Smoking and Health, 50 Years Later

By Johanna Goldberg, Information Services Librarian

On Saturday, January 11, 1964, fifty years ago this past Saturday, the U.S. Surgeon General released a report that took the country by storm: Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service.

While surgeons general had made statements regarding cigarette dangers as early as the 1920s,1 this report marked the beginning of the Office of the Surgeon General’s practice of releasing “authoritative scientific statements,”2 which continues to this day. It also marked the first time a surgeon general report received enormous media attention.1

"Percentage of persons who have never smoked by sex and age, United States, 1955." A chart from Smoking and Health. Click to enlarge.

“Percentage of persons who have never smoked by sex and age, United States, 1955.” A chart from Smoking and Health. Click to enlarge.

To produce Smoking and Health, Surgeon General Dr. Luther L. Terry assembled a committee of 10 doctors from a variety of disciplines, none of whom who had previously spoken publicly about tobacco use, to review more than 7,000 publications, including articles, reports, statements from tobacco companies, and conference proceedings. The committee did not carry out original research, instead performing a thorough review of the literature, completed in just over two years.3

"Trends in Age-Adjusted Mortality Rates for Cancer by Sex." A chart from Smoking and Health. Click to enlarge

“Trends in Age-Adjusted Mortality Rates for Cancer by Sex.” A chart from Smoking and Health. Click to enlarge

The 387-page report made some dire conclusions:

  • Smokers are 70% more likely than non-smokers to die of coronary artery disease; 500% more likely than non-smokers to die of emphysema and chronic bronchitis; and 1,000% more likely to die of lung cancer.
  • Male cigarette smokers have a “9- 10-fold risk of developing lung cancer.” That risk rises to 20-fold for heavy smokers.
  • Cigarette smokers have a 70% higher mortality rate than non-smokers.3

On Sunday, January 12, newspaper front pages and other media sources  around the country featured the report.4 The New York Times alone published 10 articles mentioning the report that day,5 with one on reporters and government employees (including the surgeon general’s assistant for information) smoking in front of the nine no-smoking signs outside the news conference auditorium.6

The report had an immediate impact. In New York, the cigarette tax revenue was 5% lower in January 1964 than the previous year, and 18% lower in February. Cigarette consumption dropped 3.5% nationwide; while it rose in coming years, it never again reached its 1963 peak. One week after the report’s debut, the Federal Trade Commission (FTC) released plans to require health warnings in cigarette advertisements and packaging. In place of the FTC’s plans, Congress passed the Cigarette Labeling and Advertising Act of 1965, followed by additional labeling laws.7

"Mortality from Cancer (All Sites), U.S. Death Registration Area of 1900, 1900-1960," a chart from Smoking and Health.

“Mortality from Cancer (All Sites), U.S. Death Registration Area of 1900, 1900-1960,” a chart from Smoking and Health.

How far have we come? In 2011 (the most recent year available from the CDC),  about 19% of adults in America smoked, compared to the approximately 40.3% in 1964.8,9 Looking for information on how to quit smoking and reduce this percentage further? Visit smokefree.gov.

References

1.The Reports of the Surgeon General: Brief history. (n.d.). Retrieved January 7, 2014, from http://profiles.nlm.nih.gov/ps/retrieve/Narrative/NN/p-nid/58.

2. The Reports of the Surgeon General: Changing conceptions of public health. (n.d.). Retrieved January 7, 2014, from http://profiles.nlm.nih.gov/ps/retrieve/Narrative/NN/p-nid/59.

3. United States Surgeon General’s Advisory Committee on Smoking and Health. (1964). Smoking and health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. Washington, D.C.: U.S. Department of Health, Education, and Welfare. Public Health Service. Accessible in full online at http://profiles.nlm.nih.gov/NN/B/B/M/Q/.

4. Housman, M. (2001). Smoking and health: The 1964 U.S. Surgeon General’s Report as a turning point in the anti-smoking movement. Health Policy Review, 2(1). Retrieved from http://www.hcs.harvard.edu/~epihc/currentissue/spring2001/housman.html.

5. NYTimes.com search. (n.d.). Retrieved January 7, 2014, from http://query.nytimes.com/search/sitesearch/#/surgeon+general/from19640112to19640112/.

6. Hunter, M. (1964, January 12). Smoking banned at news parley. But some reporters puff sheepishly in corridors. New York Times. Retrieved from http://legacy.library.ucsf.edu/tid/zbg90c00/pdf.

7. Sullum, J. (1998). For your own good: The anti-smoking crusade and the tyranny of public health. New York: Free Press.

8. CDC’s Office on Smoking and Health. (2013, June 5). Smoking and tobacco use fact sheet: Adult cigarette smoking in the United States. Retrieved January 7, 2014, from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/.

9. United States Public Health Service Office of the Assistant Secretary for Health Office on Smoking and Health, & United States Public Health Service Office of the Surgeon General. (1979). Smoking and health: A report of the Surgeon General. Appendix: Cigarette smoking in the United States, 1950-1978 (pages A-1 through A-29) (Official reports). Retrieved from http://profiles.nlm.nih.gov/ps/retrieve/ResourceMetadata/NNBCPH.

New Year’s Luck—and How to Keep Safe, 1950s Style

Bert Hansen, professor of history at Baruch College and author of Picturing Medical Progress from Pasteur to Polio: A History of Mass Media Images and Popular Attitudes in America, wrote today’s guest post. Dr. Hansen will give a Friends of the Rare Book Room talk, “Louis Pasteur: Exploring His Life in Art,on January 14. Join the Friends and register for the talk by clicking here.

At the start of every New Year, people’s attention turns to health and safety (a popular New Year’s resolution is to lose weight). And as we again confront the passage of time, thinking about what’s permanent and what is not, ephemera come to mind. Printed materials of temporary use, when they have luckily been saved and not casually discarded, are especially important for historians as sources to understand ordinary people’s life in the past.

In that spirit, it is a pleasure to share with blog followers a sampling of Lucky Safety Cards from the 1950s, recently donated to NYAM’s Rare Books and Special Collections.

Card 45, featuring Popeye.

Card 45, featuring Popeye. Click to enlarge.

Distributed free in newspapers around 1953, these 2-by-4-inch cards featured characters from popular comic strips and offered ways to be smart and prevent accidents.1 Although children appear in the frame with such cartoon characters at Popeye, Dagwood Bumstead, and the Katzenjammer Kids, it seems likely the messages were aimed at adults as well since people of all ages read newspaper comic strips assiduously.

With vivid two-color printing and graphic styles characteristic of the time, these little collectibles vividly illustrate the history of a popular public health campaign in the decade after World War II. It may not be a coincidence that during the war, cartoon and comic strip figures had been used on health and safety posters and in military instruction and recruitment.2

Modern readers may be struck by the formality of language and styles of dress, quite different than the comics’ drawing styles and casual language used from the 1960s onward. And if the points appear less flashy than modern public service announcements, we would still do well to heed most of their concerns. Each card supplements the illustration with two short texts: a very brief general rule at the bottom (suitable for memorization, perhaps) and a more concrete explanation within the frame. The rules were often puns or contained a rhyme.

“Caution, care, and common sense / eliminate home accidents.”
“Use your ears, eyes, and knows.”
“The right-of-way isn’t worth dying for.”
“Don’t learn the traffic laws by accident.”
“A slip for a trip / may break a hip.”

Each card carried a safety slogan number from 1 to 48 identifying its message (and perhaps encouraging people to collect a complete set), along with a unique serial number. The serial numbers were part of a lottery offering cash prizes. Readers were advised to check for the winning numbers in the newspaper.

It is not clear how many newspapers distributed Lucky Safety Cards. All the examples in NYAM’s collection come from three newspapers: the Albany Times-Union, the Baltimore News-Post and American, and the New York Journal-American.

The Academy holds 31 of the 48 published cards. Missing numbers are 5, 12, 13, 16, 17, 19, 21, 24, 26, 28, 29, 31, 33, 34, 37, 39, and 40. If you have one of the missing cards and want to help fill the seventeen gaps in the set, donations will be warmly received and greatly appreciated.

Although in the truest sense of the word, these cards were ephemeral, historians and artists now—and long into the future—will have permanent access to them thanks to modern conservation and preservation practices in the Academy Library’s Rare Books and Special Collections.

April 2014 update:

Thanks to a “New Yorker who enjoys flea markets,” our set of Lucky Safety Cards is one card closer to completion. Here’s card No. 24 from the set.

Lucky Safety Card 24. Click to enlarge.

Lucky Safety Card 24. Click to enlarge.

April 2017 update:

Our collection now includes cards 13, 17, 29, and 39, thanks to Diane DeBlois and Robert Harris. Just 12 more cards to go!

References

1. For a handy orientation to the wide range of advice and information in comics formats, see Sol Davidson, “Educational Comics: A Family Tree,” in the open-access journal ImageTexT 4:2, Supplement (2008) at http://www.english.ufl.edu/imagetext/archives/v4_2/davidson/.

2. Michael Rhode, “She may look clean, but. . . .  Cartoons Played an Important Role in the Military’s Health-Education Efforts during World War II,” Hogan’s Alley, 8 (Fall 2000).

Two entries in Hidden Treasure: The National Library of Medicine ed. by Michael Sappol, Bethesda, MD: National Library of Medicine / New York: Blast Books, 2012:  “Malaria Pinup Calendars (1945): Frank Mack, for the U.S. Army,” on pp. 172-173, by Sport Murphy, and “Commandments for Health (1945): Hugh Harman Productions, for the U.S. Navy,” on pp. 174-175, by Michael Rhode.

Many fascinating examples are listed in a ten-page finding aid for materials in the Otis Archives Collections, “Cartoons and Comics in the National Museum of Health and Medicine” by Michael Rhode, which may be accessed in PDF format at http://www.medicalmuseum.mil/index.cfm?p=collections.archives.collections.index.

History Night: Call for Papers

RBR desk

The New York Academy of Medicine’s Section on History of Medicine is pleased to announce its Annual History of Medicine night to be held on February 6, 2014 from 6:00 pm–7:30 pm. The event will take place at the Academy, located at 1216 Fifth Avenue at the corner of 103rd Street.

We are inviting all those interested in presenting to submit a narrative on a historical subject relating to medicine for consideration.

Note the following submission requirements:

  • Applications must include an abstract, with a  500-word maximum, and this form
  • Abstracts must be submitted no later than January 15, 2014

The time allotted for presentation is 12 minutes with an additional 3 minutes for questions/discussion. Papers selected for presentation will be determined by a panel of History of Medicine Section members.

Abstracts should be submitted electronically to Donna Fingerhut at dfingerhut@nyam.org.  Questions may be directed to Donna via email or phone (212-419-3645).

The Christmas Lectures

By Arlene Shaner, Reference Librarian for Historical Collections

The Royal Institution of Great Britain in London introduced its annual series of Christmas Lectures in 1825. Meant to appeal to young audiences, “the juvenile auditory,” these lectures offered extra-curricular science education to children at a time when very little of this programming existed for young people. The lectures provided an actively engaging experience for the audience, and lively demonstrations were a big part of the lecture experience.

Michael Faraday (1792-1867) conceived the lectures, though he had limited formal education. Apprenticed to the bookbinder George Riebau for seven years beginning in 1805, Faraday began reading some of the science books he was binding and performing experiments himself. By 1810, he attended lectures at the City Philosophical Society and then bound his lecture notes into small volumes. Faraday first lectured for the Christmas Lecture series in 1827 and went on to deliver 18 additional sets of lectures. His lectures from 1861, On the Chemical History of a Candle, are part of NYAM’s collections.

Faraday_Candle_1861

The title page of the 1861 lectures. Click to enlarge.

Many of the lectures were published and we have a variety of those volumes. John McKendrick offered a series of six lectures called Life in Motion about physiology during the 1891-92 Christmas holidays.

McKendrick_Motion_1892

A page from John McKendrick’s lectures. Click to enlarge.

The frontispiece from J. A. Fleming’s lectures, Waves and Ripples in Water, Air, and Aether (1902), gives a sense of what the demonstrations must have been like. In his preface, Fleming acknowledges that the printed volumes do not convey the same excitement of the actual demonstrations, being “destitute of the attractions furnished by successful experiments,” but he still hopes that they will be a useful tool for readers (p. viii).

Fleming_Waves_1902

The frontispiece from J. A. Fleming’s lectures. Click to enlarge.

The Christmas Lectures have been given almost every year since 1825, with the exception of an interruption from 1939 through 1942 because of the Second World War. H. Hartridge gave the lectures in 1946, and chose as his topic Colours and How We See Them (1949) because he wanted to recall a happier past and encourage thoughts of a better future. “Which of all things that we had pre-war are just as good as ever they were… At least one answer is: harmony and colour….The rich hues of spring and autumn, the glories of the setting sun, the spectrum of the rainbow” (p. v). As befits a volume on this topic, Hartridge’s volume contains a number of richly colored illustrated plates.

Hartridge_merged

Descriptive text and an illustrated plate from Hartridge’s lectures. Click to enlarge.

Since 1966, the Christmas lectures have been broadcast on television. Those who are young or young at heart can view a number of them online.

Item of the Month: Boston City Hospital, Christmas 1912

By Rebecca Pou, Archivist

BostonCityHospitalWardG

Click to enlarge.

A slim volume from our collections provides a glimpse of the holiday festivities at a public American hospital more than 100 years ago. In Boston City Hospital, Christmas 1912 we find eight photographs documenting the hospital’s holiday adornments and celebrations. The stark black and white photos of vaulted ceilings and nearly empty rooms don’t paint the cheeriest picture of the holidays, but clearly the staff put a great deal of effort into the celebrations.

These are pictures of the spaces more than the people in them. We see patients in their beds and the kitchen staff waiting for their holiday meal, but the people seem almost incidental. Some of the shots focus on the feasts on the table and the Christmas tree, while others capture the entire ward with garlands hanging from the ceiling and wreaths on the walls. These images are striking in part because the hospital’s large, communal wards look so different from patient settings in hospitals today.

BostonCityHospitalWardO

In A History of the Boston City Hospital from its Foundation until 1904, we find out a bit more about Christmas at the hospital. “Christmas trees lighted by electric bulbs” and decorated with gifts for every patient spruced up the convalescent wards.1 If you look closely at the Christmas tree above, there appear to be several small dolls in its branches.

Boston City Hospital opened in 1864. From February 1, 1912, through January 31, 1913, the hospital treated almost 13,000 people with an average of 550 residents per day. About one third of the patients were natives of Massachusetts, but patients born in 61 other countries spent time in the hospital over the course of the year. The largest number of those came from Ireland, but the annual report lists patients born in Syria (25), Barbados (5), the Fiji Islands (1), and New Zealand (2), as well as many other locations.2 The hospital merged with the Boston University Medical Center in 1996, forming the Boston Medical Center.3

Click through the gallery below for the rest of the photos from Boston City Hospital, Christmas 1912.

References

1. A History of the Boston City Hospital from its Foundation until 1904. Boston: Municipal Printing Office, 1906.

2. Forty-ninth Annual Report of the Boston City Hospital, 1912-1913. Boston: City of Boston Printing Department, 1913.

3. History. Boston University, School of Medicine, Department of Medicine. Retrieved December 17, 2013. http://www.bumc.bu.edu/medicine/dom-introduction/history/

Burn These Handkerchiefs

By Johanna Goldberg, Information Services Librarian

With cold and flu season upon us, it’s the perfect time to remind ourselves how to prevent the spread of disease.

A pamphlet from New York City’s Department of Health, likely printed in 1929, gives advice still relevant today, complete with some fabulous illustrations. The recommendations vary only slightly from those now given by the CDC.

Side one of the unfolded pamphlet.

Side two of the unfolded pamphlet.

Stay healthy!

Holiday News from the Center

NYAM Library, Rare Book Room photos by Amy Hart © 2012As the year comes to an end, there is a lot going at the Center for the History of Medicine and Public Health.

♦ We are planning our 2014 Festivals (there will be two! Save the date for the first on April 5. Keep an eye out for details coming early next year).

♦ On December 4, we will welcome a number of influential librarians to an informal roundtable to discuss the impact of open access publishing for libraries, researchers, and users. Simon Chaplin, Head of the London Wellcome library, will take part in this discussion, and in the evening present a lecture on the (often eccentric) history of medical tourism. Both events are free but require pre-registration (follow the links to register).

♦ For those in the scholarly world, details of our two research fellowships have just gone live:

  • The Paul Klemperer Fellowship supports research using our collections for the history of medicine. Find out more here.
  • The Audrey and William H. Helfand Fellowship supports work in the history of medicine and public health, with a particular focus on the use of visual materials. More details here.

Applications close March 4, 2014 for the 20142015 academic year. We encourage applicants to get in touch with our Reference Librarian for Historical Collections when shaping their applications.

♦ We are accepting applications for the 2014 Gladys Brooks Book and Paper Conservation Internship now through December 15, 2013. For more information about eligibility, click here.

♦ The Center is growing! We are looking for a curator to join the team to help us develop our scholarly and public presence through exhibitions, programming, and collection development. For more details see the job description here.

♦ The library closes early today, November 27, and will be closed on Thursday and Friday, November 28 and 29. We will also be closed on December 24 and 25.

Item of the Month: Posters from the Special Programme on AIDS, World Health Organization, 1987–1995

By Paul Theerman, Associate Director

The WHO Special Programme on AIDS was the first response of the United Nations to the pandemic that had gained world attention by the mid-1980s.1 The offspring of the first two international conferences on AIDS, in Atlanta in 1985 and in Paris the following year, the Programme was founded in February 1987. The Programme’s dynamic director, Jonathan M. Mann, had great hopes and grand plans for combating AIDS through a coordinated worldwide response—the only feasible way to control the virulent and widely spreading disease, he thought. From the beginning he also saw the AIDS outbreak as a focus for engaging global human rights issues. Under Mann, the WHO moved beyond its role of technical advisor to national governments, for it tried to take a directive role, actively engage non-governmental organizations, and promote non-discriminatory policies towards AIDS sufferers. Between 1987 and 1989, the Special Programme—which also came to be known as the Global Programme on AIDS—developed a comprehensive strategy for attacking the virus.

AIDSWorldwideEffortSIDAUnEsfuerzo

These two posters—one design in two languages—come from the heady days of the Programme’s beginning. Produced in 1987, these posters announced its slogan, “AIDS: A worldwide effort will stop it.” The posters’ design inadvertently reveals how difficult it was to talk about AIDS in the 1980s. AIDS seemed different from other diseases. First of all, it was a pandemic experienced in the west, perhaps the first such experience since the polio epidemic in the early 1950s, and before that, the influenza pandemic in 1918–19. With the rise of antibiotics and vaccination, widespread disease outbreaks in the developed world were no longer supposed to happen! As Dr. Gerald Friedland, a doctor on the front lines during the height of the pandemic, said at an event at Columbia University earlier this month, the disease caused the “inverse of the life cycle,” as it mostly impacted young people, leading to parents burying their children. “The only thing comparable was war.”

With AIDS, neither antibiotics nor vaccination worked, so epidemiologists were forced back to classic means of halting pandemics: stopping the means of transmission. Here also AIDS proved difficult. Those means—chiefly sexual contact and sharing needles—provoked strong reactions. Coupled with a long latency and an invariably fatal outcome after a horrific decline, AIDS did not have a simple profile.

The posters display that cultural unease. The UN commissioned noted New York graphic designer Milton Glaser, an internationally known logo and poster designer, with such readily recognizable designs as “I ♡ NY,” Esquire and New York magazines, and Sony, among many others. Certainly Glaser knows about the power of images to convey meaning. For these UN posters, he combined three elements, two hearts and a skull, to make a W—presumably to stand for “world” in the World Health Organization, and to reference the caption, “A worldwide effort will stop [AIDS].” But it’s not clear—and it doesn’t work in the Spanish version of the poster. Even more puzzling is the relationship of the hearts to the skulls. Is it cautionary: in the midst of love—erotic love, that is—lurks death? Is it hopeful: compassionate hearts will combine to crush AIDS? Is it both? Glaser produced a striking image, but he also produced an ambiguous one. By 1991, the red ribbon had been introduced as the predominant AIDS symbol, and it soon the supplanted the “heart-and-skull-W,” even at the UN itself.

The year that this poster came out proved to be the Programme’s high point. In 1988 a new director-general came to the World Health Organization. AIDS could not have two masters. By late 1989, the Programme’s efforts, strategies, and budget were brought up short, and Mann departed in 1990. The Programme limped along for another five years, until replaced by UNAIDS, the locus for United Nations action today. In the words of Mann’s successor,  Michael H. Merson: the Programme “was unable to muster the necessary political will . . . , and its effectiveness was compromised by . . . an increasing preference of wealthy governments for bilateral aid programs.”2 That seems where matters stand now, as we approach World AIDS Day, December 1. The story of the Special Programme on AIDS is a cautionary tale of the difficulties of grappling with a worldwide disease in a disjointed world.

References

1. Much of the history of the Special Programme on AIDS is found in two article by its founding director: Jonathan M. Mann, “The World Health Organization’s global strategy for the prevention and control of AIDS,” in AIDS—A Global Perspective [Special issue] Western Journal of Medicine 1987 Dec; 147:732–734; and Jonathan M. Mann and Kathleen Kay, “Confronting the pandemic: the World Health Organization’s Global Programme on AIDS, 1986–1989,” AIDS 1991; 5 (suppl. 2): S221–S229.

2.  Michael H. Merson, “The HIV–AIDS pandemic at 25—the global response,” New England Journal of Medicine 2006; 354:2414–2417 (June 8, 2006), quotation from page 2415.

A Different Kind of Flush

By Johanna Goldberg, Information Services Librarian

It’s World Toilet Day, a day reminding us that one-third of the world’s population does not have access to a toilet and consequently faces serious sanitary challenges.1

Similar difficulties once faced places where toilets are now widespread. In much of the Western world, filthy urban streets, unregulated sanitation, and a series of epidemics marked the early 1800s. Things began to change at the end of the century, dubbed in Sitting Pretty: An Uninhibited History of the Toilet as “the golden age of toilets,” due in part to innovative toilet design, consolidated sewage systems, and a better understanding of disease transmission.2

Flushing the toilet was a loud business in the 1800s, one often plagued by insufficient water and unpleasant smells. These issues with water toilets led to Reverend Henry Moule’s invention of the earth closet in 1860.2,3

The most basic version of the earth closet was a seat above a bucket filled with “fine dry earth, charcoal, or ashes.” Pulling a handle caused fresh earth to fall into the bucket from above. More elaborate versions included closets on adjacent floors, connected via a chute in the wall.3

The inner workings of a basic earth closet.4

The inner workings of a basic earth closet.4 Click to enlarge.

Multistory Earth Closet

Earth closets on multiple floors, connected by a chute.4 Click to enlarge.

In an 1872 pamphlet in our collection, “Earth-closets and earth sewage,” author George E. Waring, a 19th-century champion of sanitation, advocated for the earth closet’s use. According to Waring, benefits included a lack of odors; the “complete and effectual removal of all the liquid wastes of sleeping-rooms and kitchens”; the collection of “manure worth . . . at least $10 per annum for each member of the family”; and disease prevention.4

Waring acknowledged the growing popularity of the water toilet, writing:

“The water-closet is the chief thing of which women living in the country envy their city cousins the possession. In country-houses, one of the first steps toward elegance is the erection of an expensive water-closet in the house, provided with a force-pump that is doomed to break both the back and the temper of the hired man; a tank and pipes which are pretty sure to be burst by frost every winter; the annual tax of the plumber’s bill; and, worse than all, a receptacle in the garden known as a ‘cess-pool,’ which usually has a private subterranean communication with the well from which drinking water is taken.”4

By contrast, wrote Waring, the “properly constructed” earth closet was odorless and absent “of the depressing, headachy effect that always accompanies the water-closet or night chair.” He also argued that outdoor privies, if they must exist, should become earth closets.4

Clearly earth closets clearly never gained the popularity Waring hoped they’d enjoy, although some use their cousin, the composting toilet, today. Whatever toilet you use, give thanks on World Toilet Day for its enormous public health benefits.

References

1. What is World Toilet Day? (n.d.). World Toilet Day. Retrieved August 29, 2013, from http://www.worldtoiletday.org/whatis.php

2. Horan, J. L. (1998). Sitting pretty: an uninhibited history of the toilet. London: Robson.

3. Wright, L. (1960). Clean and decent: the fascinating history of the bathroom & the water closet, and of sundry habits, fashions & accessories of the toilet, principally in Great Britain, France, & America. New York: Viking Press.

4. Waring, G. E. (1872). Earth-closets and earth sewage. New York: Orange Judd and Co.

Three Days in Baden-Baden: On the Enchantments of Soviet Biography

Johanna Conterio, a Ph.D. candidate in the History Department at Harvard University specializing in modern Russia, wrote today’s guest post.

It is notoriously difficult to find biographical information about people who lived in the Soviet Union. Personal papers, the kind that historians of the United States rely on, are rarely found in state archives in Russia. Russian intellectuals historically tried to keep their materials out of state archives, associating these with policing rather than with preservation—reasonable enough, as archives were mainly acquired during police raids! But that does not mean that biographical information is impossible to find. When getting into a story in the Soviet past, certain names keep coming up, and information comes from unexpected places. A person may have written an article. If their position is given in the byline, one can figure out where they worked and perhaps find the archive of that organization, or a published history. One checks the stacks for books and brochures they have written. Perhaps they gave a talk at an international conference and left a trace in conference volumes. The more one learns, the more curious one becomes about the course of a life in the past, at first seen only in fragments.

Nikolai Ivanovich Teziakov

Nikolai Ivanovich Teziakov

I first encountered Nikolai Teziakov in a source from the Central Scientific Medical Library in Moscow. In 1923, he published a small book, Health Resorts in the Russian Socialist Soviet Republic. When the librarian delivered the book, I was surprised to find that it was in German and had been published in Berlin (in the card catalogue, the title was given in Russian).1 I had it photocopied and didn’t think about it again for some time. But as I continued my research, I started to see the name Nikolai Teziakov again and again. He was the second director of the Main Health Resort Administration, the state organ that organized Soviet health resorts, and part of the People’s Commissariat for Public Health. He worked during the Russian Civil War (1918-1922) in rural Saratov, 500 miles southeast of Moscow, heading the regional health department fighting infectious diseases and setting up sanatoria for tuberculosis patients. But some very basic questions about who he was remained unanswered. Was he a member of a political party? How did he progress from rural physician in Saratov to top official in Moscow? What was his family background? Where did he study medicine? Did he ever travel abroad? And what did he look like?

Some basic information comes from The Great Soviet Encyclopedia, and I’ve filled in some more details. Nikolai Ivanovich Teziakov was born in 1859 into a peasant family in a village outside of Sverdlovsk, in the Ural Mountains. He finished secondary school in 1879, and studied medicine in Kazan, finishing in 1884. Teziakov was enormously active in public health in Russia before the October Revolution of 1917. Following the cholera epidemic of 1892-1893, he became a sanitary physician and began to collect statistics and conduct epidemiological research. He worked to lower the rates of infant mortality through the organization of free day care for agricultural families, and to fight infectious diseases through disinfection and immunization. He was also active in training medical workers in the new field of hygiene. He attended the famous International Hygiene Exhibition in Dresden in 1911. While working in Kherson province, he wrote about the increasing rates of landlessness among the peasantry. His statistics were used by Lenin in his work On the Development of Capitalism in Russia. During the years of the Civil War, he wrote the slogan “Health Resorts for the Workers!” He was convinced that health resorts were important for the improvement of the health of the workers, an opinion shared by Lenin and Commissar [Minister] of Public Health, Nikolai Aleksandrovich Semashko, powerful patrons of Soviet health resorts, who oversaw the development of the first health resorts for workers in Europe. He died in 1925 at age 65.

But it is Teziakov’s German connections that emerged as an intriguing story, told through the official journal published by the Main Health Resort Administration, Health Resort Affairs [Kurortnoe delo], in the New York Academy of Medicine’s rich collection of Soviet medical journals.  Teziakov’s Berlin publication was meant to be a conference paper, originally to be presented at the 38th German Balneological Congress in 1923 in Aachen.2 He travelled to Germany in 1923 for the conference, but due to the French occupation of Aachen (these were eventful years in Europe!), the conference was abruptly cancelled. Nonetheless both the director and the secretary of the German Balneological Society gamely hosted him and his small Soviet entourage for ten days in Berlin. Add two new names to the historical index: Eduard Dietrich and Max Hirsch.

Teziakov was eager to see the health resorts of Germany. Together with the Soviet physician [S. V.] Korshun and a German secretary, Binger, and carrying with them a letter of introduction from Dietrich, from April 12 to 30 Teziakov visited the German health resorts Baden-Baden, Wildbad, Bad Homburg, Bad Kissingen, Wiesbaden, Bad Nauheim, and Bad Eichhausen.3 Upon his return to Moscow, Teziakov published two detailed accounts of his travels in Health Resort Affairs. Although he was impressed by the beautiful parks and gardens, clean streets, and brilliant architecture of the German baths, Teziakov was disappointed to find that these were only accessible to what he called the “grand bourgeoisie,” and deplored what he called the “commercial” organization of health resort care. Exceptions to this rule were a few charitable organizations that he visited during his three days in Baden-Baden, but Teziakov called these “pathetic.” He contrasted German with Russian medicine: “Medical help at the health resorts is in the hands of private physicians, united into unions. The organization of state or public, municipal health care such as we, Russian physicians, understand it, does not exist.”4 Teziakov’s reports were republished in a brochure for a mass audience, and reviewed by Commissar Semashko on page one of the newspaper Izvestiia. Reprising a common theme among the new Soviet leaders, Semashko wrote that the country needed to combine “German” technology and “iron discipline” with the Soviet approach to social questions. “What a fantastic order we might then establish in health resort construction,” he wrote.5

The German balneologists were also interested in developments in the Soviet Union. The director of the German Balneological Society, Eduard Dietrich, was invited to the Soviet Union in 1924, as a delegate to the Fourth All-Russian Balneological Congress in Moscow (although it remains unclear whether he attended).6 The Society’s secretary, Max Hirsch, developed an ongoing fascination with Soviet balneology and health resorts. He wrote a number of articles about Soviet balneology in the German press in the 1920s, particularly in the Journal for Scientific Balneology [Zeitschrift für wissenschaftliche Bäderkunde]7 and provided reports on various balneological conferences and proceedings to Health Resort Affairs. Hirsch’s relationship with the Soviet Union had begun, and was continued by further meetings with Teziakov in 1923 and 1924, when Teziakov returned to Germany to attend the balneological congress. Of Jewish heritage, Max Hirsch emigrated to the Soviet Union in 1933, fleeing his native Germany via Czechoslovakia. My next task is to find out what happened to him when he arrived in the USSR. Through detective work in the journals, I’ve learned not only more about Teziakov’s career, but discovered the surprising interplay of German and Soviet public health in the 1920s and 1930s, mirroring political developments of those decades.


1. N.J. Tesjakow, Das Kurortwesen in der Russischen Sozialistischen Räterepublik (Berlin: Verlagsbuchhandlung von Richard Schoetz, 1923)

2. Balneology is the science of baths or bathing, especially the study of the therapeutic use of thermal baths.

3. N.I. Teziakov, “Po germanskim kurortam (12-30 apr. 1923 g.)” Kurortnoe delo 1 (No. 6, 1923): 19.

4. N.I. Teziakov, “Po germanskim kurortam (12-30 apr. 1923 g.)” Kurortnoe delo 1 (No. 6, 1923): 30.

5. Izvestiia, August 3, 1923.

6. Christine Böttcher, Das Bild der Sowjetischen Medizin in der ärztlichen Publizistik und Wissenschaftspolitik der Weimarer Republik (Pfaffenweiler: Centaurus-Verlagsgesellschaft, 1998), 52-53.

7. This journal is also held in the collections of the New York Academy of Medicine Library.