The Marrow of Tragedy: Disease and Diversity in Civil War Medicine

Today’s guest post is written by Dr. Margaret Humphreys, Josiah Charles Trent Professor in the History of Medicine at Duke University. She is the author of Yellow Fever and the South (Rutgers, 1992) and Malaria: Poverty, Race and Public Health in the United States (Johns Hopkins, 2001), Intensely Human: The Health of the Black Soldier in American Civil War (2008) and Marrow of Tragedy: The Health Crisis of the American Civil War (2013). On Tuesday, February 21 at 6pm, Humphreys will give The John K. Lattimer Lecture: “The Marrow of Tragedy: Disease and Diversity in Civil War Medicine.” To read more about this lecture and to register, go HERE.

In a memorable scene from the movie Gone with the Wind, Southern belle, Scarlett O’Hara, picks her way through the battle-wounded men lying on the ground near the train station in Atlanta, frantically seeking Dr. Meade to help her with her sister-in-law Melanie’s imminent delivery.  Meade brushes her off and turns to a screaming soldier, telling him that his leg would have to come off, and without anesthesia.  The man’s screams echo as Scarlett heads back to Melanie’s bedside.  This cinematic portrayal of Civil War medicine reflects a wide belief that there was no anesthesia at that time.  Indeed, it was said that the war occurred “at the end of the medical middle ages.”  (This quotation is widely attributed to Union Surgeon General William Hammond, but without citation).

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Scene from Gone with the Wind (1939).

In my book, Marrow of Tragedy: The Health Crisis of the American Civil War, I begin from a different perspective, recognizing that there was such a thing as “good medicine” and “bad medicine” during the War.  Medical care could be effective, and it could make a difference in disease and injury outcomes.  For example, chloroform and ether anesthesia meant most surgery occurred with the patient unconscious (although Confederate surgeons did run out of these supplies in desperate circumstances, such as the siege of Atlanta near the end of the war).

Alarming as the notion of amputation completely without anesthesia, are the revealing mortality rates from disease at this point in the war. Put simply, for every one white Union soldier who died of disease during the War, a little over two black Union soldiers died, and almost three Confederates succumbed.[i]

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Image source: Getty Images.

How can we account for these differences?  A major factor was the quality and quantity of food, a core ingredient of the modern concept of “social determinants of health.”  White Union troops also received better hospital care, calling on part of the strong social networks of the folks back home and their political impact.  The Union hospital system was much better funded, with full access to important medicines, such as quinine, opiates, and anesthetics; and the technology of cleanliness, which included clothing, soap, and disinfectants.  Nursing care was key, as well, with northern hospitals staffed by volunteer nurses, while those in the south were often civilians or slaves challenged by lack of formal training as well as lack of resources.

To learn more about Civil War medicine, join us on Tuesday, February 21 at 6pm. Register HERE.

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Image source: Harper’s Weekly, April 9, 1864.

 

Note:

[i] Actual numbers, per 1000, were 63, 143, and 167, respectively.

Celebrate Valentine’s Day with 19th-century Medical Trade Cards

By Becky Filner, Head of Cataloging

During the last two decades of the 19th century, the United States witnessed an explosion of mass-market advertising in the form of trade cards. A combination of factors contributed. Lithography, first invented in the late 1700s, made it practical to print large runs of images relatively inexpensively. Heavy paper became less expensive because it was being made from bleached wood pulp instead of cloth. The invention of the camera supplied endless images for reproduction. Advances in high-speed steam presses made it practical to mass produce trade cards, and new modes of transportation made it possible to distribute them throughout the country.[1]

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This medical trade card for Pond’s Bitters (“cures constipation, headache, indigestion, biliousness, malaria, dyspepsia”) encourages the couple depicted to focus on each other and “let the dog have the lunch!”[2]

The cards pictured here are all from an extraordinary new collection. Late last year, the Academy library received The Bingham Patent Medicine Collection as a bequest. This rich collection – a complement to our William Helfand Collection of trade cards – contains approximately 4,900 trade cards produced by pharmaceutical manufacturers in the 19th century.

These cards advertising “El Tricofero de Barry” and “Pildoritas de Reuter” were printed in New York by Barclay & Co., but the text is in Spanish. Click to enlarge.

The late Walker Bingham was a completist, and his carefully assembled collection reflects years of assiduous collecting and research. An announcement will be made when the collection is available to the public. Meanwhile, have a look at Bingham’s book, The Snake-Oil Syndrome: Patent Medicine Advertising, for more of his cards and an excellent overview of pharmaceutical advertising. Here he writes of patent medicine:

It is probable that most of the nineteenth century patent medicines had no effect at all on the diseases that they were sold to cure. They were not even palliatives. Some sufferers may have been misled into taking patent medicines instead of more effective (and possibly more expensive) drugs prescribed by a doctor, but generally speaking, at that stage of medical learning there was often little that any doctor could do for a patient with a serious disease except give emotional support.[3]

The medicines that did have more than a placebo effect often relied on ingredients like morphine, cocaine, heroin, opium, chloroform, and alcohol. These drugs were especially dangerous when given to children or self-administered in large doses. The patent medicine business was booming in the late 19th century, and it relied heavily on advertising to attract customers since the medicines were ineffectual at best. In addition to trade cards, patent medicine companies produced millions of newspaper ads, almanacs, show cards, and other mailing pieces.

Most trade cards were designed to appeal to women and children, with sentimental images of animals, flowers, babies, families, and scenery.[4] The Valentine’s Day images below fall into this category, with roses, doves, and cherubs promoting Brown’s Iron Bitters (“Cures Malaria, Dyspepsia, Weakness, &c.”), Burdock Blood Bitters (“It makes pure, healthy blood, and regulates all the organs to a proper action, cures constipation, liver and kidney complaint, female weakness, nervous and general debility, and all the distressing miseries from which two-thirds of the women in American are suffering”), Boschee’s German Syrup (“No person suffering with consumption, coughs, colds, croup, bronchitis, asthma, or any disease of the throat, lungs or chest can take it without getting immediate relief”), and Wilson’s Popular Corn Salve (we are not told what this product does, but “every box [is] guaranteed or money refunded.”)

Most trade cards were designed to appeal to women and children, with sentimental images of animals, flowers, babies, families, and scenery. Click to enlarge.

Sentimental images of couples also sell products, including a trio of kissing couples selling Smith’s Bile Beans (they “cure biliousness”), two different images of couples with umbrellas, one selling Dr. P.O. Baldo’s Blood and Liver Pills and the other selling Wilbor’s Compound of Cod Liver Oil and Phosphates, and a trade card that recommends buying a bottle of Race’s Indian Blood Renovator for your new wife “to prove to her [your] fervent love.”

Sentimental images of couples also sell products. Click to enlarge.

Other more satiric and risqué trade cards are clearly aimed at an adult audience. The card below, “The Five Senses,” is one of the racier examples in the Library’s trade card collection. The back advertises Lash’s Kidney & Liver Bitters, described as “a mild cathartic and sure cure for constipation, indigestion, biliousness, dyspepsia, malaria, chills and fever, nervous or sick headache.” The front of the card shows a series of five images of a woman “seeing” a man, “hearing” him approaching, “smelling” a flower he has given her, and sitting in his lap while he is “feeling” her bottom. The final image, “Tasting,” shows the edge of a bed and the woman’s dress, undergarments, and stockings thrown across a chair. Apparently taking Lash’s Kidney & Liver Bitters will ensure a happy Valentine’s Day!

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“The Five Senses” (above) is one of the racier examples in the Library’s trade card collection.

References:

[1] Summarized from A. Walker Bingham’s account of trade cards in The Snake-Oil Syndrome: Patent Medicine Advertising (Hanover, Massachusetts: The Christopher Publishing House, 1994), p. 117-119.
[2] All trade cards in this post are from The Bingham Patent Medicine Collection in the Library of the New York Academy of Medicine.
[3] Bingham, p. 7.
[4] According to Bingham, mothers used to paste trade cards into albums as birthday or Christmas presents for their children (p. 117.)

Hebra’s Atlas of Skin Diseases, and #ColorOurCollections: Day 3

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It’s the third day of #ColorOurCollections, a week-long special collections coloring fest organized on social media. Every day on our blog, we will feature #ColorOurCollections coloring sheets from our library, along with content from participants worldwide.

Today’s Academy coloring sheets come from the works of Ferdinand von Hebra  (1816- 1880), a significant figure in the influential Vienna school of dermatology. Dermatology emerged as a clinical specialty in the early to mid-19th century, and in 1849, Hebra was appointed the first German language professor in the subject, at Vienna General Hospital.[i]

Hebra’s Atlas of Skin Diseases (1856 – 76) was a monumental work printed in 10 installments, with mostly life-sized illustrations, using the new technique of chromolithography, which allowed the artist to draw directly onto the lithographic stone and print in color. The illustrations were created by two Viennese painter physicians, Anton Elfinger and Carl Heitzmann. Each issue of the Atlas was dedicated to a group of disorders which affected the skin.

The “tattooed man” is an unusual addition to the Atlas, being presented as of cultural rather than the clinical interest. Unusually, the tattooed man is also identified by name, as Georg Constantin, a circus performer from Albania. Constantin was a well-known circus performer, who traveled extensively in Europe and North America. He spent time with Barnum’s Circus as “Prince Constantine,” where he also sold pamphlets describing his tattoos (which are variously described as Chinese and Burmese in origin).[ii] Constantin’s body was covered with 388 tattoos of animals and symbols in red and blue. As was Hebra’s habit, Constantin was depicted twice in the Atlas, once in full color and once as the outline drawing presented here.[iii]

Itching to color the tattooed man? Some of these intricate patterns from participating institutions may also be your groove.

From University of North Carolina at Chapel Hill’s Health Science Library: Adam Lonicer, Naturalis historiae opus novum (1551).
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From Amguedddfa Cymru – National Museum Wales: Benjamin Wilkes, Twelve new designs of English Butterflies (1742).

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We’re also loving Muhlenberg College Trexler Library‘s maps coloring book.  Check out this detailed world map of Johann Baptist Hormann’s Planiglobii terrestris cum utroq hemisphærio cælesti generalis repræsentatio (1720).muhlenbergcollege_colorourcollections_maps

References:

[i] Holubar, K. (1981), Ferdinand von Hebra 1816–1880: On the Occasion of the Centenary of His Death. International Journal of Dermatology, 20: 291–295. doi:10.1111/j.1365-4362.1981.tb04341.x

[ii] Margo DeMello, Bodies of Inscription: A Cultural History of the Modern Tattoo Community (Duke University press, 2000), p56. DeMello states that Constantin sold pamphlets describing the “Chinese cannibal natives” who had forced his tattooing on him. In Hebra’s Atlas the tattoos are identified as being Burmese. There is also a suggestion that Constantin had himself tattooed with an eye to displaying himself as a circus attraction.

[iii] Mechthild Fend, “Skin portraiture ‘painted from nature’: Ferdinand Hebra’s Atlas of Skin Diseases (1856-76)”, in Hidden Treasure, Michael Sappol (ed), New York: Blast Books, 2012, pp. 122-26.

Winter/Spring 2017 Catalog: Events with a Unique Perspective

library-programming-winter-spring-2017-thumbWelcome to The New York Academy of Medicine Library’s Winter/Spring 2017 cultural programming.  Today we launch a new season of events with a unique perspective on the history and culture of medicine and health, and what they mean for the future.

The upcoming season includes talks by prominent authors, historians and artists. Highlights include science writer Harriet Washington on the role of microbes in mental health (March 15), historian Lisa Rosner on the controversial history of vaccine advocacy starting in the 1700s (April 6), food journalist Sarah Lohman on garlic’s journey from a tuberculosis remedy to a food seasoning (June 5), and science writer Mary Roach on her new book GRUNT: The Curious Science of Humans at War (June 12).

Legacies of War: Medical Innovations and Impacts,” our special 2017 event series commemorating the 100th anniversary of the American entry into WWI, will explore how the experience of war has prompted medical innovation, including surgical techniques, prosthetics, ambulances, and trauma care. Speakers will also address the impact of conflict on the minds and bodies of soldiers and civilian populations, past and present. This series commences On February 21, with Prof. Margaret Humphreys (Duke University) speaking on “The Marrow of Tragedy: Disease and Diversity in Civil War Medicine.”

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To ensure the sustainability of our programs, we have added a nominal fee for our events. A number of events throughout the year remain free due to the generosity of our sponsors. Discounts continue to be available to our valued Friends of the Rare Book Room and Academy Fellows and Members, and we welcome students to attend for free.

Download the Winter/Spring 2017 programming catalog for more details. To register, click the names of events in the catalog, or visit www.NYAM.org/events.

We look forward to seeing you throughout the year.

Image sources:

Event Announcement: The Roles of Physicians in 19th Century Polar Exploration

Our Friends of the Rare Book Room have traveled from Louis XIV’s Paris to early twentieth century Ellis Island.  On Wednesday, February 1, we invite you to join us for the Arctic.  In this special Friends event, Dr. Douglas Kondziolka will discuss his collection of Arctic and Antarctic polar exploration books, maps, and letters from the era of the late eighteenth century through the early twentieth century. Dr. Kondziolka is a member of the neurosurgery faculty at New York University as Professor and Vice-Chair for Clinical Research.

Dr. Kondziolka’s focus on the Arctic was stimulated first by his Canadian father’s tenure with the US Air Force at their Canadian base in the Arctic in the 1950s, and later by the popular historian Pierre Berton and his book “The Arctic Grail.” Dr. Kondziolka’s collection, which began in 1994, was fostered by several trips to the arctic to visit important exploration sites. The collection documents the important steps in Arctic discovery, both for a Northwest Passage to Asia, and to the North Pole itself.

Dr. Kondziolka’s collection tells the story of a cast of unique characters, and among them many physicians, who dared to venture into lands unknown.  A few of these individuals are highlighted below:

Alexander Mackenzie
Alexander Mackenzie was the first European to travel overland to the Pacific Ocean, proving that there was no way to get there entirely by water.  His publication was received by Thomas Jefferson, who spurred him to send Lewis and Clark to “solve the American West.”

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Elisha Kent Kane
A few decades later, the Americans joined in the search for the North Pole. A bored physician, Elisha Kent Kane, was the first successful American polar explorer. His book became the #2 best seller during the Civil War, just behind The Bible.

Charles Francis Hall
Spurred by Kane’s adventures, a Cincinnati newspaperman, Charles Francis Hall, ventured up to the Arctic.  He was the first to go native, and brought Inuit back to New York to rave reviews. On his last voyage, despite being able to reach far up the coast of Greenland, his men mutinied and poisoned him, preferring to make their way back home.

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We hope you will join us on February 1 for this special event. Click here to register.

Friends of the Rare Book Room are invited to come at 6:00pm to look at selected books with the speaker in the Drs. Barry and Bobbi Coller Rare Book Reading Room prior to the talk. This event is part of our series for Friends. To join the Friends please click here.

Item of the Month: John E. Stillwell’s Prize Notebook

By Becky Filner, Head of Cataloging

In the 19th and early 20th centuries, medical schools offered academic prizes, frequently accompanied by a monetary award, for the best essays, examinations, and student notebooks.[1] The New York Academy of Medicine’s Library holds several examples of prize-winning student medical notebooks, including John E. Stillwell’s Report of Prof. Thomas’ Gynecological Clinics, Session of ’73 and ’74. This notebook is an ornate presentation copy, not the rough notes Stillwell would have taken during the clinics. Written in a neat, legible hand, it also includes a calligraphic title page and twenty-nine watercolor illustrations. The notebook is bound in full leather with blind-stamped fleurs-de-lis and shamrocks on the cover and spine. The notes are from a series of clinics offered during the 1873-1874 school year by Theodore Gaillard Thomas, a professor of gynecology at New York’s College of Physicians and Surgeons and author of A Practical Treatise on the Diseases of Women.

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Calligraphic title page of John E. Stillwell’s Report of Prof. Thomas’ Gynecological Clinics: autograph manuscript, 1873-1874.

Stillwell’s notes, like Thomas’s lectures, are organized into a series of case studies. In the case study shown below, a woman named Annie Coyle reports that “her friends noticed her abdomen increasing in size” and her “menses … are ‘larger’ and … come twice as often as they ought.” When she had an examination at the dispensary, the examiner “pronounced her pregnant”; she came to Dr. Thomas for an examination because she was “unwilling to rest under such unjust suspicions.”

Stillwell’s carefully transcribed lecture notes and a watercolor showing a woman with an ovarian tumor, from Stillwell’s autograph manuscript, Report of Prof. Thomas’ Gynecological Clinics, 1873-1874.

Dr. Thomas notes that he found an abdominal tumor and gives details on how he determined that it is a “fluid tumor” rather than one “that is filled with air or that is solid.” He rules out pregnancy because he cannot feel any movement when he places his hands on her abdomen and her mammary glands are not enlarged. His conclusion is that she has an ovarian cyst and requires an ovariotomy to remove it. Stillwell’s account of the clinic is accompanied by a watercolor of a female figure with an enlarged abdomen labeled, “Ovarian Tumor.” Other clinics in the notebook cover problems of the uterus and cervix, tumors, peritonitis, fibroids, complications during and after pregnancy, menopause, dementia, and sterility. There is even an account (with an illustration) of a woman who has two vaginas.

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Watercolor by John E. Stillwell of a retroflexed uterus, from his Report of Prof. Thomas’ Gynecological Clinics, 1873-1874.

Student medical notebooks were usually submitted anonymously to ensure that the judging would not be biased. In this case, we know that Stillwell submitted this prize-winning notebook (even though the notebook does not contain his name) because the Library acquired the notebook along with the prize itself, a wooden case of gynecological instruments with a plaque that reads, “A Prize Awarded for the best Gynecological Report of 1874 in the College of Physicians and Surgeons N.Y. by Prof. T. Gaillard Thomas to J.E. Stillwell.”[2]

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A plaque on the wooden case indicates that Stillwell received this prize from Prof. Thomas for the “best Gynecological Report of 1874 in the College of Physicians and Surgeons.”

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Stillwell’s prize consisted of a full set of gynecological instruments stored in a sturdy wooden box lined with purple velvet. The instruments were made by G. Tiemann & Co., Manufacturers of Surgical Instruments, 67 Chatham St., N.Y.

The tools include all the necessary implements for a gynecology practice in the 1870s. Thomas describes many of the tools in his A Practical Treatise on the Diseases of Women (which was a required textbooks for medical students at the College of Physicians and Surgeons around this time). Shown below are drawings of several of the tools, including “Buttles’ spear-pointed scarificator,” a “hard rubber cylinder for dry-cupping the cervix uteri,” cauterizing irons, and tools for sutures, and descriptions of how they were used.[3]

Taken from T. Gaillard Thomas’s A Practical Treatise on the Diseases of Women, 2nd ed., these drawings show obstetrical tools and give brief descriptions of how they were used.

Taken together, John E. Stillwell’s prize notebook and the handsome case of obstetrical tools that he won for his efforts provide an interesting window into both 19th-century medical school competitions and 19th-century obstetrics and gynecology.

References

[1] Contemporary handbooks from medical schools list the types of prizes awarded and the prize money attached to them. See, for example, the section on “Prizes” under “School of Medicine” in Columbia College’s Handbook of Information as to the Several Schools and Courses of Instruction 1886-1887, p. 222-225.

[2] An account of the commencement exercises of the College of Physicians and Surgeons in The Medical Record confirms Stillwell’s receipt of the Thomas prize. “The Thomas prize was awarded to J.E. Stillwell, for a report on ‘Cliniques for Diseases of Women’” (The Medical Record, ed. George F. Shrady, New York: W.M. Wood & Co., v. 9, issue of March 16, 1874, p. 158).

[3] Thomas, Theodore Gaillard.  A Practical Treatise on the Diseases of Women, 2nd ed. (Philadelphia: Henry C. Lea, 1869).

12 Gifts for the Medical History Buff in Your Life

By Emily Miranker, Project Coordinator

Search no further for one-of-a-kind gifts for the medical history buff in your life: the Library’s online shop has you covered with over 3,000 products to choose among. Find a few of our favorites below. And take an extra 15% off as our holiday gift to you: use code ZAZZLETHANKS at check out.

  1. This sturdy tote bag with a vintage advertisement for Tolu’s Rock and Rye cough tonic – good for what ails you. And groceries.

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  1. Our skeletal musicians give a whole new meaning to death metal. They might be from 1779; but our headphones are totally 21st century with a 20hz – 20,000hz range, built-in answer button and microphone to seamlessly take calls, and vegan leather padding.

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  1. This cheery orange fruits and leaves lunchbox includes a large sandwich container, two small containers and an ice pack. Dishwasher safe and BPA-free. Mangia!

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  1. Speaking of eating, food goes great with wine. These wine charms featuring skulls by 16th century Flemish anatomist Andreas Vesalius go great with glasses of wine.

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  1. Since red wine is good for your heart, admire this panel of an exquisite engraving of an anatomical heart by Scottish surgeon Charles Bell on your wall while you sip.

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  1. Keep your life in order with this desk organizer, the illustration of one of several poems gathered by Hugo Erichsen to “amuse the busy doctor in leisure hours.”

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  1. This flask is from a New York-based surgical supply company’s turn of the century catalogue. Chemistry-lovers, you’re welcome.

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  1. Never be too far away from a good book with this rather cellular-looking red marbled book endpaper wallet.

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  1. Take ‘digital’ back to its roots of actual fingers with this artificial hand by French surgeon Ambroise Paré on your laptop case.

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  1. Just in case you feel naked without your actual stethoscope around your neck: this tie.

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  1. Once upon a time, your garden was your pharmacy. Peonies were used to treat spasms and cramps, gout, headaches, and fatigue. Caffeine is more popular for fatigue now…

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  1. Baby, it’s cold outside! Magnify your warmth by snuggling up with these microscopes.

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Lastly, for the person who really and truly has everything already—or more likely just has no space—give the gift of membership to our Friends of the Rare Book Room, the people and programs that explore and support the books where all these remarkable images come from. All proceeds from the shop support the library’s collections’ preservation and public programming, and all Friends memberships are tax-deductible. Happy Holidays!

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Found in the Eyes of Rams: The Bezoar and its Powers

By Emily Miranker, Project Coordinator

This post title is not strictly true. Or remotely true, actually. Bezoars are not found in rams’ eyes (to the relief of sheep everywhere, I’m sure). Maimonides, the 12th century Sephardic Jewish philosopher, reported an Eastern belief that bezoars could be found “in the eyes of rams,” though he then went on to note that “it is found in their [rams] gallbladder and this is true.”[i] Bezoars are in fact found in goats’ stomachs and gastrointestinal tracts, as well as that of other animals such as sheep, cows and us humans.

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Our library’s trichobezoar, ca.1862. Basically the coolest hairball you’ll ever see.

A bezoar is a mass of undigested or inedible material found in the GI tract. Today, they are typically grouped into four categories: phytobezoars (made of vegetable or fruit fibers), lactobezoars (made of milk proteins), trichobezoars (made of hair and food particles) and pharmacobezoars (aggregates of various medications).[ii] Nowadays, if a bezoar doesn’t pass through the digestive system on its own they can be treated through medication to dissolve the mass, lavage therapy, and even surgery.

Once upon a time you may have wanted one in your system. I referenced this in Poisons, Pirates, and Professors in September for National Talk Like a Pirate Day. If you had been poisoned by an attacking pirate, you’d want to swallow a bezoar to cure yourself. Pierre Pomet, 17th century French druggist, wrote of bezoars curing all manner of things from smallpox to epilepsy, ending with its ability to work as an antidote to poison.[iii]

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The word bezoar comes from the Arabic bazahr or badzehr, meaning counterpoison[iv] and it is also mentioned in ancient Hebrew texts as bel zaard, “master” or “master of poison.”[v] Its power to counteract poison may come from a near eastern goat, the markhor. In Persian, mar is snake and khor means to eat. Snake-eater. So presumably immune to venom. Except that the markhor is an herbivore dining upon grasses and leaves. Misnomer alert! The name may have to do with their corkscrew-like horns (reminiscent of a winding snake) or that they are known to kill snakes on occasion.[vi]

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This handsome markhor is clearly eating carrots or yam, not a snake.  Source: A. Savin, A Markhor in Berlin Tierpark, Wikimedia Commons.

Whatever the origins of the belief in curing poison, bezoars were popular in the Middle Ages and into the 17th century as antidotes. They were carried as charms, included as decor or attached to drinking and eating vessels to protect the diner, and tests were even designed to detect fakes –the selling of which was a punishable offense.[vii]

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Another Frenchman represented in our collections’ holdings, barber surgeon Ambroise Paré, conducted an experiment to test the healing properties of a bezoar stone in the 1500s.[viii] A royal cook caught stealing silver had been sentenced to death. The cook was offered the alternative of being poisoned and then being given a bezoar under Paré’s supervision. If the cook survived the poisoning, he’d be spared. The cook lived only seven hours after the poison was administered, and Paré concluded the bezoar could not cure all poisons.

Still, the bezoar as antidote and mythical token lives on in the popular imagination. In J.K. Rowling’s Harry Potter stories, Professor Snape quizzes Harry on where he’d find a bezoar in his first potions class and later when his friend Ron Weasley is poisoned with mead –intended for Professor Dumbledore- Harry quickly shoves a bezoar down Ron’s throat.

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Box of bezoars and Half Blood Prince movie still.  Source.

Join us for a free First Mondays lunchtime tour in our Drs. Barry and Bobbi Rare Book Reading Room for a chance to see our bezoar in person. It’s well worth a visit even if poison and goat guts aren’t high on your to-do list; the Rare Book Room is pretty much the real life Hogwarts.

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References:
[i] Rosner, F. (trans.) 1988. Maimonides’ Medical Writings, Treatises on Poisons, Hemorrhoids, Cohabitation. The Maimonides Research Institute, Haifa, 1988, 49-50.
[ii] Eng, Katharine and Marsha Kay. “Gastrointestinal Bezoars: History and Current Treatment Paradigms,” Gastroenterology & Hepatology. Vol. 8, Issue 11, November 2012. 776.
[iii] Pomet, Pierre. A compleat History of drugs. Bonwick, London. 1725.
[iv] Williams, Randolph S. “The fascinating history of bezoars,” The Medical Journal of Australia. Vol. 145. December 1986. 613.
[v] Barroso, Maria Do Sameiro. “The bezoar stone: a princely antidote,” Acta Med Hist Adriat. 2014;12(1):78.
[vi] “Capra falconeri – Markhor.”Brent Huffman. An Ultimate Ungulate Fact Sheet. Accessed November 11, 2016.
[vii] Williams. 613.
[viii] Thompson, C. J. S. (1924) Poison Mysteries in History, Romance and Crime J.B. Lippincott, New York, 61-62.

Shoot That Needle Straight (Item of the Month)

By Allison Piazza, Reference Services and Outreach Librarian

November is National Diabetes Month.  As one would assume, the New York Academy of Medicine Library has a large collection of books about the disease.  As I perused the stacks, however, one title jumped out.

Shoot that Needle Straight by Robert Rantoul was published in 1947, and tells the story of Richard “Dick” Hubbard. The book opens with Dick ill, and home from boarding school.  His symptoms are numerous and puzzling, including dry tongue, a constant craving for sweets, headaches, weakness, and a drastic increase in height.  It’s not long before Dick is told he has Diabetes Mellitus, a diagnosis that elicits a “What the hell is that?” from Dick.

rantoul_shootthatneedlestraight_watermarkWhat follows is an engaging, often-times laugh-out-loud narrative of Dick’s new life with diabetes.  Accompanying each chapter are charming illustrations by W. Joseph Carr.

After he is diagnosed, Dick and his mother travel to Boston, where he will have a two-week stay at a “diabetic home” known as the Carver Home, and see a diabetes specialist by the name of Dr. Anderson.  At the Carver Home, Dick learns about diabetes and how he must control it through a home routine of proper diet and exercise.  He also learns how to give himself insulin injections from his nurse, Miss Carver:

“Disinfect before you begin.
Press the needle firmly in.
Squeeze the plunger way down far.
Withdraw the needle and there you are.”

Dick’s new life as a diabetic is not without its hiccups.  In one chapter, he goes to see a physician who claims he can cure diabetes, which he explains is the result of “a nervous condition brought on by destructive and fearful thinking processes, as a result of strain, over-worry or disasters.”  Of course, the hope for a cure is too good to be true.  The doctor in question turns out to be the head of an international narcotic ring, wanted in Argentina, Mexico and California for peddling an “iron tonic” full of morphine to unsuspecting diabetes patients.

rantoul_shootthatneedlestraight5_watermarkIn another chapter, Dick agrees to be a diabetes research participant at a lab.  In a passage that would make any 21st century Institutional Review Board member cringe, the doctor explains to Dick what it means to be a “guinea-pig”:

“For this period you must be willing to do anything we ask, regardless of your feelings…. At certain times our requests will be difficult and will, no doubt, upset you emotionally, but you must realize the emotions cannot stand in the way of medical science, and content yourself with the thought that we look upon you as a medical specimen rather than a human being.”

rantoul_shootthatneedlestraight6_watermarkAnother highlight of the book is Dick’s (somewhat inexplicable) trip to Munich, Germany with his mother during Adolf Hitler’s reign.  During the trip, Dick is hospitalized with painful sores.  The situation is, understandably, quiet stressful for Dick, but he takes it in stride:

“Nazis. Heil Hitler! The Third Reich! You read ominous stories about them, you shuddered at what people said they intended to do to America and the world, but never in your wildest dreams did you imagine yourself sick and alone among more than one thousand of them in their homeland.  What a story to take home!”

These are just some of the situations Dick encounters as a diabetic.  While highly comical, the book is also meant to educate and inform the diabetic patient.  The American Journal of Digestive Diseases reviewed the book favorably in 1948, saying:

“This is a book that might safely be presented by a physician to a diabetic patient or by anyone to a friend suffering from the disease.  …  The general dietary regimen and the insulin therapy are described in exemplary fashion.”[1]

Another review in Science Education also speaks highly of the book, which they mention “has been checked for accuracy by eminent doctors.”[2]

While Shoot that Needle Straight may no longer be medically (or politically) correct, it is one of the gems of our collection.

References

[1] The American Journal of Digestive Diseases 1948 15(3):103.

[2] Science Education 1950, 34(4): 274-275.

Blood Transfusion: 350 Years

By Paul Theerman, Associate Director

Three hundred and fifty years ago, on December 17, 1666, the Philosophical Transactions published the first account of blood transfusion, in the form of a letter from physician Richard Lower to chemist Robert Boyle.1 Lower’s experiments transfused blood from one dog to another. The article provided his methods, specifying where the arteries and veins were to be cut, how the quill was to be inserted that formed the blood’s conduit between animals, and many other details of the operation.

richard-lower-portrait

Richard Lower (1631-1691), anatomist. Oil painting by Jacob Huysmans. Source: Iconographic Collections, Wellcome Library, London, accessed through Wellcome Images.

In addition to reporting on dog-to-dog transfusions, Lower also mentioned experiments between sheep, and interspecies transfusion between dogs and sheep, alternating donor (“emitter”) and recipient. In this first communication on the subject, Lower also laid out a broad experimental program:

’Tis intended, that these tryals shall be prosecuted to the utmost variety the subject shall beare: As by exchanging the bloud of Old and Young, Sick and Healthy, Hot and Cold, Fierce and Fearful, Lame [i.e., Tame] and Wild Animals, &c. and that not only of the same, but also of differing kinds.

The 1660s were the first heady days of the new Royal Society, whose motto, Nullius in verba (“nothing through words”), was the hallmark of the new “experimental philosophy.” And so these experiments have a bit of the quality of “ringing the changes”: try all kinds of animals, in all kinds of conditions, and see what happens!

Underlying the work, though, was the stronger sense of “blood as medicine.” Seventeenth-century physicians were well aware that too little blood led to death. But more, there was a general notion that blood and health were linked, a notion that came straight out of the humoral tradition. Sanguineous dispositions were healthy ones, in distinction to the melancholic ones that too much black bile created. A balance of humors, of course, was the best, but ruddy blood had an implicit edge.

In the same letter, then, Lower made these observations:

It seems not irrational to guess afore-hand, that the exchange of bloud will not alter the nature or disposition of the Animals, upon which it shall be practiced . . . . The most probable use of this Experiment may be conjectured to be, that one Animal may live with the bloud of another; and consequently that those animals that want bloud, or have corrupt bloud, may be supplied from other with a sufficient quantity, and of such as is good . . . .

Blood transfusion could serve as a type of reverse blood-letting; for those patients with too little blood, more could be supplied, and especially “good” blood rather than “corrupt.” Animals would serve as the blood source without fear that people would take on animal natures.

Human experimentation followed quickly. Similar experiments had been going on in France, and in June 1667, physician Jean-Baptiste Denis undertook the first transfusions into a human. His account, translated and published in the Philosophical Transactions, was called “Touching a Late Cure of an Inveterate Phrensy, by the Transfusion of Blood.”2 Calves’ blood served to restore to his right mind a man under the influence of a “phrensy.” In this case, the animal was chosen for “its mildness and freshness,” in order to temper the blood of the unfortunate—a different understanding from the English!

major_watermark

This image relates more to infusion than to transfusion, that is, placing medicines directly into the body through the bloodstream. The technique lent itself to infusions of blood itself. Source: Johann Daniel Major, Chirurgia infusoria, placidis cl. virorum dubiis impugnata, cum modesta, ad eadem, responsione (Kiloni [Kiel]: Sumptibus Joh. Lüderwald, imprimeb. Joach. Reumannus, 1667), p. 2

On November 23 of that same year, Lower and his colleague, physician Edmund King, transfused sheep’s blood into a Mr. Arthur Coga, also of unsound mind. The transfusion seemed to have a good effect:

The Man after this operation, as well as in it, found himself very well, and hath given in his own Narrative under his own hand, enlarging more upon the benefit, he thinks, he hath received by it, than we think fit to own as yet.3

purmann_watermark

An image attributed as Lower and King’s 1667 transfusion of Arthur Coga. Source: Matthias Goffried Purmann, Grosser und gantz neugewundener Lorbeer-Krantz, oder Wund Artzney (Frankfort; Leipzig: Widow & heirs of M. Rohrlach, Leignitz, 1705), opposite page 292 of part 3.

But transfusion as a therapy soon petered out. One case in France died. Though Coga survived, he did not fully recover, and he was soon drinking up the 20 shilling fee he received for undertaking the procedure. Blood transfusion was mocked and abandoned in England, and outlawed in France.4

Blood transfusion only revived in the middle of the 19th century, chiefly as a way of restoring blood volume. With the investigation of blood types before World War I, and Rhesus factors before World War II, transfusion became mobilized for war with the establishment of blood banks. In the last half of the 20th century, transfusion from banked blood became standard medical practice in surgeries of all kinds, and (using blood products) for hemophilia.

Suggested Reading:

  1. Holly Tucker, Blood Work: A Tale of Murder and Medicine in the Scientific Revolution (New York: W.W. Norton and Company, 2011).
  2. Anita Guerrini, Experimenting with Animals and Humans: From Galen to Animal Rights (Baltimore: the Johns Hopkins University Press, 2003.)

References

  1. “The Method Observed in Transfusing the Bloud out of One Animal into Another,” Phil. Trans. 1665-1666 1, 353-358. Accessed November 7, 2016.
  2. “An Extract of a Letter, Written by J. Denis, Doctor of Physick and Professor of Philosophy and Mathematics at Paris, Touching a Late Cure of an Inveterate Phrensy by the Transfusion of Blood,” Phil. Trans. 1666-1667 2, 617-623. Accessed November 7, 2016.
  3. “An Account of the Experiment of Transfusion, Practised upon a Man in London,” Phil. Trans. 1666-1667 2, 557-559. Accessed November 7, 2016.
  4. Elizabeth Yale, “First Blood Transfusion: A History,” JSTOR Daily: Where News Meets Its Scholarly Match, April 22, 2015. Accessed November 7, 2016.