American drug policy as we know it today categorizes marijuana as a Schedule I substance, meaning that it is considered to place users under high risk for abuse and not accepted by the FDA or DEA as safe for use as medication with or without supervision. The FDA and DEA have rejected multiple petitions to reschedule marijuana under less restrictive categories from governmental and non-governmental entities. The Controlled Substances Act of 1970 governs federal drug policy in the United States as part of a broader effort to curtail the sale, distribution, and consumption of illegal drugs by the Nixon administration, later known as the War On Drugs.
The status quo of American drug policy extends farther back than 1970, however. When the United States Congress passed the Marihuana Tax Act championed by Federal Bureau of Narcotics Commissioner Harry Anslinger in 1937, it was a watershed moment in the history of drug policy regulation. The legislation represented a victory for marijuana opponents who successfully convinced lawmakers of a link between cannabis usage and addiction, deviance, and criminality. New York City Mayor Fiorello La Guardia looked skeptically upon the Marihuana Tax Act and its pretext. He thus called upon the New York Academy of Medicine to prepare a report drawing from a wide variety of academic disciplines to scrutinize the drug law and the beliefs about drugs held by its proponents. In the “La Guardia Report” of 1944, the Mayor’s commission on marihuana use demonstrated that the widespread fear, even panic, around marijuana use was greatly overblown.
In the 1950s and ’60s, the Academy continued to emphasize drug addiction as a treatable condition. During 1995 and 1996, NYAM’s Committee on Medicine in Society looked specifically at the concept of harm reduction. The Academy recommended policy changes that were, for the time, cutting edge. These included expansion of treatment programs, acceptance of methadone treatments, special efforts for those incarcerated, better training for medical professionals, and, especially, expanding needle exchange programs and decriminalizing needle distribution and possession. The Library’s Then and Now event “Drug Policy and Harm Reduction Services” brought that history up to the present time. A stellar panel mentioned NYAM’s continuing work in harm reduction, looked at the racial component of America’s drug control regime, considered the experience of those working in NYC’s new Overdose Prevention Centers, and noted that the most recent White House National Drug Control Strategy champions “harm reduction to meet people where they are.” For at least a quarter century, NYAM has supported the people-centered approach that lies at the heart of harm reduction. We wait to see where the national strategy goes next.
NYAM’s 1933 maternal mortality report is one of the 30 highlights of “Celebrating NYAM Milestones,” prepared for our 175th anniversary in 2022.
In 1930, the New York Academy of Medicine began a major project that resulted in the landmark report Maternal Mortality in New York City, published in 1933. In its work, the Academy was part of a great movement in the first third of the 20th century that devoted greater efforts to the problem of maternal mortality. Many reasons led to this increased emphasis in public health communities. In the American context, though, the foundation of the Children’s Bureau in 1912 brought these issues to the fore.
In the late 19th and early 20th centuries, the settlement house movement focused attention on the plight of children in urban slums and tenements. The issue eventually reached President Theodore Roosevelt, who convened the first White House Conference on Children in 1909. Three years later President Taft signed the act establishing the U.S. Children’s Bureau as a part of the Department of Labor, the first Federal agency dedicated to the welfare of children. Under its dynamic first director, Julia Lathrop (1858–1932), the bureau mounted multi-pronged programs to address the social needs of children and mothers and helped set the agenda for increased study of maternal mortality over the following years. In 1930 the bureau mounted a White House conference on child health and protection, which included maternal mortality in its scope, and in 1933, it issued a report on maternal mortality in 15 states. Its work played a leading role in the international focus on maternal health; the Library’s collections hold over 15 professional and lay studies on maternal mortality dating between 1925 and 1937, covering such disparate geographical regions as Philadelphia, Scotland, and Birmingham, Alabama. Thus when the New York Academy of Medicine took on its study, it was adding its voice to the ongoing international effort.
The Academy began its study of maternal mortality in New York City in 1930, with the assistance of the New York Obstetrical Society and the support of the Commonwealth Fund. Under the auspices of the Academy’s Public Health Relations Committee, Dr. Ransom S. Hooker (1874–1957), a prominent surgeon, was appointed director of the study. From 1930 to 1932, the city’s Health Department provided, and the Academy analyzed, 2,014 case reports on women’s deaths from childbirth as well as deaths of pregnant women. For each case, the physician was interviewed, and if the death took place in a hospital, that institution was inspected.
The analysis found huge gaps in perinatal care and obstetrical practice, partly among midwives but chiefly among physicians. The report’s chief recommendation was for increased education and training, both popular and professional. Prospective mothers should know and be able to ask for what they needed in perinatal care. Both generalist physicians and the newly forming specialist obstetricians should receive better obstetrical training in medical schools and through hospital internships. The report called for a reduction in surgical interventions “undertaken merely to alleviate pain or shorten labor.” It recommended that hospitals provide separate obstetrical clinics, wards, and delivery rooms, overseen by trained obstetricians, with rigid rules to maintain asepsis, including masking. Based on the data—which showed better results for midwife-assisted births—the report supported the practice of home delivery. Nonetheless it called for more training and greater supervision of midwives, preferably by physicians. The report concluded that “the rate of death was unnecessarily high . . . [and] two-third of all the deaths studied could have been prevented.”
The Commonwealth Fund published the landmark study on November 20, 1933, followed by the Academy’s summary in its publication Health Examiner. Iago Galdston, secretary of its Medical Information Bureau, provided major press outlets with a précis of the study, titled “Why Women Die in Childbirth,”. One sign of its reach: the January 1934 meeting of the Maternity Center Association, attended by over 500 people, focused on the report, and emphasized public education in the search for better outcomes. Four years later, Galdston adapted the study for lay audiences, including results from Philadelphia and the U.S. Children’s Bureau, as Maternal deaths—the ways to prevention (1937), also published by the Commonwealth Fund.
Immediately after the study’s release, however, obstetricians—and especially those of the New York Obstetrical Society, which helped guide the Academy’s research—thought that their authority and expertise were being questioned. In April the society released a “counter-report” upholding its members’ obstetrical abilities against the “unskilled hands” of general physicians and midwives. Some obstetricians raised their objections within the Academy, both on the report and the publicity around it. The Academy mounted an investigation, which confirmed both the results of the report and the manner of its release. And even as it objected to the report, the Society came together with the Academy in March 1934 to jointly advise the city’s Department of Health on productive ways forward. These efforts bore fruit: from 1935 to 1938, maternal mortality rates in New York City dropped by a third, from 51 to 38 deaths per 10,000 live births, and then dropped further, reaching 22 by 1942. The trend continued over the next 40 years.
What was missing in the Academy’s analysis? Any serious consideration of why health disparities played out along racial lines. That mortality followed race was clear. Each woman’s ostensible race was noted, and the results were reported out by race. The report stated that “the death rate from puerperal causes for the Negro [sic] population . . . greatly exceeds that for the white population.” The Children’s Bureau’s 1933 report found a rate for non-white women nearly twice that of white women—a conclusion that, sadly, remains virtually unchanged almost a hundred years on. Neither of these studies directly addressed causation, and when the Children’s Bureau did so in 1940, as one historian noted, they marked out Black women as inherently poor prospects for motherhood, the origin of “the Black maternal blame narrative.”
“Ransom Hooker, Surgeon, Is Dead; Former Director in Field at Bellevue Made Study Here of Maternal Mortality.” The New York Times, April 12, 1957, p. 25.
Stokes, Anson Phelps. Stokes Records: Notes Regarding the Ancestry and Lives of Anson Phelps Stokes and Helen Louisa (Phelps) Stokes. 4 vols. New York: Privately printed, 1915, 3:130, is the source of the photograph of Ransom Spafard Hooker.
Van Ingen, Philip. The New York Academy of Medicine: Its First Hundred Years. New York: Columbia University Press, 1949. Pp. 441–50.
U.S. Center for Disease Control, National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health. “Achievements in Public Health, 1900–1999: Healthier Mothers and Babies.” MMWR 48(38) (October 1, 1999): 849–58. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm, accessed March 4, 2022.
U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. The Story of the Children’s Bureau. Washington, DC: The Children’s Bureau, .
U.S. Department of Labor, Children’s Bureau. Maternal Deaths: A Brief Report of a Study Made in 15 States. Bureau Publication No. 221. Washington: Government Printing Office, 1933.
By Dr. Paul E. Sampson, Assistant Professor of History, The University of Scranton
2020 Audrey and William H. Helfand Fellow in the History of Medicine and Public Health
Over the course of the past year, I have had the privilege of spending four weeks researching in the spectacular rare book collection of the Library of the New York Academy of Medicine. My book project is entitled “Ventilating the Empire: Environmental Machines in Britain, 1700–1850” and comprises a scientific and social history of ventilation in Britain and the British empire during the long eighteenth century, roughly 1688 to 1815. By examining the design and deployment of ventilating machines in slave and naval ships, prisons and public buildings, I ask how devices designed to protect human beings from environmental hazards became a means of dividing British society along class and racial lines.
The primary subject of my research has been the life and career of prison reformer John Howard (1726–1790). I examine Howard’s career through the context of his work on “Jail Fever” (AKA typhus) which contemporary physicians and medical experts understood as an airborne disease. I argue that a key feature of Howard’s celebrity was his perceived invulnerability to airborne diseases. In addition, his influence helped to shift the discourse of prison reform away from overall institutional sanitation and towards methods intended to control the hygiene and morality of individual prisoners.
For those unfamiliar, John Howard was a noble-born, intensely religious man who was appointed sheriff of Bedfordshire in 1773. One of his duties was to inspect local prisons. Unlike many of his genteel contemporaries, he took this job seriously. He was appalled by the conditions of the prisons in Bedfordshire, and to spur reform and gather ideas for improvement, he made a series of lengthy tours to visit as many prisons as he could throughout the British Isles and continental Europe. His first published book, The State of the Prisons in England and Wales (1777), detailed his visits to dozens of county jails and bridewells (workhouses), including careful notes of the fees charged to prisoners, their daily workload, the prison diet, and the overall sanitation.
One of the primary goals of Howard’s travels was to find the best means of preventing the spread of disease. By the 1750s, prisons were increasingly perceived as public health hazards. The filthy and diseased condition of prisoners in London’s Newgate prison became a public scandal after the Lord Mayor and 56 others died of jail fever in the weeks following an audience with prisoners. Following the contemporary etiology of fever, the outbreak was attributed to the “putrid effluvia” exhaled in the breath of sick prisoners that had imparted a “poisonous quality” to the air in the courtroom.1 By 1774, Howard had achieved celebrity status by helping to author the “Act for Preserving the Health of Prisoners in Gaol.” This act stated that jail fever was caused by the “want of cleanliness and fresh air” and mandated that all interior walls and ceilings be scraped and white-washed annually and “constantly supplied with fresh air, by means of hand ventilators or otherwise.”2
However, in the wake of this achievement, Howard’s attitudes about preventing fever had begun to shift. During his tours of European prisons, he was puzzled that he rarely encountered “jail distempers” there. To explain the disparity between these and disease-ridden English institutions, Howard developed a theory of jail fever based entirely on his own “experience.” He argued that prisoners could only be infected if privation, filth, and personal intemperance weakened them enough for the contagion to take hold. Young and healthy convicts who were used to “vigorous exercise” quickly became infected due to the “sudden change of diet and lodging” that “so affects the spirits of new convicts, that the general causes of putrid fevers exert an immediate effect on them.” As a counter-example, Howard pointed to himself. During his first tours, he wrote, he had attempted to avoid breathing in contagion by “smelling to vinegar… and changing my apparel…constantly and carefully.” A few years later, however, he wrote that he “entirely omitted” such precautions. In his opinion, the real protection against infection were his habits of “temperance and cleanliness” as well as the power of “divine providence.”3
By the time the second edition of State of the Prisons came out in 1780, Howard had visited hundreds of disease-ridden institutions and avoided contracting a serious infection.While friends privately cautioned him against such continual risk-taking, Howard’s superhuman invulnerability to disease had become a key feature of his celebrity.4 Celebratory poems about Howard became, in the estimation of two literary scholars, “nearly ubiquitous in the 1780s and 1790s” as poets from Erasmus Darwin to William Cowper celebrated his arduous travels and selfless virtue.5 William Hayley’s 1780 Ode, Inscribed to John Howard attributed Howard’s “matchless fame” to his “valor’s adventr’ous step” through “malignant cells” where “fierce contagion, with affright, repels.”6
This vision of Howard as a heroic and invincible figure appeared in numerous prints and lithographs and was captured evocatively in an unfinished work by famed painter George Romney, who depicted a defiant Howard striding confidently into scenes of melodramatic suffering and disease.7
Despite his reputation, Howard wasn’t able to evade contagion forever. While travelling through southern Ukraine in the winter of 1790, Howard contracted a serious fever and died two weeks later.8 Notwithstanding his untimely death, Howard’s emphasis on invigorating labor, self-regulation, and instilling personal hygiene in convicts exerted an enormous influence. By the heyday of the modern penitentiary in the mid-nineteenth century, Howard was lauded as the founder of “prison science.”9 While jails designed during Howard’s life reflected the eighteenth-century emphasis on eliminating effluvia via ventilation, their nineteenth-century successors focused instead on insuring that each inmate was placed in solitary confinement and given a strict regimen of work and moral instruction.10
In my larger project, I argue that this is partially due to a shifting locus of responsibility for preventing airborne disease. The attention of reformers shifted from the condition of theinstitution to the character of theindividual, who became responsible for his or her own cleanliness and ventilation. To briefly illustrate this point, I will conclude with a quotation written several years after Howard’s death by naval health reformer Gilbert Blane:
Those only whose duty leads them to consider the subject, are aware how much the welfare of the human species depends on ventilation and cleanliness; and no one could render a greater service to his fellow creatures, than to impress on their minds the necessity of cultivating them as moral and religious duties.11
1. See, for example: John Pringle, Observations on the Nature and Cure of Hospital and Jayl-Fevers (London: A. Millar, 1750); “Account of the Fatal Assize,” CLA/035/02/049, Gaol Committee, 1750–1755, Notes on Ventilating Newgate, London Metropolitan Archives.
2. Act for Preserving the Health of Prisoners in Gaol and Preventing the Gaol Distemper, 1774, 14 Geo. III, c. 59.
3. John Howard, The State of the Prisons in England and Wales 2nd. Ed. (Warrington: T. Cadell 1780) 430–31.
4. Thomas Taylor, Memoirs of John Howard (London: John Hatchard, 1836) 386–87.
5. Gabriel Cervantes and Dahlia Porter, “Extreme Empiricism: John Howard, Poetry, and the Thermometrics of Reform,” The Eighteenth Century, 57:1 (Spring 2016): 97.
6. William Hayley, “Ode, Inscribed to John Howard” (Boston: J. White et. al. 1795 ).
7. George Romney, John Howard Visiting a Prison or a Lazaretto, 1790–95, courtesy of the Museum of Fine Arts, Boston, MA.
8. John Aikin, A View of the Life, Travels, and Philanthropic Labours of the Late John Howard (Boston: J. White et. al., 1794) 120–25.
9. William Hepworth Dixon, John Howard and the Prison World of Europe, 2nd ed. (London: Jackson and Walford, 1850) 1.
10. Robin Evans, The Fabrication of Virtue: English Prison Architecture 1750–1840 (London: Cambridge UP, 1982) 104–114; Michael Ignatieff, A Just Measure of Pain (London: Penguin, 1978) 3–14.
11. Gilbert Blane, “Letter to John Hippisley,” in Observations on the Diseases of Seamen (London: 1799): 614–15.
The 1830s and ’40s were years of ferment in the United States. Politically, a sea change began in 1828 with the election of Andrew Jackson to the presidency and a break with the political elites of the Eastern seaboard. Socially, the years were ones of great transformation, as new immigrants promised to alter the country’s makeup. The decades saw huge technological innovations as well, with the spread of railroads making new regional and national connections, and the newly invented telegraph shrinking information gaps. Science took on a new cultural value across the western world, manifested in the United States with the founding of the Smithsonian Institution in 1846 as a scientific research institute, followed two years later by the American Association for the Advancement of Science.
The founding of the New York Academy of Medicine was part of this ferment. A group of prominent physicians in the city met informally on December 12, 1846, to see if there were interest in creating a new organization dedicated to promoting “orthodox” medicine. On January 6, 1847, the group met again to adopt a Constitution and By-Laws, to which 132 physicians affixed their signatures. At the group’s next meeting, a week later, the donation of Martyn Paine’s Medical and physiological commentaries (1840) began the Academy Library. That venture was one of the avowed purposes of the Academy: It was organized to separate “regular” from “irregular” medical practitioners such as homeopaths and other unorthodox physicians, and to provide for intellectual growth and sociability.
The Academy stood apart from the different medical societies that had arisen in New York City. Briefly, the New York County Medical Society and other county and state societies chiefly, though not exclusively, were concerned with credentialing and the business of medicine. These concerns were not absent from the Academy, or from others like the Philadelphia College of Physicians (1787), and the Richmond Academy of Medicine (1820). But the academies were more about mutual regard, professional development, and, in the tradition of the grand academies of Europe and our own National Academy of Sciences (1863), advising government on technical matters. This NYAM did throughout its history: helping to establish the city’s Metropolitan Board of Health in 1866, assisting in the creation of a chief medical examiner’s office in 1915, advising on city sanitation in the 1920s and ’30s and on maternal mortality in 1933, and providing expert opinion about marijuana as a “gateway drug” in 1944.
By the end of the 20th century, the Academy had moved beyond advising government to jump-starting its own programs for healthy aging, schoolchildren’s health, and healthy cities overall, and promoting urban health studies around HIV/AIDS and 9/11. By the early 21st century, working toward health equity became the goal, with a multitude of paths forward. Most recently the Academy has added its efforts to combatting the COVID-19 pandemic.
Throughout 2022 the Academy is celebrating its 175th anniversary. Today we launch a new online timeline of Academy milestones, exploring these and other high points of our history. A new series of programs, “Then and Now,” will look at signature areas of Academy work in current and historical context. We are planning a Celebration of the Library open house for the fall. Throughout the year we will be mounting blog posts on highlights and figures in Academy and Library history. We invite you to read, visit, and participate . . . so stay tuned here and on the website for more to come.
Because medicine deals with the human body, emotions can run high. When the issue is contraception, emotions run even higher. As part of Banned Books Week, consider two early U.S. works on birth control that shaped a congressional career, led to imprisonment at hard labor, and resulted in a conviction for blasphemy.
The first author is Robert Dale Owen (1801–1877). Son of Robert Owen, the British textile manufacturer and socialist reformer, Owen emigrated to the United States in 1825 to the utopian community that his father had founded that year in New Harmony, Indiana. There, with feminist and socialist Frances Wright (1795–1852), he published the newspaper New-Harmony Gazette, an outlet that expressed their then-radical views on women’s rights, slavery, public education, marriage, and birth control. After he and Wright relocated to New York City, they published Owen’s Moral Physiology; or, a Brief and Plain Treatise on the Population Question (1830), one of the first books on birth control in the United States. The book was a response to the ideas of English economist Thomas Malthus (1766–1834), who posited that, otherwise unchecked, population would always outpace food supply; Owen also saw birth control within a broader political and social context of personal freedom and equality of the sexes.
While in New York, Owen became acquainted with Charles Knowlton (1800–1850), a western Massachusetts physician. A materialist and freethinker, Knowlton published Fruits of Philosophy; or, the Private Companion of Young Married People in 1832. Designed as an aid to the couples he attended, the book was originally published anonymously and printed in a small format so it could be readily concealed. Fruits of Philosophy was the first U.S. birth control book written by a physician and went into detail on methods and practicality.
Birth control was a contentious issue for many reasons. Besides the works’ frankness about subjects not openly discussed, contraception was opposed on moral and religious grounds. One reason was the traditional idea that sex within marriage should have procreation as its purpose. Beyond this, birth control was thought to lead to greater immorality, promoting sex outside of marriage and even prostitution, as the natural obstacle against freer sexual activity—that is, pregnancy—had been removed.
Owen’s and Knowlton’s books had consequences. Owen returned to Indiana in 1833 and became an Indiana state legislator in 1835. Twice, though, he ran for a seat in the U.S. House of Representatives and lost, partly on the reputation of Moral Physiology. He eventually prevailed on the strength of a Democratic electoral wave and served in the House from 1843 to 1847, helping to establish the Smithsonian Institution. His plans to remain in the House failed, though, due in part to his views on birth control, and he was defeated for re-election in 1846.
For Knowlton the consequences were far more severe. After he published Fruits of Philosophy, he was prosecuted and fined for obscenity. His booklet was then taken up by a former Unitarian minister, Abner Kneeland (1774–1844), who printed a second edition in Boston in 1832. The resulting publicity led to Knowlton’s again being convicted for obscenity and this time imprisoned for three months at hard labor. The controversy played into Kneeland’s trial for blasphemy, still a crime in Massachusetts. He was convicted in 1838 and served 60 days in jail, the last person to be imprisoned on that charge in the country. Upon his release, Kneeland moved to Iowa and set up “Salubria” (Health), a community of like-minded freethinkers.
Restricting access to contraceptive knowledge was American practice up to the mid-20th century, under the guise of anti-obscenity laws. The 1873 Federal statute known as the Comstock Law, made it illegal to use the U.S. Postal Service to distribute such information, while a 1909 act extended this ban to interstate common carriers such as railroads. Many states also had their own laws. Congress made one of the most severe laws for the District of Columbia, over which it had direct control: giving birth-control literature to another Washingtonian could result in 5 years’ imprisonment at hard labor and a $2,000 fine. Not until 1972 were all these laws overturned.
September 15 marks the beginning of National Hispanic Heritage Month, which celebrates the cultures, traditions, heritage, and achievements of those in the United States who trace their roots to Spain and the Spanish-speaking countries of Latin America. At the New York Academy of Medicine, we are celebrating the accomplishments and contributions of Hispanic Americans to medicine and public health in the United States. According to survey data compiled by the National Center for Health Workforce Analysis in 2018, more than 10% of registered nurses in the United States identified as Hispanic, Latino, or Spanish. Contrast this with Ildaura Murillo-Rohde’s remarks about the paucity of representation in Washington, DC, for Hispanic nurses early in her career: “I saw that I was the only Hispanic nurse who was going to Washington to work with the federal government, review research and education grants, etc. There was nobody else. I looked behind me and thought: ‘Where are my people?’”
Ildaura Murillo-Rohde (1920–2010) was a Panamanian American nurse, academic, and health policy advocate who championed of the unique health care needs of Hispanic populations. Murillo-Rohde earned a nursing diploma from the Medical and Surgical Hospital School of Nursing in San Antonio, Texas, before obtaining an undergraduate degree in the teaching and supervision of psychiatric nursing from Teachers College, Columbia University, in 1953. Upon graduation, she joined Bellevue Psychiatric Hospital, working with patients diagnosed with “Puerto Rican syndrome,” the name for a condition first used to describe traumatized Puerto Rican soldiers in the Korean War. Wayne County General Hospital’s Psychiatric Division in Michigan then recruited her before she returned to New York to open Elmhurst General Hospital’s first psychiatric division in Queens. In 1971 she became the first Hispanic nurse to earn a PhD from New York University.
Throughout her career Murillo-Rohde maintained a strong commitment to growing the ranks of Hispanic nurses. Informed by her experience as a reviewer of federal research and education grants, she also sought to boost the number of policy experts advising lawmakers on the health care concerns of Hispanic communities. In the 1970s, Murillo-Rohde was an active member of the American Nurses Association (ANA), where she mounted a two-year-long effort to include the Ad Hoc Committee of the Spanish-Speaking/Spanish Surname Nurses’ Caucus in the ANA’s administrative structure. In 1975, with a group of about 15 nurses, Murillo-Rohde formed the National Association of Hispanic Nurses (NAHN) after the ANA rejected attempts to formally recognize the caucus.
Since its inception, NAHN has worked broadly to improve health care delivery and outcomes for the Hispanic community in the United States. Today, the organization sponsors an award for distinction in nursing scholarship, research, and practice, as well as a scholarship for Hispanic students enrolled in nursing programs that lead to licensure.
NAHN also publishes Hispanic Health Care International, featuring research and scholarship on issues of import to US and international Hispanic populations. Judith Aponte, a 2012 NYAM Fellow and Associate Professor of Nursing at Hunter College, is a former editor-in-chief of HHCI.
Beyond her role as founder and first president of NAHN, Murillo-Rohde was an expert on psychotherapy, marriage, and family therapy, and served in several roles in academic administration, including Dean of the College of Nursing at SUNY Downstate Medical Center. Murillo-Rohde’s influence was felt internationally as well through her appointment as WHO’s psychiatric consultant to the Guatemalan government, establishing a pilot program to train personnel in psychiatric care. She further served as Permanent UN Representative to UNICEF for the International Federation of Business and Professional Women. Murillo-Rohde passed away in her native Panama in 2010 at the age of 89.
Paul Klemperer (1887–1964) spent much of his career at Mount Sinai Hospital, where he held the position of pathologist from 1927 until his retirement in 1955. Born outside of Vienna, Klemperer first enrolled at the University of Vienna, intending to become a lawyer. At the suggestion of his father, he took a class on psychoanalysis taught by family friend Sigmund Freud and began to study medicine instead. After receiving his medical degree in 1912, he spent two years studying pathological anatomy, and then served as a physician during World War I. In 1921, he emigrated to the United States, spending a year in Chicago before moving to New York, teaching briefly at the New York Post-Graduate Medical School before joining the staff at Mount Sinai. He also taught pathology at the College of Physicians and Surgeons of Columbia University for many years, and after retirement continued to teach the Albert Einstein College of Medicine.
His students and colleagues were devoted to him. In 1962, the Academy presented him with the Academy Medal for Distinguished Contributions to Biomedical Science. In his remarks George Baehr, his colleague at Mount Sinai, noted that Klemperer’s skill as a pathologist combined with his skill as a teacher made him a much-loved figure in all the institutions to which he had a connection. Neuropathologist Stanley Aronson, in a 1989 reminiscence in the Mount Sinai Journal of Medicine, recalled him as “one who was shy yet effective, retiring yet generous, undemonstrative yet passionate, learned yet learning, always learning. For he was truly our teacher.”
After he retired, Klemperer devoted significant time to the study of the history of medicine. He wrote the preface and introduction to the Academy’s publication of a translation of Giambattista Morgagni’s noted book on pathology, The Seats and causes of diseases investigated by anatomy, as well as translating five letters of Morgagni. He also wrote the introductions to several other volumes in the Academy’s history of medicine series. To honor his memory and his devotion to the history of medicine, some years after his death an anonymous group of donors endowed the fellowship that bears his name, first awarded in 1996.
William H. Helfand (1926–2018), a Philadelphia native, pursued a career as a pharmaceutical executive for Merck. His work dovetailed with his collecting interests in prints, posters, and such pharmaceutical ephemera as trade cards and almanacs, and he wrote extensively on their social history. He and his wife, Audrey, endowed positions and fellowships at several institutions, including the Philadelphia Museum of Art, the Library Company of Philadelphia, and the Grolier Club. In 1998, the couple endowed the NYAM Library fellowship that bears their name, with the first fellowship awarded in the 1999–2000 academic year.
From the beginning, the Helfand fellowship supported research on the ways that visual materials enhance the study of the history of medicine, public health, and the medical humanities. Our own Library collections are far richer in these areas because Bill supplemented his endowment with gifts of materials from his own collections, Chief among these is the William H. Helfand Collection of Pharmaceutical Trade Cards, which is digitized and available here. In addition to trade cards, Bill gave the Library almanacs, broadsides, caricatures, prints, sheet music, and other medical ephemera. Our Helfand collection is one of many; others can be found at the Huntington Library, Yale University, Duke University, and the Library Company of Philadelphia.
If you are a scholar working on a history of medicine project, please consider our fellowships. Applications are being accepted until September 17, 2021, for a month’s residence at the Library. Successful applicants will be notified by October 22, and the next two fellows may work any time during the 2022 calendar year.
Lists of all the projects that have been supported through these endowments can be found on the fellowship pages for the Klemperer Fellowship and the Helfand Fellowship; application procedures are found there as well.
 Baehr, George. “Citation and Presentation of the Academy Medal to Paul Klemperer, MD.” Bulletin of the New York Academy of Medicine 38, no. 4 (1962): 240; Aronson, S. M. “The legacy of Paul Klemperer.” The Mount Sinai Journal of Medicine, New York 56, no. 5 (1989): 347–350.
Dr. Stephen Smith (1823–1922), Academy Fellow for 68 years, had a career as a Bellevue Hospital surgeon and a professor of surgery and anatomy at Bellevue Hospital Medical College and New York University. He wrote a field manual for Civil War army surgeons, was Health Commissioner of New York from 1868 to 1875, and was a founder of the American Public Health Association and its first president. Through his work the condition of the city, the state, and the nation markedly improved by the application of public health regulations for the common good.
Stephen Smith was born on a farm in Skaneateles, New York, on February 19, 1823, the son of a cavalry officer in the Revolutionary War and his wife.  He first studied medicine at Geneva Medical College, where a fellow student was Elizabeth Blackwell, the first woman medical school graduate in the United States. He left Geneva for Buffalo Medical College and then relocated to New York City, where he finally received his medical degree from the College of Physicians and Surgeons in 1850. Smith completed his residency at Bellevue Hospital and became an attending surgeon there in 1854; the following year he was elected a NYAM Fellow. He served on the faculty of Bellevue Hospital Medical College from its founding in 1861 until 1874, when he joined the faculty in the medical department of New York University.
In addition to his work as a practicing physician and surgeon, Smith shared the editorial responsibilities for the New York Journal of Medicine with NYAM luminary Dr. Samuel Smith Purple and assumed the editorship completely when Purple retired in 1857. The journal changed its name to the American Medical Times three years later, and Smith continued as its editor until 1864. 
Mid-nineteenth-century New York City was subject to recurring outbreaks of deadly diseases. As Smith later proclaimed, “The unsanitary condition of the city prior to 1866 cannot be described so that an audience of today can fully appreciate the reality. Nuisances dangerous to life and detrimental to health existed everywhere.”  Smith used his investigative skill and editorial position to campaign for wide-ranging reforms, including sanitary inspections, street cleaning, garbage collection, and the regulation of tenement housing and slaughterhouses.
“[Smith] had no law on his side to begin with and he made his fight by publicity. He traced twenty individual typhus cases to one house in East Twentieth Street, which he found full of immigrant families suffering from typhus. Through the tax records he reached the owner, a wealthy and prominent man who flatly refused to do anything about it. Dr. Smith looked up the law and found that there was no way to proceed against the owner. He then went to William Cullen Bryant, then the editor of The New York Evening Post. ‘At the suggestion of Mr. Bryant,’ said Dr. Smith, ‘I finally succeeded in bringing the owner of the fever nest into court on the change of maintaining a nuisance. Bryant’s reporter, who had been instructed, so frightened the owner that he promised to close and repair the house if only the matter were kept out of the papers. Bryant agreed and the owner kept his promise.’” 
Smith’s work led to the noted Citizens’ Association 1865 investigation and report on sanitary conditions in the city  and the passage of the 1866 Metropolitan Health Law. He was appointed one of New York City’s first health commissioners, serving until 1875.
Once the Metropolitan Board of Health had been established, Smith argued for the establishment of a State Board of Health. To bolster his case, he used evidence from the success of other state boards of health and of the city’s board. He made his case in a series of publications, notably The Care of Health and Life in the State of New York and A State Board of Health. A Communication to a Member of the Legislature …, both published in 1880. In the latter work he noted, “Already the agitation necessary and incident to the effort to secure the passage of this Bill has produced the most gratifying results in awakening thoughtful minds all over the State to the value of preventive medicine. Not only medical men, but laymen in every pursuit of business, have expressed their surprise at their previous apathy, and their determination now to press these questions upon the attention of the Legislature until adequate legislation is obtained.” The New York State Legislature created the State Board of Health that same year; in 1901 the board was reorganized as the State Department of Health.
In between, Smith’s ambitions reached the national scene. In 1872, he was one of the founders of the country’s premier professional public health organization, the American Public Health Association. He served as its first president up to 1875. 
In later life, Smith was widely honored for his work in American public health.  He took time to reflect on the changes that his efforts achieved. His best-known book, The City That Was (1911), tells the story of the deplorable public health conditions that existed in New York City at the beginning of the 19th century and the measures he recommended to remedy those conditions, including regular sanitary inspections. 
Smith believed man’s natural lifespan to be one hundred years, based on his contention that most animals live for five times the number of years required for the complete formation of their bones. He died on August 27,1922, some six months short of his 100th birthday. 
 During the Civil War, he wrote Hand-book of Surgical Operations, with many printings in New York in 1862 and 1863. Its preface announced:
“This Hand-Book of Surgical Operations has been prepared at the suggestion of several professional friends, who early entered the medical staff of the Volunteer Army.”
After the war, Smith produced another surgical work: Manual of the principles and practice of operative surgery, which went through numerous editions between 1879 and 1887.
 “Dr. Stephen Smith Dies in 100th Year.” The New York Times, August 27, 1922, p. 28.
 Citizens’ Association of New York, Council of Hygiene and Public Health, Report of the Council of Hygiene and Public Health of the Citizens’ Association of New York Upon the Sanitary Conditions of the City (New York, NY: Appleton, 1865).
 Stephen Smith, The Care of Health and Life in the State of New York (New York, 1880)and idem, A State Board of Health. A Communication to a Member of the Legislature on Sanitary Organization and Administration in the State of New York (New York, 1880).
On February 18, 1911, a dinner in honor of Smith’s 88th birthday took place at the Hotel Plaza. The Library holds both the program for the dinner and the speeches:
Dinner in honor of Doctor Stephen Smith and in celebration of his eighty-eighth birthday on Saturday evening, the eighteenth of February, one thousand, nine hundred and eleven at the Hotel Plaza (New York: Tiffany & Co., 1911).
Addresses in recognition of his public services, on the occasion of his eighty-eighth birthday, Feb. 19, 1911 (s.l., 1911).
Ten years later, the American Public Health Association published A Half Century of Public Health Jubilee Historical Volume of the American Public Health Association in Commemoration of the Fiftieth Anniversary Celebration of its Foundation, New York City, November 14–18, 1921 (New York, 1921). The work began with Smith’s historical overview of public health. The commemorative medal has Smith’s portrait on the front, with this legend on the reverse:
To Commemorate the Semicentennial Meeting of the American Public Health Association 1872 – New York – 1922 Noteworthy because of the Participation of its Founder Dr. Stephen Smith Born Feb. 19, 1823.
 Stephen Smith. The City That Was (New York: Frank Allaben, 1911).
by guest contributor Jacob Steere-Williams, PhD, Associate Professor of History, College of Charleston.
Join us for Steere-Williams’ talk on typhoid on September 23.
For decades, thinking about and learning from past pandemics has largely been an academic exercise, one for historians and archivists who specialize in public health. Now, in the midst of a generation-defining pandemic, COVID-19, there has been an explosion of public interest in epidemics and epidemiology. Before 2020, few Americans outside of infectious disease specialists routinely spoke the words “contact tracing” and “case fatality,” or knew the difference between isolation and quarantine.
The recent surge in popular understandings of epidemics has centered on some familiar examples, such as the 1918–1919 influenza pandemic, the mistakenly called “Spanish Flu.” As this was the most significant pandemic of the 20th century, the comparisons make sense, and the public health struggle between individual rights and community health is as apt now as it was then. Other historians, seeing the rise of xenophobia as a cultural response to COVID-19 in the West, have perceptively turned our attention to 19th-century pandemics of cholera and bubonic plague. Then, as now, a uniquely durable, yet startlingly western approach to framing pandemics has been to blame Asian people and Asian cultural practices.
At a time when the cultural mileage of past pandemics is perhaps at its height in modern history, we might fruitfully turn to the history of a relatively unexplored disease, typhoid fever, to think about our current moment.
Typhoid fever is a food- and water-borne infectious disease, the most virulent of the Salmonella family. The disease continues to wreak havoc on the Global South, killing about 200,000 people each year. In the western world typhoid was at its height in the 19th century, when it was a ubiquitous and insidious reality in North America and Western Europe. In Britain, for example, typhoid annually struck up to 150,000 people, taking the lives of 20,000 each year.
Typhoid’s patterns of distribution were erratic; it might spare a community for months or even years, then erupt as a local outbreak. Epidemiologists today discuss COVID-19 as a cluster disease, exploding in localized events not unlike the way that typhoid did in the past.
Interestingly, typhoid outbreaks continued after the introduction of early sanitary improvements such as toilets, pumped water, and sanitation systems. In the second half of the 19th century no infectious disease was as central to the rise of public health than typhoid. Typhoid was a model disease because the burgeoning group of public health scientists, the first to call themselves epidemiologists, saw that stopping typhoid’s different pathways—through food, water, and healthy human carriers—could transform the nation through preventive public health.
The story of typhoid in the 19th century is one deeply tied to the emergence of modern epidemiology, which George Buchanan, Chief Medical Officer of Britain’s central public health office, called “the minute observations of particular outbreaks.” Epidemiological practice does not operate in a vacuum, then or now with COVID-19; it is inherently a political exercise. Everyday people, business owners, and politicians have to be convinced about the science of disease communication, requiring complex rhetorical strategies that tell us a great deal about the inherent struggles of public health.
 George Buchanan, “On the Dry Earth System of Dealing with Excrement,” Annual Report of the Medical Officer of the Privy Council for 1870. Parliamentary Papers. London: Eyre and Spottiswoode, 1871, 97.
From July 2019 until March 2020, with few exceptions, I spent one day out of every week in the Drs. Barry and Bobbi Coller Rare Book Reading Room of the NYAM Library. As a volunteer, I wrote for this blog, Books, Health, and History, on various topics that utilized sources from the Library’s collections; I wrote about monsters, famous female physicians, and even libraries themselves. In March, as the threat of COVID-19 became clearer, the reading room closed, and I (among many others) could no longer consult the physical collections at the NYAM Library. After discussing with Library staff, I decided that my next project would use the digital resources and collections I am lucky to have access to as a student. I compiled a bibliography of historical literature on the topic du jour—pandemics.
Awareness that one is living through a historical moment is relatively rare; this awareness has led many to look to the past for hints as to how the current COVID-19 pandemic might impact the world going forward. In compiling this bibliography, I hoped to curate a resource that historians and history enthusiasts alike could use for research on epidemic history, personal interest, or simply to try to place our present moment in a larger historical context. I searched through several databases, including JSTOR, Project MUSE, and the History of Science, Technology, and Medicine database, looking specifically for journal articles from the last two decades which used a historical perspective to discuss pandemic or epidemic diseases.
A plague visitation scene from a 1509 edition of Fasciculus Medicinae, one of the earliest illustrated medical books to be printed. Image from the NYAM Digital Collections.
I limited my search to only those articles which are available in full digitally. This choice was made in part out of necessity—during a pandemic, a person may not be able to visit a library to find and read the journal they are looking for. Since I was “volunteering from home,” I could only read through and write descriptions for articles to which I had full digital access. Of course, this is not a perfect solution. Many articles were omitted from this bibliography because they are not available online, and they would surely have been useful. The digital articles are still for the most part only available to readers with either individual or institutional subscriptions to the relevant databases or journals.
My own experience compiling this bibliography taught me quite a bit about the long and ever-changing relationship between humanity and disease throughout history. Some diseases and disease events, such as the influenza pandemic of 1918, can provide an example (or a warning) of how different public health responses can affect long-term outcomes. Others, such as the Black Death, HIV/AIDS, and countless others, show us how disease has changed art, politics, the environment, and even the minutiae of human behavior. We have already seen many of the ways COVID-19 has changed our daily lives. While it is important not to underplay the devastation wrought by epidemic disease, reading about the impacts of other, similar disease outbreaks makes it clear that this pandemic will bring with it (and perhaps already has) significant cultural, social, and economic change, and perhaps offers us some guidance in navigating the “new normal.”
Compiling the bibliography was certainly a survey for me in the history of disease, but also highlighted several obstacles brought on or exacerbated by the modern-day pandemic. The biggest of these, at least in relation to this bibliography, is access—for all the work I did to collect and curate these digital articles, and despite the fact that many databases, journals, and other resources have made some or all of their articles free to read, many of them are still accessible only to a select few. The debate over who has or should have access to academic works is one that predates the pandemic, and is perhaps beyond the scope of a blog post. The COVID-19 crisis, however, impacts everyone, and the articles in this bibliography would almost certainly be of value to any reader. When the day finally comes that the coronavirus is no longer the threat it is today, it will still be important to read and write about it—work which everyone should have the resources to do.
I hope this bibliography can be a useful and informative resource for anyone who wishes to better understand how the coronavirus pandemic fits into a much larger historical context. The history of epidemic disease can inform how we interpret our experiences and plan our next steps in the current crisis. No less important, we can consider how our modern-day experience with a pandemic informs the ways we interpret the past.