubano, Policy Associate at NYAM’s Center for Healthy Aging. Mr. Rubano plays a central role in the Academy’s next Then & Now event, “The Opportunities and Challenges of Healthy Aging in New York City.” He conducted the interviews documenting the experiences of older New Yorkers and will moderate the discussion of those experiences with historians Kavita Sivaramakrishnan, PhD, and David G. Troyansky, PhD. The event takes place online on Tuesday, November 15, 5:00 to 6:00 pm; you can register here.
The NYAM Library’s “Then & Now” series has explored a wide variety of medical and public health issues, bringing experts and researchers into dialogue with the broader NYAM community. As the Academy’s 175th anniversary celebrations wind down, we’re delighted to feature a different set of experts—older New Yorkers.
NYAM has been at the forefront of NYC older adult health and policy since 2006, when it first joined the Global Age-friendly Cities project, an international effort spearheaded by the World Health Organization (WHO). The following year saw the development of Age-friendly NYC, an award-winning partnership that reimagined how the City could meet the needs of its older residents. This shift was rooted in the 8 Domains of Livability, a collection of interconnected categories that captured the most vital aspects of healthy living for older adults in urban centers. Today, the Center for Healthy Aging (CHA) embodies this legacy in its ongoing mission to improve the health and well-being of current and future aging populations.
At present, New York City is home to roughly 1.2 million individuals aged 65+, and we were lucky enough to settle down with five of the busiest of them for personal interviews via Zoom. The participants, drawn from a network of grassroots age-friendly community groups, shared their insights, memories, experiences, and opinions (with classic New York panache) in a discussion structured around the 8 Domains of Livability. Each of the participants has maintained an active relationship with local community-based organizations, community boards, volunteer groups, or, in one case, as a part-time Reservist working with NYAM. What was immediately clear across each of the interviews was the devotion that each participant has to this city. Whether born-and-bred or a transplant, these New Yorkers were as energized by the city as one could possibly be, and it’s this vigor that brought their reflections to life.
If a single takeaway were to be drawn from these five interviews, it would be that “progress” is a constant process rather than a state-of-being or condition that is achieved. The domain of transportation illustrates this idea. The participants all remarked on the tremendous improvements in comfort and capacity that the public transportation system has undergone over their lifetimes. The advent of air conditioning to ease the misery of a summertime, rush-hour commute, the growing fleet of accessible kneeling buses that simplify the boarding process for individuals with mobility challenges, and the creation of station transfers were all viewed as highlights over the years. Yet, we also heard about significant lapses in the management of bus lines that blatantly ignore the needs of older New Yorkers and, in many instances, place undue burdens on communities of color.
Healthcare access also changed in remarkable ways, both positive and negative, over the course of their lifetimes. House calls from family doctors who knew and treated entire communities gave way to newer models of care that, while noted for their efficiency and quality, were seen as impersonal and disconnected. We heard sobering stories of healthcare in the years before desegregation and the ongoing effects of Robert Moses’ infrastructure projects, like the Cross Bronx Expressway. These stories demonstrate the necessity of continued civic and community engagement, even after broad, landmark victories. Legislative progress—such as that initiated by the Americans with Disabilities Act in 1990—must be continuously refined to ensure that the promises of better lives remain intact in an increasingly complex world.
This project has been a thrilling process in itself, and we look forward to sharing these New Yorkers’ stories, and hearing the commentary by our guest historians, Drs. Kavita Sivaramakrishnan and David Troyansky, at the upcoming November 15th Then & Now event.
By Joseph Bishop, Princeton University, and the Library’s 2022 Audrey and William H. Helfand Fellow
Mr. Bishop completed his Fellowship residency in summer 2022 and will present his research by Zoom on November 8 at 4:00 (EST). To attend his talk, “Pharmaceutical Visions: How US Drug Companies and Ad Agencies Revamped Their Credibility by Marketing with Scientific Imagery,” register through the Academy’s Events page.
This spring I spent weeks immersed in the vast historical materials available at the New York Academy of Medicine (NYAM) Library. I had the honor of receiving the Audrey and William H. Helfand Fellowship to pursue a project that I believe would have interested Bill Helfand: an examination of the changes in medical advertising at the turn of the twentieth century. During his life, Helfand amassed an extensive collection of fascinating drug and medical memorabilia and visual art. Much of his collection and work illuminates the dynamic between drugmakers and the public during the late nineteenth and early twentieth century. Significant portions of Helfand’s collection are available at NYAM, and I took advantage of the richly colored and wide-rangingcollection of patent medicine trade cards. NYAM also has mountains of pharmaceutical, medical, and allied trade journals and magazines brimming with pharmaceutical advertisements.
At the turn of the twentieth century, the American public saw the rise in large corporate pharmaceutical companies, national and corporate advertising, and federal drug regulation. An important question is what prompted the transformations in medical visual culture that helped to portray drug companies as scientific and research-oriented. To answer that question, I compare late-nineteenth-century patent medicine trade cards with medical ads in Ladies’ Home Journal in the 1920s. This comparison reveals a transition from entertainment and fantasy to a preoccupation with scientific progress and medical authority. My research at NYAM has led me to conclude that drug companies and ad agencies emphasized scientific and medical imagery to revamp their medical credibility and professional image amid national drug regulation and the public’s anger with the industry’s past association with patent medicine.
American patent medicine companies faced scrutiny for producing nostrums with cryptic contents and questionable efficacy during the first decade of the twentieth century. They depended on local advertisement imagery that reflected the nineteenth-century public’s anxieties and aspirations. Popularizations of science were created for various reasons—from entertainment to informing citizens—but they all served to increase scientific and medical awareness within the American public. Philadelphia-based ad agency N. W. Ayer’s accounts show that patent medicine was their most lucrative commodity category, carrying 26 percent of their total revenue in 1878, and their second-most lucrative commodity in 1900, carrying 15 percent. By 1879 in the US, more than 400 religious weeklies each needed a steady flow of advertising revenue to stay in business. Newspapers generated patent medicine business, and medical advertisements sustained newspapers. Nostrum manufacturers developed new marketing techniques, created novel distribution systems, pioneered brand-name products, became an economic link between urban and rural centers, and expanded markets.
Americans living through the last two decades of the nineteenth century saw an explosion of advertising trade cards. Retailers gave away these pocket-sized cards, often stuffed in product packaging as a bonus and easily collectible by customers. Patent medicine companies used these cards extensively, as they proved to be a very successful sales medium. Many people collected cards into albums and created scrapbooks, which children sometimes received as birthday or Christmas gifts.
Trade cards such as Ayer’s Ague Cure (Image 1) evoke an aura of connection with nature and adaptation to the surrounding environment. The image in the bottom right corner depicts an alligator and a couple of frogs discussing Ayer’s Cure as if they used it to protect themselves from malaria. The ad implies that Ayer’s product helps one adapt to one’s environment just as well as the alligators and frogs adapt to theirs.
On the other hand, Cas-car-ria’s trade card (Image 2) depicts a young girl holding a switch and a dog together, fending off miniature demons labeled with ailments. Cas-car-ria’s ad evokes notions of animal protection and self-protection, implying that when patients take Cas-car-ria, they harness the animal within, unleashing the strength required to fight off external demons.
The explosion of ads promoting proprietary medicines and their incessant hyperbole and mistruths eventually provoked strong public reactions that demanded transparency and regulation. There were always calls to rein in the quackery, but the inundation of promotion drove the regulation of patent medicine to become a public priority.
Examining Ladies’ Home Journal during the 1920s illustrates these changes in advertising. At this point, advertisements offered a different portrayal of scientific medicine and appealed to a more docile public regarding medical professionals. A Squibb pharmaceutical ad depicts a well-organized medicine cabinet (Image 3). The caption asks, “What is in your medicine cabinet? Are they products your physician would approve?” This approval seeking from medical authority plays into the new values of placing faith in the trained judgment of scientific and medical authority.
Ads for Zonite (Image 4) ran images of scientists wearing lab coats and examining test tubes, drawing a scientific aura into its products. Zonite also associated its product with scientific discoveries, like the Carrel-Dakin fluid (i.e., diluted bleach), a critical antiseptic used in World War I.
The ad for “Yeast Foam” (Image 5) also appeals to scientific and medical authority, depicting a man wearing a medical coat and peering into a microscope. In the foreground are two circular illustrations of microscopic specimens—one containing germs and the other germ-free. The ad portrays a professional man immersed in scientific work, suggesting that the product has been carefully vetted through scientific scrutiny for quality assurance.
Similarly, the Fleischmann advertisement (Image 6) depicts two men in lab coats working at a table equipped with flasks, a beaker, a microscope, and other scientific instruments. The caption below the image states, “Messages of startling importance from the laboratory of the scientist.” Text within the ad notes how Fleischmann’s Yeast cures various diseases. In the case of skin diseases, the ad relies on a general sense of medical authority: “Many physicians and hospitals are prescribing Fleischmann’s Yeast for impurities of the skin. It has yielded remarkable results.”
The values of corporate ad agencies following the patent medicine era are not only a reaction to muckraking journalism and reform movements. The use of scientific medical imagery conveying authority and professional judgment was also largely about revamping the medical credibility of US drug companies and corporate ad agencies; they benefited handsomely during the patent medicine era but later needed to diminish their connections to these fraudulent products. Ad agencies traced the American public’s anxieties and aspirations as they shifted from loose whimsy about panaceas in the late nineteenth century to a reverence for qualified scientific and medical experts and institutions at the beginning of the twentieth century. By tracing this transition in medical imagery, we can glean how drug companies and ad agencies shaped products to elevate their professional clout.
By Paul Theerman, Arlene Shaner, Bert Hansen, and Melissa Grafe
On Tuesday, October 18, three esteemed librarians and historians will gather—virtually—to discuss the history and prospect of medical libraries. The event features the Library’s own Historical Collections Librarian, Arlene Shaner, speaking on the development of our collections; historian of medicine Dr. Bert Hansen, on how libraries helped shape the development of medicine through history; and Dr. Melissa Grafe, head of the Medical Historical Library at Yale School of Medicine, on the future of historical collections such as the Academy Library’s. If you are interested in attending, please register here. To learn about what these speakers will present, keep reading!
Arlene Shaner, “‘A Rich Storehouse’: The NYAM Library’s Extraordinary Collections”
Arlene Shaner, our first panelist, will talk about the evolution of the NYAM Library and its collections, starting with Isaac Wood’s gift of his set of Martyn Paine’s Commentaries to the brand-new organization on January 13, 1847. What he and the early Academy Fellows had in mind was a working collection of books and journals that they would create for their own use. Because the Academy had no home of its own, and very little money, the collections grew at a very modest pace for the first few decades.
The purchase of a building in 1875 provided space for the collections to grow. The generosity of Dr. Samuel Smith Purple, who donated over 2000 journal volumes of his own after the Academy moved into its West 31st Street brownstone (at left), coupled with the 1878 decision of the Fellows to open the Library to all who wished to use it, dramatically changed the Library’s trajectory.
It opened the door to what Librarian Janet Doe later referred to as “a snowball of gifts which has rolled down through the years, gathering momentum and throwing off new snowballs that roll into other libraries.”
Shaner will offer a brief overview of some of the major gifts that helped the library become one of the most important history of medicine collections in the country, if not the world, and also tell the much less well known story of how the Library contributed to the growth of many other collections. She will also look briefly at how changes in the way information is disseminated have transformed, and continue to transform, the NYAM Library.
Bert Hansen, “The Academy Library’s Contributions to American Medicine.”
Our second panelist, historian Bert Hansen, notes that his earliest memories picture libraries as storehouses of precious treasure, an image reinforced by an architecture that made them look like giant-sized strongboxes or jewelry boxes. Built of large stone blocks and fortified like a castle, libraries he fondly recalls include the main public libraries in Chicago, Newark, and New York City, plus Butler Library at Columbia and the Morgan Library from his college years (as seen below, with NYAM the sixth). The decorated, jewelry-box style often continues inside with marbled lobbies and wood-paneled reading rooms.
But for this presentation, Hansen has gone in a new direction, focusing his attention on the kinds of contribution that libraries like that of NYAM have made to education and the world of learning in serving people who would never enter the building to examine the treasured volumes. In the recent past, virtual use through digitization has become common and will surely expand in the future. But his look at the prior century and a half will highlight other, sometimes-forgotten modes of service as examples of NYAM’s—and other research libraries’—many contributions to American medicine.
Melissa Grafe, “Preservation, Access, and the Future”
Our final panelist, librarian and historian Melissa Grafe, glimpses into the future of medical libraries and the role of physical collections in an increasingly online world. Grafe looks at the ways that technology has become deeply integrated in both medicine and in the libraries that support the medical community. Grafe will connect these modern currents to the rich trove of materials that NYAM assembled over 175 years, and the larger history that has made NYAM’s library one of the major collections connecting medical history to the present.
Nancy Spiegel, the University of Chicago Library’s bibliographer for art and cinema, writes:
In the late 18th century, a new vision of the library arose within the context of expanding literacy, and the increased publication of books and journals for the general reading public. Enlightenment architect Étienne-Louis Boullée (1728–1799) envisioned a grand design in his proposal for a French National Library in 1785. In Boullée’s presentation, the state would take responsibility for the collection, ordering, and dissemination of all available information to its citizens.
The design for the main reading room featured a vast, barrel-vaulted ceiling and a modern shelving arrangement: stacked galleries of books over flat wall-cases. These seemingly endless bookcases were open and easily browsable, in dramatic contrast to the earlier medieval system of chaining that bound both books, and readers, to a specific location. Visitors are free to wander about and converse in small groups, but there is no provision of study desks or chairs for extensive research in this idealized environment.
Now “175 years young,” the NYAM Library is one of the most significant historical medical libraries in the world. In an earlier post, we looked at how we came to that position. Now I’d like to look to explore where we are now, and where we might go in the future.
Every good special collections library has a distinct identity, focused around its collections. This is ours: we are a research library holding medical and public health literature ranging from the earliest days of printing to the early years of the 21st century. Though formed by many forces, our collection now exists to serve the advanced academic humanities researcher in a variety of disciplines, chiefly the history of medicine and public health. Much of our collection is rare, such many of the books published before 1800, or the 6,000 journal runs found in fewer than four libraries throughout the country; some of it is unique, such as the Smith papyrus, the ancient Egyptian surgical text, and the 9th-century cookbook, Apicius’ De re culinaria. To support this identity, we continue to add to our collections, selectively, focusing on books and other materials that are not found locally, and may be rare nationally. This year so far, we have added seven rare and historical books, including a 17th-century treatise on the plague, an 18th-century book on retaining one’s reason into old age, and a 19th-century promotional pamphlet on curing chronic disease. Collecting physical books remains crucial. Not all the medical literature of the past has been digitized, and reading the bare information contained in the words of the text does not begin to exhaust the experience of learning from a physical book.
Supporting academic research into the collections is important. The Library awards two residential fellowships annually, the Audrey and William H. Helfand Fellowship and the Paul Klemperer Fellowship, each supporting a month’s work. Our application period for 2023 Fellowships just closed and our review committee is now working through the applications. Through our participation in the academic group, the Consortium for the History of Science, Technology, and Medicine (CHSTM), we serve as a venue for their fellows as well, both short-term exploratory visits as well as longer term research trips.
Why support academic research? Historical scholars lay the groundwork and generate the ideas that will inform discussions in the years to come. The discipline of history provides a particular lens through which to understand our society today—and the role of medicine and public health in shaping society and being shaped by it, a central concern before the COVID-19 pandemic, brought even more sharply into relief since. Scholarly research may start in the rarefied atmosphere of academia, but that’s where concepts are developed and refined, and then honed through vigorous debate. As ideas emerge, they are picked up by thought leaders and informed citizens, and they help to shape the shared understanding and open debate of a healthy society. The Library does its part, not only in supporting academic scholars, but also in presenting their work: both our Fellows’ works-in-progress talks, part of their fellowship experience, and in lively series of more popular yet academically based talks . In 2018 we started the programmatic series Race and Health, followed in 2022 by Then and Now, pairing academic historians with public health researchers and policymakers, so that each may learn from the other, and the audience may learn from both.
What’s next for the Library in its support of academic work? Certainly continuing to add to the collections; and certainly continuing to award fellowships and welcome researchers. We will also continue our work behind-the-scenes: cataloging our holdings, so that everyone will know that we have them, and conserving our books, so that researchers of the future can use them too.
But the future should not be just more of the same! We want to support our academic researchers better going forward. How can we not just support individual researchers, but develop and sustain a creative intellectual community that can spark ideas and deepen understanding? How can we find the hidden voices in our collections, which have been smoothed over by the descriptive practices of the past? How can we supplement those voices now, by going beyond the printed word? These are all serious questions. Over the next decade, I hope we can dig more deeply and understand our collections better, to serve our users better. I hope we can find a way to support more research in our reading room, and even commission oral histories, as history starts just in the last moment.
The second great strand of the Library’s work is connecting the public with our collection. Our work is broad-based. Our practice of hosting school groups and providing tours goes back decades. While we had to pause this work during the pandemic, we then started “Virtual Visits”: online explorations of collection materials around a common theme. This past year, class visits have started up again in earnest, opening the worlds of the past through our books and images—for college students—while we offer everyone drop-in tours on the first Monday of each month.
Engaging with the physical book is important—for everyone, and for many reasons. In an increasingly digital world, we tend to think of facts, ideas, opinions, and images as disembodied—unmoored from the circumstances of production, distribution, and presentation—and therefore, mistakenly, as more authoritative. The reality of books (even acknowledging how books’ have their own ways of asserting authority) helps bring matters down to earth. Beyond that, books have a particular beauty. But this I mean not only the beauty of a well-crafted binding, or a pleasing or dramatic illustration, or a fine type-face—though I do mean those qualities, best appreciated with an authentic piece, not a facsimile, digital or otherwise. Part of the beauty of books comes rather from different qualities: its heft; a variety of different sizes of books; the thinness or thickness of the paper, and its quality, brightness, look, and feel; an exemplary job of printing and binding, or, alternately, signs of wear caused by generations of use; or even the gradual unfolding of the text as one turns from one page to the next—or bounces around, going forward and backward, engaging with the text physically while one engages with it intellectually. I should add: to appreciate the book is not to disparage the digital revolution—digital texts provide ways of advancing both intellectual and aesthetic life that are different from traditional books. In many ways digital books are better, but in many ways they are not—their experience is often “flatter.” As a society, we have room for both experiences of knowledge.
Libraries like the Academy’s are well-positioned to provide an exemplary experience of books and other library materials. Our collection is both deep and broad, even with its medical focus. And while many people may not have had an experience of a Renaissance-era oversize anatomical atlas, say, or 19th-century patent medicine ads, or 20th-century pamphlets on improving one’s health, because these materials are no longer common—well, we have them! Beyond this, though, current teenagers’ chief literary experience may well be digital, a trend that only promises to grow. We can provide students, and lifelong learners as well, with an experience not otherwise readily available: not just the book itself—though we can do that—and not just the content of the book—though we can do that, too—but also the deeper experience of understanding the book: how it came about, how it was used, how it’s made, and how it’s conserved. As other libraries empty their shelves and go all-digital, the Academy Library has an increasingly rare and valuable perspective to offer.
How can we do this better? We could engage more people in more ways. Digital products reach a broad swath of people and can draw them to the Library for an in-person experience. Hybrid models could be explored and exploited, for example marrying larger digital exhibits on expansive themes, with smaller physical displays and personal tours. We could explore taking our materials out to the community, rather than always asking people to come our way. We could make a concerted effort to find ways for all facets of society to encounter our collections. All these are possibilities, many of them being investigated and developed elsewhere. We should be actively exploring what works for us at the Academy Library.
I’m excited about the Academy Library, not just what we are doing now but what lies ahead of us. Keep connected and see what comes next!
On Wednesday, September 21, the Academy Library celebrates its achievements and looks to the future. Join us for a festive evening with a chance to meet the NYAM Library Team and explore a special display of some of our rare treasures. Register here.
By Jamie Marsella, Department of the History of Science, Harvard University, and the Library’s 2022 Paul Klemperer Fellow
Ms. Marsella completed her Fellowship residency in summer 2022 and will present her research by Zoom on September 7 at 4:00 pm (EDT). To attend her talk, “‘Where Once There Was Only Friction’: Religion, Eugenic Maternalism, and the Babies’ Welfare Association, 1908–1920,” register through the Academy’s Events page.
I’ll start this blog post with a confession: before sitting down in the NYAM Rare Book Room, I was worried there might not be enough materials to keep me busy for a full month. How profoundly wrong I was!
I arrived at NYAM to conduct research for my dissertation—an exploration of the New York Babies’ Welfare Association (1912–1920). The BWA was an organization that aimed to standardize maternal and pediatric public health programs while remaining a loose federation of public health and child welfare organizations, including private philanthropic and religious groups.
The Babies’ Welfare Association was created by the New York City Bureau of Child Hygiene in 1912. Neither organization has a stand-alone archival collection, nor do most of the 120+ individual organizations within the BWA. Before arriving, I could not have known that the NYAM Library would hold more relevant materials than I could ever have imagined.
The BWA was abundantly represented within the NYAM collections. This makes sense since, for the first two decades of the twentieth century, the BWA was a well-known, highly publicized organization in New York City. The Chief of the Bureau and President of the BWA, Dr. Sara Josephine Baker (1873–1945), was a household name not only in New York, but throughout the country, with movie reels produced by Fox Studios, a monthly Good Housekeeping column, multiple books on child health and parenting, a regular radio broadcast, and constant coverage in the local and national press.
Unlike negative eugenic programs (i.e., sterilization, anti-miscegenation laws) that came to dominate later in the century, early twentieth-century reformers understood eugenic reform as a combination of heredity and environmental conditions. In this framework, improved sanitation, nutrition, and hygiene could improve individuals and enable them to pass on these improvements to their future offspring. The BWA emphasized these changes in the environment, promoting them as eugenic maternalism. In other words, the BWA understood mothers as the family’s first line of defense against disease and, therefore, an essential part in preventing “racial degeneration.” The BWA, therefore, targeted immigrant neighborhoods with the explicit desire to “improve” white-ethnic communities and prevent future supposedly dysgenic generations.
I came to NYAM hoping to better understand why Catholic and Jewish organizations might be interested in participating in this eugenic standardization project and how their participation may have shaped how the BWA understood and operationalized eugenics. I also hoped to clarify the role that Black reformers and patients played within the BWA. Based on what I had gleaned from digitized sources, the BWA’s work with Black philanthropic groups was inconsistent, and their relationships were unclear.
The materials I’ve reviewed at NYAM paint a complicated and nuanced picture. Some religious organizations, like the New York Foundling Asylum and other benevolent institutions run by women religious, understood their own religious missions as Catholics in a way that blended nicely with the assimilationist goals of eugenic maternalism.
Similarly, Jewish organizations like the United Hebrew Charities or the Brooklyn Federation of Jewish Charities understood their work as both a religious mission and an assimilating force. Such groups were eager to associate their religious and cultural practices with Americanism, especially in the face of rising antisemitism.
Most BWA members held a capacious view of their work beyond childcare, health and hygiene, or charitable aid. As I continued to work through the Library’s documents, it became clear that members of the BWA were pursuing something far broader than public health or bodily hygiene. These programs were about “right living”—teaching women and children how to conduct themselves in public and private, how to understand one’s role as a (future) citizen, or how to raise and nurture the future citizens in their care.
Within these different organizational records, there were also small glimpses of public health work specifically targeting the Black community. While the connections between the BWA and Black New Yorkers remained muddled, my time at NYAM has helped me understand this reflects the nature of the work, which was sporadic at best and exploitative at worst. The Lincoln Hospital and Home (a BWA member) is one exception to this general rule. The hospital trained Black nurses, many of whom then worked in the hospital treating both Black and white patients or worked with the Henry Street Settlement House (another member) in their Visiting Nursing Service.
Ultimately, my time at NYAM was invaluable. The materials there allowed me to better understand how the members of the BWA negotiated amongst themselves to create a standardized eugenic program that could encompass different ethnicities and religions.
American drug policy as we know it today categorizes marijuana as a Schedule I substance, meaning that it is considered to place users under high risk for abuse and not accepted by the FDA or DEA as safe for use as medication with or without supervision. The FDA and DEA have rejected multiple petitions to reschedule marijuana under less restrictive categories from governmental and non-governmental entities. The Controlled Substances Act of 1970 governs federal drug policy in the United States as part of a broader effort to curtail the sale, distribution, and consumption of illegal drugs by the Nixon administration, later known as the War On Drugs.
The status quo of American drug policy extends farther back than 1970, however. When the United States Congress passed the Marihuana Tax Act championed by Federal Bureau of Narcotics Commissioner Harry Anslinger in 1937, it was a watershed moment in the history of drug policy regulation. The legislation represented a victory for marijuana opponents who successfully convinced lawmakers of a link between cannabis usage and addiction, deviance, and criminality. New York City Mayor Fiorello La Guardia looked skeptically upon the Marihuana Tax Act and its pretext. He thus called upon the New York Academy of Medicine to prepare a report drawing from a wide variety of academic disciplines to scrutinize the drug law and the beliefs about drugs held by its proponents. In the “La Guardia Report” of 1944, the Mayor’s commission on marihuana use demonstrated that the widespread fear, even panic, around marijuana use was greatly overblown.
In the 1950s and ’60s, the Academy continued to emphasize drug addiction as a treatable condition. During 1995 and 1996, NYAM’s Committee on Medicine in Society looked specifically at the concept of harm reduction. The Academy recommended policy changes that were, for the time, cutting edge. These included expansion of treatment programs, acceptance of methadone treatments, special efforts for those incarcerated, better training for medical professionals, and, especially, expanding needle exchange programs and decriminalizing needle distribution and possession. The Library’s Then and Now event “Drug Policy and Harm Reduction Services” brought that history up to the present time. A stellar panel mentioned NYAM’s continuing work in harm reduction, looked at the racial component of America’s drug control regime, considered the experience of those working in NYC’s new Overdose Prevention Centers, and noted that the most recent White House National Drug Control Strategy champions “harm reduction to meet people where they are.” For at least a quarter century, NYAM has supported the people-centered approach that lies at the heart of harm reduction. We wait to see where the national strategy goes next.
Our annual Color Our Collections week kicks off today! From February 7 through 11, libraries, archives, museums, and other cultural institutions showcase their collections through free, downloadable coloring books. A hundredor so books are gathered at ColorOurCollections.org. Follow #ColorOurCollections on Twitter, Instagram, Facebook, and other social media platforms to participate.
As part of the NYAM-wide celebration of our 175th anniversary, this year our coloring book presents images from our history. We feature our buildings and library reading rooms through the years, along with some of their marvelous details of design. Other images allude to NYAM’s work cleaning up the city streets, improving maternal health, and weighing in on the public health effects of using marijuana. All these stories and more are found in the new NYAM timeline. Here we present a few coloring sheets to help while away your hours; for more, check out our whole coloring book.
By Dr. Paul E. Sampson, Assistant Professor of History, The University of Scranton
2020 Audrey and William H. Helfand Fellow in the History of Medicine and Public Health
Over the course of the past year, I have had the privilege of spending four weeks researching in the spectacular rare book collection of the Library of the New York Academy of Medicine. My book project is entitled “Ventilating the Empire: Environmental Machines in Britain, 1700–1850” and comprises a scientific and social history of ventilation in Britain and the British empire during the long eighteenth century, roughly 1688 to 1815. By examining the design and deployment of ventilating machines in slave and naval ships, prisons and public buildings, I ask how devices designed to protect human beings from environmental hazards became a means of dividing British society along class and racial lines.
The primary subject of my research has been the life and career of prison reformer John Howard (1726–1790). I examine Howard’s career through the context of his work on “Jail Fever” (AKA typhus) which contemporary physicians and medical experts understood as an airborne disease. I argue that a key feature of Howard’s celebrity was his perceived invulnerability to airborne diseases. In addition, his influence helped to shift the discourse of prison reform away from overall institutional sanitation and towards methods intended to control the hygiene and morality of individual prisoners.
For those unfamiliar, John Howard was a noble-born, intensely religious man who was appointed sheriff of Bedfordshire in 1773. One of his duties was to inspect local prisons. Unlike many of his genteel contemporaries, he took this job seriously. He was appalled by the conditions of the prisons in Bedfordshire, and to spur reform and gather ideas for improvement, he made a series of lengthy tours to visit as many prisons as he could throughout the British Isles and continental Europe. His first published book, The State of the Prisons in England and Wales (1777), detailed his visits to dozens of county jails and bridewells (workhouses), including careful notes of the fees charged to prisoners, their daily workload, the prison diet, and the overall sanitation.
One of the primary goals of Howard’s travels was to find the best means of preventing the spread of disease. By the 1750s, prisons were increasingly perceived as public health hazards. The filthy and diseased condition of prisoners in London’s Newgate prison became a public scandal after the Lord Mayor and 56 others died of jail fever in the weeks following an audience with prisoners. Following the contemporary etiology of fever, the outbreak was attributed to the “putrid effluvia” exhaled in the breath of sick prisoners that had imparted a “poisonous quality” to the air in the courtroom.1 By 1774, Howard had achieved celebrity status by helping to author the “Act for Preserving the Health of Prisoners in Gaol.” This act stated that jail fever was caused by the “want of cleanliness and fresh air” and mandated that all interior walls and ceilings be scraped and white-washed annually and “constantly supplied with fresh air, by means of hand ventilators or otherwise.”2
However, in the wake of this achievement, Howard’s attitudes about preventing fever had begun to shift. During his tours of European prisons, he was puzzled that he rarely encountered “jail distempers” there. To explain the disparity between these and disease-ridden English institutions, Howard developed a theory of jail fever based entirely on his own “experience.” He argued that prisoners could only be infected if privation, filth, and personal intemperance weakened them enough for the contagion to take hold. Young and healthy convicts who were used to “vigorous exercise” quickly became infected due to the “sudden change of diet and lodging” that “so affects the spirits of new convicts, that the general causes of putrid fevers exert an immediate effect on them.” As a counter-example, Howard pointed to himself. During his first tours, he wrote, he had attempted to avoid breathing in contagion by “smelling to vinegar… and changing my apparel…constantly and carefully.” A few years later, however, he wrote that he “entirely omitted” such precautions. In his opinion, the real protection against infection were his habits of “temperance and cleanliness” as well as the power of “divine providence.”3
By the time the second edition of State of the Prisons came out in 1780, Howard had visited hundreds of disease-ridden institutions and avoided contracting a serious infection.While friends privately cautioned him against such continual risk-taking, Howard’s superhuman invulnerability to disease had become a key feature of his celebrity.4 Celebratory poems about Howard became, in the estimation of two literary scholars, “nearly ubiquitous in the 1780s and 1790s” as poets from Erasmus Darwin to William Cowper celebrated his arduous travels and selfless virtue.5 William Hayley’s 1780 Ode, Inscribed to John Howard attributed Howard’s “matchless fame” to his “valor’s adventr’ous step” through “malignant cells” where “fierce contagion, with affright, repels.”6
This vision of Howard as a heroic and invincible figure appeared in numerous prints and lithographs and was captured evocatively in an unfinished work by famed painter George Romney, who depicted a defiant Howard striding confidently into scenes of melodramatic suffering and disease.7
Despite his reputation, Howard wasn’t able to evade contagion forever. While travelling through southern Ukraine in the winter of 1790, Howard contracted a serious fever and died two weeks later.8 Notwithstanding his untimely death, Howard’s emphasis on invigorating labor, self-regulation, and instilling personal hygiene in convicts exerted an enormous influence. By the heyday of the modern penitentiary in the mid-nineteenth century, Howard was lauded as the founder of “prison science.”9 While jails designed during Howard’s life reflected the eighteenth-century emphasis on eliminating effluvia via ventilation, their nineteenth-century successors focused instead on insuring that each inmate was placed in solitary confinement and given a strict regimen of work and moral instruction.10
In my larger project, I argue that this is partially due to a shifting locus of responsibility for preventing airborne disease. The attention of reformers shifted from the condition of theinstitution to the character of theindividual, who became responsible for his or her own cleanliness and ventilation. To briefly illustrate this point, I will conclude with a quotation written several years after Howard’s death by naval health reformer Gilbert Blane:
Those only whose duty leads them to consider the subject, are aware how much the welfare of the human species depends on ventilation and cleanliness; and no one could render a greater service to his fellow creatures, than to impress on their minds the necessity of cultivating them as moral and religious duties.11
1. See, for example: John Pringle, Observations on the Nature and Cure of Hospital and Jayl-Fevers (London: A. Millar, 1750); “Account of the Fatal Assize,” CLA/035/02/049, Gaol Committee, 1750–1755, Notes on Ventilating Newgate, London Metropolitan Archives.
2. Act for Preserving the Health of Prisoners in Gaol and Preventing the Gaol Distemper, 1774, 14 Geo. III, c. 59.
3. John Howard, The State of the Prisons in England and Wales 2nd. Ed. (Warrington: T. Cadell 1780) 430–31.
4. Thomas Taylor, Memoirs of John Howard (London: John Hatchard, 1836) 386–87.
5. Gabriel Cervantes and Dahlia Porter, “Extreme Empiricism: John Howard, Poetry, and the Thermometrics of Reform,” The Eighteenth Century, 57:1 (Spring 2016): 97.
6. William Hayley, “Ode, Inscribed to John Howard” (Boston: J. White et. al. 1795 ).
7. George Romney, John Howard Visiting a Prison or a Lazaretto, 1790–95, courtesy of the Museum of Fine Arts, Boston, MA.
8. John Aikin, A View of the Life, Travels, and Philanthropic Labours of the Late John Howard (Boston: J. White et. al., 1794) 120–25.
9. William Hepworth Dixon, John Howard and the Prison World of Europe, 2nd ed. (London: Jackson and Walford, 1850) 1.
10. Robin Evans, The Fabrication of Virtue: English Prison Architecture 1750–1840 (London: Cambridge UP, 1982) 104–114; Michael Ignatieff, A Just Measure of Pain (London: Penguin, 1978) 3–14.
11. Gilbert Blane, “Letter to John Hippisley,” in Observations on the Diseases of Seamen (London: 1799): 614–15.
September 15 marks the beginning of National Hispanic Heritage Month, which celebrates the cultures, traditions, heritage, and achievements of those in the United States who trace their roots to Spain and the Spanish-speaking countries of Latin America. At the New York Academy of Medicine, we are celebrating the accomplishments and contributions of Hispanic Americans to medicine and public health in the United States. According to survey data compiled by the National Center for Health Workforce Analysis in 2018, more than 10% of registered nurses in the United States identified as Hispanic, Latino, or Spanish. Contrast this with Ildaura Murillo-Rohde’s remarks about the paucity of representation in Washington, DC, for Hispanic nurses early in her career: “I saw that I was the only Hispanic nurse who was going to Washington to work with the federal government, review research and education grants, etc. There was nobody else. I looked behind me and thought: ‘Where are my people?’”
Ildaura Murillo-Rohde (1920–2010) was a Panamanian American nurse, academic, and health policy advocate who championed of the unique health care needs of Hispanic populations. Murillo-Rohde earned a nursing diploma from the Medical and Surgical Hospital School of Nursing in San Antonio, Texas, before obtaining an undergraduate degree in the teaching and supervision of psychiatric nursing from Teachers College, Columbia University, in 1953. Upon graduation, she joined Bellevue Psychiatric Hospital, working with patients diagnosed with “Puerto Rican syndrome,” the name for a condition first used to describe traumatized Puerto Rican soldiers in the Korean War. Wayne County General Hospital’s Psychiatric Division in Michigan then recruited her before she returned to New York to open Elmhurst General Hospital’s first psychiatric division in Queens. In 1971 she became the first Hispanic nurse to earn a PhD from New York University.
Throughout her career Murillo-Rohde maintained a strong commitment to growing the ranks of Hispanic nurses. Informed by her experience as a reviewer of federal research and education grants, she also sought to boost the number of policy experts advising lawmakers on the health care concerns of Hispanic communities. In the 1970s, Murillo-Rohde was an active member of the American Nurses Association (ANA), where she mounted a two-year-long effort to include the Ad Hoc Committee of the Spanish-Speaking/Spanish Surname Nurses’ Caucus in the ANA’s administrative structure. In 1975, with a group of about 15 nurses, Murillo-Rohde formed the National Association of Hispanic Nurses (NAHN) after the ANA rejected attempts to formally recognize the caucus.
Since its inception, NAHN has worked broadly to improve health care delivery and outcomes for the Hispanic community in the United States. Today, the organization sponsors an award for distinction in nursing scholarship, research, and practice, as well as a scholarship for Hispanic students enrolled in nursing programs that lead to licensure.
NAHN also publishes Hispanic Health Care International, featuring research and scholarship on issues of import to US and international Hispanic populations. Judith Aponte, a 2012 NYAM Fellow and Associate Professor of Nursing at Hunter College, is a former editor-in-chief of HHCI.
Beyond her role as founder and first president of NAHN, Murillo-Rohde was an expert on psychotherapy, marriage, and family therapy, and served in several roles in academic administration, including Dean of the College of Nursing at SUNY Downstate Medical Center. Murillo-Rohde’s influence was felt internationally as well through her appointment as WHO’s psychiatric consultant to the Guatemalan government, establishing a pilot program to train personnel in psychiatric care. She further served as Permanent UN Representative to UNICEF for the International Federation of Business and Professional Women. Murillo-Rohde passed away in her native Panama in 2010 at the age of 89.
Our annual Color Our Collections week kicks off today! From February 1st through 5th libraries, archives, museums, and other cultural institutions showcase their collections through free, downloadable coloring books. A hundred books or so are gathered at ColorOurCollections.org. Follow #ColorOurCollections2021 on Twitter, Instagram, Facebook, and other social media platforms to participate.
The NYAM Library’s coloring book presents images from the Renaissance to the 20th century. Here are a few coloring sheets to help while away your hours; for more, check out our whole coloring book.