Category Archives: History of medicine

Combatting Tuberculosis in America After its Microbial Discovery 

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By Sean Purcell, The Media School, Indiana University-Bloomington and the Library’s 2023 Helfand Fellow 

Mr. Purcell completed his Fellowship residency in the summer of 2023 and will present his research by Zoom on Thursday, December 7 at 4 p.m. (EST). To attend his talk, “A Portrait of Tuberculosis (as a Young Microbe): Representing Consumption at the Turn of the Twentieth Century,” register through NYAM’s Events page. 

I spent a month over the spring and summer looking through the New York Academy of Medicine Library collections, working towards a mixed methods dissertation, titled The Tuberculosis Specimen: The Dying Body and its Use in the War Against the “Great White Plague.” I came to the library with an interest in the visual culture surrounding tuberculosis at the turn of the twentieth century, and in my research, I have cast a wide net, looking at an array of images, from doctors’ portraits to children at play, from histological samples to photographs of wet specimens. 

The turn of the twentieth century saw major shifts in the public, professional, and governmental interventions against tuberculosis. Robert Koch’s 1882 essay on the microbial cause of the disease led to a broad shift in how medical professionals and the lay public understood and combatted the disease. Koch had figured out a process to isolate the bacteria in laboratory animals and used a series of chemical baths to stain Mycobacterium tuberculosis a bright blue (fig. 1). Seeing the bacteria clear as day under the microscope helped move germ theory forward, and forced doctors and health worker to reconsider how to treat a disease that was, prior to Koch’s essay, considered a constitutional malady. The period after Koch’s essay saw the rise of public health interventions against the disease and the popularization of the tuberculosis sanatorium. 

Figure 1. An illustration of Mycobacterium tuberculosis. From Aetiology of Tuberculosis, 1890, Robert Koch.  

The most influential figure in the burgeoning sanatorium movement was Edward Livingston Trudeau. A doctor who had sought a cure for his own tuberculosis in upstate New York, Trudeau built his own laboratory and sanatorium, the Adirondack Cottage Sanatorium, in 1880 (figs. 2 & 3). This institution became a central fixture in the decades to come, as it was equipped with research facilities, and published its public-facing journal for tuberculous patients, The Journal of Outdoor Life.  

Figure 2. The most reproduced image from the Adirondack Sanatorium, showing the first cottage where patients were treated. From A history of the National Tuberculosis Association; the anti-tuberculosis movement in the United States, 1921, Adolphus S. Knopf.  
Figure 3. A view of the facilities at Trudeau’s Adirondack Sanatorium. From A history of the National Tuberculosis Association; the anti-tuberculosis movement in the United States, 1921, Adolphus S. Knopf. 

While Trudeau’s sanatorium was the most prominent institution, it was far from the only one. Many for-profit institutions opened their doors during this period, in addition to the development of publicly funded sanitaria in certain states. Assisting the larger, long-term treatment facilities, some cities and hospitals adopted a dispensary system, where tuberculous patients could get assistance and medicine within an urban space.  

These dispensaries served patients, but also sought to teach the urban poor lessons on hygiene. Doctors and public health workers reeled at the dusty, ill kept living conditions of the urban poor, and argued that improper sputum management, poor ventilation, and dark living conditions were contributing to tuberculosis infections in American cities (figs. 4 & 5). While ideas regarding the “healing air” of a specific environment were becoming out of fashion for tuberculosis practitioners in the early 1900’s, most doctors argued that tuberculous patients should get away from the polluted and uncirculated air common to urban environments (figs. 6 & 7).  

Figure 4. An exhibit showing the unhealthy living conditions of the working poor. The caption reads: “Type of tenement house room as first seen by Department of Health Nurse. Man is ill with Tuberculosis. Baby is ill with Scarlet Fever. Others are in danger of infection. Family is destitute.” From “Album of photographs of exhibits by various departments of the City of New York, Royal S. Copeland, Commissioner, and various health agencies,” 1921.  
Figure 5. An exhibit showing the interventions of a public health nurse. The caption reads: “Same room after nurse has performed her duties. Man has been removed to Sanatorium. The baby has been removed to hospital. Financial aid has been obtained and landlord has been induced to paint room. Instruction has been given to mother in personal hygiene, cleaning up, order, proper diet.” From “Album of photographs of exhibits by various departments of the City of New York, Royal S. Copeland, Commissioner, and various health agencies,” 1921. 
Figure 6. A day camp run by Bellevue Hospital where patients could spend time outdoors on a boat. From New York City’s Institutions for the Tuberculous: Clinics, Sanatoria, Preventoria, Day Camps and other Agencies, 1926, The Tuberculosis Sanatorium Conference of Metropolitan New York. 
Figure 7. Tuberculous patients were instructed to spend as much time as possible outside, no matter the weather. From Pulmonary tuberculosis, its modern and specialized treatment, 1907, Albert Philip Francine.  

The fight against tuberculosis in this period saw a collection of different interventions, and the New York Academy of Medicine’s library offers a unique glimpse into the work of scientists and medical professionals who were trying to fight the disease. My time here as a Helfand fellow has been a boon to this research because of the library’s extensive collections, much of which has not been digitized. 
 
References:  
Feldberg, Georgina D. Disease and Class: Tuberculosis and the Shaping of Modern North American Society. (New Brunswick: Rutgers University Press, 1995). 

Koch, Robert. “Aetiology of Tuberculosis.” Translated by T. Saure. Transactions of the Massachusetts Medical Association. (New York: William R. Jenkins, 1890).  

Koch, Robert. “Die Ätiologie der Tuberculose.” In Gesammelte Werke von Robert Koch, 1:446–54, 467–565. (Leipzig: Verlag Von Georg Thieme, 1912). 

The Healing Power of Art and Community: Viewing the AIDS Quilt at 36 

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By Paul Theerman, Director 

The first panel of the AIDS quilt was put together in 1987—this year the Quilt is 36 years old! 

Image courtesy of National AIDS Memorial.

The AIDS Quilt was the brainchild of gay activist Cleve Jones. A protégé of Harvey Milk, the San Francisco city supervisor murdered in 1978, Jones honored Milk’s life and service with candlelight marches through the city. For the 1985 march he saw the ravages that AIDS was making in the gay community and asked that marchers write the names of friends lost to AIDS on posters. Placed on a wall, the posters resembled a quilt; by 1987 the names had been captured in fabric, a traditional way of memorializing people and events. The NAMES Project AIDS Memorial Quilt was born.  

Cleve Jones, activist and founder of the quilt, in front of a panel. Image taken from Wikipedia.

The quilt was first displayed on the National Mall in Washington, DC, on October 11, 1987, and contained 1,920 names—a dramatic demonstration of the terrible effects of the disease, only a few years after it came to public notice. At the quilt’s October 1996 display, it covered the entire Mall and was the last time that the whole quilt could be displayed at once. In the years since the quilt began, it has been exhibited throughout the world, often in connection with World AIDS Day on December 1. Today the quilt contains almost 50,000 panels, representing 110,000 individuals. The National AIDS Memorial in San Francisco is responsible for the quilt, mounts special efforts to address the presence of HIV/AIDS in the Black and Native American communities, and shares the quilt online. 

An image of the quilt being displayed in Washington, DC around 1987. Image taken from National AIDS Memorial. 
Advertising the digitization of the quilt from National Aids Memorial, as per their website.

This year, the New York Academy of Medicine is proud to host a portion of the AIDS quilt for World AIDS Day on December 1. We’ll reveal the quilt at our Celebration of the Library on November 29 and exhibit it in the Academy Building throughout December. We hope you can join us to view this sober but also hopeful reminder of how disease devastates communities, and how communities respond, through art, with remembrance and resilience. 

A panel from the AIDS quilt at the National Building Museum used as part of Wikimedia Commons.

_______ 

References  

“The History of the Quilt,” The National AIDS Memorial, https://www.aidsmemorial.org/quilt-history,  accessed November 20, 2023. 

The Art of Anatomy with the Art Students League

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By Arlene Shaner, Historical Collections Librarian

In July 2023, artist and teacher Dan Thompson brought a group of students to the Library’s Drs. Barry and Bobbi Coller Rare Book Reading Room. The students were here in New York for a week-long workshop organized by the Art Students League, “Musculoskeletal Gross Anatomy for the Figurative Artist.” We looked at anatomical atlases dating from the early 16th through the mid-20th centuries. Viewing items from our collection—like the first two images here—and engaging with the students made up the first day of the workshop. The balance took place in the Weill Cornell Medicine anatomy lab, where students worked directly with cadavers.

From Nouveau recueil d’ostéologie et de myologie…, 1779, by Jacques Gamelin

As the course description explains, “This course presents the study of anatomy as a convergence between anatomical and structural drawing. Motivated students of representational art will have unparalleled opportunities for developing detailed anatomical knowledge through their work in Cornell College of Medicine’s anatomy lab, where they will explore the complexities of the body through the study of prosections and cadavers. Prosections are specially prepared human anatomical specimens, wrapped in a damp preservative, as well as plastinated specimens, which allow for the study of deeper and more isolated anatomical structure. Through laboratory drawing, participating students will become more familiar with the manner of interlocking deeper forms—forms which are not typically clear on anatomical models (due to the haphazard ways that art school skeletons are wired together). Ultimately, students will work towards achieving greater anatomical clarity and validity in their drawing studies, which will be applied to creating higher quality figurative work in the visual arts, from a finer appreciation of human construction.”

From Anatomie du gladiateur combattant…, 1812, Jean-Galbert Salvage

Dan teaches at the New York Academy of Art and I have hosted Dan’s New York Academy of Art students here for several years; I first hosted his workshop for the Art Students League in the summer of 2022. This year Dan invited me to visit Weill Cornell’s anatomy lab with the workshop class so that I could gain a deeper understanding of how he teaches with human specimens and watch students make their own drawings and sculptures from cadavers, prosections, and plastinated specimens. Being in the anatomy lab was, for me, a transformative experience, as I had never had the opportunity to see actual cadavers and specimens and think about their relationship to images from historical texts that I share with classes when they visit. 

Workshop participant Karina Fuhrman shared images from the visit to the rare book room. The drawings were done by Dan Thompson and the sculpture was done by Karina during her time in the dissection lab.

After the class had ended, I asked if the students would be willing to send their work to me so that we could share it with a broader audience. Many sent images, and it is a privilege to be able to show some of those here.

Artist: Alan Lee
Artist: Anna Charuvastra
Artist: Chalice Mitchell
Artist: Eva Avenue
Artist: Jae Park
Artist: Kristin duCharme
Artist: Renee Wang

Classes from many local institutions regularly visit the rare book room to engage with materials from our collections. Dr. Evelyn Rynkiewicz, who teaches at FIT, has brought her class “Disease Ecology in a Changing World” more than once. After their 2022 visit, she wrote a blog post about the experience, which you can find here.   
 
If you are interested in bringing your class to the New York Academy of Medicine Library, please reach out to ashaner@nyam.org.

A Summer Script for Relaxation

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by Anthony Murisco, Public Engagement Librarian

Relaxation is just what the doctor ordered! Specifically, Dr. George S. Stevenson of the National and International Association for Mental Health. In his book, How to Deal with Your Tensions (1957), he says that “anxiety and tension” are essential parts of being alive. If we did not experience these feelings, we wouldn’t be equipped to manage the high or low-intensity situations we experience day to day.  It is indeed an anxious time. We face threats such as climate change and the spread of misinformation. Writing in 1957, Dr. Stevenson spoke of real high tensions his society faced, “While it is true that we live today under pressure of intense competition, economic uncertainty, and the possibility of war…” Stevenson continued, “our ancestors faced other perils of equal magnitude.” It is important to realize each generation has its own struggles. 

The title page of How To Deal With Your Tensions by George S. Stevenson, MD. It carries the seal of approval from the National Association for Mental Health. The emblem for that is a large bell with MH inscribed on it.

Dr. Stevenson produced eleven tenets for dealing with our feelings. These range from “Talk It Out” to “Shun the ‘Superman’ Urge’ to “Give the Other Fellow A Break.” We know these ideas but hearing them prescribed feels different.

One of Stevenson's tips. This says "7. Shun the "Superman" Urge" and features a balding man with glasses and a pipe wearing a costume similar to Superman. His hands are at his sides in classic Superman fashion.

The two that we want to focus on are #2, “Escape for a While,” and #11, “Schedule Your Recreation.” His ideas of escape are not necessarily jetting off to an island vacation! You can find escape by “[losing] yourself in a movie or a book or a game.” Even a “brief trip or change of scene” can make you feel relaxed. Public parks are beautiful places to go for a stroll. 

Scheduling recreation is sometimes hard—especially for an adult. When  we are younger, we get scheduled vacation. The summer is ours! As adults, we have more responsibilities. As Dr. Stevenson mentioned, we don’t have to schedule a week-long trip! We can buy tickets in advance to the latest blockbuster or art-house film. We can schedule an hour or two before bed to transport ourselves with the help of a book. 

Another of Stevenson's steps is "11. Schedule your recreation." This image features a woman making a ship in a bottle. She stands next to an array of tools while she places a tiny tool into the bottle. It looks as though she has almost finished the project.

This summer we asked, “How are you recharging?” We want to hear what recreation and relaxation you have been taking part in. Dr. Stevenson has spoken of the benefits but so have others. 

In 1924, Joseph Ralph, a psychologist and psychoanalyst, declared that he had found the fountain of youth. It was not in some unobtainable secret cave, and he was not going to keep it to himself. The secret to still being young was electronic relaxation, a method of inducing tension.

The title page of "The Man Who Stopped Growing Old." This features a portrait of the subject, Jason Ralph. It identifies him as well as his profession of psychologist and psycho-analyst.

Ralph declared that the secret to eternal youth lived in the cell’s protoplasm. Through wear and tear, the protoplasm becomes weak, causing us to age. The agent responsible was not our physicality but instead our mental conflicts. Our intense emotional reactions cause the protoplasm inside the cells to harden. If hardened, they can no longer provide us with the energy we need. He deduced that this is why we acted “older.”  By creating tension, Ralph believed the protoplasm was being stretched and worked out like a muscle.

Even your insurance company wants you to relax! Metropolitan Life Insurance gave advice in their pamphlet “Relax and Revive.” In comparing the body to the mechanical machines, we use daily, they remind us that “extra care avoids shutdowns.”

The title page for Relax and Revive by Met Life. The font is turquoise.

Whether we get a day, a whole weekend, or the entirety of a season, it’s important to carve out time for yourself. As Met Life put it, “How you use your precious hours of leisure is of the greatest importance in keeping yourself fit, and in fighting the good fight on the home front.” To take care of what you need to take care of, you have to start with yourself.

Like Dr. Stevenson, the insurance company wanted you to figure out what works best for you. Besides the typical ways we think of recreation, the pamphlet stated that perhaps just sitting there is what works for you! “Maybe idleness is your recreation. That’s all right too.”

An image of a man showing the fish that he and his son caught to his neighbor. The two adult men are separated by a fence. The boy has climbed the fence to proudly speak with his dad.

While we all may have ideas of what recreation is, it looks different for all. We wanted to share how people have been relaxing so far this summer. We’ve gotten pictures, postcards, and stories from fellow NYAM staff, friends, family, and patrons. We thank everyone for their responses so far.

The staff here at NYAM filled out beautiful New York City—centric postcards. They relayed their goals for the summer, which included personal goals (vacations, exercise, spending time with family and pets, and of course, recovery), as well work goals (planning notable events, organizing office space, and remembering to respond to emails on time).

A colorful illustrated postcard of times square. The iconic yellow taxi rides through the street. Marquees for Broadway productions illuminate the sky. They are Phantom of the Opera, West Side Story, Hair, and South Pacific.

We even got a response from a friend of a famous 100-foot-tall ape…

A response that reads "This summer I am climbing the Empire State Building with a giant gorilla."

Parks are always fun to visit during the summer. This one comes from Theodore Roosevelt National Park in North Dakota, one of 63 with that distinction.

A scan of a postcard from Theodore Roosevelt National Park. This shows the Painted Canyon. The canyon appears very yellow.

Indiana seems like a popular destination this summer. Three of our postcards come from different parks there.

Rachel visited Wolf Park and talked about the different wildlife she saw there, including foxes, turtles, and of course, wolves! She mentioned how the park gave her tips on how to help the wildlife there and in the larger environment.

A scan of a postcard from wolf Park. Three wolves are howling to the left. There is another wolf who is howling to the right,.

Megan went on a trip to Turkey Run State Park in Indiana where she went on a hike for her recent birthday. She loved being in nature with her sister and best friends.

A scan of a postcard from Turkey Run State Park. It shows a walking bridge surrounded by green trees.

Our Historical Collections Librarian sent a postcard from a road trip she took. One of her stops brought her to the Indiana Dunes National Park. There she got to walk along the Lake Michigan Shoreline!

A scan of a postcard from Indiana Dunes National Park. It is the shoreline of Lake Michigan. The sun is setting right in the middle.

One of our patrons, Dr. Sharon Packer, sent us these photos from Bearsville, New York. The pictures remind us of the beauty and therapeutic power of relaxing in our natural environment. For those in a big city, it’s nice to get away for a bit. We are lucky to live only a train ride away from such different scenery. There also looks to be delicious home cooking! Both making and eating are perfect relaxation practices.

A photo with a blooming pink flower in frame. Behind it is a small, shy brown dog looking at the camera.
A delicious looking quiche that is set in front of a red barn. The quiche has cut scallions on top.

We don’t want to scare you; the summer is not over yet! With that, we are still collecting postcards and pictures.

Postcards/letters can be sent to:
Attn – NYAM Library
The New York Academy of Medicine
1216 Fifth Avenue
New York, NY 10029

Or you can always e-mail us at: librarysocial@nyam.org.

We look forward to hearing from you! And more importantly, we hope you are having a relaxing summer.

A large pink flower is in focus.

References:
Harris, Antron. The Man Who Stopped Growing Old : Joseph Ralph, Psychologist and Psycho-analyst, Discoverer of the Electronic Relaxation Method of Mental and Physical Rejuvenation. B.F. Tibby, 1924.

Metropolitan Life Insurance Company. Relax and Revive. Metropolitan Life Insurance Company, 1920?.

Stevenson, George S. How to Deal with Your Tensions. National Association for Mental Health, c1957.

May 2023 NYAM Library Wrap-Up

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By Anthony Murisco, Public Engagement Librarian

May brought us flowers and a lot to celebrate on social media!

Throughout the month of May we observed Mental Health Awareness Month. This included sharing information and graphics from the National Alliance on Mental Illness. On May 11, we observed National Children’s Mental Health Awareness Day. Kids often imitate adult behavior. Passing down healthy habits, including ones related to mental health, is imperative!

A colorful illustration of a group of kids. They are in front of a door. One boy is tying roller skates. A blonde haired girl is running to another boy who is riding a fake horse with a cowboy hat.

The popularity of Star Wars continues to this day. Just after the movie’s premiere in the late 1970’s, President Carter and the National Immunization Program asked the film’s two droids, R2-D2 and C-3PO, to star in a campaign promoting immunization. A television commercial and a poster were made for this, with the latter in our collection.

The Star Wars droids are asking parents of Earth to immunize their children in this printed PSA.

School nurses are some of the first healthcare workers that children meet. On May 10th we celebrated them. National School Nurses Day invites us to thank these caregivers. This photograph from Health Work in the Schools by Ernest Bryant Hoag and Lewis M. Terman shows a school nurse in action.

A black and white image. Caption reads "School nurse recording pulse and temperature in an open-air class."

Who better than to help us celebrate Mother’s Day and Women’s Health Week than the Roman goddess of women’s health, Juno. She made her appearance in 1950 at the Cleveland Health Museum, helping to explain how the female body worked.

A photograph of the transparent Juno statue from the side. Juno is a life-size woman.

Do you like foraging for your food? Then you probably celebrated National Mushroom Hunting Day on May 17th. The Field Book of Common Gilled Mushrooms by William S. Thomas helps you identify which you can eat and which you cannot!

A colorful illustration of various mushrooms.

World Goth Day happened on May 22nd. The macabre is at the forefront of this often-misunderstood subculture. We showed off some of the many skeletons in our collection, including this from The Last Will and Testament of Basil Valentine by Basil Valentine.

A skeleton stands on a platform.

One of New York City’s prominent bridges, The Brooklyn Bridge, celebrated its 140th birthday on May 24th. It appears on a card from our William H. Helfand Pharmaceutical Trade Card collection promoting Lydia E. Pinkham’s Vegetable Compound.

The front side of the trading card. A drawing of the "East River Bridge" is front and center with ships sailing around it. Lydia E. Pinkham's Vegetable compound is a featured banner in the middle of the bridge.

International Plastic Free Day on May 25th seeks to have at least one day without single-use plastics. The day usually falls around Memorial Day, a long weekend often spent enjoying picnics, the beach, or hiking, all occasions tempting us to be wasteful. To keep on enjoying, we need to squash the usage of these products.

An illustration of two beach-goers unable to go to the beach. A sign reads "No Bathing. Polluted."

Throughout the month, artists used the hashtag and prompt #MerMay as a creative inspiration signaling mermaids and mermen. Towards the end of the month, we shared another image from the Helfand Trade Card collection, this one featuring the aquatic folk using Ayer’s Hair Vigor to attract sailors.

Four mermaids are applying hair tonic. In the background a fifth mermaid is approaching a ship.

Finally, we are counting down the days until Museum Mile Festival 2023! On Tuesday, June 13th, cultural institutions along Museum Mile on 5th Avenue will be celebrating with extended hours, giveaways, and a look inside the collections. The NYAM Library will be set up at 103rd and 5th—come visit us!

The New York Academy of Medicine Library posts updates like this throughout the week. We can be found online over at Facebook, Instagram, and Twitter. Check back here or on our social media for more chances for a look inside our collection!

A skeleton sits in a chair. They are surrounded by old books.

Speaking For Themselves: Mental Health Memoirs

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By Anthony Murisco, Public Engagement Librarian 

Since 1949, May has been recognized in the United States as Mental Health Awareness Month. The National Association for Mental Health, now Mental Health America, set up the month of educational events to clear up misconceptions about mental health and provide resources to those who need them.  

The knowledge of public health is always changing. What may have been taken as fact years ago is not necessarily the truth now. This is true for understanding mental health, or formerly, mental hygiene.  


 
From November 8th to 15th in 1912, the National Committee for Mental Hygiene and the Committee on Mental Hygiene of the New York State Charities Aid Association hosted a conference at the College of the City of New York. These two organizations brought together some of the leading minds on the subject. This was a relatively new idea. Modern understanding of psychiatry had begun less than a hundred years earlier.  

The goal of this conference was what the public could do regarding their own mental health. They came up with six tenets. 

While worded harshly in today’s terms, these suggestions try to offer a compassionate understanding of mental illness. The fourth, “Speak and think of insanity as a disease and not as a crime,” stands out as something we continue to struggle with today.  
 

One of the forefathers of the mental health awareness movement would not be considered a traditional mental health expert. Clifford Whittingham Beers was born in 1896. Mental illness ran in his family. He himself served several stints in mental institutions. Upon the cruel treatment inflicted upon him at these hospitals, he went on to write a memoir on the subject. In A Mind That Found Itself, he writes of the degradation that he and his fellow patients were subject to. This memoir was key to providing a voice for those who were afraid to speak of their own illness. In 1909 Beers founded the organization now called Mental Health America.  
 

From the first edition of A Mind That Found Itself.

Since the publication of Beers’ book, several writers have explored their own experience. These mental health memoirs offer both guidance and companionship to those who also suffer. They provide maps for those who care about those who may be suffering and allows a peek inside minds that many cannot comprehend.  

Some of these authors bring humor to their reflections.  Two funny people wrote about their own struggles. Kevin Breel is a Canadian comedian. He also suffers from depression. His memoir, Boy Meets Depression, allows readers into the mind of someone who experienced the mental illness early on in life. Sara Benincasa is known for being a comical blogger. Her own memoir Agorafabulous! reveals her fight with depression as well as agoraphobia, the fear of leaving one’s house.  

Graphic memoirs allow us to see with the author’s vision. In dealing with mental health, we get to experience dark visions or the physical manifestation of anguish.  


 
The Hospital Suite by John Porcellino starts off with a hospitalization. After his illness, Porcellino‘’s health didn’t get better. His brief stint had taken a toll on his mental health. He writes about the experience of his recovery from an obsessive-compulsive episode. Porcellino is candid about his struggles and his fears of his bouts recurring. 


 
Ellen Forney was diagnosed with bipolar disorder before her thirteenth birthday. Afraid of stunting her creativity, she seeks treatment that will help her fulfill her potential. She begins to look at other artists who have suffered from mental illness. Finding all minds are different, she wonders what’s going to be best for her. Forney takes us on her personal highs and lows in Marbles. 


 
Towards the end of his work on the epidemic of mental fatigue and pressure, People Under Pressure, Albert M. Barrett, MD, offered a sympathetic take on mental health challenges. For fifteen years prior to his 1960 publication, he worked alongside counselors and therapists. Barrett urges us to consider a different point of view. He writes, “For no man is an island, and the relief we provide other human beings will reflect itself in our own peace of mind.” Compassion is vital towards greater public health. 
 
 
References: 

Barrett, Albert M. People under Pressure. College and University Press, 1960.  

Benincasa, Sara. Agorafabulous!: Dispatches from My Bedroom. William Morrow Paperbacks, 2013.  

Breel, Kevin. Boy Meets Depression: Or Life Sucks and Then You Die Live. Harmony Books, 2015.  

Clifford, Beers W. A Mind That Found Itself; an Autobiography. Longmans, Green, and Co., 1908.  

Forney, Ellen. Marbles: Mania, Depression, Michelangelo, & Me: A Graphic Memoir. Gotham Books, 2012.  

National Committee for Mental Hygiene, and State Charities Aid Association (N.Y.). Committee on Mental Hygiene. Proceedings of the Mental Hygiene Conference and Exhibit at the College of the City of New York…. Committee on Mental Hygiene of the State Charities Aid Association, 1912.  

Porcellino, John. The Hospital Suite. Drawn & Quarterly, 2014.  

Frederick Banting and the Isolation of Insulin

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By Paul Theerman, Director

F. G. Banting, December 27, 1922.
(All photos from the University of Toronto Libraries.)

One hundred years ago, on December 21, 1922, Frederick Grant Banting (1891–1941) addressed the New York Academy of Medicine. He had been invited to give a talk on his new therapy that used insulin to treat diabetes. Less than a year earlier, in January 1922, the first diabetes sufferer had been successfully treated for this invariably fatal condition. Less than a year later, on December 10, 1923, Banting’s name was read out at the Nobel ceremony in Stockholm, as he and John Macleod were awarded the prize in Physiology or Medicine. During this Nobel month—the annual prizes were given out last Saturday, the 10th—we take a look at this signal discovery.

The story of the isolation and therapeutic use of insulin can be told as a remarkably short and direct one. After medical and surgical training at the University of Toronto and serving in World War I, Frederick Banting set up his medical practice in London, Ontario. He also taught there, at the University of Western Ontario, and as part of preparing for his lectures, he considered a possible solution to a persistent problem in diabetes studies. For over 50 years, medical researchers had explored the role of the pancreas gland in digestion, and specifically in diabetes. This condition is characterized by high levels of sugar in the urine, leading to frequent urination, increased thirst and hunger, and dramatic weight loss. The condition can progress to the acute symptoms of nausea, vomiting, and coma, eventually leading to death. There is no cure. In Banting’s time, sufferers faced a near-starvation diet as part of a difficult and short life.

By the turn of the century, diabetes researchers had focused on the role in diabetes of the “islets of Langerhans,” microscopic glands spread throughout the pancreas. They supposed that a hormone produced by these glands—called “insulin” from the Latin word for “island,” given its source in the islets—played a crucial role in sugar metabolism. To use this insight therapeutically, though, ran up against a seemingly insurmountable challenge. One could hope to treat diabetes by administering an extract from the glands, and the usual way of preparing such extracts was to grind up the organ and then isolate and purify the hormone. But most of the pancreas produces digestive juices, and these juices promptly broke down the hormone. In 1920, Banting, reading through the medical literature, had a crucial insight: tying off the pancreatic duct could cause the rest of the pancreas to deteriorate, leaving behind only the insulin-producing islets. He took his idea to physiologist J. R. R. Macleod (1876–1935) at the University of Toronto, who provided him with a laboratory, experimental animals, and a medical student to help, Charles H. Best (1899–1978).

J. R. R. Macleod, ca 1923.
Graduation photograph of Charles Best, 1921.

By April 2021, Banting and Best had begun work, tying off the pancreatic ducts in dogs, waiting for the pancreas to deteriorate, and then isolating the insulin from the remaining pancreatic tissue.

J. B. Collip, ca. 1920.
F. G. Banting (right) and C. H. Best with a dog on the roof of the Medical Building, University of Toronto, [August 1921].

They soon turned instead to fetal calves as an insulin source—at an early stage of development, the islets of Langerhans already produced the hormone, while the pancreas’s digestive enzymes had not yet begun to be produced. In December Macleod assigned biochemist James Collip (1892–1965) to the project, to help purify the insulin and avoid allergic reactions.

After success in dogs, in January 1922 came the first successful therapeutic use in humans, at Toronto General Hospital, on 14-year-old Leonard Thompson. Then living on a 450-calorie-per-day diet and shrunk to 65 pounds, Thompson responded well to the insulin injections, and went on to live many more years. On February 7 Banting and Best announced their success at the Academy of Medicine of Toronto.

There was an immediate world-wide response. Patients flocked to Toronto for treatment. By 1923, the Eli Lilly Company was producing insulin commercially. In June 1923, John D. Rockefeller, Jr., contributed $150,000—equivalent to over $2.6M today—to 15 hospitals in the United States and Canada to support the use of insulin, including two New York hospitals, the Physiatric Institute and Presbyterian Hospital; two hospitals in Toronto; and $5,000 for the Banting-Best Fund of the University of Toronto. By December 1923, J. Sjöquist in his Nobel Presentation Speech could state: “Since [its discovery], the new remedy, the production of which does not offer any great technical difficulties, has come into use in practically all countries and with favourable results.”

Banting’s rewards were immediate and great. In 1922, he was given a Senior Demonstrator position at the University of Toronto, and the next year elected to the Banting and Best Chair of Medical Research at the University of Toronto. In August 1923 he made the cover of Time magazine. In December 1923 he and Macleod were awarded the Nobel Prize in Medicine or Physiology. Banting shared the credit and his prize money with Charles Best while Macleod did the same with James Collip. In 1925, the Banting Research Foundation was established, a private institution that supported his research, as well as that of other Canadian scientists. In 1934, he received a knighthood from King George V, and the following year was made a Fellow of the Royal Society.

In 1930, Banting was appointed the inaugural departmental chair of the Banting and Best Department of Medical Research. There he developed an interest in aviation medicine. With his help, Wilbur R. Franks (1901–1986), his Toronto colleague, developed an aviation “g-suit.” This garment used water-filled bladders to counteract the g-forces that developed during rapid acceleration that pulled blood away from the brain and caused blackouts. Banting was on his way to England to assist Franks in testing the suit for wartime use when his plane crashed in Newfoundland, near the town of Musgrave Harbour. He died February 21, 1941, at the age of 49. The New York Academy of Medicine had awarded Banting honorary Fellowship in 1933; at their May 1941 meeting, the Fellows honored his memory.

The story of insulin is, of course, more complex than this quick sketch affords. Historian Michael Bliss has looked more closely at Banting’s complicated life, and various authors have considered Banting’s long line of predecessors, the tensions among the Toronto team, and how credit was granted—or not—for isolating insulin. What is sure, though, is that this advance improved the lives of millions within a dramatically short span of time—a rare feat in the history of medicine.

Bibliography

Frederick G. Banting, “Facts; Biographical; Nobel Lecture,” The Nobel Prize in Physiology or Medicine 1923, https://www.nobelprize.org/prizes/medicine/1923/banting/facts/, accessed November 30, 2022.

F. G. Banting and C. H. Best, “The Internal Secretion of the Pancreas,” The Journal of Laboratory and Clinical Medicine, 7 (5; February 1922): 256–71.

Michael Bliss, Banting: A Biography (Toronto: University of Toronto Press, 1992).

Michael Bliss, The Discovery of Insulin (Chicago: University of Chicago Press, 1982).

Alberto de Leiva, Eulàlia Brugués, and Alejandra de Leiva-Pérez, “El descubrimiento de la insulina: continúan las controversias después de noventa años/The discovery of insulin: Continued controversies after ninety years,” Endocrinología y Nutrición (English Edition) 58/9 (November 2011): 449–56. DOI: 10.1016/j.endoen.2011.10.001. https://www.elsevier.es/en-revista-endocrinologia-nutricion-english-edition–412-articulo-the-discovery-insulin-continued-controversies-S2173509311000614, accessed November 30, 2022.

“The Discovery and Early Development of Insulin,” The University of Toronto Libraries, March 2003, https://insulin.library.utoronto.ca/, accessed November 30, 2022.

Allison Piazza, “Shoot That Needle Straight (Item of the Month),” Books, Health, and History, November 18, 2016, https://nyamcenterforhistory.org/2016/11/18/shoot-that-needle-straight-item-of-the-month/, accessed November 30, 2022.

“Rockefeller Gives $150,000 for Insulin,” The New York Times, June 20, 1923.

James Ralph Scott, “In Memoriam, Frederick Grant Banting,” Bulletin of the New York Academy of Medicine 17 (5; May 1941): 400–402.; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1933643/?page=1, accessed December 13, 2022.

J. Sjöquist, “Presentation Speech [on the occasion of the award of the Nobel Prize in Physiology or Medicine to Frederick Grant Banting and John James Richard Macleod],” December 10, 1923. The Nobel Prize in Physiology or Medicine 1923, https://www.nobelprize.org/prizes/medicine/1923/ceremony-speech/, accessed November 30, 2022.

Ignazio Vecchio, Cristina Tornali, Nicola Luigi Bragazzi, and Mariano Martini, “The Discovery of Insulin: An Important Milestone in the History of Medicine,” Frontiers in Endocrinology. 9 (23 October 2018): 613. doi: 10.3389/fendo.2018.00613. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6205949/, accessed November 30, 2022.

William Helfand’s Pharmaceutical Trade Cards and the Changing Character of Drug Advertising

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By Joseph Bishop, Princeton University, and the Library’s 2022 Audrey and William H. Helfand Fellow

Mr. Bishop completed his Fellowship residency in summer 2022 and will present his research by Zoom on November 8 at 4:00 (EST). To attend his talk, “Pharmaceutical Visions: How US Drug Companies and Ad Agencies Revamped Their Credibility by Marketing with Scientific Imagery,” register through the Academy’s Events page.

This spring I spent weeks immersed in the vast historical materials available at the New York Academy of Medicine (NYAM) Library. I had the honor of receiving the Audrey and William H. Helfand Fellowship to pursue a project that I believe would have interested Bill Helfand: an examination of the changes in medical advertising at the turn of the twentieth century. During his life, Helfand amassed an extensive collection of fascinating drug and medical memorabilia and visual art. Much of his collection and work illuminates the dynamic between drugmakers and the public during the late nineteenth and early twentieth century.  Significant portions of Helfand’s collection are available at NYAM, and I took advantage of the richly colored and wide-ranging collection of patent medicine trade cards. NYAM also has mountains of pharmaceutical, medical, and allied trade journals and magazines brimming with pharmaceutical advertisements.

At the turn of the twentieth century, the American public saw the rise in large corporate pharmaceutical companies, national and corporate advertising, and federal drug regulation. An important question is what prompted the transformations in medical visual culture that helped to portray drug companies as scientific and research-oriented. To answer that question, I compare late-nineteenth-century patent medicine trade cards with medical ads in Ladies’ Home Journal in the 1920s. This comparison reveals a transition from entertainment and fantasy to a preoccupation with scientific progress and medical authority. My research at NYAM has led me to conclude that drug companies and ad agencies emphasized scientific and medical imagery to revamp their medical credibility and professional image amid national drug regulation and the public’s anger with the industry’s past association with patent medicine.

American patent medicine companies faced scrutiny for producing nostrums with cryptic contents and questionable efficacy during the first decade of the twentieth century. They depended on local advertisement imagery that reflected the nineteenth-century public’s anxieties and aspirations. Popularizations of science were created for various reasons—from entertainment to informing citizens—but they all served to increase scientific and medical awareness within the American public. Philadelphia-based ad agency N. W. Ayer’s accounts show that patent medicine was their most lucrative commodity category, carrying 26 percent of their total revenue in 1878, and their second-most lucrative commodity in 1900, carrying 15 percent. By 1879 in the US, more than 400 religious weeklies each needed a steady flow of advertising revenue to stay in business. Newspapers generated patent medicine business, and medical advertisements sustained newspapers. Nostrum manufacturers developed new marketing techniques, created novel distribution systems, pioneered brand-name products, became an economic link between urban and rural centers, and expanded markets.

Americans living through the last two decades of the nineteenth century saw an explosion of advertising trade cards. Retailers gave away these pocket-sized cards, often stuffed in product packaging as a bonus and easily collectible by customers. Patent medicine companies used these cards extensively, as they proved to be a very successful sales medium. Many people collected cards into albums and created scrapbooks, which children sometimes received as birthday or Christmas gifts.

Image 1:“Ayer’s Ague Cure Is Warranted to Cure All Malarial Disorders”
Dr. J. C. Ayer & Co. (Lowell, MA)
Produced ca. 1875–1895
From the William H. Helfand Collection of
Pharmaceutical Trade Cards at The New York Academy of Medicine
Chromolithograph, 6.1 x 11.6 cm

Trade cards such as Ayer’s Ague Cure (Image 1) evoke an aura of connection with nature and adaptation to the surrounding environment. The image in the bottom right corner depicts an alligator and a couple of frogs discussing Ayer’s Cure as if they used it to protect themselves from malaria. The ad implies that Ayer’s product helps one adapt to one’s environment just as well as the alligators and frogs adapt to theirs.

Image 2: “Cas-car-ria Is Worth Its Weight in Gold”
Product: Cas-car-ria
Produced ca. 1875–1895
From the William H. Helfand Collection of
Pharmaceutical Trade Cards at The New York Academy of Medicine
Chromolithograph, 5.8 x 7.8 cm

On the other hand, Cas-car-ria’s trade card (Image 2) depicts a young girl holding a switch and a dog together, fending off miniature demons labeled with ailments. Cas-car-ria’s ad evokes notions of animal protection and self-protection, implying that when patients take Cas-car-ria, they harness the animal within, unleashing the strength required to fight off external demons.

The explosion of ads promoting proprietary medicines and their incessant hyperbole and mistruths eventually provoked strong public reactions that demanded transparency and regulation. There were always calls to rein in the quackery, but the inundation of promotion drove the regulation of patent medicine to become a public priority.

Image 3: “What is in your medicine cabinet?”
Ladies’ Home Journal, February 1924, p. 144
Manufacturer: E. R. Squibb and Sons
From Ohio State University

Examining Ladies’ Home Journal during the 1920s illustrates these changes in advertising.  At this point, advertisements offered a different portrayal of scientific medicine and appealed to a more docile public regarding medical professionals. A Squibb pharmaceutical ad depicts a well-organized medicine cabinet (Image 3). The caption asks, “What is in your medicine cabinet? Are they products your physician would approve?” This approval seeking from medical authority plays into the new values of placing faith in the trained judgment of scientific and medical authority. 

Image 4: “Zonite: the World War Antiseptic”
Ladies’ Home Journal, March 1924, p. 192
Manufacturer: Zonite
From Ohio State University

Ads for Zonite (Image 4) ran images of scientists wearing lab coats and examining test tubes, drawing a scientific aura into its products. Zonite also associated its product with scientific discoveries, like the Carrel-Dakin fluid (i.e., diluted bleach), a critical antiseptic used in World War I.

Image 5: “Why the familiar cake of Yeast Foam is now eaten as well as used in bread”
Ladies’ Home Journal, May 1921, p. 49
Manufacturer: Northwestern Yeast Co. (Chicago, IL)
From the University of Michigan

The ad for “Yeast Foam” (Image 5) also appeals to scientific and medical authority, depicting a man wearing a medical coat and peering into a microscope. In the foreground are two circular illustrations of microscopic specimens—one containing germs and the other germ-free. The ad portrays a professional man immersed in scientific work, suggesting that the product has been carefully vetted through scientific scrutiny for quality assurance.

Similarly, the Fleischmann advertisement (Image 6) depicts two men in lab coats working at a table equipped with flasks, a beaker, a microscope, and other scientific instruments. The caption below the image states, “Messages of startling importance from the laboratory of the scientist.” Text within the ad notes how Fleischmann’s Yeast cures various diseases. In the case of skin diseases, the ad relies on a general sense of medical authority: “Many physicians and hospitals are prescribing Fleischmann’s Yeast for impurities of the skin. It has yielded remarkable results.”

Image 6: “Ten or fifteen years of life”
Ladies’ Home Journal, September 1921, p. 45
Manufacturer: The Fleischmann Company (New York, NY)
From the University of Michigan

The values of corporate ad agencies following the patent medicine era are not only a reaction to muckraking journalism and reform movements. The use of scientific medical imagery conveying authority and professional judgment was also largely about revamping the medical credibility of US drug companies and corporate ad agencies; they benefited handsomely during the patent medicine era but later needed to diminish their connections to these fraudulent products. Ad agencies traced the American public’s anxieties and aspirations as they shifted from loose whimsy about panaceas in the late nineteenth century to a reverence for qualified scientific and medical experts and institutions at the beginning of the twentieth century. By tracing this transition in medical imagery, we can glean how drug companies and ad agencies shaped products to elevate their professional clout.

Then & Now: The Past and Future of Medical Libraries

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By Paul Theerman, Arlene Shaner, Bert Hansen, and Melissa Grafe

On Tuesday, October 18, three esteemed librarians and historians will gather—virtually—to discuss the history and prospect of medical libraries. The event features the Library’s own Historical Collections Librarian, Arlene Shaner, speaking on the development of our collections; historian of medicine Dr. Bert Hansen, on how libraries helped shape the development of medicine through history; and Dr. Melissa Grafe, head of the Medical Historical Library at Yale School of Medicine, on the future of historical collections such as the Academy Library’s. If you are interested in attending, please register here. To learn about what these speakers will present, keep reading!

Étienne-Louis Boullée’s grand 1785 design for a French National Library.[1]

Arlene Shaner, “‘A Rich Storehouse’: The NYAM Library’s Extraordinary Collections”

Arlene Shaner, our first panelist, will talk about the evolution of the NYAM Library and its collections, starting with Isaac Wood’s gift of his set of Martyn Paine’s Commentaries to the brand-new organization on January 13, 1847. What he and the early Academy Fellows had in mind was a working collection of books and journals that they would create for their own use. Because the Academy had no home of its own, and very little money, the collections grew at a very modest pace for the first few decades.

The purchase of a building in 1875 provided space for the collections to grow. The generosity of Dr. Samuel Smith Purple, who donated over 2000 journal volumes of his own after the Academy moved into its West 31st Street brownstone (at left), coupled with the 1878 decision of the Fellows to open the Library to all who wished to use it, dramatically changed the Library’s trajectory.

The Academy Library at 17 West 43rd Street

It opened the door to what Librarian Janet Doe later referred to as “a snowball of gifts which has rolled down through the years, gathering momentum and throwing off new snowballs that roll into other libraries.”

Shaner will offer a brief overview of some of the major gifts that helped the library become one of the most important history of medicine collections in the country, if not the world, and also tell the much less well known story of how the Library contributed to the growth of many other collections. She will also look briefly at how changes in the way information is disseminated have transformed, and continue to transform, the NYAM Library.

The former Main Reading Room in the  Academy’s current building.
The Rare Book and History Room in the 1930s, now the Drs. Barry and Bobbi Coller Rare Book Reading Room.

Bert Hansen, “The Academy Library’s Contributions to American Medicine.”

Our second panelist, historian Bert Hansen, notes that his earliest memories picture libraries as storehouses of precious treasure, an image reinforced by an architecture that made them look like giant-sized strongboxes or jewelry boxes. Built of large stone blocks and fortified like a castle, libraries he fondly recalls include the main public libraries in Chicago, Newark, and New York City, plus Butler Library at Columbia and the Morgan Library from his college years (as seen below, with NYAM the sixth). The decorated, jewelry-box style often continues inside with marbled lobbies and wood-paneled reading rooms.

But for this presentation, Hansen has gone in a new direction, focusing his attention on the kinds of contribution that libraries like that of NYAM have made to education and the world of learning in serving people who would never enter the building to examine the treasured volumes. In the recent past, virtual use through digitization has become common and will surely expand in the future. But his look at the prior century and a half will highlight other, sometimes-forgotten modes of service as examples of NYAM’s—and other research libraries’—many contributions to American medicine.

Melissa Grafe, “Preservation, Access, and the Future”

Our final panelist, librarian and historian Melissa Grafe, glimpses into the future of medical libraries and the role of physical collections in an increasingly online world. Grafe looks at the ways that technology has become deeply integrated in both medicine and in the libraries that support the medical community. Grafe will connect these modern currents to the rich trove of materials that NYAM assembled over 175 years, and the larger history that has made NYAM’s library one of the major collections connecting medical history to the present.

References

[1]Nancy Spiegel, the University of Chicago Library’s bibliographer for art and cinema, writes:

In the late 18th century, a new vision of the library arose within the context of expanding literacy, and the increased publication of books and journals for the general reading public. Enlightenment architect Étienne-Louis Boullée (1728–1799) envisioned a grand design in his proposal for a French National Library in 1785. In Boullée’s presentation, the state would take responsibility for the collection, ordering, and dissemination of all available information to its citizens.

The design for the main reading room featured a vast, barrel-vaulted ceiling and a modern shelving arrangement: stacked galleries of books over flat wall-cases. These seemingly endless bookcases were open and easily browsable, in dramatic contrast to the earlier medieval system of chaining that bound both books, and readers, to a specific location. Visitors are free to wander about and converse in small groups, but there is no provision of study desks or chairs for extensive research in this idealized environment.

Nancy Spiegel, “The Enlightenment and grand library design,” The University of Chicago Library News, April 26, 2011: https://www.lib.uchicago.edu/about/news/the-enlightenment-and-grand-library-design/, accessed October 7, 2022. The image is from Étienne-Louis Boullée, Mémoire sur les moyens de procurer à la bibliothèque du Roi les avantages que ce monument exige, 1785.