Scent Track

Today’s guest post is written by Ann-Sophie Barwich, Ph.D., scholar in the Presidential Scholars in Society and Neuroscience program at the Center for Science and Society, Columbia University. Her work is on current and past developments in olfactory research (1600 to today). On Wednesday, April 26, Barwich will give her talk, “Scent Track: What can the History of Olfaction tell us about Theorizing in the Life Sciences?” To read more about this lecture and to register, go HERE.

Scientific interest in the senses has always been preoccupied with vision and its underlying mechanisms. In comparison, smell is one our least understood senses. This may sound surprising given the importance of smell in flavor perception. Human cuisine represents one of the most central elements of human culture. While the cultural history of scent has gathered sufficient attraction in the humanities and social sciences, its scientific history has yet to be told.

Many of the central research questions about the characteristics of olfaction remain unresolved even to date. How do we classify smells? How many smells are there, and is there such a thing as olfactory primaries? Modern research on smell was revolutionized with the discovery of the olfactory receptors by Linda Buck and Richard Axel in 1991. Their discovery presented the key causal entity to model the molecular basis of smell and granted them the 2004 Nobel Prize in Physiology of Medicine. Since then, olfaction started to emerge as a modern model system in neuroscience.

Nonetheless, records of scientific theorizing about the material basis of odor reach much further back. These hidden experimental records of research on smell offer us an intriguing, yet untold, history of creativity in scientific reasoning. For large parts of the history of science, scientific approaches to smell were faced with its apparent lack of testability. An inherent difficulty for odor description and classification is that sense of smell is incredibly hard to study in a controlled setting. How do you visualize and materialize odor to turn it into an object of objective measurement and comparison? In reply to these questions, several answers were developed from various disciplinary perspectives throughout the past centuries. These ideas present a hidden heuristic source for widening our theoretical understanding of smell even today.

Figure1

Linnaeus’ classification of odors in medicinal plants in his Clavis Medicinae (1766).

My talk reconstructs a conceptual history of materiality that has informed scientific approaches to smell, and I analyze this material history of olfaction by three stages. First, smells are investigated as “objects in nature,” drawing on 18th-century expertise in botany and horticulture that arranged odors according to their diverse plant origins. Botanical classifications, such as in Linnaeus’ Odores Medicamentorum (1752) and Clavis Medicinae (1766), conceptualized odors as objects in nature. Here, the affective nature of smell was investigated with regard to the medicinal powers of plants. Meanwhile, perfumers have always experimented with odorous plant substances but their knowledge was a well-kept secret. Some records, such as George William Septimus Piesse’s The Art of Perfumery (1857), illustrate that these practices addressed the various possibilities for the material manipulation of odorous substances (e.g., through mechanical force, solvent extraction, distillation). They further conceptualized the psychological effects of odor by analogy with other sensory qualities such as taste, color, and sound. Can we blend odors like colors? Can we understand the harmony between odor notes in parallel with musical chords?

Figure2

Analogy of odors with sounds to define harmonic chords in perfumery. Source: Piesse 1857, The Art of Perfumery.

Second, smells are framed as “objects of production” in light of the industrialization of perfumery after the rise of synthetic chemistry at the end of the 19th-century. In earlier chemistry, smells were modeled as immaterial spirits that represented vital forces, such as in the Spiritus Rector theory by Herman Boerhaave. This theory was soon abandoned by a more mechanistic causal understanding of odorous particles, especially after Antoine-François de Fourcroy’s extraction of urea as the ‘smelling principle’ of horse urine. This discovery of the chemical basis of odors and its subsequent exploration with the rise of synthetic chemistry presented a fundamental conceptual liberation of smells from their plant origins. New scents, sometimes even unknown in nature, were now produced in the laboratory.

Figure3

Vanillin was first synthesized by Ferdinand Tiemann and Wilhelm Haarmann in 1874. It’s synthesis, illustrated above, was further refined by Karl Reimer in 1874. Source: Wikipedia (Yikrazuul).

Third, the introduction of molecular visualization and computational techniques in the 20th century abstracted smells further from their natural origins, and this advancement laid the foundation for smells to turn into what Hans-Jörg Rheinberger calls “epistemic objects.” This transformation signifies the integration of smell into the growing scientific domain of biochemical science. Confronted with the sheer diversity of chemical structures responsible for odor qualities, the classification of smells now required the integration of two seemingly separate data sets: a stimulus classification of chemical similarity on the one hand and an ordering of perceptual classes on the other. In this context, the food scientist John Amoore proposed a classification of five to seven primary odors in the 1960s and 1970s.

While this classificatory strategy was soon rendered too simplistic, it provides one of the earliest expressions of a central question in modern olfactory research: How does the chemical basis of odors relate to their perceptual quality? Can we predict smells from the molecular structure of their stimuli? Notably, this question remains open but of central scientific interest today.

Join us on Wednesday, April 26 to learn more about this topic. To RSVP to this free lecture, click HERE.

 

Robert L. Dickinson: Doctor and Artist

Today’s guest post is written by Rose Holz, Ph.D., historian of medicine and sexuality at the University of Nebraska – Lincoln where she serves as the Associate Director of the Women’s & Gender Studies Program and Director of Humanities in Medicine.  She is the author of The Birth Control Clinic in a Marketplace World (Rochester, 2012). Her current project investigates the intersection of medicine and art by way Dr. Robert L. Dickinson (1861-1950) — gynecologist, sexologist, and artist extraordinaire — and his prolific ten-year collaboration with fellow artist Abram Belskie (1907-1988). Not only did it yield in 1939 the hugely influential Birth Series sculptures but also hundreds of medical teaching models about women’s and men’s sexual anatomies. On Thursday, April 13, Rose will give her talk, “Art in the Service of Medical Education: The Robert L. Dickinson-Belskie Birth Series and the Use of Sculpture to Teach the Process of Human Development from Fertilization Through Delivery.” To read more about this lecture and to register, go HERE.

My interest in Dr. Robert L. Dickinson began many years ago when I was in graduate school, working on my Ph.D. in history and writing my dissertation on the history of birth control clinics in America. And, as has been the case with so many other scholars who have written about matters related to women, medicine, and sexuality in the twentieth century U.S., Dickinson made his brief cameo entrance into my story, though not without leaving behind a lasting impression.

For me it was the images — because, like me, Dickinson was compelled to color and draw. Early on, while pouring over Planned Parenthood records, I remember chuckling over a letter he had written to a contraceptive manufacturer complaining about the poor quality of one of their products, to which he then attached a drawing to illustrate his case.

Then there were the birth control manuals Dickinson wrote in the 1930s. Not only did he illustrate all the contraceptive methods then available, but he also offered birds-eye-view, architectural-style drawings to visualize how best to lay out gynecological clinics. More intriguingly still was what he included at the center of this architectural drawing, a tiny woman lying on the gynecological table with her legs spread wide open as the doctor conducted the physical exam.

IMG_4813

Pages from “Control of Contraception (2nd edition)” by Robert L. Dickinson.

As somebody who also loves small things—especially miniature worlds populated by miniature people—I could not help but find myself be smitten by this unusual man. However, at the time I had a different story to tell, a Ph.D. to defend, and a new job as a professor to pursue. And as the years passed, Dickinson slowly receded into the background.

IMG_1603

Drawings of the location of Embryo and size of Fetus. Source.

But Dickinson is not one to be denied, and that he has remained in obscurity for so long somehow explains to me why he has resurfaced—with a glorious vengeance—into my imagination. Indeed, he has made it clear to me that his story will be told; his skills as a doctor and artist properly recognized. And he has made it further clear that this story will begin with what he created in the twilight of his life: The 1939 Birth Series sculptures.

IMG_2449

Dickinson and Belskie’s “Sculptured Teaching Models Collection.” From the unprocessed Abram Belskie Papers, Belskie Museum, Closter, NJ.

Join us on Thursday, April 13 to learn more about Dr. Robert L. Dickinson and his Birth Series sculptures. To RSVP to this free lecture, click HERE.

Lady Mary Wortley Montagu and Immunization Advocacy

Today’s guest post is written by Lisa Rosner, Ph.D., Distinguished Professor of History at Stockton University. Recent publications include The Anatomy Murders (University of Pennsylvania Press, 2009) and Vaccination and Its Critics (ABC-Clio, 2017). She is the project director and game developer for The Pox Hunter, funded by an NEH Digital Projects for the Public grant.  On Thursday, April 6, Lisa will give her talk, “Lady Mary’s Legacy: Vaccine Advocacy from The Turkish Embassy Letters to Video Games.” To read more about this lecture and to register, go HERE.

In a letter dated April 1, 1717 – 300 years ago — Lady Mary Wortley Montagu (1689–1762), the wife of the British ambassador to Turkey, provided the first report from an elite European patient’s perspective of the middle-eastern practice of inoculation, or ingrafting, to prevent smallpox. She wrote to her dear friend, Sarah Chiswell:

“I am going to tell you a thing that will make you wish yourself here. The small-pox, so fatal, and so general amongst us, is here entirely harmless, by the invention of engrafting, which is the term they give it. There is a set of old women, who make it their business to perform the operation, every autumn, in the month of September, when the great heat is abated. People send to one another to know if any of their family has a mind to have the small-pox; they make parties for this purpose, and when they are met (commonly fifteen or sixteen together) the old woman comes with a nut-shell full of the matter of the best sort of small-pox, and asks what vein you please to have opened. She immediately rips open that you offer to her, with a large needle (which gives you no more pain than a common scratch) and puts into the vein as much matter as can lie upon the head of her needle, and after that, binds up the little wound with a hollow bit of shell, and in this manner opens four or five veins…

The children or young patients play together all the rest of the day, and are in perfect health to the eighth. Then the fever begins to seize them, and they keep their beds two days, very seldom three. They have very rarely above twenty or thirty in their faces, which never mark, and in eight days time they are as well as before their illness. Where they are wounded, there remains running sores during the distemper, which I don’t doubt is a great relief to it. Every year, thousands undergo this operation, and the French Ambassador says pleasantly, that they take the small-pox here by way of diversion, as they take the waters in other countries. There is no example of any one that has died in it, and you may believe I am well satisfied of the safety of this experiment, since I intend to try it on my dear little son.”

Lady_Mary_Wortley_Montagu_with_her_son_Edward_by_Jean_Baptiste_Vanmour

Mary Wortley Montagu with her son Edward, by Jean-Baptiste van Mour. Source: Wikimedia Commons.

This is probably the most famous passage in all Lady Mary’s voluminous correspondence. It deserves even more attention than it usually gets, because it is the first example, in the western history of medicine, of a mother’s perspective on the practice of immunization. We tend to hear a great deal from scientists like Jenner about their discoveries, but much less from mothers who adopted their techniques for children.

But Lady Mary was not just a mother, she was also an acute observer with an inventive and inquisitive mind, and a particular interest in what we would now call public health practices. She had lost a beloved brother to smallpox; she had also contracted the disease, and though she survived, she carried the scars for the rest of her life. As she traveled from London to Constantinople, she was particularly interested in innovations and cultural attitudes toward hygiene and domestic health, especially as they affected women’s lives.

Her enthusiasm for light, clean, airy environments comes through in her very first letter, written from the Netherlands. She wrote:

“All the streets are paved with broad stones and before many of the meanest artificers doors are placed seats of various coloured marbles, so neatly kept, that, I assure you, I walked almost all over the town yesterday, incognito, in my slippers without receiving one spot of dirt; and you may see the Dutch maids washing the pavement of the street, with more application than ours do our bed-chambers.”

For that reason, she noted:

“Nothing can be more agreeable than travelling in Holland. The whole country appears a large garden; the roads are well paved, shaded on each side with rows of trees.”

She was much less pleased with Vienna, for though there were certainly many magnificent sights, the city itself was dark and crowded. She complained:

“As the town is too little for the number of the people that desire to live in it, the builders seem to have projected to repair that misfortune, by clapping one town on the top of another, most of the houses being of five, and some of them six stories … The streets being so narrow, the rooms are extremely dark; and, what is an inconveniency much more intolerable … there is no house has so few as five or six families in it.”

As her travels continued throughout the fall and winter, another custom, neglected in England, caught her attention: the stove, valuable for warmth and for lengthening the growing season. At one of the formal dinners she attended, she was offered oranges and bananas and wondered how they could possibly be grown in Austria. She wrote:

“Upon inquiry I learnt that they have brought their stoves to such perfection, they lengthen their summer as long as they please, giving to every plant the degree of heat it would receive from the sun in its native soil. The effect is very near the same; I am surprised we do not practise [sic] in England so useful an invention. This reflection leads me to consider our obstinacy in shaking with cold, five months in the year rather than make use of stoves, which are certainly one of the greatest conveniencies [sic] of life.”

Mary_Wortley_Montague

Mary Wortley Montagu in Turkish dress. Souce: Wikimedia Commons.

When she arrived in Constantinople and spent time with ladies of the court, both Turkish and European, Lady Mary continued to pursue her interest in gardens, in baths, in the light airy spaces found in both European and Turkish households. She was not the first European to report on the practice of “ingrafting”: her family physician in Constantinople, Dr. Emmanuel Timoni, had previously sent a report to the Royal Society of London. But seeing a disease, so dangerous in Europe, treated as an excuse for a children’s party turned her into an advocate. As she wrote:

“I am patriot enough to take the pains to bring this useful invention into fashion in England, and I should not fail to write to some of our doctors very particularly about it, if I knew any one of them that I thought had virtue enough to destroy such a considerable branch of their revenue, for the good of mankind. But that distemper is too beneficial to them, not to expose to all their resentment, the hardy wight that should undertake to put an end to it. Perhaps if I live to return, I may, however, have courage to war with them. Upon this occasion, admire the heroism in the heart of your friend.”

After she returned to London, she kept her promise “to war” with the physicians in support of inoculation. When smallpox broke out in her social circle in 1722, she decided to inoculate her daughter, and the operation was performed with great success. Physicians who visited her found “Miss Wortley playing about the Room, cheerful and well,” with a few slight marks of smallpox. Those soon healed, and the child recovered completely. The visiting physicians were impressed, and they began to incorporate inoculation into their own practices.

As the epidemic raged, Lady Mary convinced her most prominent friend, Caroline, Princess of Wales, to inoculate the two royal princesses, Amelia and Caroline. Having received the royal seal of approval, smallpox inoculation became fashionable practice among British elites throughout the 18th century.

Memorial_to_Lady_Mary_Wortley_Montague_in_Lichfield_Cathedral

Memorial to the Rt. Hon. Lady Mary Wortley Montague erected in Lichfield Cathedral by Henrietta Inge. Source: Wikimedia Commons.

In 1789, Mrs. Henrietta Inge, Lady Mary’s niece, erected a memorial to her accomplishments in Litchfield Cathedral. The text reads:

“[She] happily introduc’d from Turkey, into this country the Salutary Art Of inoculating the Small-Pox. Convinc’d of its Efficacy She first tried it with Success on her own Children, And then recommended the practice of it To her fell-w-Citizens. Thus by her Example and Advice, We have soften’d the Virulence, And excap’d the danger of this malignant Disease.”

We can recognize in Lady Mary – and in Mrs. Inge — advocates of a kind met with very frequently in the history of vaccination: mothers whose personal experience led them to champion the discoveries that preserved their family’s health and well-being.

Bibliography:

  1. Grundy, Isobel. Lady Mary Wortley Montagu. Oxford: Oxford University Press, 1999.
  1. Montagu, Lady Mary Wortley. Letters of Lady Mary Wortley Montagu. Written during her travels in Europe, Asia, and Africa. Paris: Firman Didot, 1822. Available in many editions online.
  1. Rosner, Lisa. Vaccination and Its Critics. A Documentary and Reference Guide. Santa Barbara, CA: Greenwood, 2017.

Shop ad for Lady mary post

Infectious Madness, the Well Curve and the Microbial Roots of Mental Disturbance

3cfce0fe054a12627f41292ec26e6b22Today’s guest post is written by Harriet Washington, a science writer, editor and ethicist. She is  the author of several books, including Medical Apartheid: The Dark History of Experimentation from Colonial Times to the Present. On Wednesday, March 15 at 6pm, Washington will discuss: “Infectious Madness, the Well Curve and the Microbial Roots of Mental Disturbance.” In this talk, based on her book Infectious Madness: The Surprising Science of How We “Catch” Mental Illness, Washington traces the history, culture and some disturbing contemporary manifestations of this ‘infection connection.” To read more about this lecture and to register, go HERE.

“Mind, independent of experience, is inconceivable.” —Franz Boas

Psychological trauma, stress, genetic anomalies and other experiences that limit the healthy functioning of the mind and brain are widely recognized as key factors in the development of schizophrenia, major depression, and bipolar disorder.  However, despite a plethora of examples and evidence of microbial disorders from rabies to paresis, infection has been slow to join the pantheon.  This aversion persists largely because the perceived causes of mental disorders have evolved not only with our scientific knowledge of medicine but also with our tenacious cultural beliefs and biases.  Instead, we have long clung to what  Robert Sapolsky calls a “primordial muck” of attribution that includes broken taboos, sin—one’s own or one’s forbears’— and even bad mothering.

Brueghel_dancingMania

Representation of the dancing mania by Flemish painter Pieter Brueghel the Younger.Source.

Flemish painter Pieter Brueghel the Younger (1564–1636) painted the above representation of the dancing mania known as choreomania or St. Anthony’s Fire, which has seized a pilgrimage of epileptics en route to the church at Molenbeek. Such compulsive dancing was originally ascribed to satanic influence such as bewitchment, and later to a collective hysterical disorder, but is now ascribed to ergotism— the  infection of rye and other grains by the fungus Claviceps purpurea.  When people ate the tainted bread, their symptoms included compulsive dancing. Some have ascribed the mass hysteria of the Salem witch trials to ergotism.  Streptoccocal infections have also produced cases called Sydenham’s chorea.

Not all traditional “causes” of mental illness are confined to the past.  As late as the 1980s, the alternating rage, coldness and oppressive affection of domineering “schizophrenogenic mothers” was taught in psychology classes as the root of schizophrenia, just as Tourette’s syndrome initially was laid to poor parenting.

For Infectious Madness: The Surprising Science of How We “Catch” Mental Illness, I interviewed scientists working on the effects of infections on mental health such as Susan Swedo, chief of the pediatrics and developmental neuroscience branch at the National Institute of Mental Health, who studies the role of Group A strep (GAS) infections in children in rapid-onset cases of obsessive compulsive disorder, anorexia, and Tourette syndrome. Other visionary researchers, such as E. Fuller Torrey, executive director of Maryland’s Stanley Medical Research Institute, and Robert Yolken, director of developmental neurovirology at Johns Hopkins University, have for decades investigated the role of microbes in mental illness and have traced the path of viruses such as influenza, herpes simplex and Toxoplasma  gondii, among other microbes, in schizophrenia and bipolar disorder.

There are a myriad of ways in which infections cause or encourage mental disease. In order to suit its own need to reproduce within the stomach of a cat, the unicellular parasite Toxoplasma gondii changes the behavior of rodents — and incidentally, use it to gain entry. This seems strange, but changing the behavior of a host to suit its own needs is a common stratagem of parasites. The Cordyceps fungus, for example, manipulates an ant in the Amazon into climbing a tree where the fungal spores can be more widely disseminated. The spore- bearing branches extend from the corpse of the ant pictured below.

Ant1

The Cordyceps fungus manipulates an ant in the Amazon into climbing a tree where the fungal spores can be more widely disseminated. The spore-bearing branches extend from the corpse of the ant.Photograph © Gregory Dimijian, MD.

Infection, redux

“Everything has been thought of before, but the problem is to think of it again.” —Goethe

There is a long, all but forgotten history of infectious theories of mental illness. In his 1812 psychiatry text Medical Inquiries and Observations upon the Diseases of the Mind, for example, Benjamin Rush, MD, included a first detailed taxonomy of mental disorders, each with its own physical cause. He cited disruptions of blood circulation and  sensory overload as the basis of mental illness, and he treated his patients with devices meant to improve circulation to the brain, including such Rube Goldberg designs as a centrifugal spinning board, or to decrease sensory perceptions, such as a restraining chair with a head enclosure.

Restraining Chair

Pictured here is the “tranquilizing chair” in which patients were confined. The chair was supposed to control the flow of blood toward the brain and, by lessening muscular action or reducing motor activity, reduce the force and frequency of the pulse.Photograph © 2008 Hoag Levins.

Paresis, an infectious mental disorder

In 1857, Drs. Johannes Friedrich Esmark and W. Jessen suggested a biological cause for paresis: syphilis. Many researchers started to view paresis as the tertiary stage of syphilis, which often attacked the brain indiscriminately, and they began referring to it as neurosyphilis. This theory held out hope that if syphilis was ever cured, paresis could be too.

Nineteenth-century asylum keepers, however, persisted in viewing paresis as wholly mental in character. The long-standing insistence on divorcing physical illnesses from mental ones had to do with religious philosophy and culture but also with the politics of the asylum, which remained a battleground between physicians and religious and philosophical healers.

Matters were complicated by the fact that most physicians, despite the evidence that paresis was the mental manifestation of a physical disease, continued to treat paretics with the same ineffectual therapeutics given other mentally ill patients. Traditional treatments such as “douches, cold packs, mercury, blistering of the scalp, venesection, leeching, sexual abstinence, and holes drilled into the skull [trephination]” continued—without positive results. Even when toxic mercury-based treatments for syphilis were replaced by Paul Ehrlich’s safer, more effective arsenic-based Salvarsan (also called arsphenamine and compound 606), it was not used against paresis.

But in June 1917, Professor Julius Wagner-Jauregg of the University of Vienna Hospital for Nervous and Mental Diseases undertook a radical approach. He had noticed that some paretic patients improved markedly after contracting an infectious illness that gave them fevers. He decided to fight fire with fire by turning one disease against another: he sought to suppress the symptoms of paresis by infecting its sufferers with malaria.

Before Wagner-Jauregg won the Nobel and Freud forged the future of psychiatry, a paradigm shift had already taken place that transformed science’s approach to the nature of disease. It is the very framework that supports the role of infection in mental illness—germ theory. Developed by Louis Pasteur and Robert Koch, germ theory posits that specific microbes such as bacteria, viruses, and prions (infectious proteins) cause illness.

For more on this fascinating topic, join Harriet Washington on Wednesday, March 15 at 6pm.  More information can be found here

The Marrow of Tragedy: Disease and Diversity in Civil War Medicine

Today’s guest post is written by Dr. Margaret Humphreys, Josiah Charles Trent Professor in the History of Medicine at Duke University. She is the author of Yellow Fever and the South (Rutgers, 1992) and Malaria: Poverty, Race and Public Health in the United States (Johns Hopkins, 2001), Intensely Human: The Health of the Black Soldier in American Civil War (2008) and Marrow of Tragedy: The Health Crisis of the American Civil War (2013). On Tuesday, February 21 at 6pm, Humphreys will give The John K. Lattimer Lecture: “The Marrow of Tragedy: Disease and Diversity in Civil War Medicine.” To read more about this lecture and to register, go HERE.

In a memorable scene from the movie Gone with the Wind, Southern belle, Scarlett O’Hara, picks her way through the battle-wounded men lying on the ground near the train station in Atlanta, frantically seeking Dr. Meade to help her with her sister-in-law Melanie’s imminent delivery.  Meade brushes her off and turns to a screaming soldier, telling him that his leg would have to come off, and without anesthesia.  The man’s screams echo as Scarlett heads back to Melanie’s bedside.  This cinematic portrayal of Civil War medicine reflects a wide belief that there was no anesthesia at that time.  Indeed, it was said that the war occurred “at the end of the medical middle ages.”  (This quotation is widely attributed to Union Surgeon General William Hammond, but without citation).

atlanta

Scene from Gone with the Wind (1939).

In my book, Marrow of Tragedy: The Health Crisis of the American Civil War, I begin from a different perspective, recognizing that there was such a thing as “good medicine” and “bad medicine” during the War.  Medical care could be effective, and it could make a difference in disease and injury outcomes.  For example, chloroform and ether anesthesia meant most surgery occurred with the patient unconscious (although Confederate surgeons did run out of these supplies in desperate circumstances, such as the siege of Atlanta near the end of the war).

Alarming as the notion of amputation completely without anesthesia, are the revealing mortality rates from disease at this point in the war. Put simply, for every one white Union soldier who died of disease during the War, a little over two black Union soldiers died, and almost three Confederates succumbed.[i]

hospital-scene

Image source: Getty Images.

How can we account for these differences?  A major factor was the quality and quantity of food, a core ingredient of the modern concept of “social determinants of health.”  White Union troops also received better hospital care, calling on part of the strong social networks of the folks back home and their political impact.  The Union hospital system was much better funded, with full access to important medicines, such as quinine, opiates, and anesthetics; and the technology of cleanliness, which included clothing, soap, and disinfectants.  Nursing care was key, as well, with northern hospitals staffed by volunteer nurses, while those in the south were often civilians or slaves challenged by lack of formal training as well as lack of resources.

To learn more about Civil War medicine, join us on Tuesday, February 21 at 6pm. Register HERE.

sanitary-commission

Image source: Harper’s Weekly, April 9, 1864.

 

Note:

[i] Actual numbers, per 1000, were 63, 143, and 167, respectively.

When Mexican Physicians Take to the Streets and to Villages

Today’s guest post is written by Dr. Gabriela Soto Laveaga, Professor of the History of Science at Harvard University. Her book Jungle Laboratories: Mexican Peasants, National Projects and the Making of the Pill (Duke University Press, 2009) won the 2010 Robert K. Merton Best Book prize in Science, Knowledge, and Technology Studies from the American Sociological Association. On Thursday, November 17th at 6pm, Soto Laveaga will give The Iago Galdston Lecture: “When Mexican Physicians Take to the Streets and to Villages.” There is no charge, but please register in advance here.

In late November of 1964 more than two hundred residents and interns from one of Mexico City’s leading public hospitals threatened to strike because they were denied a Christmas bonus. Their unexpected response revealed the financially precarious situation of junior doctors and the worrisome state of many of the nation’s public hospitals. The subsequent walk-out launched ten months of unprecedented actions in hospitals, clinics, and, surprisingly, Mexico City streets.

demonstration

Physician demonstration demanding “a solution to the medical problem in the country.”

As the movement gained momentum, physicians’ demands for living wages and better working conditions shifted to incorporate a call for social justice for peasants and blue-collar workers. The shift away from hospital-based labor demands alarmed an increasingly repressive regime that set out to discredit physicians through media manipulation, intimidation, and incarceration. By March 1965 many young physicians, once heralded as the future of the nation, were portrayed in the government-controlled media as traitors of the state.

codedmessage

Coded message requesting state governors send information about tension in hospitals. Source: National Archives, Mexico City.

Declassified material offers an extraordinary opportunity to learn —via decoded messages, transcribed wire-tapped conversations, and memos to the president— how the government sought to deal with unruly doctors. It is especially interesting to learn how the government used media – television and newspapers – to distort claims and dismiss doctors’ demands as the actions of a “greedy” profession. Especially revealing is, for example, how secret service agents infiltrated hospitals to gain first-hand knowledge of a movement that quickly became national in scope.

Throughout the multiple walk-outs, hospital emergency rooms remained opened but newspapers created a sense of growing dread among the population. In news stories doctors were often labeled “lazy,” “traitorous,” “murderous,” and, most often, as elites disconnected from the rest of society.

secretservicepicture

Secret Service picture of physicians protesting in May 1965. Source: National Archives, Mexico City.

Days before the 1965 State of the Union address, President Gustavo Diaz Ordaz sent military personnel to oust doctors from key hospitals. In his address the president spent more than thirty minutes speaking about the irresponsible “homicidal actions” of striking physicians. In the aftermath of the movement, more than five hundred physicians lost their license to practice medicine (most were able to practice again in the next presidential administration) and for the following fifty years, until summer 2015, there were no national, doctor-led movements in Mexico.

silentprotest

Doctors taking over downtown streets in silent protest, May 1965. Source: Página 24.

Of note is that after the social movement was unceremoniously truncated a handful of striking doctors joined an urban guerrilla Movimiento Revolucionario del Pueblo (People’s Revolutionary Movement) intent on destroying the government through violence. These doctors were, in turn, captured and together with other members of the guerrilla spent nearly a decade in Lecumberri prison for acts of treason.

The “medical” movement, as it came to be known, was really about two (often at odds) issues: the role of physicians in a rapidly changing society and the country’s need to provide proper healthcare to all working Mexicans, a right established in the 1917 Constitution. In fact young doctors’ reactions may be rooted not in 1960s urban discontent but, curiously, in experiences of city doctors in rural Mexico.

nurses

Nurses forming a  human barrier to protect striking physicians, 1965.

Starting in 1936, all Mexican medical students were required to spend time in remote, poor, and/or indigenous areas provided much-needed primary care. This mandatory social service was later written into the Mexican Constitution. For many city physicians their social service time was a transformative experience. For example, treating patients in extreme poverty while living with them as neighbors and facing similar hardships (such as lack of electricity or running water) sensitized many physicians to the complexity of providing care in Mexico. In addition, these doctors experienced, often for the first time, the deep socio-economic divisions in the country. It was young doctors most moved by their social service year who, oral histories reveal, were more likely to join a social movement.

Currently Mexico’s public healthcare system is going through dramatic shifts, and the 1965 movement is a reminder of the powerful and evolving role that physicians have played in transforming care in the country.

A Visit to the Drs. Barry and Bobbi Coller Rare Book Reading Room

Dr. Patrick Brunner, the author of today’s guest post, is Instructor in Clinical Investigation at The Rockefeller University.

On July 26 2016, a group of young physician-scientists from The Rockefeller University visited the Drs. Barry and Bobbi Coller Rare Book Reading Room at the New York Academy of Medicine. As part of the Clinical Scholars curriculum, led by Dr. Barry Coller and Dr. Sarah Schlesinger, these researchers regularly meet for educational tutorials, and the excursion to the Rare Book Room has clearly been one of the highlights of this past semester.

Arlene Shaner, the curator of this exceptional collection, presented seminal works to the group, and her deep insight and passion for the history of medicine made the excursion a unique experience. Ms. Shaner started the tour with the presentation of one of the most outstanding works of Western medicine – Andreas Vesalius’ opus magnum “De humani corporis fabrica libri septem” (On the fabric of the human body in seven books) from 1543. Ms. Shaner comprehensively and clearly outlined the historical context in which this book had been published, and fascinated her audience with a display of the book’s iconic woodprints. This artwork, which everyone in the room had seen in numerous reproductions, now laid open in its original form – showing the famous muscle man posing in front of an Italian landscape, and the skeleton, leaning on a spade, gazing towards the sky.

vesaliusgravedigger_watermark

Skeleton from the 1543 Fabrica. Click to enlarge.

A letter, sent from Oxford, dated July 7th, 1909, had been incorporated into the book as an inscription. From this letter one can learn that Sir William Osler himself donated the book to the New York Academy of Medicine. Ms. Shaner clearly knows each and every inch of this version of Vesalius work, one of three copies that the New York Academy of Medicine holds.

osler_detail_watermark Inscription by Sir William Osler found in our 1543 Fabrica. Click to enlarge.

Vesalius’ Fabrica has undoubtedly been one of the most influential books on human anatomy, overthrowing the observations and influences of the Greek physician Galen, which had been uncontested by Western medical science for more than 1300 years. And it was not until 1628 that another seminal work, which had also been put on display for the evening, William Harvey’s treatise “Exercitatio anatomica de motu cordis et sanguinis in animalibus” (On the motion of the heart and blood in animals), established that blood circulates in a closed system, and that the heart acts as a pump – a manuscript considered by many scholars to be the single most important publication in the history of physiology.

The visitors from The Rockefeller University were greatly impressed by the richness of this library – especially as they learned that all the books are available for review through the library’s archives, be it the “Anatomia hepatis” (The anatomy of the liver) by Francis Glisson, or the first atlas of skin diseases by the dermatological founding father Ferdinand von Hebra.

Arlene Shaner also presented Bernhard Siegfried Albinus’ “Tabulae sceleti et musculorum corporis humani” (Tables of the skeleton and muscles of the human body), first published in Leiden in 1747, which not only depicts anatomical studies in a monumental fashion, but presents the models within elaborate and artful surroundings – overall, an impressive testimonial of its time.

The climax of the visit was the display of a very special gift donated to the New York Academy by Sir Alexander Fleming – a capsule containing a colony of Penicillium, taken from the original culture that produced one of the world’s first antibiotics for medical use. And it has only been about 70 years since this medication became available!

fleminggrayobverse_watermarkCapsule containing a colony of Penicillium, donated by Sir Alexander Fleming. Click to enlarge.

Seeing all these treasures that irreversibly changed the world, and learning about the stories behind them in the context of both medical and art history, was a unique, and almost sensual, learning experience for the visitors, and Ms. Shaner’s never-ending expertise helped everyone in the room to deeply dive into history.

Aldous Huxley once said: “The charm of history and its enigmatic lesson consist in the fact that, from age to age, nothing changes and yet everything is completely different.”  Understanding the challenges that these authors face during their life times, which may not have been quite so different from the ones that we face today, while, at the same time witnessing the dramatic changes that have been instigated by their works, was a true inspiration. The afternoon passed quickly, and everyone agreed that they wanted to come back and further explore this treasury in the middle of New York City.

Deafness as a Public Health Issue in the 1920s & 1930s (Part 2 of 2)

Today we have part two of a guest post written by Dr. Jaipreet Virdi-Dhesi, the 2016 Klemperer Fellow in the History of Medicine at the New York Academy of Medicine and a SSHRC Postdoctoral Fellow in the Department of History at Brock University in St. Catharines, Ontario. She is working on her first book, Hearing Happiness: Fakes, Fads, and Frauds in Deafness Cures, which examines the medical history of hearing loss and “quack cures” for deafness. Some of these cures are explored on her blog, From the Hands of Quacks. You can find her on twitter as @jaivirdi.

Promotional photo by the New York League for the Hard of Hearing and its hearing clinic for testing and examination (The Bulletin, Dec. 1935)

Promotional photo by the New York League for the Hard of Hearing and its hearing clinic for testing and examination (The Bulletin, Dec. 1935)

The New York League for the Hard of Hearing launched several campaigns during the 1930s addressing the “psychological aspect” of acquired deafness mentioned by Wendell C. Phillips. Since deafness is an invisible affliction, Phillips emphasized the deafened person often feels isolated and unable to adjust to the sensory change, especially if the hearing loss occurred suddenly. Other otologists agreed as many patients narrated similar stories: their hearing was perfectly fine and normal, then one day something happened and they became deaf, and the process of coming to terms to the newfound deafened state was a difficult one. Illness such as influenza, pneumonia, meningitis, diphtheria, scarlet fever, measles, or ear abscesses were usually the culprit. So too were heard injuries, age-onset deafness in the elderly, misuse of drugs such as quinine, a poor diet (including too much sugar), and other ordinary factors:

“It is well to bear in mind the effects of hair-dyes, excessive smoking or drinking, and indeed, improper underwater swimming and diving. Vigorous blowing of the nose is also frequent causes of hearing impairment.”[1] 

Otologists claimed individuals needed to take responsibility for their hearing—to conserve what hearing one had, through proper diet, lifestyle, and hygiene, before it disintegrated. This was a remarkable shift from the 1920s “prevention of deafness” campaigns that concentrated on a screening program of early detection and medical care. While constant surveillance was still promoted, the late-1930s campaigns transformed hearing loss into an affliction that could easily be treated or managed by good habits.

Pamphlets reveal how parents were encouraged to become more “ear-minded” toward their children, that is, to pay attention if their child exhibits any signs of hearing loss, to avoid a circumstance in which a neglected hearing issue ends up turning a deafened child into a problem.

Advertisement for the New York League Hard of Hearing (The Bulletin, 1934).

Advertisement for the New York League Hard of Hearing (The Bulletin, 1934).

Image 6b

Advertisement for the New York League for the Hard of Hearing (The [Hearing] News, October 1935)

 

 

 

 

 

 

 

 

 

 

In other words, the “problem of deafness” became less about the triumphs of medical cures for hearing loss or social organizations providing communication services, but more about conserving one’s hearing before it was gradually diminished. Themes for “Better Hearing Week” especially reflect this: the 1937 theme was “It’s Sound Sense to Conserve Hearing,” while the 1938 was “Help Conserve Hearing.”

Front page of the October 1937 issue of The Bulletin magazine, promoting the National Hearing Week, with reprints of letters from FDR.

Front page of the October 1937 issue of The Bulletin magazine, promoting the National Hearing Week, with reprints of letters from FDR

The American Society for the Hard of Hearing also launched their own campaigns. In 1937, the organization listed a four-point program publicizing their mandates: the prevention of deafness, the conservation of hearing, the alleviation of social conditions affecting the hard of hearing, and rehabilitation. In addition to popular radio broadcasts on the National Broadcasting System, 327 feature articles and 189 editorials were released in over 1600 newspapers.

“Hearing through Life,” a national campaign launched by the ASHH (Hygeia, October 1937).

“Hearing through Life,” a national campaign launched by the ASHH (Hygeia, October 1937).

The publicity campaigns of the 1920s and 1930s were really about transforming public perceptions of the hard of hearing and deafened as handicapped persons, rather than as “defectives”—an important observation in light of the eugenicist concerns of the period. But they were also about addressing hearing impairment not as a social or educational issue, but as a public health issue, one that required cooperation between different levels of civic infrastructures. As otologist Edmund Prince Fowler noted in 1940, the hearing impaired “should never be dismissed with the thought, “Nothing can be done.”[2]

Promotional photo for the League’s “Children’s Auditory Training Project” campaign of the 1940s (The Bulletin, Nov-Dec, 1949)

Promotional photo for the League’s “Children’s Auditory Training Project” campaign of the 1940s (The Bulletin, Nov-Dec, 1949)

Special thanks are owed to Arlene Shaner at the NYAM Library for her generous research assistance and lively conversations.

References

[1] Samuel Zwerling, “Problems of the Hard of Hearing,” Hearing News (January 1938).

[2] Bulletin of the New York League for the Hard of Hearing, 18.7 (November 1940).

Deafness as a Public Health Issue in the 1920s & 1930s (Part 1 of 2)

Today we have part one of a guest post written by Dr. Jaipreet Virdi-Dhesi, the 2016 Klemperer Fellow in the History of Medicine at the New York Academy of Medicine and a SSHRC Postdoctoral Fellow in the Department of History at Brock University in St. Catharines, Ontario. She is working on her first book, Hearing Happiness: Fakes, Fads, and Frauds in Deafness Cures, which examines the medical history of hearing loss and “quack cures” for deafness. Some of these cures are explored on her blog, From the Hands of Quacks. You can find her on twitter as @jaivirdi.

In 1935, physician Francis L. Rogers of Long Beach read a paper addressing the worrisome statistics of deafness. One study discovered nearly thirty-five thousand Americans were deaf. Another found that out of a million people tested for their hearing, 6% had significant hearing impairment. Yet another study reported three million people had some kind of hearing impairment. This “problem of deafness,” Rogers emphasized, “is primarily of public health and public welfare.” Not only were there too many people failing to adequately care for their hearing, but many cities, schools, and governments lacked the proper infrastructure to educate the public on the importance of hearing preservation. Indeed, as Rogers stressed: “Today the three great public health problems confronting the world are heart disease, cancer, and deafness.”[1]

Image 1

A window display in Detroit (Hearing News, June 1942)

The notion of deafness being statistically worrying as a public health issue actually dates to the late nineteenth century, especially to the work of otologist James Kerr Love of Glasgow. Love conducted several statistical studies of the ears of deaf schoolchildren, discovering that the majority of them were not completely deaf, but had some level of “residual” hearing. With proper medical treatment, the hearing could be intensified enough to warrant a “cure.” For other cases, children could be taught to make use of that residual hearing through invasive training using acoustic aids and other kinds of hearing technologies.

Love’s research concluded that many deafness cases could actually be relieved if the ears of children were examined early and frequently—that is, deafness could be prevented. His “prevention of deafness” concept was influential for the new generation of otologists in America, especially those who were members of the New York Academy of Medicine’s Section of Otology during the first three decades of the twentieth century.

To raise awareness on the necessity of proper medical examinations and frequent hearing tests, these otologists collaborated with social organizations such as the New York League for the Hard of Hearing, which was established in 1910. The League was a progressive group catering to the needs of hard of hearing or deafened persons who were raised in a hearing society rather than in a D/deaf community and communicated primarily with speech and lip-reading rather than sign language. Composed mostly of white, middle-class, and educated members who lost their hearing from illness, injury, or progressive deafness, the League strove to construct hearing impairment as a medical issue. They argued hearing impairment was not an issue of education or communication, but rather a handicap.

Image 2

An otologist examining a young patient’s ear (Hygeia, June 1923)

The collaboration between New York otologists and the League eventually created a national network of experts, social services, teachers, physicians, and volunteers who banded together to address the so-called “problem of deafness.” That is, the problem of how to best integrate the hard of hearing, the deafened, and to some extent, even the deaf-mutes, into society. One key achievement of the League was the establishment of hearing clinics to properly assess hearing impairment, especially in children, to ensure medical care could be provided before it was too late. This project was primarily spearheaded by Harold M. Hays (1880-1940), who was recruited as president of the League in 1913, becoming the first active otologist collaborating with the League. After the First World War, Hays set up a clinic for treating hearing loss in children at the Manhattan Eye, Ear, and Throat Hospital.

Image 3

Group hearing tests of schoolchildren, using an audiometer. Headphones are used first on the right ear, then the left. (Hygeia, February 1928)

Hays claimed that hearing impairment might be a handicap, but “the sad part of it is that 90 percent of all hearing troubles could be corrected if they were treated at the proper time.” With regular hearing tests, this was possible. Yet, as Hays argued, regular hearing tests were not considered on par with other hygienic measures under public health services:

We are saving the child’s eyes! We are saving the child’s teeth! Is it not worth while to save the child’s ears?”[2]

During the 1920s, Hays’ activism for regular hearing tests was so instrumental that in 1922, the League’s newsletter, The Chronicle, told its readers “we believe that the League would justify its existence if it did no other work than to prevent as much deafness as possible.”  To achieve this mandate, the League launched a large public campaign to raise awareness on the importance of medical care. Indeed, in one report for the League, Hays remarked that with the increased publicity, there were 10,000 calls to the League in 1918 alone inquiring about aural examinations. A steady increase in patients would follow: 17 clinic patients in 1924, 326 in 1926, and then 1,531 in 1934.

Another publicity campaign spearheaded by the League was the establishment of “Better Hearing Week” in 1926, a week-long awareness program (later renamed “National Hearing Week”). Held in October, the campaign included symposium discussions on the “Problems of the Hard of Hearing,” including topics on the relationship between the physician and his deafened patient, how the deafened could build their lives, and even on newest technological developments in hearing aids. October issues of The Bulletin (the renamed League newsletter) and the Hearing News, the newsletter of the American Society for the Hard of Hearing (ASHH) included reprints of letters from prominent leaders supporting the mandates of “Better Hearing Week,” including letters from President Roosevelt and New York Mayor LaGuardia.

Image 4

Advertisement for Western Electric Hearing Aid, the “Audiophone.” These before-and-after shots were powerful for demonstrating the effects of “normal” hearing, sending the message that outward signs of deafness, such as the “confused face,” could easily disappear once being fitted properly with a hearing aid. (Hearing News, December 1936)

The 1920s publicity campaigns were primarily focused on fostering ties between otologists and the League, in cooperation with hospitals and schools. In 1927, the League purchased audiometers and offered invitations to conduct hearing tests in schools across New York, so children with hearing impairment could be assessed accordingly. Two years later, the League worked with Bell Laboratories to further substantiate the conviction that deafness was a serious problem amongst schoolchildren and that something needed to be done.

At the same time otologists across America established joint ventures between organizations like the America Medical Association and the American Otological Society. They formed committees to write reports to the White House on the national importance of addressing the “prevention of deafness.” Wendell C. Phillips (1857-1934), another president of the League and the founder of ASHH, particularly emphasized the need to address the “psychologic conditions and mental reactions” of the deafened patient, for the tragedy of acquired deafness meant it is a “disability without outward signs, for the deafened person uses no crutch, no black goggles, no tapping staff.”[3] It was an invisible handicap that needed to be made visible if it was to be prevented, if not cured.

References

[1] The Federation News, August 1935.

[2] Harold M. Hays, “Do Your Ears Hear?” Hygeia (April 1925).

[3] Wendell C. Phillips, “Reminiscences of an Otologist,” Hygeia (October 1930).

Many Anatomy Lessons at the New York Academy of Medicine

Kriota Willberg, the author of today’s guest post, explores the intersection of body sciences with creative practice through drawing, writing, performance, and needlework. She is offering the workshop “Visualizing and Drawing Anatomy” beginning June 6 at the Academy. Register online.

Cheselden's Osteographia, 1733, opened to the title page and frontispiece.

Cheselden’s Osteographia, 1733, opened to the title page and frontispiece.

Different Disciplines, Same Body

I teach musculoskeletal anatomy to artists, dancers, and massage therapists. In my classes the students study the same raw material, and the set of skills each group acquires can be roughly organized around three distinct areas: representation of the body, kinesiology (the study of movement), and palpation (feeling the body).

As an anatomy teacher I am constantly on the prowl for images of the body that visually reinforce the information my students are learning. The Internet has become my most utilized source for visual teaching tools. It is full of anatomy virtual galleries, e-books, and apps. 3D media make it ever easier to understand muscle layering, attachment sites, fiber direction, and more.

In spite of the overwhelming volume of quality online cutting-edge anatomical imagery, I find myself drawn to historical 2D printed representations of the body and its components, once the cutting-edge educational technology of their respective centuries. Their precision, character, size, and even smell enhance my engagement with anatomical study. Many of these images emphasize the same principles as the apps replacing them centuries later.

The Essential Structure Of The Body

Different artists prefer different methods of rendering bodies in sketches. One method is to organize the body by its masses, outlining its surface to depict its bulk. Another method is to draw a stick figure, organizing body volume around inner scaffolding.

Plate XXXIII in Cheselden, Osteographia, 1733.

Plate XXXIII in Cheselden, Osteographia, 1733.

And what is a skeleton but an elaborate stick figure? William Cheselden’s Osteographia (1733) presents elegant representations of human and animal skeletons in action. These images remind us that bones are rigid and their joints are shaped to perform very specific actions. The cumulative position of the bones and joints gives the figure motion. In Cheselden’s world of skeletons, dogs and cats fight, a bird eats a fish, a man kneels in prayer, and a child holds up an adult’s humerus (upper arm bone) to give us a sense of scale while creating a rather creepy theatrical moment.

Muscle Layering

3D apps and other imaging programs facilitate the exploration of the body’s depth. One of the challenges of artists and massage therapists studying anatomy is transitioning information from the 2D image of the page into the 3D body of a sculpture or patient.

Planche 11 in Salvage, Anatomie du gladiateur combattant, 1812.

Planche 11 in Salvage, Anatomie du gladiateur combattant, 1812.

Salvage’s Anatomie du gladiateur combattant: applicable aux beaux artes… (1812) is a 2D examination of the 3D Borghese Gladiator. Salvage, an artist and military doctor, dissected cadavers and positioned them to mimic the action depicted in the statue. His highly detailed images depict muscle layering of a body in motion. The viewer can examine many layers of the anatomized body in action from multiple directions, rendered in exquisite detail. Salvage retains the outline of the body in its pose to keep the viewer oriented as he works from superficial to deeper structures.

Tab. VIII in Albinus, Tabulae sceleti et musculorum corporis humani, 1749.

Tabula VIII in Albinus, Tabulae sceleti et musculorum corporis humani, 1749 edition.

Bernhard Siegried Albinus worked with artist Jan Wandelaar to publish Tabulae sceleti et musculorum corporis humani (1749). Over their 20-year collaboration, they devised new methods for rendering the dissected body more accurately.  The finely detailed illustrations and large size of the book invite the reader to scrutinize the dissected layers of the body in all their detail. Although there is no superficial body outline, the cadaver’s consistent position helps to keep the reader oriented. On the other hand, cherubs and a rhinoceros in the backgrounds are incredibly distracting!

Fiber Direction

Familiarity with a muscle’s fiber direction can make it easier to palpate and can indicate the muscle’s line of pull (direction of action).

Figure in Berengario, Anatomia Carpi Isagoge breves, 1535.

Figure in Berengario, Anatomia Carpi Isagoge breves, 1535.

The images of Jacopo Berengario da Carpi’s Anatomia Carpi Isagoge breves, perlucide ac uberime, in anatomiam humani corporis… (1535) powerfully emphasize the fiber direction of the muscles of the waist. This picture in particular radiates the significance of our “core muscles.” Here, the external oblique muscles have been peeled away to show the lines of the internal obliques running from low lateral to high medial attachments. The continuance of this line is indicated in the central area of the abdomen. It perfectly illustrates the muscle’s direction of pull on its flattened tendon inserting at the midline of the trunk.

The Internal Body Interacting with the External World

One of the most important lessons of anatomy is that it is always with us. Gluteus maximus and quadriceps muscles climb the stairs when the elevator is broken. Trapezius burns with the effort of carrying a heavy shoulder bag. Heck, that drumstick you had for lunch was a chicken’s gastrocnemius (calf) muscle.

Tab. XII in Speigel, De humani corporis fabrica libri decem, 1627.

Tab. XII in Speigel, De humani corporis fabrica libri decem, 1627.

Anatomists from Albinus to Vesalius depict the anatomized body in a non-clinical environment. One of my favorites is Adriaan van de Spiegel and Giulio Casseri’s De humani corporis fabrica libri decem (1627). In this book, dissected cadavers are depicted out of doors and clearly having a good time. They demurely hold their skin or superficial musculature aside to reveal deeper structures. Some of them are downright flirtatious, reminding us that these anatomized bodies are and were people.

Kriota Willberg's self portrait. Courtesy of the artist.

Kriota Willberg’s self portrait. Courtesy of the artist.

I am so enamored of van de Spiegel and Casseri that I recreated page 24 of their book as a self-portrait. After my abdominal surgery, the image of this cadaver revealing his trunk musculature resonated with me. In my portrait I assume the same pose, but if you look closely you will see stitch marks tracing up my midline. I situate myself in a “field” of women performing a Pilates exercise that challenges abdominal musculature. And of course, I drew it in Photoshop.