How Long Will We Wait? A Recap of Our Latest Race & Health Series Event

This guest post is by Dr. Danielle Laraque-Arena, the 2019 Scholar in Residence at the New York Academy of Medicine. She is the tenured Professor of Pediatrics, Psychiatric & Behavioral Sciences, Public Health & Preventive Medicine at SUNY Upstate Medical University (UMU), the Former President of UMU, and moderated the Race & Health Series event, “How Long Will We Wait? The Desegregation of American Hospitals” on July 10, 2019.

The Race & Health Series, a powerful series of presentations, was initiated early this year, envisioning a more just society, reviewing key lessons of the past, evaluating current status of health equity, and engaging in robust dialogue with the community on the social, economic, and systemic issues that keep all people from enjoying a healthy life. The first presentation in this series reviewed the history of the Tuskegee Syphilis Study and posed the question of whether Tuskegee could happen again. The second presentation, “How Long Will We Wait? The Desegregation of American Hospitals,” was prefaced by a showing of the documentary film, Power to Heal: Medicare and the Civil Rights Revolution, followed by a community-engaged discussion of the implications of the film for our current-day realities.

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The Academy Library displayed archival Harlem Hospital photos in the lobby.

Barbara Berney, Ph.D., M.P.H. produced the documentary film. Dr. Berney, a distinguished scholar in public health, environmental justice and the US healthcare system, joined us from the shores of California. Barbara was joined by Professor Adam Biggs, an American historian from the University of South Carolina. The two scholars spoke to the diverse audience of about 300 people from the Harlem area, New York City, and New York State at large. They took us on a historical journey of the deeply segregated United States of the Jim Crow period. Their focus was on recounting the impact of Jim Crow state and local laws that dictated every aspect of life for black Americans following Reconstruction. During this period, segregation was mandated in all public facilities such as restrooms, restaurants, hotels/motels, schools, and hospitals. Professor Biggs highlighted the period from 1919–1935, focusing on the desegregation of Harlem Hospital. The audience, many of whom work or have worked at Harlem Hospital, were on the edge of their seats for this important discussion.

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The author (left) with panelists Barbara Berney and Adam Biggs.

The background analysis of the Jim Crow period led to a focused discussion regarding the segregation of American hospitals and the dire conditions of health care for black Americans. The response from black physicians, the formation of the National Medical Association, the advocacy efforts of the NAACP, and the force of the conviction of people of conscience throughout the United States led to the partnering of the American government under John F. Kennedy and then Lyndon B. Johnson with activists, to begin to transform the landscape of American life and politics. The palpable national tone of the bitter struggles of the Civil Rights movement—with activities such as voter registration in the southern states that often led to the murders of civil rights activists—was ever real for many who in the audience had lived through those dark days.

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Audience members at the panel discussion respond to the speakers’ powerful remarks.

In fact, among the attendees were individuals such as Phyllis Cunningham and Roger Platt, both of whose efforts were shared in the film. I had the honor of working with both Phyllis (nurse, activist) and Roger (internist, hospital inspector) during my 24 years in the Harlem area, but had renewed respect when I witnessed—as demonstrated in the film—their immense courage during the dangerous times of the 60’s. Others featured in the film included David Satcher, M.D., Ph.D., former U. S. Surgeon General. I had the pleasure of speaking with Dr. Satcher a number of times. He spoke of the achievements of the Civil Rights movement, the passage of Medicare, and the continued aspiration for universal access for all: recognizing that health care is a right and not a privilege.

The film also reviewed the passage of the Civil Rights Act of 1964 and of Medicare in 1965. The intersection of these two landmark events leveraged their collective impact to amplify the message that health care is a human right. At the time of the passage of the Medicare legislation, the persistence of the “separate but equal” effect of Hill-Burton Act, providing for hospital construction, was alive. As Johnson noted, a hammer was needed to propel the desegregation of hospitals, and this was done by having the receipt of federal dollars in support of the care of the elderly be contingent upon desegregation of hospital services. The key lesson was that incremental progress, as had been imperfectly done in education, would not yield the fundamental results needed in health care. Civil rights were to be baked into the administrative process. Desegregation occurred through the brute application of the principle “follow the money.”

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Audience members lined up to ask questions at the end of the discussion.

The two-hour session engaged questions from the audience. Individuals lined up to ask the obvious: How do we learn from the courage of those who achieved so much in the past decades? Does such courage exist today? What was the effect of desegregation on the elimination of health disparities—and by implication, is desegregation sufficient? The importance of history, the importance of courage under fire, and the lifelong commitment to social justice and health justice was clear from the engagement of the audience and the resounding voices of our distinguished panel.

Members and Fellows of the Academy, please follow our blog—and show your strong support for The New York Academy of Medicine by making sure your membership/fellowship dues are paid and up to date. Post a response to this blog and let us know how the Academy can work for you and continue the struggle for social justice and health equity. Thank you!

“Filth is the Arch Enemy of Health”: The Committee on Public Health and Waste Management in New York City

This guest post is by Tina Peabody, 2019 Audrey and William H. Helfand Fellow at the New York Academy of Medicine, and a doctoral candidate in history at the University of Albany, SUNY focusing on the urban environment in the United States. She is currently completing her dissertation entitled “Wretched Refuse: Garbage and the Making of New York City”, a social and economic history of waste management in New York City between the 1880s and 1990s.

The Committee on Public Health at the New York Academy of Medicine is well known for their role in creating the Department of Sanitation in 1929, through the development of the Committee of Twenty on Street and Outdoor Cleanliness. However, the broader Committee’s activism on sanitation has a longer and more complex history. Soon after its formation in 1911, the Committee on Public Health decried the conditions of city streets. They held conferences on sanitation in 1914 and 1915 which included representatives of the Department of Street Cleaning and other municipal departments.[1] While Department of Street Cleaning Commissioner J. T. Fetherston claimed he could not update equipment nor flush streets with water, he nonetheless encouraged the Committee to educate the public about the connections between dirt and disease.[2]  With that in mind, the Committee wrote a report in 1915 which connected the pathogens in street dirt to illness.[3]

Two men hauling garbage into an open refuse truck.

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The Committee of Twenty was particularly concerned about open refuse trucks which could spew dust and debris. Images: Committee of Twenty, Committee on Public Health Archives, New York Academy of Medicine, ca. 1930.

In 1928, a subcommittee called The Committee of Twenty was formed, in part because conditions did not improve substantially after the conferences and report.[4]  Among their recommendations, the Committee of Twenty supported the creation of a unified sanitation agency with full control over street cleanliness.[5]  They envisioned themselves as educators for the Department of Sanitation as well as the public, and they researched the latest collection methods and equipment from Europe to recommend improvements.[6] The newly-created Department of Sanitation, however, resisted investing in the recommended equipment, partially due to the expense.[7] Still, the Committee monitored street conditions, and kept photographic evidence of city and private sanitation trucks spewing dust and debris on the streets or other violations of sanitary ordinances.

Commitee of Twenty, Dirty Streets

Picture of overflowing refuse cans from the Committee of Twenty. Image: Committee of Twenty, Committee on Public Health Archives, New York Academy of Medicine, ca. 1930.

The Committee of Twenty also educated the public about outdoor cleanliness and especially the connections between dirt and disease. They issued pamphlets warning that “filth is the arch enemy of health,” and urged them to take personal responsibility for clean streets. “Do not put all the blame on the city administration,” one pamphlet read. “This is your city. A clean city means better health, better business; greater happiness for all; respect for law and order.”[8]  Along with educational literature, they placed litter baskets around the city, and posted signs which reminded New Yorkers of sanitary practices like “curbing” dogs.[9]  They also encouraged public participation in solving sanitary problem in novel ways, such as holding a contest for the best litter basket design in 1930.[10] 

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Educational Pamphlet from the Committee of Twenty. Image: Committee of Twenty, Committee on Public Health Archives, New York Academy of Medicine, ca. 1930.

The Committee was also influential in the citywide cleanup effort in preparation for the 1939 New York World’s Fair. Members of the Committee of Twenty and their allies argued that the Fair was the perfect opportunity for improving street cleanliness. Committee members Bernard Sachs and E. H. L. Corwin wrote that New York City was “the ‘Wonder City of the World,’ beyond a doubt; the ‘cleanest city,’ by no means. But we must make it that.”[11]  In line with the idea, Mayor Fiorello LaGuardia declared April 1939 “dress up paint up” month, and launched a broad beautification effort which included removal of litter, dog waste, and even “beggars, vagrants and peddlers.”[12]  Bernard Sachs was the representative for the Committee of Twenty on the Mayor’s Committee on Property Improvement, which was developed for the cleanliness campaign.

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Educational pamphlet from the Committee of Twenty. Image: Committee of Twenty, Committee on Public Health Archives, New York Academy of Medicine, ca. 1930.

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Educational pamphlet from the Committee of Twenty. Image: Committee of Twenty, Committee on Public Health Archives, New York Academy of Medicine, ca. 1930.

In 1950, the Committee on Public Health supported an initiative to introduce alternate side street parking to allow street cleaning unobstructed from parked automobiles, but otherwise was much less active on sanitation issues after the 1939 World’s Fair.[13]  At a meeting with Department of Sanitation Commissioner Andrew Mulrain in 1950, the Committee even debated whether unclean streets actually did cause disease.[14]  One Dr. Lincoln wondered if clean streets were not simply a matter of “public pride.” [15]  Still, the Committee’s early work on outdoor cleanliness would have a lasting legacy, particularly in terms of public education. The Outdoor Cleanliness Association, which was formed shortly after the Committee of Twenty [16], continued their educational work with regular cleanliness drives through the 1950s and 1960s in coordination with the Sanitation and Police departments.

References

 [1] “Minutes of the Meeting of the Public Health, Hospital, and Budget Committee October 26, 1914,” The Public Health Committee of the New York Academy of Medicine Minutes 1914–1915 (New York, NY), 74; “Minutes of the Meeting of the Public Health, Hospital, and Budget Committee Conference on Street Cleaning May 7, 1915,” The Public Health Committee of the New York Academy of Medicine Minutes 1914–1915 (New York, NY), 153–55.

[2] “Minutes of the Meeting of the Public Health, Hospital, and Budget Committee,” November 16, 1914, The Public Health Committee of the New York Academy of Medicine Minutes 1914–1915 (New York, NY), 84–85; “Minutes of the Meeting of the Public Health, Hospital, and Budget Committee Conference on Street Cleaning May 7, 1915,” The Public Health Committee of the New York Academy of Medicine Minutes 1914–1915 (New York, NY), 153-54 .

[3] Committee on Public Health, “Thirty Years in Community Service 1911–1941: A Brief Outline of the Work of the Committee on Public Health Relations of the New York Academy of Medicine” (The New York Academy of Medicine, 1941), 79.

[4] Committee on Public Health, “Thirty Years in Community Service 1911–1941,” 80.

[5] “Minutes of the Meeting of the Executive Committee of the Committee on Public Health Relations,” May 14, 1928, The Public Health Committee of the New York Academy of Medicine Minutes 1927–1928 (New York, NY), 134; Committee on Public Health, “Thirty Years in Community Service 1911–1941: A Brief Outline of the Work of the Committee on Public Health Relations of the New York Academy of Medicine,” 10.

[6] Committee on Public Health, “Thirty Years in Community Service 1911–1941,” 80.

[7] Committee on Public Health, “Memorandum of a Conference between Dr. William Schroeder, Jr., Chairman, Sanitary Commission…..May 19, 1931,” 1–4, Committee on Public Health Archives, Box 4, Folder 50c.

[8] Committee of Twenty on Street and Outdoor Cleanliness, “Why Clean Streets? Because Filth Is the Arch Enemy of Health” (New York Academy of Medicine, n.d.), Special Collections, New York Academy of Medicine Library.

[9] Committee on Public Health, “Thirty Years in Community Service 1911–1941: A Brief Outline of the Work of the Committee on Public Health Relations of the New York Academy of Medicine,” 80.

[10] Committee of Twenty on Street and Outdoor Cleanliness, “Prize Contest for the Design of a Litter Basket For New York City” (New York Academy of Medicine, n.d.), Special Collections, New York Academy of Medicine Library.

[11] Bernard Sachs and E. H. L. Corwin, “Fair Offers Opportunity: City Is Urged to Institute a Program of Outdoor Cleanliness,” New York Times, July 4, 1938.

[12] Marshall Sprague, “Clean City for Fair: Public and Private Groups Hard at Work Dressing Up New York for April, 1939 Mayor Is Enthusiastic Keeping Waters Pure Refurbishing Statues Beautification Drives,” New York Times, September 18, 1938; Elizabeth La Hines, “Drive Is Begun For a Tidy City During the Fair: Outdoor Cleanliness Group to Ask Wide Aid in Fight on Sidewalk Rubbish One Nuisance Abated Aid Through New Equipment Model for Other Cities,” New York Times, April 9, 1939.

[13] Committee on Public Health, “Pioneering in Public Health for Fifty Years” (The New York Academy of Medicine, 1961), 62.

[14]  “Minutes of the Meeting of the Subcommittee on Street Sanitation,” June 21, 1950, The Public Health Committee of the New York Academy of Medicine Minutes 1949–1950 (New York (N.Y.)), 473.

[15]  Ibid.

[16]  George A. Soper, “Attacking the Problem of Litter in New York,” New York Times, November 5, 1933.

 

 

 

 

 

The Medical Journals of U.S.-Occupied Haiti

This guest post is by Matthew Davidson, a doctoral candidate at the University of Miami and the 2019 Paul Klemperer Fellow at the New York Academy of Medicine. His research examines public health in Haiti during the 1915-1934 U.S. occupation.

During the nineteen years of the early twentieth century that the United States occupied Haiti (1915-1934), U.S. officials liked to claim that they had brought modern medical thought to the Caribbean country. Their contention was bunk, but it apparently felt very real when the Haitian physician, Dr. François Dalencour, received a letter from a French colleague asking for copies of any Haitian medical publications. “I was ashamed,” Dalencour later wrote, “of being obliged to tell the truth, to say that there were none. [i] He would have been able to send along reports authored by the occupation medical service, but there was apparently nothing current otherwise. Haiti, Dalencour decided, needed a medical journal.

Soon after, he established one.

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The first issue of Le Journal Médical Haïtien (NYAM). 

The occupation, it turns out, was indeed an important period for Haitian medical thought. As was the case in other fields, it provoked a flurry of intellectual production. Consequently, whereas doctors such as Dalencour lamented the lack of Haitian medical publications at the start, by the end the local medical establishment could boast of several. U.S. officials claimed this was a sign of how far medicine in Haiti had “progressed” under their tutelage, but it was truly more the product of Haiti’s own medical tradition. [ii] Meant to advance medical practice and public health policy, the journals provided a forum for Haitian practitioners to debate and discuss all sorts of matters related to health and medicine in the country.

Dalencour’s periodical, Le Journal Médical Haïtien, was arguably the most important of the occupation-era publications. Not only was it the first, founded in May 1920, but it also did the most to open up space for the Haitian medical profession to articulate ideas and positions about their field. With U.S. personnel otherwise completely dominating all aspects of medicine and public health in Haiti, Le Journal Médical Haïtien was the only venue (outside of individual private practices) actually controlled by Haitians. It accordingly brought together “all members of the Haitian Medical Corps, without any distinction”: doctors, pharmacists, dentists and midwives. [iii] In doing so, the journal bridged longstanding divisions within the medical corps and laid the foundation for further independent initiative.

As Le Journal Médical Haïtien facilitated the reorganization of the Haitian medical profession, it also laid bare the lie that the occupation brought medical modernity to the country. After all, it was not because the U.S. introduced “scientific medicine” or any other set of ideas to Haiti that the journal appeared. Rather, it had its genesis in the pre-occupation period. As Dalencour wrote in the first issue, the project was first conceived in 1903. He was still a medical student at the time, so establishing a journal for medical reform was a “somewhat pretentious idea.” [iv] Nonetheless, it was then, well before the Americans landed, that the first steps were taken to establish a “general review of the medical movement in Haiti” (as Le Journal Médical Haïtien was later billed). The principles laid out by Dalencour and his collaborators in 1920 were even the same as those declared in 1903. All that had changed was the name. Dalencour had originally chosen the title Haïti Médicale, but – further reflecting the strength of Haiti’s pre-occupation medical and intellectual traditions – another journal had taken that name in 1910. [v]

The next to emerge was Les Annales de Médecine Haïtienne. Established in 1923 by two young doctors, Drs. N. St. Louis and F. Coicou, Les Annales was associated with a newly reorganized union, le Syndicat des Médecins. Much more oppositional in outlook, the journal was conceived as an “organ for the expansion of medicine in Haiti and for the defense of the interests of the medical corps.” [vi] Explicitly anti-occupation, it actively contested the U.S. health project in Haiti and worked to organize Haitian doctors against it under the auspices of le Syndicat des Médecins. It was not merely a political publication, though, for it also carried articles dedicated to public health education and research in the medical sciences. Over time, such articles became more and more prominent, and as the occupation ended Les Annales de Médecine Haïtienne essentially transitioned to purely scientific journal. U.S. medical sciences, however, continued to be received coolly.

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May-June 1932 issue of Les Annales de Médecine Haïtienne (Schomburg Center, NYPL).

The last of the occupation-era publications was the only one that owed its existence to the occupation health project. The Bulletin de la Société de Médecine d’Haïti, founded with that society in 1927, was the sole journal fostered by U.S. officials, and it was the only one to have U.S. practitioners on its editorial board or to publish articles authored by occupation doctors. The society itself was organized and controlled by the occupation health service, the Service d’Hygiène. Accordingly, most independent doctors (i.e., those not directly employed by the Service d’Hygiène) tended to find the Société “too American” and remained outside of it. [vii] Nonetheless, the Bulletin was more than just an American journal based in Haiti.

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The first issue of the Bulletin de la Société de Médecine d’Haïti (NYAM).

The Bulletin de la Société de Médecine d’Haïti was an important register for the medical sciences in Haiti. From 1927 until the end of the occupation, it published an impressive array of scholarship, much of it by Haitian practitioners. With an emphasis on medical specialization, it tended to be more concerned with the medical sciences than with public health policy or practice, and it accordingly developed a reputation for being the most scientific of the journals. As a project, however, the Bulletin mostly just brought to fruition ideas and proposals first put forth in the pages of Le Journal Médical Haïtien (or by the 1890 Société de Médecine de Port-au-Prince before that). In form as much as in content, then, the Bulletin was as Haitian as it was American. Consequently, when the American editors shuttered the journal in 1934 with the end of the occupation, the Haitian medical establishment remained committed to the project: it lived on as the Bulletin du Service d’Hygiene et d’Assistance Publique – Medicale et Sanitaire.

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The first issue of the Bulletin du Service d’Hygiene et d’Assistance Publique – Medicale et Sanitaire (NYAM).

Each of these journals have largely been overlooked by historians, despite being incredibly rich sources. With their debates about public health policy, research on various health matters, clinical notes, correspondence between doctors and medical officials, translated articles from abroad, social commentary, and more, they offer significant insight into the state of medical care and the politics of health during the occupation. They would also be of interest to anyone thinking about Haitian social and intellectual history more generally. Few copies of each journal still exist, but they – with the exception of Les Annales – can be found at the New York Academy of Medicine library.

References

[i] Dalencour, François, « En Manière de Programme. » Le Journal Médical Haïtien (Première Année, No. 1, May, 1920; New York Academy of Medicine Library).

[ii] See, for instance, Parsons, Robert P., History of Haitian Medicine (New York: Paul B. Hoeber Inc., 1930).

[iii] Dalencour, François, « En Manière de Programme. » Le Journal Médical Haïtien (Première Année, No. 1, May, 1920; New York Academy of Medicine Library).

[iv] Dalencour, François, « En Manière de Programme. » Le Journal Médical Haïtien (Première Année, No. 1, May, 1920; New York Academy of Medicine Library).

[v] Haïti Médicale was published from 1910-1913, and then was briefly revived again in 1920.

[vi] Les Annales de Médecine Haitienne (9eme Année, No. 3 &4, Mars-Avril 1932; Schomburg Center for Research in Black Culture, New York Public Library).

[vii] Bordes, Ary, Haïti Médecine et Santé Publique sous l’Occupation Américaine, 1915-1934 (Haiti: Imprimerie Deschamps, 1992), 300.

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

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

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

Historia Ænigmatica, de gemellis Genoæ connati

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

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

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

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

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

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

 

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

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

References

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

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

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

Further Reading

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

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

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

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

Remembering the Syphilis Study in Tuskegee

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

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

Photograph of Participant in the Tuskegee Syphilis Study

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

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

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

Kenan Thompson Hugh Laurie

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

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

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

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

Footnotes

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

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

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

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.

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“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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The First Yellow Fever Pandemic: Slavery and Its Consequences

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

Germ City: Microbes and the Metropolis Opens

By Anne Garner, Curator of Rare Books and Manuscripts and Rebecca Jacobs, Andrew W. Mellon Postdoctoral Fellow, Museum of the City of New York

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Typist wearing mask, New York City, October, 16, 1918. Courtesy of the National Archives.

On certain October mornings during 1918, masks like the one in the above photograph would have been a common sight on New York’s streets. Men and women wore them on their commutes to work, or even while doing their jobs, as office workers, postal carriers, and sanitation workers. Over 30,000 New Yorkers died during the 1918 influenza pandemic. And yet, because the city had learned from other contagious disease outbreaks and adjusted its public response and infrastructure accordingly, these numbers were comparatively low side-by-side with other American cities.

A hundred years later, Germ City: Microbes and the Metropolis, opening today at the Museum of the City of New York, explores New York City’s history of battles with contagious disease. The exhibition is co-presented with The New York Academy of Medicine, in collaboration with the Wellcome Trust as part of their Contagious Cities project. Contagious Cities encourages local conversations about the global challenge of epidemic preparedness.

Germ City tells the very personal stories of New Yorkers’ experiences and their responses to the threat of contagious disease over time using historical objects, oral histories, and artwork. Artist Mariam Ghani’s film, inspired by Susan Sontag’s Illness as Metaphor, invites audiences at the main gallery’s entrance to engage with the themes of metaphor and disease. Ghani’s work leads into the main gallery, where the stories of the some of the city’s many microbes—flu, cholera, diphtheria, the common cold, cholera, smallpox, TB, polio, HIV, and others —are explored through scientific models, historical objects, and contemporary artworks.

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Orders for hospitalization for Mary Riley, August 29–31, 1854.

During the 1854 cholera epidemic, physicians visited the homes of the sick and issued orders for hospitalization, most hastily written on scrap paper. According to these notes, this patient, Mary Riley, delayed going to the hospital and died the following day.

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Letter from Mary Putnam Jacobi to Sophie Boaz, February 27, 1884.

The impact of diphtheria, another devastating disease of the 19th and early 20th century, is crystalized in the compelling story of Ernst Jacobi, the son of Abraham Jacobi, the father of pediatrics and himself a committed diphtheria researcher. An 1884 letter in the New York Academy of Medicine’s collections, written by Abraham Jacobi’s wife, the physician and activist Mary Putnam Jacobi, documents the devastating death of Ernst from diphtheria.

While this first section of the exhibition establishes just some of the contagious diseases that have hit New York over time, the remaining four sections of the exhibition probe the responses of the government, medical professionals, and ordinary citizens to the threat of epidemics. A common first response to contagion is to contain it. Visitors learn about New York’s man-made quarantine islands, Hoffman and Swinburne, and the exile of “Typhoid Mary” to nearby North Brother Island. These islands, now covered in overgrowth and closed to the public, are still visible from Manhattan’s shores.

Jordan Eagle’s Blood Mirror, a sculpture created with the blood of gay, bisexual, and transgender men to protest the U.S. government’s ban on their donating blood, provokes viewers to consider the potential consequences of linking particular identities with disease and thus isolating populations.

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Jordan Eagles, Blood Mirror, 2015–present Artwork on gallery floor. On loan from the artist.

The exhibition also explores the ways researchers, public officials, and ordinary New Yorkers have attempted to gather information in an effort to fight contagion. The Citizens’ Association of New York’s map of lower Manhattan illustrates the 1864 survey of New York households, conducted by physicians going door-to-door recording instances of typhoid, cholera, and other deadly diseases.

A copy of one survey, conducted by Dr. William Hunter, records the living conditions of a family of three recent Irish immigrants living on West 14th Street—all with typhoid fever. Science journalist Sonia Shah’s “Mapping Cholera” project illuminates the similarities between nineteenth-century New York’s vulnerability to cholera and more recent outbreaks in Haiti.

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Sonia Shah, Excerpt from Mapping Cholera: A Tale of Two Cities, 2015. Designed and built by Dan McCarey. Courtesy of the Pulitzer Center on Crisis Reporting.

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Postcard, Harlem Hospital. From the collection of Dr. Robert Matz.

Over time, New Yorkers have been reliant on medical research, medicine, and family and professional caregivers to provide respite from disease. A collection of postcards from the Academy Library donated by retired physician Dr. Robert Matz depict key institutions where epidemiological research, treatment, and care were given in an effort to save the lives of the city’s sickest. Many of these facilities—hospitals, sanitaria, and health resorts—have been torn down or transformed over time, becoming another invisible layer in the city’s architectural history.

New Yorkers sought care from old family recipes, as with Selma Yagoda’s recipe for chicken soup, and from patent medicines, cheap formulas widely available over the counter, which claimed to cure many ailments, including malaria and the Spanish flu.

 

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Diphtheria pamphlets

Germ City also engages with the ways cities create infrastructure and policies that support health. Public officials sometimes used creative delivery methods to communicate health information to wider audiences. In 1929, The Diphtheria Prevention Commission inundated the city’s subways and streets with placards and brochures in Spanish, Polish, Yiddish, and Greek, directing New Yorkers to get immunized for diphtheria.  David Lynch’s 1991 “Clean Up” video offers a dark and at times surreal look at the city’s rat problem, illustrating the importance of public hygiene. A number of private and public organizations mobilized to minimize disease outbreaks through outreach and education.

Following the main gallery, visitors are invited to engage hands-on with copies of collections materials in the “Reading Room,” in a range of formats (visual, audio, video). People can share their own family stories of disease through our public collecting initiative.

Germ City will be on view until April 28th, 2019. In coordination with the exhibition, the Academy is offering a slate of programming in partnership with the Museum of the City of New York. The first of these, “The World’s Deadliest Pandemic: A Century Later,” will take place at the Museum on September 27th. We hope to see you there (register here.)

The Red Cross Institute for Crippled and Disabled Men and the “Gospel of Rehabilitation”

Today we have a guest post written by Ms. Julie M. Powell, 2018 recipient of the Audrey and William H. Helfand Fellowship in the History of Medicine and Public Health. Ms. Powell is a PhD candidate at The Ohio State University, her dissertation topic explores the growth of wartime rehabilitation initiatives for disabled soldiers and the rhetoric that accompanied and facilitated this expansion. 

In May 1917, one month after the United States joined the First World War, the American Red Cross created the Institute for Crippled and Disabled Men to “build up re-educational facilities which might be of value to the crippled soldiers and sailors of the American forces.”[1] To this end, Director Douglas McMurtrie (1888–1944) collected approximately 3,500 separate books, pamphlets, reports, and articles from the European continent, North America, and the United Kingdom and its Dominions. He and his research staff pored over the documents, authoring reports, news articles, and lectures that were subsequently fed back into circulation both in the United States and abroad. A look at the collection and the work of the Institute provides a window into the development of rehabilitative care in the early twentieth century, demonstrating that transnational medical networks operated and expanded throughout the war and that the transmission of information and ideology often went hand in hand.

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The Red Cross Institute for Crippled and Disabled Men, 1918.

The proliferation of literature on rehabilitation (including surgical amputation, orthopaedics, prosthetic design, physical therapy, and vocational re-education) can be attributed both to a sense of urgency—20 million men were wounded in the war—and to the relative newness of the field. The first orthopaedic institute was created in Munich in 1832 and the next in Copenhagen in 1872 but these, and others that followed, focused exclusively on care for disabled children. The first significant moves toward the retraining of adults were taken up in the two decades before the war. In 1897, in Saint Petersburg, disabled men began to be trained in the manufacture of orthopaedic devices and in 1908, with the founding of a school in Charleroi, Belgium, the industrially maimed were taught bookbinding, shoe repair, basket making, and more. The first retraining school for invalided soldiers was created in December 1914 in Lyon, France, four months after the outbreak of hostilities. The school provided the inspiration for over 100 similar schools throughout France. The period 1915–1917 saw a proliferation of orthopaedic and re-education institutions throughout Europe and the western world. It was on these models that the Red Cross Institute was founded.

The first institution of its kind in the United States, the Red Cross Institute for Crippled and Disabled Men resided at 311 Fourth Avenue (now Park Avenue South) in New York. Disabled men, either funded by the U.S. Army or attending through no-interest loans, trained in four trades: welding, mechanical drafting, printing, and the manufacture of artificial limbs. McMurtrie and his staff hosted meetings of disabled men—punctuated by cake and ice cream—wherein testimonials from the recently rehabilitated served as recruitment tools for the Institute.

But the broadest impact of the Institute came from its crusade to spread what McMurtrie referred to as the “gospel of rehabilitation”—an insistence on returning the disabled man to independence and self-sufficiency that he might eschew charity and compete fairly in the labor marketplace. Such notions were deeply rooted in classical liberalism, a foil to large-scale social welfare programs that would only emerge in the wake of the Second World War. In The Disabled Soldier, McMurtrie wrote plainly:

When the crippled soldier returns from the front, the government will provide for him, in addition to medical care, special training for self-support. But whether this will really put him back on his feet depends on what the public does to help or hinder, on whether the community morally backs up the national program to put the disabled soldier beyond the need of charity… In light of results already obtained abroad in the training of disabled soldiers, the complete elimination of the dependent cripple has become a constructive and inspiring possibility. Idleness is the great calamity. Your service to the crippled man, therefore, is to find for him a good busy job, and encourage him to tackle it. Demand of the cripple that he get back in the work of the world, and you will find him only too ready to do so.[2]

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A reproduction (right) of part of McMurtrie’s poster exhibit for the Institute featuring the liberal “gospel of rehabilitation”: self-sufficiency, competition, and independence from charity.

McMurtrie’s gospel sounded the same notes as the works of U.S. Allies across the pond, whose material he’d spent years collecting. In 1918, famed novelist, advocate of the war wounded, and editor for the rehabilitation journal Reveille, John Galsworthy warned against the perils of charity, of “drown[ing] the disabled in tea and lip gratitude” and thereby “unsteel[ing] his soul.” Rather, he wrote:

We shall so re-create and fortify…[the disabled soldier] that he shall leave hospital ready for a new career. Then we shall teach him how to tread the road of it, so that he fits again into the national life, becomes once more a workman with pride in his work, a stake in the country, and the consciousness that, handicapped though he be, he runs the race level with his fellows, and is by that so much the better man than they.[3]

Such rhetoric was of a piece with appeals from British Minister of Pensions, John Hodge, for the restoration of men to “industrial independence,” that they might “hold their own in the industrial race.”[4]

When McMurtrie invited the world’s newly-minted experts in rehabilitation to New York in 1919, they shared—as they had through pamphlets, pictures, and films—not just information but ideology. Discussions on war surgery and the organization of rehabilitation schemes unfolded side-by-side with talks on public education and encouragement of the disabled to train.

Such propaganda efforts were critical. According to McMurtrie: “The self-respect of self-support or the ignominy of dependence—which shall the future hold for our disabled soldiers?” The credit or blame, he held, would rest with a public that either demanded self-sufficiency or patronized its men with charity.

References:
[1] Douglas C. McMurtrie, The Organization, Work and Method of the Red Cross Institute for Crippled and Disabled Men (New York: The Red Cross Institute for Crippled and Disabled Men, 1918).
[2] Douglas McMurtrie, The Disabled Soldier (New York: The Macmillan Company, 1919), 37.
[3] John Galsworthy, “Foreword,” The Inter-allied Conference on the After-Care of Disabled Men: Reports Presented to the Conference (London: His Majesty’s Stationary Office, 1918): 13–17. Reprinted in his book of essays Another Sheaf (New York: Charles Scribner’s Sons, 1919).
[4] John Hodge, “The Training of Disabled Men: How We Are Restoring Them to Industrial Independence,” Windsor Magazine no. 281 (1918): 569–571.
[5] McMurtrie, The Disabled Soldier, 75.

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