A Network of Eugenic Maternalism: Finding the New York Babies’ Welfare Association at the New York Academy of Medicine Library

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),[1] 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.

An informative organizational chart created by the BWA from Report of the Babies’ Welfare Association, 1912–1915.

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.

Sisters of Charity and their young charges at the New York Foundling Asylum.
Image Courtesy of the New-York Historical Society.

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.

Young girls from the Hebrew Orphan Asylum practicing patriotism at a camp excursion.
Hebrew Orphan Asylum. Report of the Ninety Ninth Annual Meeting and the Ceremonies Commemorating the Centennial Anniversary of the founding of the Hebrew Orphan Asylum, 1822–1922. 1922; New York Academy of Medicine Library.

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.

The graduating class of nurses trained at the Lincoln Hospital, 1905.
Lincoln Hospital and Home. Sixty-Fifth Annual Report, 1904–1905. 1905;
New York Academy of Medicine Library.

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.  


References

[1] For more information on S. Josephine Baker, see “Highlighting NYAM Women in Medical History: Sara Josephine Baker, MD, DrPh” on the NYAM blog “Books, Health, and History.”

‘Sick and In Prison’: Airborne Disease and Prison Reform in the career of John Howard (1726–1790) 

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.  

Text Box

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 

Image 2: Howard was keenly impressed by the prison regime in Bern, Switzerland. Howard wrote that the city was “one of the cleanest I have seen” and included illustrations of the employment of male and female prisoners as street cleaners. Note the iron collars with hooks affixed to the prisoners’ necks to deter escape attempts.  
“Employment of Criminals” and “Employment of female Criminals,” in John Howard. The State of the Prisons in England and Wales. 2nd. Ed. (Warrington: T. Cadell, 1780) 109–10. Images courtesy of the New York Academy of Medicine Library. 
 

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

Image 3: George Romney’s study for a never-completed painting of John Howard visiting a prison or lazaretto. Howard is the figure standing defiantly on the far left.  
George Romney, John Howard Visiting a Lazaretto (1790–95). Courtesy of the Museum of Fine Arts, Boston, MA. 
 

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 the institution to the character of the individual, 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 [1780]).

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.

English-Language Manuscript Cookbooks

By Stephen Schmidt, Manuscript Cookbooks Survey

Over the course of a decade, culinary historian Stephen Schmidt has advised the NYAM Library on our extensive manuscript cookbook collection. This blog post is a version of the essay he wrote about our digital collection Remedies and Recipes: Manuscript Cookbooks. As part of Bibliography Week 2021, he is speaking on “Manuscript Cookbooks and Their Audience” on January 30.

Introduction to Manuscript Cookbooks

The modern Anglo-American tradition of manuscript cookbooks might be said to begin with the world’s first printed cookbook, De honesta voluptate et valetudine, or “On right pleasure and good health.” Written by the celebrated humanist writer Bartolomeo Sacchi, known as Platina, and first published around 1474, the book was translated into Italian, French, and German within a few decades of publication, and it remained widely read throughout Europe into the early eighteenth century. The book featured both a new cuisine and, just as importantly, a new attitude toward food and cooking. Platina presented an interest in food and its preparation as a kind of connoisseurship akin to the connoisseurship of painting, music, or literature. Europe came to call Platina’s attitude toward food and cooking “epicurean,” and those who espoused it “epicures.” At the dawn of the sixteenth century, these new individuals were emblematic of the Renaissance European world.

Platynae De honesta uoluptate: & ualitidine (Venice,  1498)

When Italian epicureanism was first unleashed in Europe, England was in the throes of its own cultural and intellectual Renaissance. Among the English elite classes, the quest for new knowledge found expression in the collecting and creating of recipes, known then and well into the nineteenth century by the now-archaic word “receipts.” Originally the word receipt meant a prescription for a medicine or remedy. During the Renaissance, as the knowledge-hungry English began to write and collect prescription-like formulas for all sorts of things, the term receipt broadened accordingly: directions for farming and building; formulas for chemistry and alchemy; recipes for practical household products like cleaning solutions and paints, and, amid the growing epicurean spirt of the time, food recipes. The sixteenth-century English made a distinction between receipts pertaining to the home and commonly undertaken by women, and receipts for things involving work outside the home, assumed to be the concern of men. Thus, most who collected food and drink recipes also collected receipts for medicines, remedies, cosmetics, and household necessities such as candles, cleaners, pesticides, fabric dyes, and ink. Today, these books of mixed home recipes are often referred to as “cookbooks” when a substantial portion of their recipes concern food and drink.

Cookbooks in History—Manuscript and Print

There is a persistent belief that in the early modern world recipes originated in the home and then were subsequently picked up in print cookbooks. In fact, this was true in England only during the Renaissance, that is, up to about 1625. Only about a dozen cookbooks were published in England, from the first, in 1500, to that date. This may have been due to a lack of demand, but it was also surely due to the thorny practical problem that, cookbooks being a new idea, a community of writers possessing the specialized skills needed to produce them had yet to develop. Printers solved this problem in the only way they could: by cobbling together their printed cookbooks from manuscript cookbooks compiled by ladies of the peerage and then slapping titles and, in some instances, putative authors on them, all of whom, of course, were men. In most instances, the women who actually wrote these cookbooks were unacknowledged—some of their manuscripts may well have been pilfered from their estates—although two Renaissance cookbook authors, John Partridge and Gervase Markham, did explicitly credit noble ladies as the true originators of their printed books. While manuscript cookbooks preceded print cookbooks during the English Renaissance, this situation was soon to change.

G.M. [Gervase Markham], The English House-Wife (1637), in A way to get wealth: containing sixe principall vocations or callings, in which every good husband or housewife may lawfully imploy themselves (London, 1638)

During the seventeenth century, the number of published cookbooks grew rapidly in England, as did the number of manuscript cookbooks, to judge from those now extant. As the use of printed cookbooks spread, most recipes in manuscript cookbooks cycled through print at some point. In fact, quite a few manuscript cookbooks compiled after the mid-seventeenth century contain recipes copied verbatim from print. As English cookbook publishing matured, female cookbook authors appeared, starting with the remarkable Hannah Woolley, active in the 1650s through the early 1670s. In the eighteenth and nineteenth centuries, female cookbook authors, who generally branded themselves “experienced housekeepers” rather than professional cooks, dominated English and American cookbook publishing. The relationship between manuscript and print, however, remained the same: recipes cycled from print into manuscript and back into print again, until cooking fashions changed and the old recipes were replaced by new ones.

The NYAM Collection

The eleven NYAM receipt books in Recipes and Remedies show the same organization patterns common to most manuscript books in the English-language tradition. For example, in most of the NYAM books, the culinary recipes are separated from the medical and household recipes in some fashion. In some of the NYAM books, recipes are clustered by subject matter, that is, a clutch of food recipes will be followed by a clutch of medical recipes, and so on. In other NYAM manuscript cookbooks, the culinary recipes are written from the front of the notebook while the medical and household recipes are written from the back of the notebook going toward the center. In one item in the NYAM collection, the medical and household recipes are also written upside down in relation to the culinary recipes, making the separation more explicit.

“a receipt for pound cake,” from Hoffman cook book : manuscript, circa 1835-1870

The Hoffman cook book in the NYAM collection is rare in that it unveils a style of cooking outside the mainstream norm. Written in halting English by a German immigrant to America, this highly interesting cookbook is composed primarily of German-inflected recipes like those we today associate with the so-called Pennsylvania Dutch. It also contains recipes for standard American dishes, such as roast turkey, pumpkin pie, and pound cake, but approached in idiosyncratic ways by a woman struggling to interpret a cuisine that was foreign to her. While the author of this cookbook was a cultural and linguistic outsider and her cooking outside the contemporaneous American mainstream, she was also a woman of privilege, a member of a prosperous German-American family that had owned paper mills in Maryland since the eighteenth century. For these reasons she was the sort of person, whether in Germany or America, who would be expected to use recipes and perhaps also to collect them.

Manuscript cookbook authors tended primarily to collect recipes for fruit preserves, fruit and flower wines, sweet dishes, cakes, and, after 1700, breads and cakes served at breakfast or with tea. About half of the manuscript cookbooks in the NYAM collection reflect the typical manuscript preference for sweets. Most of the culinary and drink recipes in Gemel book of recipes and A collection of choise receipts are geared to banqueting, an extravagant repast of sweets that was sometimes served after important meals and sometimes staged as a stand-alone party during the sixteenth and seventeenth centuries. Recipe book, 1700s titles its culinary section “Wines, Sweetmeats, & Cookery”; recipes in the first two categories far outnumber those in the last. Receipt book, 1848–circa 1885, by an American woman named Jane Beck, can be aptly described as a cake cookbook. This inclination can be explained, in part, by the fact that many ladies personally participated in preserve-making, distilling, and baking, while relegating the preparation of the principal dishes of dinner entirely to their cooks. In addition, the success of sweet dishes and cakes hinges on precise recipes, while savory dishes can be successfully executed intuitively, without recipes, at least by good cooks, or so people seem to have believed. Finally, up through the nineteenth century, the biggest per capita consumers of sugar in the world were the British, with the Americans not far behind.

“For the Jaundies” and “Almond Butter,” from A collection of choise receipts : manuscript, circa 1680-1700

Conclusion

Manuscript cookbooks contain insights that historical printed cookbooks lack. Manuscript recipes are likely to have been cooked from, if not by the person who collected the recipe and wrote it down in her book, at least by the person from whom the recipe was collected. Thus manuscript cookbooks contain concrete details that historical printed cookbooks generally lack: the precise motion of the hand in stirring; the most suitable cuts of meat; the time that a cooking process takes; the signs that something is going wrong; the size and number of molds needed for individual cakes; the clues that a dish is done; and so on. Manuscript recipes not only illuminate the making of specific dishes but also basic kitchen conditions and broad practices in historical cooking.

A special feature of manuscript cookbooks is that they reflect the tastes of individual households. Thus, while most printed cookbooks published between 1675 and 1800 outline the same three basic recipes for lemon cream, contemporaneous manuscript cookbooks present dozens of different recipes for this favorite dessert, some tart and others sweet, some rich and others lean, suiting the varied tastes of the epicures of centuries past.

Living through COVID-19: What can we learn from typhoid epidemics of the past?

by guest contributor Jacob Steere-Williams, PhD, Associate Professor of History, College of Charleston.

Join us for Steere-Williams’ talk on typhoid on September 23. 

For decades, thinking about and learning from past pandemics has largely been an academic exercise, one for historians and archivists who specialize in public health. Now, in the midst of a generation-defining pandemic, COVID-19, there has been an explosion of public interest in epidemics and epidemiology. Before 2020, few Americans outside of infectious disease specialists routinely spoke the words “contact tracing” and “case fatality,” or knew the difference between isolation and quarantine.

The recent surge in popular understandings of epidemics has centered on some familiar examples, such as the 1918–1919 influenza pandemic, the mistakenly called “Spanish Flu.”[1] As this was the most significant pandemic of the 20th century, the comparisons make sense, and the public health struggle between individual rights and community health is as apt now as it was then. Other historians, seeing the rise of xenophobia as a cultural response to COVID-19 in the West, have perceptively turned our attention to 19th-century pandemics of cholera and bubonic plague. Then, as now, a uniquely durable, yet startlingly western approach to framing pandemics has been to blame Asian people and Asian cultural practices.[2] 

At a time when the cultural mileage of past pandemics is perhaps at its height in modern history, we might fruitfully turn to the history of a relatively unexplored disease, typhoid fever, to think about our current moment.

Typhoid fever is a food- and water-borne infectious disease, the most virulent of the Salmonella family. The disease continues to wreak havoc on the Global South, killing about 200,000 people each year. In the western world typhoid was at its height in the 19th century, when it was a ubiquitous and insidious reality in North America and Western Europe. In Britain, for example, typhoid annually struck up to 150,000 people, taking the lives of 20,000 each year.

Thomas Godart, “Head and Neck of a Patient Suffering from Typhoid Fever.” Courtesy of the Wellcome Library.

Typhoid’s patterns of distribution were erratic; it might spare a community for months or even years, then erupt as a local outbreak. Epidemiologists today discuss COVID-19 as a cluster disease, exploding in localized events not unlike the way that typhoid did in the past.

Interestingly, typhoid outbreaks continued after the introduction of early sanitary improvements such as toilets, pumped water, and sanitation systems. In the second half of the 19th century no infectious disease was as central to the rise of public health than typhoid. Typhoid was a model disease because the burgeoning group of public health scientists, the first to call themselves epidemiologists, saw that stopping typhoid’s different pathways—through food, water, and healthy human carriers—could transform the nation through preventive public health.[3]

“Avoid the Grip of the Typhoid Hand,” in G.S. Franklin, “Sanitary Care of Privies” (1899), from “Health and Sanitation: Disease and the Working Poor,” https://www.wm.edu/sites/wmcar/research/danvilledig/millworker-life/health-sanitation/index.php.

The story of typhoid in the 19th century is one deeply tied to the emergence of modern epidemiology, which George Buchanan, Chief Medical Officer of Britain’s central public health office, called “the minute observations of particular outbreaks.”[4] Epidemiological practice does not operate in a vacuum, then or now with COVID-19; it is inherently a political exercise. Everyday people, business owners, and politicians have to be convinced about the science of disease communication, requiring complex rhetorical strategies that tell us a great deal about the inherent struggles of public health.

“Transmission of Typhoid Fever,” in George Whipple, Typhoid Fever; Its Causation, Transmission, and Prevention (New York: John Wiley and Sons, 1908).

__________

Notes

[1] See, for example, a recent blog post in Nursing Clio: Jessica Brabble, Ariel Ludwig, and Thomas Ewing, “‘All the World’s a Harem’: Perceptions of Masked Women During the 1918–19 Flu Pandemic,” Nursing Clio. https://nursingclio.org/2020/09/08/all-the-worlds-a-harem-perceptions-of-masked-women-during-the-1918-1919-flu-pandemic/.

[2] Catherine E. Shoichet, “What historians hear when Trump calls coronavirus ‘Chinese’ and ‘foreign,’” CNN. https://www.cnn.com/2020/03/12/us/disease-outbreaks-xenophobia-history/index.html.

[3] Graham Mooney, “How to Talk About Freedom During a Pandemic,” The Atlantic. https://www.theatlantic.com/ideas/archive/2020/05/freedom-pandemic-19th-century/611800/.

[4] George Buchanan, “On the Dry Earth System of Dealing with Excrement,” Annual Report of the Medical Officer of the Privy Council for 1870. Parliamentary Papers. London: Eyre and Spottiswoode, 1871, 97.

Desegregating Harlem Hospital: A Centennial

This guest post is from Adam Biggs, faculty at the University of South Carolina Lancaster and panelist at the recent Academy Race & Health series event, “How Long Will We Wait? The Desegregation of American Hospitals.” Professor Biggs teaches courses in African American Studies and U.S. History, and his research explores the desegregation process at Harlem Hospital from 19191935.

“As I look back with charity at that period,” wrote Aubré Maynard in 1978, “I deplore the fact that I suffered more from the hostility and jealousy of some of my black colleagues than from the antipathy of whites, from whom I expected frank racial animosity.”[1] Lingering more than fifty years after he joined Harlem Hospital as one of its first black interns, Maynard’s feelings of resentment stemmed from acrimony that emerged during the desegregation process. After successfully overcoming white opposition, a heated debate broke out in Harlem over how best to utilize the facility in the interest of racial justice. But rather than a “magic bullet” for the problem of race, desegregation became a mirror of truth, exposing endemic obstacles to racial equality still deeply embedded within the medical profession and internalized within Harlem’s black medical community.

HarlemHospital_Ward_1929_watermark

Harlem Hospital ward, 1929. Image: Harlem Hospital records, 1887-1962, NYAM Collection.

Black civic activists had been advocating to desegregate New York’s municipal hospital system since the early 1910s.[2] But black practitioners would not gain entrance until the nation’s wartime effort placed a burden on medical staffing that could not be ignored. With a reluctant city administration, a small number of practitioners began acquiring low-level positions as early as 1917, and in August 1919, Louis T. Wright became the first black doctor to join the Harlem Hospital staff.[3] Continued advocacy over the next decade pushed the hospital to gradually incorporate black physicians and nurses into its ranks.

HarlemHospital_NurseClass_1929_watermark

Nurses of the class of 1929, Harlem Hospital, New York City. Image: Harlem Hospital records, 1887-1962, NYAM Collection.

This process, however, was not without challenges. For many of the established white staff, the presence of African Americans proved untenable. Shortly after their appointments, the hospital saw a mass exodus of white practitioners who transferred or resigned in protest. Many of those remaining displayed their discontent by acting with belligerence or passive aggression toward the new black hires.[4] Tensions reached a peak in 1927 when a hospital riot was barely averted after a junior white intern, dining in the cafeteria, threw water in the face of Aubré Maynard, a senior resident at the time.[5] Well publicized incidents such as this one amplified the hospital’s toxic racial climate and undermined the public’s trust.

In 1929, Mayor James Walker responded by reorganizing the municipal hospital administration. His reforms led to the dismissal of twenty-three white and two black physicians along with the appointment of twelve new black doctors and the promotion of Louis Wright to the Harlem Hospital board. Within a year, African Americans came to represent approximately forty percent of physicians on staff, making Harlem Hospital the first municipal institution of its kind to embrace the ideal of integration.[6]

Louis-T-Wright-colleagues-Harlem-Hospital-NY

Louis T. Wright and colleagues at patient bedside, Harlem Hospital, New York, N.Y. From left to right: Dr. Lyndon M. Hill, Dr. Louis T. Wright, Dr. Myra Logan, Dr. Aaron Prigot, unidentified African American woman patient, and unidentified hospital employee. Image: Joe Covello (for Black Star), CC-BY SA 3.0

But, while meaningful, the celebration was short-lived. Conflicts soon emerged over who should receive the coveted appointments and whether to transform the hospital into a cutting-edge integrated research facility or an institution dedicated to the training of black personnel.[7] Harlem’s local black medical association, the North Harlem Medical Society, split in two between those supporting and those opposing the hospital administration.[8] Bitter rivalries formed between graduates of black medical programs and those from predominantly white medical schools.[9] Not isolated to Harlem, the conflict also attracted the attention of the national black press, the National Medical Association, and the NAACP. Prominent churches, political leaders, and labor organizations throughout the city got involved as well. Louis Wright became a focal point of contention. A representative of the hospital administration and graduate of Harvard Medical School, opponents labeled him an “Uncle Tom” while supporters characterized the attacks against him as petty envy.[10]

The conflict came to an end in March 1935 when a riot broke out in Harlem. E. Franklin Frazier, a prominent black sociologist, investigated the cause of unrest and determined the hospital’s perpetual discord was a contributing factor.[11] In the years that followed, Harlem’s medical community directed greater public attention toward matters of patient care.

Latent resentment, however, lingered for decades. In 1952, despite an illustrious career, when Wright was nominated for the National Medical Association’s distinguished service award, he received only one vote.[12] Public doubts about black doctors and Harlem Hospital also persisted. Maynard lamented that accepting black doctors onto its staff had the ironic side-effect of diminishing the hospital’s reputation among Harlem residents.[13] Local political figures and New York’s medical community held similar doubts. In 1958, when Martin Luther King, Jr., was taken to Harlem Hospital for emergency care, one nurse in attendance recalled, “a lot of time was wasted while they argued.…They didn’t want to take him to the black hospital.”[14]

HarlemHospital_CorettaScottKing_1958_watermark

Coretta Scott King in children’s ward of Harlem Hospital with flowers sent to Martin Luther King, Jr., September 1958. Image: Harlem Hospital records, 1887-1962, NYAM Collection.

More than a celebratory centennial, the story of desegregation at Harlem Hospital raises meaningful questions about how best to address the problem of race in medicine. The conflicts that emerged within Harlem’s black medical community were not peculiar racial idiosyncrasies but, rather, emblematic of unresolved tensions evident in the profession at large and unaddressed in the hospital reforms. Desegregation proved not to be a miracle cure but instead led to a renewed call for black doctors to further interrogate the deeply embedded, protean forms of racial exclusion that endured in their profession and American society. Today, it reminds us that even watershed victories require continued vigilance and an unyielding commitment to the pursuit of racial justice.

References

[1] Aubré de L. Maynard, Surgeons to the Poor: The Harlem Hospital Story  (New York: Appleton-Century-Crofts, 1978). 51.

[2] Michael L. Goldstein, “Black Power and the Rise of Bureaucratic Autonomy in New York City Politics: The Case of Harlem Hospital, 1917–1931,” Phylon 41, no. 2 (1980): 191.

[3] Maynard, Surgeons to the Poor: The Harlem Hospital Story: 18-25.

[4] Louis Tompkins Wright. “I Remember….” In Louis T. Wright Papers, Box 130-1, Folder 12. Manuscript Division, Moorland–Spingarn Research Center, Howard University, n. d. p. 93–94; Maynard, Surgeons to the Poor: The Harlem Hospital Story: 23.

[5] Maynard, Surgeons to the Poor: The Harlem Hospital Story: 43.; “Barely Avert Riot at Harlem Hospital,” New York Amsterdam News, 6 July 1927, 1, 2.

[6] “Harlem Hospital Staff Is Reorganized, Giving Place to Nineteen Negro Doctors.” New York Age, 22 February 1930, 1.

[7] Ibid.

[8] “Doctors Quit North Harlem Society to Form New Medical Body; Old Body Repudiated,” New York Age, 24 May 1930, 1, 3.

[9] Maynard, Surgeons to the Poor: The Harlem Hospital Story: 53.

[10] “Plan City Hall March in Fight on Hospital,” New York Amsterdam News, 8 March 1933, 1, 2; Vanessa Northington Gamble, Making a Place for Ourselves: The Black Hospital Movement, 1920–1945 (New York: Oxford University Press, 1995), 58–66.

[11] Charles V. Hamilton, Adam Clayton Powell, Jr.: The Political Biography of an American Dilemma (New York: Cooper Square Press, 2002). 55–63.

[12] W. Montague Cobb, “Louis Tompkins Wright, 1891–1952,” Journal of the National Medical Association 45, no. 2 (1953): 3.

[13] Maynard, Surgeons to the Poor: The Harlem Hospital Story: 81–82.

[14] Ebony Magazine. “[IN MY LIFETIME] Goldie Brangman on Saving Martin Luther King’s Life.” 2016.

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.

Commitee of Twenty, Dusty Trucks 2

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.

Committee of Twenty, Why Clean Streets 1

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

Committee of Twenty, Why Clean Streets 2

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.