Ambroise Paré on gunshot wounds (Item of the Month)

By Lisa O’Sullivan, Director, Center for the History of Medicine and Public Health

The August item of the month is Ambroise Paré’s (1510 –1590) Les Oeuvres, or Works. Published in 1575 in 26 sections or books, the folio volume has 295 illustrations and includes Paré’s writings on anatomy, surgery, obstetrics, instrumentation, and monsters. This post focuses on Paré’s military surgery and is the first in a series of occasional posts looking at the relationship between medicine and war.

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Frontispiece of the first (1575) edition of Les Oeuvres, dedicated to King Henri III. Click to enlarge.

Dedicated to Henri III, Paré presents Les Oeuvres as an accumulation of his life’s studies and experience, and it incorporates many of his earlier publications. The French barber surgeon spent much of his life at war, serving in over 40 campaigns, and published numerous highly influential books, many of them directly based on his practice of military surgery.i Paré’s career was a prestigious one, progressing from working as an apprentice barber surgeon to great prominence as surgeon to Henry II, and subsequently his successors Francois II, King Charles IX, and Henry III.

Like his contemporary Andreas Vesalius, Paré is now celebrated as an emblematic figure of Renaissance thinking, willing to look beyond the established authorities and instead rely on the evidence of his own experience. In the Oeuvres, for instance, he mocks the use of “mummy” or “mummia,” a popular remedy ostensibly created from Egyptian mummies and used extensively by physicians.ii Such a position was particularly provocative given Paré’s identity as a surgeon, rather than a university trained physician with a formal education and knowledge of Greek and Latin.

Despite Paré’s close connections with many of its members, the Parisian Faculty of Medicine attempted to block the publication of the Oeuvres, arguing that the Faculty needed to approve all publications relating to medicine and surgery. In addition, they objected to Paré’s use of French, as he was among a small but increasing number of practitioners writing in the vernacular rather than the more scholarly Latin, making such works vastly more accessible to students of surgery operating outside the universities and the lay public.iii

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Reminiscent of a “wound man,” this illustration demonstrates techniques for extracting broken arrows from the body. Click to enlarge.

Much of Paré’s renown was based on his early work in the military context. Throughout the Oeuvres, he returns to examples of treating soldiers wounded during conflict. Perhaps the most famous vignette describes how, during his first campaign in 1536, Paré found that he had insufficient boiling oil to use in cauterizing gunshot wounds, and instead used a liniment made of egg yolk, rose oil, and turpentine. The following day, he discovered that those soldiers treated with the liniment were in a better condition than those whose wounds had been treated according to the prescribed manner. He subsequently argued for the treatment of gunshot wounds with liniments and bandaging, as well as removing affected tissue from the wound.iv

Gunpowder, whether projected from cannons or shot from firearms, had become a significant factor on European battlefields in the late 14th century. The use of gunpowder dramatically changed the practice of warfare. Increasingly numerous and accurate firearms contributed to the number of soldiers killed and wounded. These weapons produced new types of wounds that penetrated into the body, carrying foreign materials with them and leading to gangrene, while also deafening and blinding those near blasts.v

Descriptions of surgical tools, including a variety of tools for extracting bullets from wounds. On the top left, "crane bill" forceps for fragmented bullets; on right a shorter "duck bill" instrument designed for extracting whole bullets. At bottom, "lizard noses" for drawing out flattened bullets.

A variety of tools for extracting bullets from wounds. On the top left, “crane bill” forceps for fragmented bullets; on right a shorter “duck bill” instrument designed for extracting whole bullets. At bottom, “lizard noses” for drawing out flattened bullets. Click to enlarge.

Surgeons based their treatment of gunshot wounds on the belief that the gunpowder carried into the body by the bullets brought poison with it. This idea came from Giovanni da Vigo (1450–1525), an Italian surgeon whose 1514 Practica in arte chirurgica copiosa and 1517 Pratica in professione chirurgica were highly influential surgical texts. Rapidly translated into multiple European languages, these books include da Vigo’s suggestion to cauterize (burn) the wound with boiling oil in order to counteract the poisonous traces of gunpowder and to seal any severed arteries. This procedure became considered standard practice.viParé, after his experience with liniment rather than oil, experimented further, and recounts seeking advice from other surgeons and testing a folk remedy for onion poultices for burns suggested by an older local woman. Concluding that they were effective against blistering offered Paré another rhetorical opportunity to emphasize his commitment to observation and experimentation.vii

The evidence found in earlier surgical manuals suggests that medieval surgeons had made similar experiments, and that it was the popularity of the more recent ideas promulgated by da Vigo that led to treatments with cauterization and oil.viii While he was not the only surgeon to be working towards more humane and effective treatment of gunshot wounds, Paré became the most well-known and is often celebrated today as the “father” of modern military surgery.ix This reputation rests on not only his work around gunshot wounds but his broad interests, influence, and innovation. A future post will explore other aspects of Paré’s Oeuvres and its long-term impact on military surgery.

References

i.  A full bibliography of his works was produced by Academy librarian Janet Doe in 1937. See Janet Doe, A Bibliography of the Works of Ambroise Pare; Premier Chirurgien et Conseiller du Roy (Chicago: University of Chicago Press, 1937).

ii. Ambroise Paré, Les Oeuvres de m. Ambroise Paré … Avec les figures & portraicts tant de l’anatomie que des instruments de chirurgie, & de plusieurs monstres. Le tout diuisé en vingt six livres … (Paris : Chez G. Buon, 1575), p399.

iii. Paré defended his publication with a written defense and in the Parisian courts. While the verdict was not recorded, the book went on sale and sold out almost immediately. See Wallace B Hamby, Ambroise Paré, Surgeon of the Renaissance (St. Louis: W.H. Green, 1967), pp153-156.

iv. Ambroise Paré, Les Oeuvres de m. Ambroise Paré, pp357-359.

v. John Pearn, “Gunpowder, the Prince of Wales’s Feathers and the Origins of Modern Military Surgery,” ANZ Journal of Surgery 82 (2012): 240–244, 241; Kelly R DeVries, “Military Surgical Practice and the Advent of Gunpowder Weaponry,” The Canadian Bulletin of Medical History / Bulletin canadien d’histoire de la médecine 7(2) (1990):131-46, p135.

vi. DeVries, “Military Surgical Practice and the Advent of Gunpowder Weaponry,” pp141-142.

vii. Ambroise Paré, Les Oeuvres de m. Ambroise Paré, p359.

viii. DeVries, “Military Surgical Practice and the Advent of Gunpowder Weaponry,” p142.

ix. Frank Tallett, War in Context: War and Society in Early Modern Europe : 1495-1715 (London, US: Routledge, 2010), pp108-110.

The Origins of Automated Ice

By Danielle Aloia. Special Projects Librarian

This August, for most of us, ice is a second thought:  easily obtained for cooling drinks and chilling food, and usually only a few steps away.   An 1844 title in our collections offers an intriguing snapshot of a time when this was not always the case.

In 1844, a Londoner with a shop on Regent Street and an inventive mind published The Ice Book: Being a Compendious and Concise History of Everything Connected with Ice.  His name was Thomas Masters.   In this publication, Masters enumerates the practical uses–both culinary and medical– of his own patented ice machine.  In his introduction, Masters describes his obsession with the process of freezing:

The transformations narrated in the “Arabian Nights,” those gorgeous repositories of Eastern legendary lore, are not more marvelous or more speedy than the change of a liquid body to a block of solid ice.1

During the course of The Ice Book, Masters introduces his invention and its applications and takes readers on a whirlwind tour of ice through space and time.  Along the way, he also supplies some delectable frozen recipes–sign us up for the maraschino ice cream, the nectar ice and the punch a la Victoria, stat.

Masters reports that the Greeks and Romans were known to use snow from the surrounding mountains to cool their wine.2 Nero’s cooks flavored snow with “honey, juices, and pulp of fruits,” creating a precursor to the flavored ice of today, and eventually ice cream.3

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Depiction of a runner delivering snow from the mountains to Nero. Published in the National Dairy Council’s Ice Cream Through the Years, 1946.

Masters also describes Indian methods of making artificial ice, reporting that during the winter months, ice was created by filling rows of small earthen pans with boiled water, which was then cooled and left overnight.  The thin ice was gathered up, thrown in a pit that was lined with straw and layered with blankets, and pressed into a solid mass.  The pit was closed up with straw, blankets and a thatched roof.

Masters devotes a significant portion of his narrative to the promotion of his portable “patent freezing machine.”  In his introduction he writes:

The preparation of one of the most delectable refections known to this advanced era of modern culinary civilization, has been hitherto left to the experienced confectioner, on whose skill, not always within reach, depended the supply.  By attending to the instructions contained in the following pages, ices may now be procured from the machine within five minutes.4

A review of the book in The Patent Journal and Inventors’ Magazine offers this glowing endorsement of The Ice Book:

The specification of Mr. Masters’ patent appeared in #53 of our journal…it will be seen that he invented a number of very ingenious apparatus, by means of which, the luxury of cold liquors, &c. may be the most readily supplied; his Ice safes and well are excellent, and his ready mode of freezing, astonishing.  It is really a disgrace to buttermen and other shopkeepers to vend their edibles in the nasty state they frequently do, and the public should demand the use by tradesmen of these safes…5

The benefits of Masters’ machine were not limited to food and drink preparation.  Ice was used in medicine to relieve headaches, fever, hemorrhaging, and, believe it or not, symptoms of rabies.6 Masters includes testimonials from MDs.  One Dr. John Ryan writes that Masters’ machine will “enable [doctors] at all seasons, whether in the crowded fever wards of the hospital, or in private practice, to obtain for the patient a necessary adjunct to medical treatment.”7

An elevation of a double-motion machine with pails (B), a2 (machinery), and P (flapdoor).  Some were made with a drawer underneath, which serves as a wine-cooler.  Plate 1 published in Thomas Masters' The Ice Book, published in 1844.

An elevation of a double-motion machine with pails (B), a2 (machinery), and P (flapdoor).  Some were made with a drawer underneath, which serves as a wine-cooler.  Plate 1 published in Thomas Masters’ The Ice Book, published in 1844.

A single-motion machine with a freezer that is rotated by turning the crank handle at the top.  Plate 3, published in Thomas Masters' The Ice Book, 1844.

A single-motion machine with a freezer that is rotated by turning the crank handle at the top.  Plate 3, published in Thomas Masters’ The Ice Book, 1844.

The machine had various interchangeable parts and could be setup for private use to make blocks of ice, flavored ice and ice cream, and to cool wine and drinks. In plate 6 below, Figures 1-3 depict the special churns needed to get the fineness and smoothness necessary to keep the flavored ice or ice cream from separating; “a proper beating-up, a process which never can be accomplished by the hand.”8 Figures 4-5, depict separate ice preserving containers for game, fish, butter, etc. Figures 6-8, depict the cold storage for beverages, such as wine and beer.

Plate 6 published in Thomas Masters' The Ice Book, 1844.

Plate 6 published in Thomas Masters’ The Ice Book, 1844.

Below, we’ve included a few tantalizing recipes from the book.  Masters supplies instructions for making plain and flavored ice creams:

Recipes for plain, pistachio, biscuit, maraschino, "nouveau" and cinnamon ice creams, from Thomas Masters' The Ice Book, 1844.

Recipes for plain, pistachio, biscuit, maraschino, “nouveau” and cinnamon ice creams, from Thomas Masters’ The Ice Book, 1844.

Recipes for pine-apple, ginger, and apricot ice cream, from Thomas Masters' The Ice Book, 1844.

Recipes for pine-apple, ginger, and apricot ice cream, from Thomas Masters’ The Ice Book, 1844.

Other recipes instruct on making flavored ices.

Wine ices, from Thomas Masters' The Ice Book, 1844.

Wine ices, from Thomas Masters’ The Ice Book, 1844.

Raspberry water ice et al., published in Thomas Masters' The Ice Book, 1844.

Raspberry water ice et al., published in Thomas Masters’ The Ice Book, 1844.

Apple water ice et al., published in Thomas Masters' The Ice Book, 1844.

Apple water ice et al., published in Thomas Masters’ The Ice Book, 1844.

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How to clarify sugar, from Thomas Masters’ The Ice Book 1844.

We found this errata slip laid in amusing:

Errata slip, Thomas Masters' The Ice Book, 1844.

Errata slip, Thomas Masters’ The Ice Book, 1844.

Another peculiar aspect of this work is the Appendix. Masters delights in supplying real-life anecdotes about ice.  Among the highlights are an ice storm in 1672 that destroyed numerous trees; an ice market in 19th-century St. Petersburg containing the bodies of thousands of frozen animals, captured inside ice; and in that same city, the Ice Palace of St. Petersburg built near the banks of the River Neva in 1739, which began to give way under its own weight before the last ice blocks were placed.9  We’ll be returning to this book again for these fascinating stories, and for the recipes within…particularly on hot summer days.

References

1.   Masters, Thomas. The Ice Book. London: Simpkin, Marshall, & Co., 1844.

2.  Masters, 6.

3.  National Dairy Council. Ice Cream through the Years.  Chicago: National Dairy Council, 1946.

4.  Masters, x.

5.  “Thomas Masters’ Ice Book:  The Ice Book: Being a Compendious and Concise History of Everything Connected with Ice.”  Patent Journal and Inventors’ Magazine, June 5, 1847, accessed online.

6.  Masters, pp. 180-187.

7.  Masters, pp. 185-187.

8.  Masters, pp. 194-196.

9. Masters, pp. 134-146.

 

Historical Advice on Breastfeeding in Honor of World Breastfeeding Week

By Becky Filner, Head of Cataloging

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“Mother nursing twins simultaneously.”  From Reginald Charles Jewesbury’s Mothercraft, antenatal and postnatal.

World Breastfeeding Week – August 1-7, 2016 – seeks to promote, protect, and support breastfeeding. How was breastfeeding regarded in the past? To answer this question, I consulted books on child rearing from the early 19th century to the mid-20th century.

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Title page, William Buchan’s 1804 Advice to Mothers.

The earliest book I looked at, Dr. William Buchan’s 1804 Advice to Mothers, on the Subject of Their Own Health; and on the Means of Promoting the Health, Strength, and Beauty, of Their Offspring, is extremely critical of women who do not breastfeed:

Unless the milk….finds the proper vent, it will not only distend and inflame the breasts, but excite a great degree of fever in the whole system… It may be said, that there are instances without number, of mothers who enjoy perfect health, though they never suckled their children. I positively deny the assertion; and maintain, on the contrary, that a mother, who is not prevented by any particular weakness or disease from discharging that duty, cannot neglect it without material injury to her constitution.1

At the end of the 19th century, Dr. Genevieve Tucker’s Mother, Baby, and Nursery: A Manual for Mothers (1896) also strongly advocates breastfeeding:

Every mother who has health sufficient to mature a living child ought, if possible, to nurse it from her own breast. Her own health requires it, as the efforts of the child to draw the milk causes the uterus to contract, and nothing else will take its place to her infant.2

Much of her other advice seems outdated now, including her claim that “nursing babies suffer from too frequent nursing” and her suggestion to nurse “as seldom as possible at night.” Perhaps strangest to modern ears is her analysis of a woman’s ability to nurse based on her physical and emotional state:

Different temperaments and constitutions in women have great influence in the quantity and quality of milk. The richest milk is secreted by brunettes with well developed muscles, fresh complexions, and moderate plumpness. Nervous, lymphatic, and fair-complexioned women, with light or auburn hair, flabby muscles, and sluggish movements, as a rule, secrete poor milk. Rheumatic women secrete acid milk, which causes colic, diarrhea, and marasmus in the child.3

Tucker also suggests that a nursing mother should be producing a whopping forty-four ounces of breast milk every twenty-four hours.

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Breastfeeding baby, from Stella B. Applebaum’s Baby, A Mother’s Manual, published ca. 1946.

Dr. Charles Gilmore Kerley in his Short Talks with Young Mothers: On the Management of Infants and Young Children  wrote in the early 19th century that contemporary pressures on women hinder their breastfeeding abilities:

A mother, to nurse her child successfully, must be a happy, contented woman… The American women of our large cities assume the cares and responsibilities of life equally with men. Among the so-called higher classes, — those who have all that wealth and position can give, — there is a constant struggle for social pre-eminence. Among the majority of the so-called middle classes the contest for wealth and place never ceases from the moment the school days begin until death or infirmity closes the scene. Among the poor there are the ceaseless toil, the struggle for food and shelter, the care of the sick, and the frequent deaths of little ones in the family whom they are unable properly to care for. In all classes, therefore, the conditions of life are such as seriously to interfere with the normal function of nursing, no matter how excellent may be the mother’s physical condition.4

This emphasis on a woman’s mind being at rest is repeated in much of the early 20th- century literature on breastfeeding.

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“Hungry!” from Myrtle M. Eldred and Helen Cowles Le Cron’s For the Young Mother, 1921. p. 31.

Most of the books from the first few decades of the 20th century contain a passage about keeping the breasts and nipples clean. Kerley and others recommend washing the nipples (and even the child’s mouth!) with a solution of boracic (boric) acid. Myrtle M. Eldred and Helen Cowles Le Cron write in For the Young Mother (1921) that “the breasts are tender and easily infected at first, so that the boric acid acts as a cleanser to protect the baby from possible germs and as a preventive of abscessed breasts.5”Boric acid, though it is sometimes used as an antiseptic, is toxic to humans if taken internally or inhaled in large quantities. Other books recommend rinsing the breasts with hot water prior to nursing.6

Many books also contain lists of foods the nursing mother should and should not eat. Dr. Anne Newton, in her Mother and Baby: Helpful Suggestions Concerning Motherhood and the Care of Children (1912), advises mothers to practice “sacrifice and self-denial” in eating meals, and to avoid rich and seasoned foods altogether.7 Newton specifies that mothers should eat “nothing about which there is any question of fermentation. Such vegetables as cabbage, turnips, cauliflower, and tomatoes should not be given until the baby is four months old at least, and even then certain things may cause discomfort and cannot be indulged until the child is weaned.8” Dr. Thomas Gray, in Common Sense and the Baby: A Book for Mothers, notes that the breastfeeding mother should “eat an abundance of wholesome, nutritious food; avoid indigestible pastries and salads. Take sparingly of tea and coffee. Drink freely cocoa and milk. Eat fruits – not acid.9”  Some more recent books are much less rigid about the mother’s diet. Dr. Dorothy Whipple, writing in 1944, is less cautious, and argues that there’s very little a mother can eat that harms a nursing baby, mentioning only certain foods like onions that may, in breast milk, deter babies with its “unusual taste.10

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A mother breastfeeding and a selection of foods recommended for the breastfeeding mother, taken from Stella B. Applebaum’s Baby:  A Mother’s Manual (1946).

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Front cover of the New York City Health Department’s The Care of Baby, 1932.

None of the books I consulted recommended breastfeeding to two years or beyond, the WHO’s current recommendation on breastfeeding. Most books recommend weaning the baby between eight and fourteen months of age.  The New York City Department of Health warns against weaning in summer because of the risk of spoiled cow’s milk:

If possible, do not wean your baby during the hot summer months…. If you are well, it will not harm you to nurse your child until the dangerous, hot weather is over. This precaution may mean saving your child’s life.”11

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“One of life’s richest experiences,” from Dorothy Whipple’s Our American Babies, published in 1944.

Another common thread in the literature about breastfeeding is an emphasis on the pleasure and health benefits experienced by the nursing mother.  According to Tucker, “under the right conditions of lactation, … the mother should thrive and even grow stout.12” Others emphasize that breastfeeding will help the mother “get her ‘good figure’ back much more quickly than the mother who doesn’t nurse” because “nursing causes the uterus or womb to contract.13” Stella Applebaum provides this summary of the mother-baby nursing relationship:

Mother’s milk is the perfect baby food. From a healthy mother’s clean nipples, this pure, fresh, warm, nourishing, digestible food is delivered, germ-free, directly into the baby’s mouth. At the same time mother’s milk protects him against certain diseases. Suckling at the breast makes the baby feel close to his mother, happy, and secure.

Nursing benefits you, too. It stimulates the uterus to contract to normal size and contributes to your personal enjoyment and contentment. Propped in a comfortable chair or bed, you share a uniquely satisfying experience with your baby.14

Other writers underscore the vital role nursing plays in strengthening the emotional bonds between mother and child.   Buchan writes in 1804 that “the act itself is attended with sweet, thrilling, and delightful sensations of which those only who have felt them can form any idea.15” Dorothy Whipple has the last word:

…to sit in a comfortable chair and hold a little snuggling baby in your arms, to watch him grab that nipple with all the fury of his tiny might and suck and work away until he reaches that complete satisfaction that comes to a baby with a full stomach is one of the pleasantest sensations in life.16

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A mother and her baby breastfeeding while lying down, from Louise Zabriskie’s Mother and Baby Care in Pictures, published in 1941.

References

1.  Buchan, William. Advice to Mothers, on the Subject of Their Own Health; and on the Means of Promoting the Health, Strength, and Beauty, of Their Offspring. Philadelphia: John Bioren, 1804, p. 75-76.

2-3. Tucker, Genevieve. Mother, Baby, and Nursery: A Manual for Mothers. Boston: Roberts Brothers, 1896, p. 85-87.

4. Kerley, Chalres Gilmore. Short Talks with Young Mothers: On the Management of Infants and Young Children. New York: G.P. Putnam’s Sons, 1904, p. 13-15.

5.  Eldred, Myrtle M. For the Young Mother. Chicago: The Reilly & Lee Co., 1921, p. 37.

6.  Kenyon, Josephine Hemenway. Healthy Babies Are Happy Babies: A Complete Handbook for Modern Mothers. Boston: Little, Brown, and Company, 1934, p. 55-56; Zabriskie, Louise. Mother and Baby Care In Pictures. Philadelphia: J.B. Lippincott Company, 1941, p. 131.

7.  Newton, Anne B. Mother and Baby: Helpful Suggestions Concerning Motherhood and the Care of Children. Boston: Lothrop, Lee & Shepard Co., 1912, p. 74.

8.  Ibid., p. 78.

9.  Gray, Thomas N. Common Sense and the Baby: A Book for Mothers. New York: the Bewick Press, 1907, p. 39.

10. Whipple, Dorothy V. Our American Babies: The Art of Baby Care. New York: M. Barrows and Company, Inc., 1944, p. 139.

11.  New York City Department of Health. The Care of Baby. New York: Department of Health, 1932, p. 10.

12. Tucker, p. 86.

13. NYC Dept. of Health. The Care of Baby, p. 5.

14. Applebaum, Stella B. Baby: A Mother’s Manual. Chicago and New York: Ziff-Davis Publishing Company, 1946.

15. Buchan, p. 79.

16. Whipple, p. 122.

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).

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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]

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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).

Presentations Announced for the Fifth Annual History of Medicine Night: Insights from the Early Modern Period

The New York Academy of Medicine’s Section on History of Medicine will hold the “Fifth Annual History of Medicine Night: Insights from the Early Modern Period” on March 11 from 6:00 pm–7:30 pm at NYAM, 1216 Fifth Avenue at the corner of 103rd Street. Register to attend here.
RBR shelfPresenters will address historical topics relating to medicine with a focus on the Early Modern period.  This year’s presenters are:

Barbara Chubak, MD
Urology Resident (PGY-5), Montefiore Medical Center
“Imagining Sex Change in Early Modern Europe”

Jeffrey M. Levine, MD
Assistant Clinical Professor of Medicine and Palliative Care
Icahn School of Medicine at Mount Sinai
“A Fresh Look at the Historiated Initials in the De Humani Corporis Fabrica”

John E. Jacoby, MD, MPH
Assistant Clinical Professor of Medicine and Pediatrics
Icahn School of Medicine at Mount Sinai
“On the Life of Dr. Robert Levett: The Philosophy of Primary Care”

Nina Samuel, PhD
Center for Literary and Cultural Research
University of Berlin
“The Art of Hand Surgery”

Michelle Laughran, PhD
Associate Professor of History
Saint Joseph’s College of Maine
“The Medical Renaissance among Three Plagues: Epidemic Disease, Heresy and Calumny in Sixteenth-Century Venice”

Sharon Packer, MD
Assistant Clinical Professor of Psychiatry and Behavioral Sciences
Icahn School of Medicine at Mount Sinai
“Epidemic Ergotism, Medieval Mysticism & Future Trends in Palliative Care”

Part two of this lecture series, “History of Medicine Night: 19th– and 20th-Century Stories,” will take place on May 6, 2015.

Who Becomes a Medical Doctor in New York City: Call for Papers

RBR deskThe New York Academy of Medicine’s Section on History of Medicine is pleased to announce “Who Becomes a Medical Doctor in New York City: Then and Now—A Century of Change” to be held on December 11, 2014 from 6:00 pm–7:30 pm. The event will take place at the Academy, located at 1216 Fifth Avenue at the corner of 103rd Street.

We are inviting all those interested in presenting to submit an abstract with one aspect of how individuals were selected, or excluded from, the study of medicine in New York City over time. These might include, but need not be limited to, decisions based on academic qualification, race, sexual orientation, ethnicity, economics, and country of origin. The influence of career expectations for the profession and social and cultural factors motivating individuals to become a medical doctor may also be considered.

Note the following submission requirements:

  • Applications must include an abstract, with a 250-word maximum, and this form.
  • Abstracts must be submitted no later than October 30, 2014

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

Abstracts should be submitted electronically to Suhani Parikh at sparikh@nyam.org.  Questions may be directed to Suhani via email or phone (212-419-3544).

History Night Presentations Announced

The New York Academy of Medicine’s Section on History of Medicine will hold the “Fourth Annual History of Medicine Night – Part One: Spotlight on New York” on February 6 from 6:00 pm–7:30 pm at NYAM, 1216 Fifth Avenue at the corner of 103rd Street. Register to attend here. A second evening of presentations is being planned for spring.

RBR deskThe night will feature the following presentations, as described by the speakers:

“Psychiatric Criminology in the Eugenic Era: The New York Police Psychopathic Laboratory, 1915-1929”
Sara Bergstresser, M.P.H., Ph.D., Columbia University, Bioethics

“First, I explore the historical background of North American and European psychiatry, criminology, and eugenics in the nineteenth century, including threads of early convergence. Next, I examine the development of eugenic psychiatry and its intersections with eugenic criminology, with a particular emphasis on New York State in the early twentieth century. I then present a case study from that time period, which is based primarily on materials from the archives of the New York Police Psychopathic Laboratory. I go on to argue that in this case the workings of psychiatric criminology were more eclectic and uncertain than they may otherwise appear based on broad descriptions of the eugenic era.”

“Not for Self but Others: The Presbyterian Hospital Goes to War”
Pascal J. de Caprariis, M.D., Lutheran Medical Center

“On March 11, 1940 the U.S. Surgeon General reached out to Presbyterian Hospital’s medical board president to develop a military hospital to support US troops in an eventual war. Structured to receive patients from combat areas and follow American troops throughout war, it was to provide complex medical and surgical care over the course of three years and two months abroad.”

“The Cancer Education Campaigns in Progressive Era New York City: The Role of Women”
Elaine Schattner, M.A., M.D., F.A.C.P., Weill Cornell Medical College

“At the start of the 20th century, myths about cancer’s causes and treatments were widespread. Fear of the disease—and of inept surgeons—was rampant. Many afflicted fell prey to hoaxers selling bogus salves, patent medicines and painless “cures.” In April 1913, a prominent New York City surgeon and gynecologist, Dr. Clement Cleveland, invited a group of well-to-do ladies, bankers and physicians to his home. They heard from statisticians and public health specialists, and considered what might be done to reduce cancer’s mounting toll. The group met formally again in June 1913 at the Harvard Club in New York City. They formed the American Society for the Control of Cancer (ASCC), which three decades later became the American Cancer Society.”

“A Diagnosis of Philanthropy: Carnegie and Rockefeller and the Medical Profession”
Catherine (Katia) Sokoloff, Sarah Lawrence College

“Through exploring the evolving interests of Andrew Carnegie and John D. Rockefeller during the Progressive Era, this paper unearths how these philanthropists and their advisers facilitated and funded the writing of the infamous Flexner Report in 1910. The report, also called Bulletin Number Four, exposed the inadequacies of medical schools and catalyzed dramatic education reforms.”

“Organizing Orthopaedic Societies in New York City in the 1880s: The New York Orthopaedic Society, the New York Academy of Medicine Section of Orthopaedic Surgery and the American Orthopaedic Association”
Jonathan B. Ticker, M.D., College of Physicians and Surgeons, Columbia University

“After the seventh general meeting of the New York Orthopaedic Society (NYOS) on January 4, 1886, steps were taken to merge NYOS into a section of the New York Academy of Medicine (NYAM). Thus, on January 29, 1886, NYOS adjourned and the NYAM Section of Orthopaedic Surgery began. On January 29th, 1887, the chairman of the Section and 15 others “[met] and [discussed] the organization of a national orthopaedic society.” This led to the founding of the American Orthopaedic Association (AOA).”

History Night: Call for Papers

RBR desk

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

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

Note the following submission requirements:

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

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

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

Rehousing the Diploma Collection

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

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

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

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

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

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

Certificate signed by Woodrow Wilson.

Certificate signed by Woodrow Wilson.

Certificate signed by Andrew Johnson.

Certificate signed by Andrew Johnson.

Certificate signed by Abraham Lincoln.

Certificate signed by Abraham Lincoln.

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

Photographs of Howard and Edith Lilienthal attached to a certificate

Photographs of Howard and Edith Lilienthal attached to a passport.

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

Certificate in Arabic with gold ornament

Certificate in Arabic with gold ornament

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

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

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

Repairing paper certificates in the conservation lab.

Repairing paper certificates in the conservation lab.

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

A certificate and seal, re-housed.

A certificate and seal, re-housed.