20th-Century Teeth: Dentistry at the Turn of the Century

By Johanna Goldberg, Information Services Librarian

This is part of an intermittent series of blogs featuring advertisements from medical journals. You can find the entire series here.

“How did you learn to be a dentist? Did you go to a college?”

“I went along with a fellow who came to the mine once. My mother sent me. We used to go from one camp to another. I sharpened his excavators for him, and put up his notices in the towns–stuck them up in the post-offices and on the doors of the Odd Fellows’ halls. He had a wagon.”

“But didn’t you never go to a college?”

“Huh? What? College? No, I never went. I learned from the fellow.”

Trina rolled down her sleeves. She was a little paler than usual. She fastened the buttons into the cuffs and said:

“But do you know you can’t practise unless you’re graduated from a college? You haven’t the right to call yourself, ‘doctor.'”1

In Frank Norris’ 1899 novel McTeague: A Story of San Francisco—better known for its depiction of greed than the professionalization of dentistry—the title character loses his 12-year-old dental practice after California requires practitioners to hold a degree in the field. The timing couldn’t be worse for McTeague: he’d only just fulfilled a long-held dream, obtaining and hanging an enormous golden tooth outside his dental parlor.

McTeague’s fictionalized struggle was based in reality: until the mid to late 1800s, dentistry in the United States was not a regulated profession. Alabama became the first state to regulate dentists in 1841, and other states followed suit through the end of the century.2 In 1885, California passed a law requiring practicing dentists to register with a board, which could call up registrants for examination. Diplomas from a licensed dentistry school—the University of California College of Dentistry opened in San Francisco in 1882—also qualified registered dentists to practice. In 1901, a new law made practicing dentistry in California even more restrictive, part of a nationwide move to tighter regulation.3,4 In the novel as it would have been in real life, McTeague’s practice was toast.

Advertisements in dental journals from the era depict the trend toward professionalization, along with other technological advances. In 1840, the Baltimore College of Dental Surgery opened its doors as the first dental school in the world; by 1895, it had some local competition, including the Dental Department of the Baltimore Medical College.4 This school advertised heavily in journals like the American Journal of Dental Science.

Ad for the Dental Department of the Baltimore Medical College in the American Journal of Dental Science, vol. 33, no. 10, February 1900.

Ad for the Dental Department of the Baltimore Medical College in the American Journal of Dental Science, vol. 33, no. 10, February 1900.

Intriguingly, not only dental schools advertised in dentistry journals: The February 1901 volume of Dental Hints includes an ad encouraging dentists to take up a correspondence course in optometry, “on account of the intimate relationship between the eye and the teeth.” Huh?

Advertisement for the Philadelphia Optical College in Dental Hints, vol. 3, no. 2, February 1901.

Advertisement for the Philadelphia Optical College in Dental Hints, vol. 3, no. 2, February 1901.

Dental journal advertisements also reflect anesthetic advances. William Morton, a dentist, performed the first public demonstration of ether as a surgical anesthetic in 1846.2 A similar demonstration of nitrous oxide in 1845 did not go so well: dentist Horace Wells extracted a tooth before administering the proper dosage, and the patient cried out in pain. The drug was tabled for about 20 years; by 1869, it was commonly used either on its own or in conjunction with ether for dental procedures.2,5 Dental surgeries held less risk than other medical procedures, as they were commonly performed either in the patient’s or dentist’s home, locations less teeming with deadly microbes than operating theaters. After advances in antiseptic surgery by people like Joseph Lister, dental surgery became even safer—and Dr. Joseph Lawrence named an antiseptic mouthwash in his honor.5,6

Codman & Shurtleff's Inhaler for Gas or Ether advertisement in Dental and Oral Science Magazine, vol. 1, no. 2, May 1878.

Codman & Shurtleff’s Inhaler for Gas or Ether advertisement in Dental and Oral Science Magazine, vol. 1, no. 2, May 1878.

Listerine advertisement in the American Journal of Dental Science, vol. 33, no. 10, February 1900.

Listerine advertisement in the American Journal of Dental Science, vol. 33, no. 10, February 1900.

Local anesthetics also entered the market around the turn of the century. Some, like Mylocal, contained cocaine—though in the case of Mylocal, that cocaine was to be added by the practitioner prior to use. Perhaps unsurprisingly, the amount of cocaine used in local anesthetics was often poorly controlled, with sometimes dire results.5 Another local anesthetic, Eureka, proudly advertised that it “[avoids] that most dangerous drug that is known to the profession as COCAINE.” A third, Wilson’s Local Anaesthetic, notes that it is “non-secret and positively guaranteed.” Unfortunately, its ads don’t state what these non-secret ingredients are.

Advertisement for Mylocal anaesthetic in the American Journal of Dental Science, vol. 39, no. 1, January 1908.

Advertisement for Mylocal anaesthetic in the American Journal of Dental Science, vol. 39, no. 1, January 1908.

Advertisement for Eureka Local Anaesthetic in Dental Hints, vol. 3, no. 2, February 1901.

Advertisement for Eureka Local Anaesthetic in Dental Hints, vol. 3, no. 2, February 1901.

Advertisement for Wilson's Local Anesthetic in Dental Clippings, vol. 3, no. 6, April 1901.

Advertisement for Wilson’s Local Anesthetic in Dental Clippings, vol. 3, no. 6, April 1901.

Other turn-of-the-century advances include the development of tube toothpaste in the 1880s (previously, toothpaste had only been available in powdered form); awareness of microbial causes of tooth decay, leading to the promotion of flossing and brushing in the 1890s; and the use of gold foil as a cavity filling in the 1850s.2 The ads below reflect these advances and others, and were selected to show the relatively pain-free side of dentistry.

R. S. Williams Toothbrushes advertisement in Dental and Oral Science Magazine, vol. 1, no. 2, May 1878

R. S. Williams Toothbrushes advertisement in Dental and Oral Science Magazine, vol. 1, no. 2, May 1878.

Ney's Gold Plates advertisement in the American Journal of Dental Science, vol. 33, no. 1, May 1899.

Ney’s Gold Plates advertisement in the American Journal of Dental Science, vol. 33, no. 1, May 1899.

Dental Floss Silk advertisement in advertisements in the American Journal of Dental Science, vol. 33, no. 10, February 1900.

Dental Floss Silk advertisement in advertisements in the American Journal of Dental Science, vol. 33, no. 10, February 1900.

McConnell Dental Chair advertisement in Dental Hints, vol. 3, no. 4, April 1901.

McConnell Dental Chair advertisement in Dental Hints, vol. 3, no. 4, April 1901.

Standard Dental Manufacturing Co. advertisement in Dental Hints, vol. 3, no. 5, May 1901.

Standard Dental Manufacturing Co. advertisement in Dental Hints, vol. 3, no. 5, May 1901.

Dentacura toothpaste advertisement in Dental Hints, vol. 3, no. 11, November 1901.

Dentacura toothpaste advertisement in Dental Hints, vol. 3, no. 11, November 1901.

Munson's Standard Teeth advertisement in Dental Hints, vol. 3, no. 12, December 1901.

Munson’s Standard Teeth advertisement in Dental Hints, vol. 3, no. 12, December 1901.

Prophylactic Toothbrush advertisement in Dental Summary, vol. 22, no. 7, July 1902.

Prophylactic Toothbrush advertisement in Dental Summary, vol. 22, no. 7, July 1902.

Antikamnia and Odontoline advertisements in advertisements in the American Journal of Dental Science, vol. 39, no. 4, April 1908.

Antikamnia and Odontoline advertisements in advertisements in the American Journal of Dental Science, vol. 39, no. 4, April 1908.

Baker Coat Co. and Keeton Gold advertisements in the American Journal of Dental Science, vol. 39, no. 4, April 1908.

Baker Coat Co. and Keeton Gold advertisements in the American Journal of Dental Science, vol. 39, no. 4, April 1908.

Bowl Spittoon advertisement in the American Journal of Dental Science, vol. 39, no. 4, April 1908.

Bowl Spittoon advertisement in the American Journal of Dental Science, vol. 39, no. 4, April 1908.

References

1. Norris F. McTeague.; 1899. Available at: http://www.gutenberg.org/files/165/165-h/165-h.htm. Accessed May 9, 2016.

2. History of Dentistry Timeline. Available at: http://www.ada.org/en/about-the-ada/ada-history-and-presidents-of-the-ada/ada-history-of-dentistry-timeline. Accessed May 9, 2016.

3. Newkirk G. California. In: Koch CRE, ed. History of dental surgery: Dental laws and legislation, dental societies and dental jurisprudence, Vol. III. Fort Wayne, Ind.: National art publishing Company; 1910:755–756. Available at: https://books.google.com/books?id=9iE-AQAAMAAJ&pgis=1. Accessed May 9, 2016.

4. Schulein TM. A chronology of dental education in the United States. J Hist Dent. 2004;52(3):97–108.

5. Enever G. History of dental anaesthesia. In: Shaw I, Kumar C, Dodds C, eds. Oxford Textbook of Anaesthesia for Oral and Maxillofacial Surgery. Oxford: Oxford University Press. doi:10.1093/med/9780199564217.001.0001.

6. From Surgery Antiseptic to Modern Mouthwash | LISTERINE®. Available at: http://www.listerine.com/about. Accessed May 10, 2016.

Cupid Out of Sorts—Is Advised to Take a Turkish Bath

By Anne Garner, Curator, Center for the History of Medicine and Public Health

Near Çemberlitas Square in Istanbul, a stone’s throw away from the Grand Bazaar, stands the ethereal Çemberlitas hammam, built in 1584. At first glance, one might think the frontispiece of David Urquhart’s Manual of the Turkish Bath depicts this famous Turkish bath, with its domed vaults and cut-away star windows in the ceiling.

The Hammam. In: Urquhart, Manual of the Turkish Bath, 1865.

It does not. Instead, the engraving depicts a proposed new construction in 19th-century London.

By the 1870s, these baths, modeled on Turkish hammams, were scattered across England and America, largely through the efforts of Scotsman David Urquhart.

In the mid-19th century, Urquhart, an antiquarian and diplomat who had travelled widely in Spain, Morocco, and Turkey, ignited a wave of enthusiasm for public baths in Britain. He wrote about the dry hot-air bath, or hammam, he visited in Turkey in his travelogue, The Pillars of Hercules.

Urquhart’s ideas gelled when he met Irish physician Richard Barter. In 1843, Barter opened the first public bath facility of its kind in the UK designed for medical benefits and fitted with Russian-style baths. In 1856, Barter invited Urquhart to visit, and the two devised a new “improved Turkish bath,” using dry heat to maximize the medical benefits.1

In 1861, Urquhart spoke to the Medical Society of London, arguing that the Turkish bath could alleviate a long list of illnesses. Urquhart believed that visiting the Turkish bath was beneficial to pregnant women and could aid digestion. He also championed its potency as a remedy for bronchitis, asthma, fever, diabetes, syphilis, baldness, and a handful of other maladies, including dementia and insanity.2

By the following decade, Urquhart’s bath at his Riverside home in England was well known, and served as an early model for other baths, including the first bath in London, on Bell Street in 1860. The celebrated Victorian dermatologist Erasmus Wilson describes his visit to Riverside in the 1850s:

We arrive at the door of the Frigidarium; we loosen the latchets of our shoes, and we leave them behind the lintel; the portal opens and we enter. The apartment is small, but it is sunny and bright; throughout the glass doors we see a balcony festooned with the tendrils of the rose…3

The Riverside bath was comprised of a hot room, built directly over the part of the floor with the hottest air underneath (240-250 F); followed by a second hot room, kept at 170F; and, down a set of marble steps, a third area with a divan, kept at 150F. Soft pillows were available for comfortable reclining in each space.

The Bath at Riverside. In Wilson, The Eastern or Turkish Bath, 1861.

The Bath at Riverside. In Wilson, The Eastern or Turkish Bath, 1861.

Wilson describes an adjacent washing area enclosed by a curtain:

We seat ourselves on the clean marble at the edge of the Lavaterina; our host plays the soft pad of gazul4 over the head, the back, the sides; we complete the operation on the limbs and feet ourselves; Basin after basin of warm water rinses the gazul and the loosened epidermis from the surface, and we rise…

After this scrub-down, Wilson visited the piscina, a square pool, for a cold water plunge. Wilson explains that typically this might be followed by a second washing, a warm Turkish towel, and a period of relaxation.

In 1862, Urquhart supervised the construction of another London bath at 76 Jermyn Street (the hammam depicted in the first image of this post). After several decades of popularity with Londoners it closed because of disuse. A bomb destroyed the facility in April 1941.

Section of the Hammam, Jermyn Street. In Urquhart, Manual of the Turkish Bath, 1865.

Plan of the Hammam, Jermyn Street. In Urquhart, Manual of the Turkish Bath, 1865.

Manual of the Turkish Bath presents many of Urquhart’s arguments for the health benefits of the Turkish bath in Socratic dialogue form. It is also notable for its case histories. A paper by Arthur Leared, “Treatment of Consumption by the Turkish Bath” notes the improved health of several patients he treated at 76 Jermyn Street. Leared reports that a 17-year-old wood engraver whose sister and mother died of phthisis and suffered from the same disease improved markedly with treatment:

April 16th—Twenty-first week of Bath treatment; has had about fifty baths in all. Is now in all respects going on well. Sleeps well, and has no night-sweats; appetite good; bowels regular; cough almost gone. Has worked ten hours a day for last two months, except on days when he takes a bath.

By the 1860s, Urquhart’s new Turkish bath had caught the notice of the Brooklyn physician Dr. Charles Shepard. Shepard’s 1873 pamphlet praised Urquhart’s revival of the bath, and promoted a new bath established by Shepard in Brooklyn Heights.

The pamphlet takes as its conceit the suggestion that even Cupid needs a pick-me-up sometimes:

Introduction to Shepard, The Turkish Bath, 1873.

The narrative unfolds with charming illustrations:

The pamphlet includes Shepard’s plan for his Brooklyn Heights bath. New Yorkers were encouraged to visit 9am to 9 pm, all days of the week except for Sundays. It remained open until 1913.

Plan and prices of the Turkish Baths in Brooklyn Heights. In Shepard, The Turkish Bath, 1873.

View of Brooklyn, showing the location of the Hammam. In Shepard, The Turkish Bath, 1873. Click to enlarge.

The Bath’s exterior. In Shepard, The Turkish Bath, 1873.

Whether in London or Brooklyn, these 19th and early 20th century baths provided centers of calm in a bustling city. As David Urquart said:

Well can I recall the Hammam doors which I have entered, scarcely able to drag one limb after the other, and from which I have sprung into my saddle again, elastic as a sinew and light as a feather.5

References

1. This was the Hydropathic Establishment of St. Anne’s in Cork. In many parts of Europe today, the “Turkish bath” is known as the “Irish-Roman bath.” See victorianturkishbath.org.

2. Urquhart, David. Manual of the Turkish Bath. John Fife (Ed.). London: John Churchill & Sons, 1865.

3. Wilson, Erasmus. The Eastern, or Turkish Bath: Its History, Revival in Britain, and Application to the Purposes of Health. London: John Churchill, 1861.

4. Soap.

5. Shepard, Charles H. The Turkish Bath. Brooklyn, NY: S.W. Green, 1873. P.30.

Beyond “The Yellow Wallpaper”: Silas Weir Mitchell, Doctor and Poet

By Johanna Goldberg, Information Services Librarian

To celebrate National Poetry Month, we are sharing poems from our collection throughout April.

Today, Silas Weir Mitchell (1829–1914) is best known as the purveyor of the Rest Cure, made infamous by Charlotte Perkins Gilman’s short story “The Yellow Wallpaper.” But while he was alive, he was renowned as a pioneering doctor of nervous diseases and a successful author.

Mitchell began his medical career researching rattlesnake venom. With the outbreak of the Civil War, he shifted focus, beginning work as a contract surgeon at Philadelphia’s Turner’s Lane Hospital, specializing in nervous diseases.

"Ward at the Civil War Hospital." In Burr, Weir Mitchell: His Life and Letters, 1929.

“Ward at the Civil War Hospital.” In Burr, Weir Mitchell: His Life and Letters, 1929.

Here, he treated and studied patients with nervous system injuries and syndromes, including one he named causalgia (a form of neuropathic pain). These studies informed his numerous pamphlets and books and helped establish his reputation as a father of American neurology.1–3 After the war, Mitchell continued his research at the Philadelphia Orthopaedic Hospital and Infirmary for Nervous Diseases. He determined that eyestrain could cause headache, and also discovered the rare vascular pain disorder erythromelalgia, or Weir Mitchell’s disease.1

Dr. Mitchell examining a Civil War veteran at the Clinic of the Orhopaedic Hospital, Philadelphia. In Burr, Weir Mitchell: His Life and Letters, 1929.

“Dr. Mitchell examining a Civil War veteran at the Clinic of the Orthopaedic Hospital, Philadelphia.” In Burr, Weir Mitchell: His Life and Letters, 1929.

More controversially, Mitchell also developed the Rest Cure, a treatment for the now passé diagnoses of neurasthenia (physical and mental exhaustion) and hysteria. Women most often received the Rest Cure, which typically involved six to eight weeks of isolation, bed rest, a high calorie diet, massage, and electrotherapy.4 Though the Rest Cure seems problematic to modern eyes, it was an accepted and popular practice for decades, seen as a valuable alternative to drug treatment.3

And what about men experiencing neurasthenia? For them, Mitchell developed the West Cure. Men—including Walt Whitman and Theodore Roosevelt—were sent West to “engage in vigorous physical activity … and to write about the experience.”5 The different treatments used for the same diagnosis—neurasthenia—speak volumes to how differently men and women can be viewed and medicalized.5

The Sargent portrait of Dr. Mitchell. In Burr, Weir Mitchell: His Life and Letters, 1929.

“The Sargent portrait of Dr. Mitchell.” In Burr, Weir Mitchell: His Life and Letters, 1929.

In addition to his medical research and private practice, Mitchell also enjoyed a career as an author. He published numerous short stories, 19 novels, a biography of George Washington, and 7 books of poetry.3 We have one of these poetry books, A Psalm of Deaths and Other Poems (available in full online), in our collection. We feature two poems from the volume here.

When Mitchell wrote “Of Those Remembered” in 1899, he was no stranger to loss: he had experienced the death of his father (1858), his first wife (1862), his mother (1872), and his sister (1874) in quick succession, along with the deaths of so many Civil War soldiers.2

Of Those Remembered

There is no moment when our dead lose power;
Unsignaled, unannounced they visit us.
Who calleth them I know not. Sorrowful,
They haunt reproachfully some venal hour
In days of joy, and when the world is near,
And for a moment scourge with memories
The money changers of the temple-soul.
In the dim space between two gulfs of sleep,
Or in the stillness of the lonely shore,
They rise for balm or torment, sweet or sad,
And most are mine where, in the kindly woods,
Beside the child like joy of summer streams,
The stately sweetness of the pine hath power
To call their kindred comforting anew.
Use well thy dead. They come to ask of thee
What thou hast done with all this buried love,
The seed of purer life? Or has it fallen unused
In stony ways and brought thy life no gain?
Wilt thou with gladness in another world
Say it has grown to forms of duty done
And ruled thee with a conscience not thine own?
Another world! How shall we find our dead?
What forceful law shall bring us face to face?
Another world! What yearnings there shall guide?
Will love souls twinned of love bring near again?
And that one common bond of duty held
This living and that dead, when life was theirs?
Or shall some stronger soul, in life revered,
Bring both to touch, with nature’s certainty,
As the pure crystal atoms of its kind
Draws into fellowship of loveliness?

The volume closes with a poem perfect for National Poetry Month: “Of a Poet” (1886).

Of a Poet
Written for a child

He sang of brooks, and trees, and flowers,
Of mountain tarns, of wood-wild bowers
The wisdom of the starry skies,
The mystery of childhood’s eyes,
The violet’s scent, the daisy’s dress
The timid breeze’s shy caress
Whilst England waged her fiery wars
He praised the silence of the stars,
And clear and sweet as upland rills
The gracious wisdom of her hills.
Save once when Clifford’s fate he sang,
And bugle-like his lyric rang,
He prized the ways of lowly men,
And trod, with them, the moor and fen.
Fair Nature to this lover dear
Bent low to whisper or to hear
The secrets of her sky and earth,
In gentle Words of golden Worth.

References

1. Silas Weir Mitchell, Papers, 1788; 1850-1928; 1949. Available at: http://www.collegeofphysicians.org/FIND_AID/hist/histswm1.htm. Accessed April 7, 2016.

2. Bailey P. Silas Weir Mitchell, 1829-1914. National Academy of Sciences; 1958. Available at: http://www.nasonline.org/publications/biographical-memoirs/memoir-pdfs/mitchell-silas.pdf. Accessed April 7, 2016.

3. Todman DH. History of Neuroscience: Silas Weir Mitchell (1829-1914). IBRO Hist Neurosci. 2008. Available at: http://ibro.info/wp-content/uploads/2012/12/Mitchell-Silas-Weir.pdf. Accessed April 7, 2016.

4. Science Museum, London. Rest cure. Brought to Life. Available at: http://www.sciencemuseum.org.uk/broughttolife/techniques/restcure. Accessed April 7, 2016.

5. Stiles A. Go rest, young man. Monit Psychol. 2012;43(1):32. Available at: http://www.apa.org/monitor/2012/01/go-rest.aspx. Accessed April 7, 2016.

The Berg Brothers: Bibliophile Surgeons

By Anne Garner, Curator, Center for the History of Medicine and Public Health

New York physicians Henry W. and Albert A. Berg are well-known to students of literature. In 1940, Albert A. Berg founded the New York Public Library’s spectacular Berg Collection, endowed in his older brother Henry’s memory. It is a magical place, nestled on the third floor of NYPL’s Steven A. Schwarzman building, with endlessly deep collections in its vaults (I should know, I was lucky enough to work there). Highlights include a typescript draft of T.S. Eliot’s The Wasteland, annotated by Ezra Pound; the manuscript notebooks containing five of Virginia Woolf’s seven novels; and a map drawn by Jack Kerouac of territory covered on the cross-country trip that inspired On The Road.

Left: Dr. Albert A. Berg, holding Blake's Europe, in an oil portrait by Jean Spencer hanging in The New York Public Library's Berg Collection. Right: Dr. Henry W. Berg in an oil portrait by Ellen Emmett Rand, also in the New York Public Library's Berg Collection. In Szladits, Brothers: The Origins of the Henry W. and Albert A. Berg Collection,1985.

Left: Dr. Albert A. Berg, holding Blake’s Europe, in an oil portrait by Jean Spencer hanging in The New York Public Library’s Berg Collection.
Right: Dr. Henry W. Berg in an oil portrait by Ellen Emmett Rand, also in the New York Public Library’s Berg Collection.
In Szladits, Brothers: The Origins of the Henry W. and Albert A. Berg Collection,1985. Click to enlarge.

Fourteen years separated the eldest and youngest Berg siblings, but they had much in common, including interests in book collecting and literature, along with an aptitude for real estate investment (a pastime that funded their library interests). The two doctors lived together until Henry’s death in 1939 in a townhouse on East 73rd Street. The story of Henry and Albert Berg’s establishment of one of the world’s great literary collections is told in Lola Szladits’ excellent book, The Brothers.

The medical legacy of the brothers, both prominent New York doctors, is less widely known. Henry and Albert’s father, Moritz Berg, immigrated to America from Hungary in 1862 with designs to work as a doctor. He found work instead as a tailor to support his family of eight children. Moritz died of cancer when Albert was young, and Henry, already interested in medicine himself, determined that Albert should follow the same career path.1

Henry W. and Albert A. Berg (seated, second and third from left), most likely in a family portrait (circa 1900). In Szladits, Brothers: The Origins of the Henry W. and Albert A. Berg Collection,1985.

Henry W. and Albert A. Berg (seated, second and third from left), most likely in a family portrait (circa 1900). In Szladits, Brothers: The Origins of the Henry W. and Albert A. Berg Collection,1985.

Henry earned his medical degree from Columbia University’s College of Physicians and Surgeons in 1878, specialized in infectious disease, and headed Mount Sinai’s isolation service. He taught both neurology and pediatrics at the College of Physicians and Surgeons.2 Henry was attending physician at Willard Parker Hospital on East 16th Street for 40 years, until his death in 1939.3 His active role on Willard Parker’s board is documented in the Academy’s collection of Willard Parker minute books.

It was Henry who mentored Albert, put him through medical school, and showed him he could be a great doctor. All early indications were to the contrary: Albert repeatedly ditched class to play pool. Their mother was skeptical that Henry could ever make a doctor out of him.4 But by graduation (also from College of Physicians and Surgeons), Albert was a decorated prizewinner.5 And as a surgeon, he proved a brilliant and visionary pioneer, a key player in the development of abdominal surgery in the United States.

Albert A. Berg as a young doctor (seated, second from left). In Szladits, Brothers: The Origins of the Henry W. and Albert A. Berg Collection,1985, page 37.

Albert A. Berg as a young doctor (seated, second from left). In Szladits, Brothers: The Origins of the Henry W. and Albert A. Berg Collection,1985, page 37.

Albert’s exceptional skill as a surgeon is attested in a tribute article by Dr. Leon Ginzberg in a festschrift volume of the Journal of the Mount Sinai Hospital devoted to Albert’s career:

[Dr. Berg’s] tremendous capacity for work, his boldness and resolution, his extraordinary operative skill and his refusal to remain on the accepted path, had brought his service to an enviable position in the field of abdominal surgery. The most significant studies from his clinic were in the fields of gastroduodenal and jejunal ulcers. Other important contributions were made to the subjects of colonic, and more particularly rectal and recto-sigmoidal carcinoma….to chronicle adequately all of Dr. Berg’s ‘labors in the vineyard’ would be to write an important chapter in the history of the development of abdominal surgery in the United States.6

Title page of Alfred A. Berg’s Surgical Diagnosis, 1905, given by the author to the New York Academy of Medicine Library.

Albert’s skill and personal style made him one of New York’s most recognizable doctors by the 1920s. In physical appearance he was “six feet tall, slender, and forbidding.”7 Katie Loucheim’s remembrance in the New Yorker compares his appearance to an “esteemed rabbi…with a Vandyke beard…his manner in speaking and his voice were reassuring.”8 He wore a red carnation in his lapel, even during surgery, until the death of his brother in 1939.9

Albert—or A.A. as his medical friends called him—observed an almost fanatical devotion to the operating room. Loucheim reports that Albert regularly scheduled surgery for a few minutes before midnight on New Year’s Eve, believing that if he began the new year in surgery he could secure for himself a happy year. Berg’s dexterity as a surgeon ensured that he could easily converse about rare books while operating on patients, including his friend, the great book collector Carl Pforzheimer. Seven days a week, the Fifth Avenue bus—“Berg’s green taxi” to his colleagues, dropped him halfway down the block in front of the canopy of Mount Sinai. Other passengers complained because it wasn’t an actual bus stop (in turn, the conductors and bus drivers relied on Berg for any surgical needs).10

Mount Sinai Hospital, circa 1913. From The Dr. Robert Matz Collection of Medical Postcards.

Mount Sinai Hospital, circa 1913. From The Dr. Robert Matz Collection of Medical Postcards.

A stone’s throw away from A.A. Berg’s beloved Guggenheim pavilion at Mount Sinai Hospital, the Berg name lives on. On the third floor of the New York Academy of Medicine in the former periodicals room is a bronze plaque commemorating the gifts of Drs. Henry W. and Albert A. Berg to the Academy. A bequest from Albert endowed the third floor room that bears their name and still supports the acquisition of library periodicals today. Both brothers were Academy Fellows (Henry beginning in 1890, Albert in 1900).

Albert seems to have recognized how vital a good set of tools were to students of surgery. A copy of his last will and testament in the Academy’s archives entrusts his surgical instruments, instrument bags, and laboratory equipment, including two microscopes and examination tables and one portable operating table, to “one or more deserving young surgeons” to be selected at the Academy’s discretion.11 The items are no longer at the Academy; perhaps they were also used by a student whose path to medicine was at first uncertain, but later found his or her way.

New York Times article from July 18, 1950 announcing Albert A. Berg's bequests, including to the New York Public Library and the New York Academy of Medicine.

New York Times article from July 18, 1950 announcing Albert A. Berg’s bequests, including to the New York Public Library and the New York Academy of Medicine. Click to enlarge.

References

1. Szladits, Lola. Brothers : The Origins of the Henry W. and Albert A. Berg Collection. New York: New York Public Library, 1985. pp. 9-10.

2. Szladits, pp. 10-11.

3. Medical Society of the State of New York. Medical Directory of New York, New Jersey and Connecticut. New York: 1899-1939.

4. Louchheim, Katie. “Sweeping Formalities and Offstage Flourishes.” The New Yorker 3 Nov. 1975: 40-48. Print.

5. Szladits, pp. 11.

6. Ginzburg, Leon. “Some of the Principles and Methods contributed by the service of Dr. A.A. Berg.” Journal of the Mount Sinai Hospital Volume 17.6 (1951): 356-368. The Journal of the Mount Sinai Hospital has been digitized and is available online.

7. Szladits, 39.

8. Loucheim, 41.

9. New Yorker and Szladits.

10. Szladits, 42.

11. The New York Academy of Medicine Archives. Library Correspondence, 1927-1974.

Dr. David Hosack, Physician to Hamilton and Burr

By Johanna Goldberg, Information Services Librarian

With Hamilton-mania sweeping the nation, we’re not throwing away our shot to discuss the physician present at the infamous 1804 Hamilton-Burr duel, Dr. David Hosack.

Hosack was born in New York City in 1769. Like Alexander Hamilton, he attended Kings College (now Columbia University), then transferred to Princeton. After graduating in 1789, he received his medical education from the University of Pennsylvania.1 He briefly practiced in Alexandria, Virginia and New York, then went to Edinburgh and London to further his medical education. These travels both increased his medical knowledge and nurtured his interest in botany and botanical gardens. In 1801, this life-long interest led to Hosack’s founding of the Elgin Botanical Garden, the first garden of its kind in the United States, located where Rockefeller Center stands today.1,2

By 1794, Hosack had returned to New York City. He formed a medical practice with noted physician Samuel Bard and gained a reputation for the successful treatment of yellow fever.2 As his practice grew, he counted among his patients New York’s elite. Not only did Hosack provide care for Hamilton and his family (including at the deathbeds of both Hamilton and his son, Philip, after their two deadly duels), he also served as physician to Aaron Burr and his daughter and close confidant, Theodosia Burr Alston.3 Our collection includes numerous manuscript materials from Hosack relating to his practice, including copies of a letter to Theodosia and one to her husband, Joseph Alston. These letters give a sense of Hosack’s warmth and dedication to his patients.

Theodosia Burr Alston, 1802. Portrait by John Vanderlyn. Courtesy of the New-York Historical Society.

Theodosia was an educated woman; her father supervised her rigorous studies. In 1801 at age 18, she married Joseph Alston, 22, a member of the South Carolina legislature and a future governor of the state. After the birth of their son Aaron Burr Alston in 1802, Theodosia’s health declined.4

Hosack’s letter to Joseph Alston from June 12, 1808 begins: “Mrs. Alston having been under my care as her physician, you will naturally expect from me some account of her situation.” Theodosia had recently traveled to New York, and text that follows describes the effect of her journey on her health:

When she arrived she was much exhausted by the fatigue of her voyages—added to the diseases under which she labors—but by change of climate I hope she is likely to be benefited—her appetite tho still bad is somewhat improved—the pain on her right side and shoulder still continue troublesome, attended occasionally with violent spasms of the stomach and her other complaints, I mean those of the womb, remain as before—her general appearance is somewhat improved. My attentions hitherto have been directed to the general state of her health, when that is mended she will be enabled to make use of such remedies as are calculated to remove her local diseases—with the views of improving her strength. I have advised her to pass a few weeks at the Ballston Springs—she has already made some use of the waters and finds them to agree with her—but drinking them at the springs will be more serviceable to her—they are especially calculated to improve her appetite and strength, and in some instances have been found beneficial in obstructions both of the liver and womb which are her complaints—yesterday she left New York on her way to the springs—should any thing of importance occur and I receive information of it, you may expect again to her from me.

I am Dear Sir with respect and esteem

Your

David Hosack

Recto and verso of a copy of David Hosack's letter to Joseph Alston. In: D. Hosack. Copies of Letters and Documents 1801-1826.

Recto and verso of a copy of David Hosack’s June 12, 1808 letter to Joseph Alston. In: D. Hosack. Copies of Letters and Documents, 1801-1826. Click to enlarge.

By August 20, Theodosia’s health improved sufficiently that Hosack provided her with one of the remedies mentioned in his letter to her husband two months prior. The copy of the letter to Theodosia (written in a messier hand than the one to her husband) tells her what to eat and avoid while on the medication (“be careful to avoid acids and stimulant foods—lemonade, the acid fruits – spices,” instead eating “soups – milk – eggs – arrowroot – tapioca – rice – puddings etc.”). Hosack also recommended that two to three baths per week would “be useful in lessening your pain at the same time that it will give more effect to the medicine now directed.”

David Hosack’s August 20, 1808 letter to Theodosia Burr Alston. In: D. Hosack. Copies of Letters and Documents, 1801-1826. Click to enlarge.

Theodosia died young, but not due to her lingering post-partum health problems. In January 1813, just seven months after the death of her son, she was aboard the ship Patriot when it disappeared off the coast of Cape Hatteras on its way to New York. While stormy weather most likely caused the ship’s loss, some believed that pirates were to blame.4,5

Portion of page 59 of the January 12, 1913 New York Times. Click to enlarge.

Portion of page 59 of the January 12, 1913 New York Times. Click to enlarge.

David Hosack died of a stroke in 1835.1 His son, pioneering surgeon Alexander Eddy Hosack, took on much of his father’s practice, including the care of Aaron Burr.6,7 Alexander’s New York Times obituary noted:

It is said that on one occasion [Alexander Hosack] asked Mr. Burr if he did not experience contrition at times for having shot Hamilton. Burr, with an expression of stern feeling, replied with emphasis: ‘No, Sir; I could not regret it. Twice he crossed my path. He brought it on himself.’

Aside from his treatment of elite patients like Burr, Alexander Hosack (1805–1871) made a name for himself through his medical endeavors. Like his father, he received his medical degree from the University of Pennsylvania, after which he worked as a doctor in Paris for three years. He was the first doctor in New York City to use ether during surgery, and he developed a number of surgical instruments. In addition, he helped establish the Emigrants’ Hospital on Ward’s Island.6

The Hosack name lives on at the Academy. In 1885, the estate of Celine B. Hosack, widow of Alexander, bequeathed $70,000 to the Academy for a new building or an auditorium within that building.8 The original Hosack Hall was on West 43rd Street, in the Academy’s home from 1890 until 1926. When the Academy moved to its current location in 1926, the new auditorium retained a name deeply embedded in American and medical history.

Left: Hosack Hall on West 43rd St. Image in Van Ingen, The New York Academy of Medicine: Its first hundred years, 1949. Right: Hosack Hall Today, at 1216 Fifth Avenue.

Left: Hosack Hall on West 43rd Street. Image in Van Ingen, The New York Academy of Medicine: Its first hundred years, 1949. Right: Hosack Hall today, at 1216 Fifth Avenue. Click to enlarge.

References

1. Jeffe ER. Hamilton’s physician: David Hosack, Renaissance man of early New York. New-York J Am History. 2004;Spring(3):54–58. Available at: http://www.alexanderhamiltonexhibition.org/about/Jeffe – Hamiltoss Physician.pdf. Accessed January 15, 2016.

2. Hosack AE. A memoir of the late David Hosack. Lindsay & Blakiston; 1861. Available at: https://books.google.com/books?id=o4A22YJI53YC&pgis=1. Accessed January 19, 2016.

3. Garrison FH. David Hosack. Bull N Y Acad Med. 1925;1(5):i4–171. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2387360&tool=pmcentrez&rendertype=abstract. Accessed January 15, 2016.

4. James ET. Notable American Women, 1607-1950: A Biographical Dictionary, Volume 1. Cambridge: Harvard University Press; 1971. Available at: https://books.google.com/books?id=rVLOhGt1BX0C&pgis=1. Accessed January 19, 2016.

5. Mystery of Aaron Burr’s daughter baffles a century. New York Times. http://timesmachine.nytimes.com/timesmachine/1913/01/12/100604845.html?pageNumber=59. Published January 12, 1913. Accessed January 15, 2016.

6. Alexander Eddy Hosack, M.D. New York Times. http://timesmachine.nytimes.com/timesmachine/1871/03/07/78760572.html.  Published March 7, 1871. Accessed January 15, 2016. 

7. Obituaries. Med Surg Report. 1871;24(734):262. Available at: https://books.google.com/books?id=_kKgAAAAMAAJ&pgis=1. Accessed January 19, 2016.

8. Van Ingen P. The New York Academy of Medicine: Its first hundred years. New York: Columbia University Press; 1949.

Lost and Found

Paul Theerman, Associate Director, Center for the History of Medicine and Public Health

David Livingstone (1813–1873), in Livingstone, Missionary Travels and Researches in South Africa, opposite page 1.

David Livingstone (1813–1873), in Livingstone, Missionary Travels and Researches in South Africa, opposite page 1. Click to enlarge.

“Dr. Livingstone, I presume?”

One of the great phrases of the 19th century and the butt of many jokes, the words were apparently first spoken when journalist Henry Morton Stanley came to an African village in 1871 on a quest for the elusive Scottish missionary, Dr. David Livingstone, not seen for many years, whose birthday we celebrate today, March 19.

It seems such a non sequitur: one white man enters a village in the middle of Africa—it was Ujiji, on the shores of Lake Tanganyika, near the town of Kigoma, Tanzania—walks over to the only other white person for hundreds of miles, and either feigns uncertainty about his identity, or approaches him with mock humility. Stanley recorded the scene in his book, How I Found Livingstone, and attributed the phrase to shyness:

I would have run towards him, only I was a coward in the presence of such a mob [of onlookers]—would have embraced him, only he being an Englishman, I didn’t know how he would receive me, so I did what cowardice and false pride suggested what was the best thing—walked deliberately to him, took off my hat, and said, “Dr. Livingstone, I presume?”

“Yes,” said he, with a kind smile, lifting his cap slightly.

I replaced my hat on my head, and he puts on his cap, and we both grasp hands, and then I say aloud: “I thank God, Doctor, I have been permitted to see you.”

He answered, “I feel thankful I am here to welcome you.” 1

How did Livingstone get to Africa, and why was there such a fuss about finding him?

Medicine was one part of the path—Christianity was the other. As a young child growing up in Blantyre, Scotland, Livingstone (1813–1873) became entranced by the missionary movement. In this he was influenced by his father, Neil, a traveling tea salesman and fervent churchman. The younger Livingstone coupled his Christianity with a love of science and the outdoors, and, prompted by the church circles in which he moved, developed a desire to serve as a missionary. Of very poor means and a mill worker from his early teens, bright and ambitious, Livingstone set out to achieve his goal. In his mid-20s, he undertook two years of courses of medical lectures at Anderson’s University Glasgow, 1836–1838. Accepted provisionally as a missionary by the London Missionary Society—a more vigorous and evangelical group than that in the established church—he took further medical training in London, 1839–1840, including at Charing Cross Hospital—as well as theological study. He obtained a license to practice, then started out. His first choice, China, was closed to him due to the Opium Wars, and at the end of 1840 he instead left for South Africa.2

The term “medical missionary” is a freighted one. Consider that at the time Livingstone trained, the germ theory of disease had not yet been established; neither had antiseptic procedures. The causes, even the identities, of the major tropical diseases had not yet been worked out. Antibiotics and antifungal medications were decades off; rehydration therapy for cholera and similar diseases had not yet been determined. For a venture into Africa, about the only specifically useful item in Livingstone’s arsenal was quinine, to battle the symptoms of malaria, part of Western therapeutics since the 17th century. Most of what he could do was palliative care—dressing wounds and providing beds to make room for healing.

Title page of Livingstone, Missionary Travels and Researches in South Africa.

Title page of Livingstone, Missionary Travels and Researches in South Africa. Click to enlarge.

Once in South Africa, Livingstone traveled first to Kuruman, a missionary outpost set up by fellow Scot Robert Moffat. After marrying Moffat’s daughter, Mary, Livingstone and his wife established Kolobeng mission in Botswana in 1847. At this time, they intended to live among Africans in order to convert them, to provide for their medical needs, and to compete with African religious leaders and healers. In the book that made his reputation, Missionary Travels and Researches in South Africa (1857), Livingstone imaginatively plays out a dialogue between a Western “medical doctor” and an African “rain doctor.”3 The worldviews were mutually incomprehensible and the competition fierce, especially after conversion stopped one of the village leaders from his rainmaking work. In the ensuing three-year drought, Christianity itself was on trial. The drought did not end, there were raids by Boers (Dutch settlers), and the Africans left. In 1852, Livingstone closed his mission and sent his wife and children to England.4

In his years in southern Africa, Livingstone found that his true calling did not lie in the work of the solitary missionary:

Sending the Gospel to the heathen must . . . include much more that is implied in the usual picture of a missionary, namely, a man going about with a Bible under his arms. The promotion of commerce ought to be specially attended to, as this, more speedily that anything else, demolishes that sense of isolation which heathenism engenders . . . . My observations on this subject make me extremely desirous to promote the preparation of the raw materials of European manufactures in Africa, for by that means we may not only put a stop to the slave-trade, but introduce the negro family into the body corporate of nations, no one member of which can suffer without the others suffering with it. . . . [F]or neither civilization nor Christianity can be promoted alone. In fact, they are inseparable.5

"The missionary's escape from the lion." In Livingstone, Missionary Travels and Researches in South Africa, opposite page 13. Click to enlarge.

“The missionary’s escape from the lion.” In Livingstone, Missionary Travels and Researches in South Africa, opposite page 13. Click to enlarge.

He eventually captured his new vision with the phrase, “Christianity, Commerce, and Civilization.”6 Medicine was part of it all: supporting healing as part of the compassion that Christianity enjoined; providing health in support of commerce, maintaining both healthy places and healthy people; and being an integral part of Western civilization, and by example, persuading others of that civilization’s value and truth. This was all caught up in his new mission: through Christianity, Western civilization, and commerce to bring slavery to an end.

For this purpose, Livingstone began to explore the great unknown territories of Africa. His first expedition lasted from 1852 to 1856, running across Africa from Angola to Mozambique. He was the first westerner to see Victoria Falls, the world’s largest waterfall, and was regaled by the London press and the Royal Geographical Society on his return. He resigned from the London Missionary Society and went back to Africa as head of the government-sponsored Zambezi Expedition, 1858–1864, to explore the commercial possibilities of the Zambezi River valley. It failed—Livingstone had great ideas but little skill in leading others. After two years in England, he returned to Africa alone in order to seek find the source of the Nile. From 1866 until his death in 1873, he wandered, chiefly in the Congo and along Lake Tanganyika.

Victoria Falls, , in Livingstone, Missionary Travels and Researches in South Africa, opposite title page.

Victoria Falls, in Livingstone, Missionary Travels and Researches in South Africa, opposite title page. Click to enlarge.

Only the barest of notes came out, requesting supplies and medicines. Livingstone was often in a desperate state, ill, hungry, and without help. Stanley’s visit reinvigorated him, though he would not accompany the journalist back to the coast. Within 18 months, Livingstone was dead, at the age of 60. His African servants removed his internal organs, salted the body, dried it in the sun, and took it to the coast for transport to England. In a grand funeral, the body was buried in Westminster Abbey in April 1874.

When Stanley came out of the forest to greet Livingstone, it was not just the brash American finding the kindly medical missionary. It was rather the shrewd journalist coming to face to face with the embodiment of an idea: that exploration would lead to commerce, commerce to civilization, both to the triumph of Christianity, and all to end slavery. Strength of will was all that was needed for success, and medicine was bound up deeply in it. In Livingstone’s case, will was not enough, and his efforts gave out. The link of commerce, Christianity, and civilization continued into the next century, but would eventually falter as well. Medical missions continue, some religious and some not, but Livingstone’s grand vision is now greatly tempered.

References

1. Henry Morton Stanley, How I Found Livingstone: Travels, Adventures, and Discoveries in Central Africa, including Four Months Residence with Dr. Livingstone (London: Sampson, Low, Marston, Low, and Searle, 1872), p. 412, quoted in Daniel Liebowitz, The Physician and the Slave Trade: John Kirk, the Livingstone Expeditions, and the Crusade Against Slavery in East Africa (New York: W. H. Freeman and Co., 1999), p. 156.

2. For the particulars on Livingstone’s life, and detail about his medical training, see “Livingstone Online: Exploring the Manuscripts of David Livingstone” (accessed March 18, 2015), and particularly “David Livingstone’s Life” and “David Livingstone’s Medical Education.”

3. David Livingstone, Missionary Travels and Researches in South Africa: Including a Sketch of Sixteen Years’ Residence in the Interior of Africa, and a Journey from the Cape of Good Hope to Loanda on the West Coast; Thence across the Continent, down the River Zambesi, to the Eastern Ocean (London: John Murray, Albemarle Street, 1857), with the dialogue on pages 23–25.

4. Livingstone, Missionary Travels, p. 92.

5. Livingstone, Missionary Travels, p. 28.

6. The phrase comes from evangelist Thomas Foxell Buxton, whom Livingstone heard present in London in the summer of 1840, in his last year of preparation. “David Livingstone, 1813–1873,” as part of Princeton University Library’s online exhibition, “To the Mountains of the Moon: Mapping African Exploration, 1541–1880” (2007) (accessed March 18, 2015).

7. Liebowitz, The Physician and the Slave Trade, pp. 164–66.