Huber the Tuber, Corky the Killer, and The Mind

Posted on January 24, 2014 by nyamhistorymed

By Danielle Aloia, Special Projects Librarian

Harry A. Wilmer (1916-2005) was a well-known psychiatrist, writer, Jungian analyst, and founder of the Institute for the Humanities at Salado (you can learn more about his achievements at the Salado Institute website). Among his publications—most written or edited with professional psychiatrists in mind—are three health information books for children: The Lives and Loves of Huber the Tuber, Corky the Killer: A Story of Syphilis, and The Mind: First Steps.

In Huber the Tuber, Wilmer gives life to the tiny tubercle bacillus, Huber, and his friends as they embark on the invasion of Lungland. A 1943 book review by Sally Lucas Jean describes the book as “A riotously gay tale of a tuberculosis bacillus and his friends. The entire gang is so personalized as to become real creatures battling against Monosights.”¹ The Monosights are the good guys in the story, trying to subdue the tubercle from invading their land (in biology, monocytes are white blood cells that react to infections).

Huber the Tuber invades Lungland. Click to Enlarge.

In Corky the Killer, “an articulate microbe of the Treponema pallidum tribe describes what goes on from the start of a syphilitic infection and what may happen if proper treatment is not given.”² Corky and friends invade the body using the Whirling Dervish Dance of the Spirochetes (a type of bacteria) to spiral through the skin and invade the blood.

The Whirling Dervish Dance of the Spirochetes. Click to Enlarge.

These two books are great examples of how public health concerns can be brought to public attention in new and dramatic ways in order to curb the spread of disease. Hidden Treasure: The National Library of Medicine devotes a chapter to them, describing them as having “a bit of magic in them: the health message is subordinated to the sheer joy of visual storytelling.”³ This joyful storytelling can be seen in a YouTube video of a young girl reading Huber the Tuber.

“The Author’s Imaginative Model of the Inside World of the Mind.” Click to enlarge.

In The Mind, Wilmer describes perception, emotion, action, and all the functions of the mind in between through the example of a fire engine. When you see a fire engine you perceive a red moving object. Then you classify that image as a warning signal. Anxiety begins to rise and you prepare for fight or flight. Your conscious mind and your conscience work together with your unconscious mind to determine your thought process. Because you have experience with what a fire engine means you know there may be a fire happening somewhere and you determine how it may affect you. A 1965 book review says “All in all, a charming book with unusual ideas.”⁴

These books remain excellent examples of how an author can present seemingly dense scientific information through illustrations and comic relief.

1. Jean, Sally Lucas. 1943. Book Review. Am J Public Health Nations Health 33(4): 445–446.

2. Doppler, William. 1946. Book Review. Am J Public Health Nations Health 36(9): 1068–1069.

3. Sappol, Michael. 2012. Hidden Treasure: The National Library of Medicine. New York: Blast Books.

4. Book Review. 1965. The American Biology Teacher. 27(2): 565.

Smoking and Health, 50 Years Later

Posted on January 13, 2014 by nyamhistorymed

By Johanna Goldberg, Information Services Librarian

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

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

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

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

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

The 387-page report made some dire conclusions:

Smokers are 70% more likely than non-smokers to die of coronary artery disease; 500% more likely than non-smokers to die of emphysema and chronic bronchitis; and 1,000% more likely to die of lung cancer.

Male cigarette smokers have a “9- 10-fold risk of developing lung cancer.” That risk rises to 20-fold for heavy smokers.

Cigarette smokers have a 70% higher mortality rate than non-smokers.³

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

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

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

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

References

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

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

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

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

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

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

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

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

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

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

Posted on January 8, 2014 by nyamhistorymed

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

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

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

Card 45, featuring Popeye. Click to enlarge.

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

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

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

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

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

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

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

: Card 1, with Jiggs from “Bringing Up Father.”

: Card 2, with Dagwood Bumstead from “Blondie.”

: Card 3, featuring the Katzenjammer Kids.

: Card 4, featuring Little Iodine.

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

April 2014 update:

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

Lucky Safety Card 24. Click to enlarge.

April 2017 update:

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

References

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

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

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

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

History Night: Call for Papers

Posted on January 3, 2014 by nyamhistorymed

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

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

Note the following submission requirements:

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

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

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

The Christmas Lectures

Posted on December 23, 2013 by nyamhistorymed

By Arlene Shaner, Reference Librarian for Historical Collections

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

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

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

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

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

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

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

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

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

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

Item of the Month: Boston City Hospital, Christmas 1912

Posted on December 18, 2013 by nyamhistofmed

By Rebecca Pou, Archivist

Click to enlarge.

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

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

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

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

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

References

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

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

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

Burn These Handkerchiefs

Posted on December 11, 2013 by nyamhistorymed

By Johanna Goldberg, Information Services Librarian

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

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

Side one of the unfolded pamphlet.

Side two of the unfolded pamphlet.

Stay healthy!

Rehousing the Diploma Collection

Posted on December 5, 2013 by nyamhistofmed

Today’s post was written by the 2013 Gladys Brooks Conservation Intern, Caroline Evans.

The diploma collection at The New York Academy of Medicine contains over eight hundred certificates, diplomas, seals and proclamations granted by universities, professional societies and institutions across a wide geographical span. The items in the collection range from the mid-eighteenth century up to the late twentieth century. The diplomas were the subjects of a major collections care project carried out in the Gladys Brooks Book and Paper Conservation Lab by Caroline Evans (summer intern), with the assistance of Emily Moyer (Collections Care Assistant) and Allie Rosenthal (volunteer).

Piles of diplomas to be sorted, cleaned, and housed.

While most of the earlier diplomas are printed or written on parchment and display elaborate calligraphy, many of the later items in the collection are printed on paper. The diplomas can provide a glimpse into the changing methods of printing during this period, as well as into the preservation needs of flat paper—in some cases, for instance, some of the ink in the signatures had begun to flake, and seals on parchment were cracked. In addition to dry cleaning the diplomas and making the appropriate efforts to stabilize each of these items, we constructed folders and housing for each diploma or seal before sorting them by size, date, and granting institution.

Over the course of this undertaking, some gems emerged—documents significant to the history of the Academy and to the history of medicine. Among these are certificates nominating and appointing military ranks to fellows of the Academy and other doctors serving in wartime. In addition to signatures from the “Secretary of War”, many of these documents boast signatures from various Presidents of the United States. Indeed, while sorting through the collection, we encountered wartime documents—appointments or commendations thanking military doctors for their service—with signatures from Presidents Abraham Lincoln, Andrew Jackson, Andrew Johnson, Herbert Hoover, William Howard Taft, Woodrow Wilson, and Warren G. Harding, to name a few.

Certificate signed by Woodrow Wilson.

Certificate signed by Andrew Johnson.

Certificate signed by Abraham Lincoln.

Occasionally found tacked onto the back of certificates and acknowledgments of service were documents indicating the intersection of military service and medical research—for example, a letter from Walter Reed Hospital to a soldier encouraging him to participate in a study on the effect of injections of yellow fever. There are also a significant number of female medical professionals whose successes and contributions to the field of medicine and women’s health are commemorated in the collection. Some of these awards and diplomas are dated as early as the nineteenth century.

Photographs of Howard and Edith Lilienthal attached to a certificate

Photographs of Howard and Edith Lilienthal attached to a passport.

The diploma collection contains items printed in French, Portuguese, Hungarian, Latin, Hebrew and Arabic that display a variety of design styles. One particularly beautiful certificate from 1945 was granted by the Société Impériale de Médecine de Constantinople, written in Arabic on thin paper with gold leaf.

Certificate in Arabic with gold ornament

Key to the City of San Juan Batista, granted to Isidor Rubin.

Some more recent certificates are printed in color, with hand-colored borders and modern, stylized type. The diplomas on paper were a special challenge to clean and house, as many of the papers had become brittle or were adhered to acidic backings. This allowed the aspiring conservators interning and volunteering in the lab ample practice with paper repair. Diplomas printed on vellum provided their own challenges, however, as humidity fluctuations over time caused some of the works to curl and stretch, obscuring and fading labels and printed text.

Repairing paper certificates in the conservation lab.

These challenges, in addition to the diverse languages present in the collection, necessitated some additional investigation for the creation of new labels for each item. In the end, though, the lab was able to create a location guide with the identifying information for each sorted, cleaned, and re-housed object, so that the diploma collection will be accessible well into the future.

A certificate and seal, re-housed.

Holiday News from the Center

Posted on November 27, 2013 by nyamhistofmed

As the year comes to an end, there is a lot going at the Center for the History of Medicine and Public Health.

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

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

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

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

Applications close March 4, 2014 for the 2014–2015 academic year. We encourage applicants to get in touch with our Reference Librarian for Historical Collections when shaping their applications.

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

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

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

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

Posted on November 26, 2013 by nyamhistofmed

By Paul Theerman, Associate Director

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

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

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

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

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

References

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

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