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

By Jamie Marsella, Department of the History of Science, Harvard University, and the Library’s 2022 Paul Klemperer Fellow

Ms. Marsella completed her Fellowship residency in summer 2022 and will present her research by Zoom on September 7 at 4:00 pm (EDT). To attend her talk, “‘Where Once There Was Only Friction’: Religion, Eugenic Maternalism, and the Babies’ Welfare Association, 1908–1920,” register through the Academy’s Events page.

I’ll start this blog post with a confession: before sitting down in the NYAM Rare Book Room, I was worried there might not be enough materials to keep me busy for a full month. How profoundly wrong I was!

I arrived at NYAM to conduct research for my dissertation—an exploration of the New York Babies’ Welfare Association (1912–1920). The BWA was an organization that aimed to standardize maternal and pediatric public health programs while remaining a loose federation of public health and child welfare organizations, including private philanthropic and religious groups.

The Babies’ Welfare Association was created by the New York City Bureau of Child Hygiene in 1912. Neither organization has a stand-alone archival collection, nor do most of the 120+ individual organizations within the BWA. Before arriving, I could not have known that the NYAM Library would hold more relevant materials than I could ever have imagined.

The BWA was abundantly represented within the NYAM collections. This makes sense since, for the first two decades of the twentieth century, the BWA was a well-known, highly publicized organization in New York City. The Chief of the Bureau and President of the BWA, Dr. Sara Josephine Baker (1873–1945),[1] was a household name not only in New York, but throughout the country, with movie reels produced by Fox Studios, a monthly Good Housekeeping column, multiple books on child health and parenting, a regular radio broadcast, and constant coverage in the local and national press.

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

Unlike negative eugenic programs (i.e., sterilization, anti-miscegenation laws) that came to dominate later in the century, early twentieth-century reformers understood eugenic reform as a combination of heredity and environmental conditions. In this framework, improved sanitation, nutrition, and hygiene could improve individuals and enable them to pass on these improvements to their future offspring. The BWA emphasized these changes in the environment, promoting them as eugenic maternalism. In other words, the BWA understood mothers as the family’s first line of defense against disease and, therefore, an essential part in preventing “racial degeneration.” The BWA, therefore, targeted immigrant neighborhoods with the explicit desire to “improve” white-ethnic communities and prevent future supposedly dysgenic generations.

I came to NYAM hoping to better understand why Catholic and Jewish organizations might be interested in participating in this eugenic standardization project and how their participation may have shaped how the BWA understood and operationalized eugenics. I also hoped to clarify the role that Black reformers and patients played within the BWA. Based on what I had gleaned from digitized sources, the BWA’s work with Black philanthropic groups was inconsistent, and their relationships were unclear.

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

The materials I’ve reviewed at NYAM paint a complicated and nuanced picture. Some religious organizations, like the New York Foundling Asylum and other benevolent institutions run by women religious, understood their own religious missions as Catholics in a way that blended nicely with the assimilationist goals of eugenic maternalism.

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

Similarly, Jewish organizations like the United Hebrew Charities or the Brooklyn Federation of Jewish Charities understood their work as both a religious mission and an assimilating force. Such groups were eager to associate their religious and cultural practices with Americanism, especially in the face of rising antisemitism.

Most BWA members held a capacious view of their work beyond childcare, health and hygiene, or charitable aid. As I continued to work through the Library’s documents, it became clear that members of the BWA were pursuing something far broader than public health or bodily hygiene. These programs were about “right living”—teaching women and children how to conduct themselves in public and private, how to understand one’s role as a (future) citizen, or how to raise and nurture the future citizens in their care.

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

Within these different organizational records, there were also small glimpses of public health work specifically targeting the Black community. While the connections between the BWA and Black New Yorkers remained muddled, my time at NYAM has helped me understand this reflects the nature of the work, which was sporadic at best and exploitative at worst. The Lincoln Hospital and Home (a BWA member) is one exception to this general rule. The hospital trained Black nurses, many of whom then worked in the hospital treating both Black and white patients or worked with the Henry Street Settlement House (another member) in their Visiting Nursing Service.

Ultimately, my time at NYAM was invaluable. The materials there allowed me to better understand how the members of the BWA negotiated amongst themselves to create a standardized eugenic program that could encompass different ethnicities and religions.  


References

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

In Praise of Ephemera: Disability History and the New York Academy of Medicine Library

By Dr. Eileen V. Wallis, Professor of History, California State Polytechnic University—Pomona, and the Library’s 2020 Paul Klemperer Fellow

Dr. Wallis completed her Fellowship residency in summer 2022 and will present her research by Zoom on August 2 at 4:00 pm (EDT). To attend her talk, “California and the Search for Medical Legitimacy, 1850–1880,” register through the Academy’s Events page.

As true of many researchers, the hunt for historical primary and secondary sources for my book project, “California and the Politics of Disability, 1850-1970,” has led me down many paths. This book project uses Los Angeles County as a case study to understand how the interplay between state and county governments shaped the lived experiences of Californians deemed “mentally disordered” from 1850 to 1970. “Mentally disordered” was not a socio-medical category, but rather a bureaucratic one. It is, however, still a useful construct for understanding the ways in which California’s politicians, doctors, and progressive reformers lumped together populations experiencing what today we would consider two distinct categories of disability—mental illnesses and developmental disorders—for their own convenience.[1] These were also the two populations arguably most vulnerable to institutionalization in this era, as well as the ones least likely to leave primary sources behind them. The time span of this study was chosen because it encompasses the rise of institutions for the disabled in California; the shift in them from care custodialism; the era of overcrowding, abuse, and crisis; and the ultimate dismantling of most state institutions for the disabled, a process that began in the late 1950s and culminated with the passage of the Lanterman Disability Service Act in 1969 and the beginning of the era of deinstitutionalization.

Disabled Americans are frequently absent from or hidden within the historical record. The study of sickness and disability, Gracen Brilmyer writes, is often marked by “layers of absences, subtleties, inaccuracies, and perspectives that are embodied in records, archives, and the lack thereof.”[2] However, because the New York Academy of Medicine Library began collecting so early, and because the Academy’s interests were so wide-ranging, it has amassed a strong collection of materials of use to anyone interested in the history of disability in the United States. Interestingly, many of the items it holds related to and in some cases created by Californians cannot be found in collections in the Golden State, but only in New York City at the Academy Library.

“Evolution of Treatment Methods of a Hospital for the Mentally Retarded” California Mental Health Research Monograph no. 3, 1965. New York Academy of Medicine Library

In 1965, two researchers working for California’s Department of Mental Hygiene, Esther Pond and Stuart Brody, produced a report called “Evolution of Treatment Methods of a Hospital for the Mentally Retarded.” Focused on what was then-called the Sonoma State Hospital in Sonoma County, California, the state’s oldest institution for the developmentally disabled, this report was officially California Mental Health Research Monograph no. 3.[3] It was prepared specifically for use by the Department, printed on cheap paper, given only a pink paper cover, and was likely expected to be, eventually, discarded. The Department certainly could not have anticipated that it would still exist, more than fifty years later, tucked away in a filing cabinet in the New York Academy of Medicine Library.

Sonoma Home for the Feeble Minded,
California State Archives
Biennial Report of the State Department of Mental Hygiene, p. 3, New York Academy of Medicine Library

Indeed, a remarkable number of materials generated by California’s Department of Mental Hygiene, which operated all of California’s state asylums and institutions for the mentally ill and developmentally disabled through the late 1960s, found their way into the Library’s collections. Another example is the 1950–1952 Biennial Report of the California State Department of Mental Hygiene. Like “Evolution of Treatment Methods,” this report has only a paper cover and is held together with staples. It is, however, lushly illustrated with photos, charts, and graphs, including a page featuring both then-Governor of California Earl Warren (soon to be Chief Justice of the United States Supreme Court) and Department head Frank Tallman commenting favorably about the work then being done. Because it covers the years 1950 to 1952, the Biennial Report captures California’s asylums and institutions as the state both embarks on a massive post-war building spree but is also beginning to look for quicker ways to “treat and release” individuals. The report excitedly discusses the use of invasive treatments and psychosurgeries such as electroshock (now known as electroconvulsive therapy or ECT), insulin shock, and lobotomies as heralding a promising new era of medical treatment. The modern reader, of course, knows this is not what would ultimately happen. To read such a report today is jarring, but it is, nonetheless, a valuable snapshot of a key transitional moment for both California and indeed for the care of mentally ill and disabled Americans nationwide.

Cover, “Lanterman Mental Retardation Services Act” brochure, c. 1971. New York Academy of Medicine Library

Many of these items are only discoverable by using the Library’s printed catalog, as they were acquired before the advent of online catalogs and have not yet been included in the Library’s projects to convert its printed catalogs to digital form. Some are what is known as ephemera, items that were created for a “specific, limited purpose” and for “one-time or short-term use.”[4] In the last two decades historians have found them to be an incredibly rich source of information, often capturing information about people (women, African Americans, the working classes, etc.) who are “rarely visible in archival collections or mainstream publications.”[5] These absences become more profound the farther back in time one travels. Thus, scholars often make use of institutional and medical reports like Pond and Brody’s and the Biennial Report to try to excavate from within them as much as possible about the lived experiences of Californians in state institutions during the nineteenth and twentieth centuries.

For the researcher interested in American disability history, the Library’s printed catalog volumes lead to a treasure trove of primary sources, and well-worth exploring alongside the online catalog. When combined with its other holdings, the New York Academy of Medicine Library’s collections show tremendous promise for furthering our understanding of the history of disability in the United States.[6]


References

[1] English authorities used the term in similar ways, although usually without including mental illness. For a discussion of that context, see Mark Jackson, The Borderland of Imbecility: Medicine, Society, and the Fabrication of the Feeble Mind in Late Victorian and Edwardian England (Manchester: Manchester University Press, 2000).

[2] Gracen Brilmyer, “Towards Sickness: Developing a Critical Disability Archival Methodology,” in Journal of Feminist Scholarship Volume 17 Issue 17 (Fall 2020): 27.

[3] Sonoma State Hospital began in the 1870s as California’s first state Home for Feeble-Minded Children, a name which unfortunately tells us a great deal about how these individuals were perceived by society at the time. It later became the Sonoma State Home, the Sonoma State Hospital, and finally the Sonoma Developmental Center.

[4] The nature of such items unquestionably poses challenges for librarians and archivists, both in their physical care and in how to catalog them. Rebecca Alternatt and Adrien Hilton, “Hidden Collections within Hidden Collections: Providing Access to Printed Ephemera,” in The American Archivist Volume 75, No. 1 (Spring/Summer 2012): 173.

[5] There is debate in the field as to what is and what is not ephemera. Rebecca Altermatt and Adrien Hilton, for example, argue that any kind of government document is not ephemera. However, as this report was not a publication of the state of California itself but of one department within that government, and created for short-term internal use, the question is open for debate. Altermatt and Hilton, 173.

[6] As disability history and Disability Studies have evolved as research fields, scholars have pushed to move us beyond the medical model of disability, which sees disability as mainly a pathology, as something to be cured, to the social model, which urges an examination of disability as both a social construction and as a lived experience. As scholars Susan Burch and Ian Sutherland explain, “disability is often less about physical or mental impairments than it is about how society responds to impairments.” Susan Burch and Ian Sutherland, “Who’s Not Here Yet? American Disability History,” in Radical History Review Issue 94 (Winter 2006): 128–29.

Controlling Substances: The Evolution of the American Moral and Medical Drug Policy Regime 

By Logan Heiman, Digital Collections Manager

Senate hearings on narcotic addiction in 1969.

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 “La Guardia Report,” 1944.

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.

NYC’s Overdose Prevention Center
(Photo credit: OnPoint NYC)

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.

Maternal Mortality In New York City: NYAM’s Landmark 1933 Study

By Paul Theerman, Director

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.

Dr. Ransom Spafard Hooker, 1907

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.”

Begun in the 1930s, NYAM’s work continues to the present in the 2018 New York Maternal Mortality Summit and the ongoing efforts of the Women’s Health Research and Well-being Working Group.

_________

Sources:

King, Charles R. “The New York Maternal Mortality Study: A Conflict of Professionalization.” Bulletin for the History of Medicine 65 (1991): 476–502.

New York Academy of Medicine, Committee on Public Health Relations. Maternal Mortality in New York City: A Study of All Puerperal Deaths, 1930–1932. New York: The Commonwealth Fund, 1933. Quotation on p. 163.

Owens, Deirdre Cooper, and Sharla M. Fett. “Black Maternal and Infant Health: Historical Legacies of Slavery.” American Journal of Public Health 109(10)(October 2019): 1342–45. https://ajph.aphapublications.org/doi/10.2105/AJPH.2019.305243, accessed March 4, 2022.

“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.

Taylor, Morgan. “An Untold Story: Black Maternal Mortality in the United States.” Nursing Clio, January 20, 2022. https://nursingclio.org/2022/01/20/an-untold-story-black-maternal-mortality-in-the-united-states/, accessed March 4, 2022.

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, [2012].

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.

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

By Dr. Paul E. Sampson, Assistant Professor of History, The University of Scranton 

2020 Audrey and William H. Helfand Fellow in the History of Medicine and Public Health 

Over the course of the past year, I have had the privilege of spending four weeks researching in the spectacular rare book collection of the Library of the New York Academy of Medicine. My book project is entitled “Ventilating the Empire: Environmental Machines in Britain, 1700–1850” and comprises a scientific and social history of ventilation in Britain and the British empire during the long eighteenth century, roughly 1688 to 1815. By examining the design and deployment of ventilating machines in slave and naval ships, prisons and public buildings, I ask how devices designed to protect human beings from environmental hazards became a means of dividing British society along class and racial lines.  

Text Box

The primary subject of my research has been the life and career of prison reformer John Howard (1726–1790). I examine Howard’s career through the context of his work on “Jail Fever” (AKA typhus) which contemporary physicians and medical experts understood as an airborne disease. I argue that a key feature of Howard’s celebrity was his perceived invulnerability to airborne diseases. In addition, his influence helped to shift the discourse of prison reform away from overall institutional sanitation and towards methods intended to control the hygiene and morality of individual prisoners. 

For those unfamiliar, John Howard was a noble-born, intensely religious man who was appointed sheriff of Bedfordshire in 1773. One of his duties was to inspect local prisons. Unlike many of his genteel contemporaries, he took this job seriously. He was appalled by the conditions of the prisons in Bedfordshire, and to spur reform and gather ideas for improvement, he made a series of lengthy tours to visit as many prisons as he could throughout the British Isles and continental Europe. His first published book, The State of the Prisons in England and Wales (1777), detailed his visits to dozens of county jails and bridewells (workhouses), including careful notes of the fees charged to prisoners, their daily workload, the prison diet, and the overall sanitation.  

One of the primary goals of Howard’s travels was to find the best means of preventing the spread of disease. By the 1750s, prisons were increasingly perceived as public health hazards. The filthy and diseased condition of prisoners in London’s Newgate prison became a public scandal after the Lord Mayor and 56 others died of jail fever in the weeks following an audience with prisoners. Following the contemporary etiology of fever, the outbreak was attributed to the “putrid effluvia” exhaled in the breath of sick prisoners that had imparted a “poisonous quality” to the air in the courtroom.1 By 1774, Howard had achieved celebrity status by helping to author the “Act for Preserving the Health of Prisoners in Gaol.” This act stated that jail fever was caused by the “want of cleanliness and fresh air” and mandated that all interior walls and ceilings be scraped and white-washed annually and “constantly supplied with fresh air, by means of hand ventilators or otherwise.”2  

However, in the wake of this achievement, Howard’s attitudes about preventing fever had begun to shift. During his tours of European prisons, he was puzzled that he rarely encountered “jail distempers” there. To explain the disparity between these and disease-ridden English institutions, Howard developed a theory of jail fever based entirely on his own “experience.” He argued that prisoners could only be infected if privation, filth, and personal intemperance weakened them enough for the contagion to take hold. Young and healthy convicts who were used to “vigorous exercise” quickly became infected due to the “sudden change of diet and lodging” that “so affects the spirits of new convicts, that the general causes of putrid fevers exert an immediate effect on them.” As a counter-example, Howard pointed to himself. During his first tours, he wrote, he had attempted to avoid breathing in contagion by “smelling to vinegar… and changing my apparel…constantly and carefully.” A few years later, however, he wrote that he “entirely omitted” such precautions. In his opinion, the real protection against infection were his habits of “temperance and cleanliness” as well as the power of “divine providence.”3 

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

By the time the second edition of State of the Prisons came out in 1780, Howard had visited hundreds of disease-ridden institutions and avoided contracting a serious infection. While friends privately cautioned him against such continual risk-taking, Howard’s superhuman invulnerability to disease had become a key feature of his celebrity.4 Celebratory poems about Howard became, in the estimation of two literary scholars, “nearly ubiquitous in the 1780s and 1790s” as poets from Erasmus Darwin to William Cowper celebrated his arduous travels and selfless virtue.5 William Hayley’s 1780 Ode, Inscribed to John Howard attributed Howard’s “matchless fame” to his “valor’s adventr’ous step” through “malignant cells” where “fierce contagion, with affright, repels.”6

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

This vision of Howard as a heroic and invincible figure appeared in numerous prints and lithographs and was captured evocatively in an unfinished work by famed painter George Romney, who depicted a defiant Howard striding confidently into scenes of melodramatic suffering and disease.7  

Despite his reputation, Howard wasn’t able to evade contagion forever. While travelling through southern Ukraine in the winter of 1790, Howard contracted a serious fever and died two weeks later.8 Notwithstanding his untimely death, Howard’s emphasis on invigorating labor, self-regulation, and instilling personal hygiene in convicts exerted an enormous influence. By the heyday of the modern penitentiary in the mid-nineteenth century, Howard was lauded as the founder of “prison science.”9 While jails designed during Howard’s life reflected the eighteenth-century emphasis on eliminating effluvia via ventilation, their nineteenth-century successors focused instead on insuring that each inmate was placed in solitary confinement and given a strict regimen of work and moral instruction.10  

In my larger project, I argue that this is partially due to a shifting locus of responsibility for preventing airborne disease. The attention of reformers shifted from the condition of the institution to the character of the individual, who became responsible for his or her own cleanliness and ventilation. To briefly illustrate this point, I will conclude with a quotation written several years after Howard’s death by naval health reformer Gilbert Blane: 

Those only whose duty leads them to consider the subject, are aware how much the welfare of the human species depends on ventilation and cleanliness; and no one could render a greater service to his fellow creatures, than to impress on their minds the necessity of cultivating them as moral and religious duties.11 


1. See, for example: John Pringle, Observations on the Nature and Cure of Hospital and Jayl-Fevers (London: A. Millar, 1750); “Account of the Fatal Assize,” CLA/035/02/049, Gaol Committee, 1750–1755, Notes on Ventilating Newgate, London Metropolitan Archives.

2. Act for Preserving the Health of Prisoners in Gaol and Preventing the Gaol Distemper, 1774, 14 Geo. III, c. 59.

3. John Howard, The State of the Prisons in England and Wales 2nd. Ed. (Warrington: T. Cadell 1780) 430–31.

4. Thomas Taylor, Memoirs of John Howard (London: John Hatchard, 1836) 386–87.

5. Gabriel Cervantes and Dahlia Porter, “Extreme Empiricism: John Howard, Poetry, and the Thermometrics of Reform,” The Eighteenth Century, 57:1 (Spring 2016): 97.

6. William Hayley, “Ode, Inscribed to John Howard” (Boston: J. White et. al. 1795 [1780]).

7. George Romney, John Howard Visiting a Prison or a Lazaretto, 1790–95, courtesy of the Museum of Fine Arts, Boston, MA.

8. John Aikin, A View of the Life, Travels, and Philanthropic Labours of the Late John Howard (Boston: J. White et. al., 1794) 120–25.

9. William Hepworth Dixon, John Howard and the Prison World of Europe, 2nd ed. (London: Jackson and Walford, 1850) 1.

10. Robin Evans, The Fabrication of Virtue: English Prison Architecture 1750–1840 (London: Cambridge UP, 1982) 104–114; Michael Ignatieff, A Just Measure of Pain (London: Penguin, 1978) 3–14.

11. Gilbert Blane, “Letter to John Hippisley,” in Observations on the Diseases of Seamen (London: 1799): 614–15.

The New York Academy of Medicine at 175

By Paul Theerman, Director

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 Constitution and By-Laws of the
New York Academy of Medicine,
adopted January 6, 1847

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 new “Rare Book and History Room” in the 1930s

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.

A teacher is observed demonstrating proper toothbrushing techniques to a group of kindergarten children

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.

Mary Ann Payne, MD, NYAM’s First Woman President, 1987-1988

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.

Health and Heresy

By Paul Theerman, Director

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.

Title page of the Library’s copy of Robert Dale Owen’s Moral Physiology; or, a Brief and Plain Treatise on the Population Question, 5th edition, 1831, published through Owen’s partnership with Frances Wright.
“Alas, that it should ever have been born!” frontispiece to Owen’s Moral Physiology, showing a mother leaving a child at a foundling hospital. The engraving is by American artist and engraver Asher B. Durand, based on a work by French artist, Pierre-Roch Vigneron.
Title page from the Library’s copy of Charles Knowlton’s Fruits of Philosophy; or, the Private Companion of Adult People, 4th edition, 1839. (The title varied slightly from edition to edition.)

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.

Celebrating National Hispanic Heritage Month: Dr. Ildaura Murillo-Rohde, PhD, RN, FAAN

By Logan Heiman, Digital Collections Manager

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, PhD, RN, FAAN (1920–2010). National Association of Hispanic Nurses.

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.

Murillo-Rohde in the 1970s. Barbara Bates Center for the Study of the History of Nursing, MC 172.

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.

References

1. Aponte, Judith. School of Nursing at Hunter College, City University of New York, 2021. http://www.hunter.cuny.edu/nursing/faculty/judith-aponte

2. Brush, Barbara & Villarruel, Antonia (2014). “Heeding the Past, Leading the Future.” Hispanic Health Care International. 12. DOI: 10.1891/1540-4153.12.4.159.

3. Feldman Harriet, PhD, RN, FAAN, et al. Nursing Leadership: A Concise Encyclopedia. 2nd ed., Springer Publishing Company, 2011, p. 393.

4. Ildaura Murillo-Rohde Papers, Barbara Bates Center for The Study of The History of Nursing, School of Nursing, University of Pennsylvania.

5. Portillo, Carmen. “25 and Counting.” Minority Nurse Magazine. 30 Mar. 2013. https://minoritynurse.com/25-and-counting/

6. U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. 2019. Brief Summary Results from the 2018 National Sample Survey of Registered Nurses, Rockville, Maryland. https://data.hrsa.gov/DataDownload/NSSRN/GeneralPUF18/nssrn-summary-report.pdf

The Faces Behind Our Fellowships

By Arlene Shaner, Historical Collections Librarian

The Library has two residential research fellowships, the Paul Klemperer Fellowship in the History of Medicine and the Audrey and William H. Helfand Fellowship in the History of Medicine and Public Health. While there is plenty of information on our website about how to apply for our fellowships, there is no information there about the people for whom they are named, and it seems appropriate to share a little bit about them.

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.

Paul Klemperer, M.D. (1887–1964). NYAM Library Collections.

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.”[1]

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.[2] 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.

William H. Helfand (1926–2018). Image from the New York Times, October 5, 2018.

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.

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[1] 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.

[2]William Helfand, a Collector Intrigued by Quackery, Dies at 92,The New York Times, October 5, 2018.

Stephen Smith, MD, New York Pioneer of Public Health

by Paul Theerman, Director

At its Annual Meeting of the Fellows, November 12, 2020, The New York Academy of Medicine is presenting the Stephen Smith Medal for Distinguished Contributions in Public Health to the Honorable Andrew M. Cuomo, Governor of the State New York. The following appreciation of Smith is based on an exhibit that Historical Collections Librarian Arlene Shaner created in 2005 when the award was established.

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, MD, n.d. NYAM Library Carte-de-visite collection, http://dcmny.org/islandora/object/nyam%3A1012.

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. [1] 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. [2]

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.” [3] 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.

Stephen Smith. The City That Was (New York: Frank Allaben, 1911, frontispiece.

“[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.’” [3]

Smith’s work led to the noted Citizens’ Association 1865 investigation and report on sanitary conditions in the city [4] 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. [5]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. [6]

From the book presented to Smith at a dinner in his honor, February 18, 1911. MS [Stephen Smith], a token of profound esteem and high regard from his many friends. [New York], Tiffany Co., 1911.

In later life, Smith was widely honored for his work in American public health. [7] 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. [8]

Smith’s intertwined initials, from the book presented to him at a dinner in his honor, February 18, 1911. MS [Stephen Smith], a token of profound esteem and high regard from his many friends. [New York], Tiffany Co., 1911.

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. [3]

_____

Notes

[1] Jay H. Glasser, PhD, Elizabeth Fee, PhD, and Theodore M. Brown, PhD. “Stephen Smith (1823–1922): Founder of the American Public Health Association,” American Journal of Public Health, 2011 November; 101 (11): 2058. https://ajph.aphapublications.org/doi/10.2105/AJPH.2009.188920, accessed November 2, 2020.

[2] 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.

[3] “Dr. Stephen Smith Dies in 100th Year.” The New York Times, August 27, 1922, p. 28.

[4] 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).

[5] 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).

[6] “APHA Past Presidents.” https://www.apha.org/about-apha/executive-board-and-staff/apha-executive-board/apha-past-presidents, accessed November 2, 2020.

[7] Two examples:

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.

[8] Stephen Smith. The City That Was (New York: Frank Allaben, 1911).