The Medical Journals of U.S.-Occupied Haiti

Posted on May 29, 2019 by nyamhistory

This guest post is by Matthew Davidson, a doctoral candidate at the University of Miami and the 2019 Paul Klemperer Fellow at the New York Academy of Medicine. His research examines public health in Haiti during the 1915-1934 U.S. occupation.

During the nineteen years of the early twentieth century that the United States occupied Haiti (1915-1934), U.S. officials liked to claim that they had brought modern medical thought to the Caribbean country. Their contention was bunk, but it apparently felt very real when the Haitian physician, Dr. François Dalencour, received a letter from a French colleague asking for copies of any Haitian medical publications. “I was ashamed,” Dalencour later wrote, “of being obliged to tell the truth, to say that there were none. [i] He would have been able to send along reports authored by the occupation medical service, but there was apparently nothing current otherwise. Haiti, Dalencour decided, needed a medical journal.

Soon after, he established one.

LeJournalMedicalHaitien_May1920_1_watermark

The first issue of Le Journal Médical Haïtien (NYAM).

The occupation, it turns out, was indeed an important period for Haitian medical thought. As was the case in other fields, it provoked a flurry of intellectual production. Consequently, whereas doctors such as Dalencour lamented the lack of Haitian medical publications at the start, by the end the local medical establishment could boast of several. U.S. officials claimed this was a sign of how far medicine in Haiti had “progressed” under their tutelage, but it was truly more the product of Haiti’s own medical tradition. [ii] Meant to advance medical practice and public health policy, the journals provided a forum for Haitian practitioners to debate and discuss all sorts of matters related to health and medicine in the country.

Dalencour’s periodical, Le Journal Médical Haïtien, was arguably the most important of the occupation-era publications. Not only was it the first, founded in May 1920, but it also did the most to open up space for the Haitian medical profession to articulate ideas and positions about their field. With U.S. personnel otherwise completely dominating all aspects of medicine and public health in Haiti, Le Journal Médical Haïtien was the only venue (outside of individual private practices) actually controlled by Haitians. It accordingly brought together “all members of the Haitian Medical Corps, without any distinction”: doctors, pharmacists, dentists and midwives. [iii] In doing so, the journal bridged longstanding divisions within the medical corps and laid the foundation for further independent initiative.

As Le Journal Médical Haïtien facilitated the reorganization of the Haitian medical profession, it also laid bare the lie that the occupation brought medical modernity to the country. After all, it was not because the U.S. introduced “scientific medicine” or any other set of ideas to Haiti that the journal appeared. Rather, it had its genesis in the pre-occupation period. As Dalencour wrote in the first issue, the project was first conceived in 1903. He was still a medical student at the time, so establishing a journal for medical reform was a “somewhat pretentious idea.” [iv] Nonetheless, it was then, well before the Americans landed, that the first steps were taken to establish a “general review of the medical movement in Haiti” (as Le Journal Médical Haïtien was later billed). The principles laid out by Dalencour and his collaborators in 1920 were even the same as those declared in 1903. All that had changed was the name. Dalencour had originally chosen the title Haïti Médicale, but – further reflecting the strength of Haiti’s pre-occupation medical and intellectual traditions – another journal had taken that name in 1910. [v]

The next to emerge was Les Annales de Médecine Haïtienne. Established in 1923 by two young doctors, Drs. N. St. Louis and F. Coicou, Les Annales was associated with a newly reorganized union, le Syndicat des Médecins. Much more oppositional in outlook, the journal was conceived as an “organ for the expansion of medicine in Haiti and for the defense of the interests of the medical corps.” [vi] Explicitly anti-occupation, it actively contested the U.S. health project in Haiti and worked to organize Haitian doctors against it under the auspices of le Syndicat des Médecins. It was not merely a political publication, though, for it also carried articles dedicated to public health education and research in the medical sciences. Over time, such articles became more and more prominent, and as the occupation ended Les Annales de Médecine Haïtienne essentially transitioned to purely scientific journal. U.S. medical sciences, however, continued to be received coolly.

May-June 1932 issue of Les Annales de Médecine Haïtienne (Schomburg Center, NYPL).

The last of the occupation-era publications was the only one that owed its existence to the occupation health project. The Bulletin de la Société de Médecine d’Haïti, founded with that society in 1927, was the sole journal fostered by U.S. officials, and it was the only one to have U.S. practitioners on its editorial board or to publish articles authored by occupation doctors. The society itself was organized and controlled by the occupation health service, the Service d’Hygiène. Accordingly, most independent doctors (i.e., those not directly employed by the Service d’Hygiène) tended to find the Société “too American” and remained outside of it. [vii] Nonetheless, the Bulletin was more than just an American journal based in Haiti.

BulletinDeLASocieteDeMedecineDHaiti_Jan1927_1_watermark

The first issue of the Bulletin de la Société de Médecine d’Haïti (NYAM).

The Bulletin de la Société de Médecine d’Haïti was an important register for the medical sciences in Haiti. From 1927 until the end of the occupation, it published an impressive array of scholarship, much of it by Haitian practitioners. With an emphasis on medical specialization, it tended to be more concerned with the medical sciences than with public health policy or practice, and it accordingly developed a reputation for being the most scientific of the journals. As a project, however, the Bulletin mostly just brought to fruition ideas and proposals first put forth in the pages of Le Journal Médical Haïtien (or by the 1890 Société de Médecine de Port-au-Prince before that). In form as much as in content, then, the Bulletin was as Haitian as it was American. Consequently, when the American editors shuttered the journal in 1934 with the end of the occupation, the Haitian medical establishment remained committed to the project: it lived on as the Bulletin du Service d’Hygiene et d’Assistance Publique – Medicale et Sanitaire.

BulletinDuServiceDHygieneEtDAssistancePublique_Jun1934_1_watermark

The first issue of the Bulletin du Service d’Hygiene et d’Assistance Publique – Medicale et Sanitaire (NYAM).

Each of these journals have largely been overlooked by historians, despite being incredibly rich sources. With their debates about public health policy, research on various health matters, clinical notes, correspondence between doctors and medical officials, translated articles from abroad, social commentary, and more, they offer significant insight into the state of medical care and the politics of health during the occupation. They would also be of interest to anyone thinking about Haitian social and intellectual history more generally. Few copies of each journal still exist, but they – with the exception of Les Annales – can be found at the New York Academy of Medicine library.

References

[i] Dalencour, François, « En Manière de Programme. » Le Journal Médical Haïtien (Première Année, No. 1, May, 1920; New York Academy of Medicine Library).

[ii] See, for instance, Parsons, Robert P., History of Haitian Medicine (New York: Paul B. Hoeber Inc., 1930).

[iii] Dalencour, François, « En Manière de Programme. » Le Journal Médical Haïtien (Première Année, No. 1, May, 1920; New York Academy of Medicine Library).

[iv] Dalencour, François, « En Manière de Programme. » Le Journal Médical Haïtien (Première Année, No. 1, May, 1920; New York Academy of Medicine Library).

[v] Haïti Médicale was published from 1910-1913, and then was briefly revived again in 1920.

[vi] Les Annales de Médecine Haitienne (9eme Année, No. 3 &4, Mars-Avril 1932; Schomburg Center for Research in Black Culture, New York Public Library).

[vii] Bordes, Ary, Haïti Médecine et Santé Publique sous l’Occupation Américaine, 1915-1934 (Haiti: Imprimerie Deschamps, 1992), 300.

Through The Grapevine: writing for Alcoholics Anonymous

Posted on June 25, 2018 by nyamhistory

By Anne Garner, Curator of Rare Books and Manuscripts

Alcoholics Anonymous first issued The Grapevine in June of 1944, seventy-four years ago this month. In the journal’s inaugural issue, an uncredited author recounts the founding of the publication “in a big, smoke-filled room” where “six ink-stained wretches sipped at their Cokes … a cashier, a radio script writer: an author: a bookseller: an art director: a wife and mother of two.” When questioned on the journal’s purpose, the mother of two explains. It’s about “A.A.’s whole design of living. There’s going to be a big, full-page on local group doings … and we’re planning to get all the big general stuff on alcoholism into the paper. Best of all, we think, is the Servicemen’s Letter page…”[1]

1Grapevine_sept1946_v3n4_watermarked

While managed by senior advisor and Alcoholics Anonymous founder Bill W., The Grapevine was conceived and established by a handful of New York “A.A.” women. In “–the story of your magazine – – ” published in the December 1948 issue, the initial idea for the serial publication was credited to “Lois K., a New York member,” who suggested a trial run. A preliminary meeting between Lois K. and three other women in the program, Priscilla P., Grace O. and Marty M. (the latter was the founder of the National Committee for Education on Alcoholism) solved initial questions about content and funding. They also decided that male representation was needed, and added two men to their staff, Chase H. and Abbott T. Alcoholics Anonymous founder Bill W. gave the plan his blessing, and in his first editorial for the publication, called The Grapevine, “a lighted lamp.”[2]

The initial print run was 1,200 copies, and demand was steady. Members voted on October 3, 1945 to designate The Grapevine as the initial periodical of A.A. In 1944 and 1945, the journal was produced entirely by non-paid volunteers; by 1948, The Grapevine was supported by four paid staff. In September of 1948, a smaller, pocket format was conceived (the earliest editions bear a fruit-heavy vine on the cover with the issue information but no title, in an instance of design safeguarding anonymity.)

2Grapevine_July1955_v12no2_watermarked

The first edition of “Alcoholics Anonymous,” or “the Big Book,” (1939) included only one essay about a female in recovery. But from the beginning, The Grapevine was more inclusive of women’s stories. An early article by founding member Grace O. focused on female membership and the perceived challenges by men of women at meetings. Here, she ticks out some of the complaints expressed by male members, who believed “women talk too much,” “many women form attachments that are too intense,” “women’s feelings get hurt too often,” and that they frequently “are attention demanders;” she concludes that the way forward is with patience and acknowledgement of common purpose.[3] As Leslie Jamison writes in her 2018 book, The Recovering, “Describing the ‘traditional beliefs’ that inflect how male and female drinking have been understood differently, one clinical textbook puts it like this. ‘Intoxication in a woman was thought to signal a failure of control over her family relationships.’”[4]

A selection of The Grapevine from 1948-1949.

Pnina Levy demonstrates that in the earliest years of the organization men and women shared editorial and writing responsibilities for the serial, though the organization wasn’t always able to shake the entrenched cultural and social gender stereotypes of the early post-War period.[5] A May 1949 article, “Lady A.A.s Get Their Heads Together” acknowledged the challenges of “scurrying to fix dinner, wash dishes, prepare kids for bed, dress yourself and make the meeting across town by 8 o’clock.”[6] In a “Vino Vignette” published in a 1946 issue, Esther E. tells of the difficulties of moving to her new town of San Antonio to kindle a regular meeting because she’s a woman. She’s successful assembling a group of three females and one male; eventually, as she says, “‘evah-thing’ caught fire.” The December 1955 issue has no less than five articles by women, including articles about co-ed sponsorship, a narrative of a former female prisoner in recovery, and “My Son and I and AA,” written by a New York program mother.[7]

Today, The Grapevine is still in print, along with La Vina, for Spanish audiences. Current information about subscriptions and excerpts from past issues can be found here.

References

[1] Anonymous. “Grapevine’ in Bow.” The Grapevine. June 1944. Vol 1, No. 1.

[2] Anonymous. “—the story of your magazine—“ The Grapevine. December 1948. Vol 5, No. 7; Bill W., “The Shape of Things to Come,” The Grapevine. June 1944. Vol. 1, No. 1.

[3] Grace O. “Women in A.A. Face Special Problems.” The Grapevine. October 1946. Vol. 3, No. 5, P. 1, pp 6 – 7, 10.

[4] Leslie Jamison. The Recovering. New York: Little Brown, 2018.

[5] Pnina Levi. “Gender and Alcoholism: Pioneering alcoholic women’s contribution to Alcoholics Anonymous, 1937 – 60.” Social History of Alcohol and Drugs. 2015. Vol. 29, pp. 112-35.

[6] Anonymous. “Lady A.A.’s Get Their Heads Together.” The Grapevine. May 1949. Vol. 5, No. 12, p. 11.

[7] See, “I’ve Changed My Tune,” “My Son and I and AA,” “Adding Up the Score,” “A Lady’s Gripe,” “I’ve Got What I Want for Christmas,” all from The Grapevine. December 1955. Vol. 12, No. 7.

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

Posted on May 26, 2016 by nyamhistorymed

By Johanna Goldberg, Information Services Librarian

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

References

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

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

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

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

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

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

Fascinating Mad Men-Era Advertisements

Posted on May 13, 2015 by nyamhistorymed

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

This is part of an intermittent series of blogs featuring advertisements found in our collection. You can find the entire series here.

In American Journal of Obstetrics and Gynecology 83, no. 3 (1962).

Nobody conjures the ’60s better than Matthew Weiner and the writers, designers, and stylists of AMC’s Mad Men. We’ll miss the quotidian details: the trash left behind at the Draper family picnic, that unbelievable maternity dress of Trudy’s, the choking smoke of Mohawk’s planes, Metro-North’s trains, and Don’s automobiles. When Sally Draper puts a plastic dry-cleaning bag over her head and her mother scolds her—not out of fear for her safety and only for dumping her dry-cleaning on the floor—we’re gob-smacked. These moments crystallize the seismic shifts that have occurred in cultural expectations over the last fifty years.

The Academy Library has strong holdings in the major journals of the 19th and 20th centuries. Journals were then, as they are now, the primary place of publication for innovations and discoveries. In addition, the advertisements aimed at the professional readers of these journals offer insights into changing cultural beliefs. Most libraries excised the advertisements, especially if they were gathered in a separate section of the journal. The Academy tradition was to keep the advertising, and these ads are now heavily used by historians.

The images and texts in these advertisements provide artists, writers, and historians with richly-textured cultural context. There is much to be learned, for example, from looking at the way antidepressants were marketed to women in the twentieth century, at the early advertisements for the birth control pill, and at tobacco advertising aimed directly at physicians as consumers. Here, a look at a Flavorwire piece we wrote using ads entirely from our collections and relating them to Mad Men.

More Doctors Smoke Camels

Posted on February 21, 2014 by nyamhistorymed

By Johanna Goldberg, Information Services Librarian, with Andrew Gordon, Systems Librarian

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

From the 1930s into the 1950s, medical journals—including the Journal of the American Medical Association and the New England Journal of Medicine—ran advertisements for cigarettes.^1,² The New York State Journal of Medicine alone published 600 pages of cigarette advertisements spanning more than two decades, starting in 1933.³ Around the same time, advertising agencies created campaigns featuring physicians; these continued until 1954, as concerns about the negative health effects of smoking grew.²

“How mild can a cigarette be?” Published in the New England Journal of Medicine, volume 240, number 17, April 28, 1949. Click to enlarge.

Presented chronologically below are some of the cigarette advertisements—and one cigarette paraphernalia‎ ad—that appeared in medical journals during the 20-year period. Note especially the 1945 series of ads that ran in several medical journals, including the Medical Woman’s Journal, celebrating the work of war doctors and suggesting that a Camel cigarette could be a welcome break.

Notable, too, is that the earliest ad shown here—printed in Preventive Medicine in 1937—comes from a New York Academy of Medicine publication.

For more information on the history of cigarette advertising, including the use of medical professionals in ads, visit SRITA, Stanford Research into the Impact of Tobacco Advertising.

“Let Your Own Experience Guide You.” Published in Preventive Medicine, volume 7, number 1, April 1937. Click to enlarge.

“Look this way for more pleasure.” Published in the New England Journal of Medicine, volume 218, number 14, April 7, 1938. Click to enlarge.

“How much do you smoke?” Published in JAMA, volume 12, number 11, March 11, 1944. Click to enlarge.

"The Army Doctor's Call to Action!" Published in Medical Woman's Journal, volume 52, number 4, April 1945. Click to enlarge.

“The Army Doctor’s Call to Action!” Published in the Medical Woman’s Journal, volume 52, number 4, April 1945. Click to enlarge.

Combat Team in White! Published in Medical Woman's Journal, volume 52, number 5, May 1945. Click to enlarge.

Combat Team in White! Published in the Medical Woman’s Journal, volume 52, number 5, May 1945. Click to enlarge.

"The Flying Capsules." Published in Medical Woman's Journal, volume 52, number 6, June 1945. Click to enlarge.

“The Flying Capsules.” Published in the Medical Woman’s Journal, volume 52, number 6, June 1945. Click to enlarge.

"Welcome Home, Doctor!" Published in Medical Woman's Journal, volume 52, number 12, December 1945.

“Welcome Home, Doctor!” Published in the Medical Woman’s Journal, volume 52, number 12, December 1945. Click to enlarge.

“Recommended by Physicians to Patients who are ‘Problem Smokers.'” Published in JAMA, volume 133, number 11, March 15, 1947. Click to enlarge.

“Some questions about filter cigarettes that may have occurred to you, Doctor.” Published in the New York State Journal of Medicine, volume 53, number 12, June 15, 1953. Click to enlarge.

“When your patients ask . . . ‘Which Cigarette Shall I Choose?'” Published in the New York State Journal of Medicine, volume 54, number 12, June 15, 1954. Click to enlarge.

References

1. Healy, M. (2011, August 4). Cigarette packages in medical journals: New look for a new age. Los Angeles Times. Retrieved from http://www.latimes.com/health/boostershots/la-heb-cigarette-packages-medical-20110804,0,7658494.story#axzz2rL60QSQm.

2. Gardner, M. N., & Brandt, A. M. (2006). The Doctors’ Choice Is America’s Choice. American Journal of Public Health, 96(2), 222–232. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470496.

3. Blum, A. (2010). When “More doctors smoked Camels”: Cigarette advertising in the journal. Social Medicine, 5(2), 114–122. Retrieved from http://www.socialmedicine.info/index.php/socialmedicine/article/view/461/0.

Shadow Journals: The Story of Medical Advertising (Part 3 of 3)

Posted on October 21, 2013 by nyamhistofmed

Today we have the third and final part of a guest post written by David Herzberg, Ph.D., who will present “The Other Drug War: Prescription Drug Abuse and Race in 20th-Century America” on Tuesday, October 22. Read part one here and part two here.

We don’t have a definitive history of medical advertising (dissertators, take note!). In fact, the world of medicine barely appears in the standard histories of advertising beyond 19^th-century patent medicines. We know all about the key campaigns that transformed the wider advertising industry: Uneeda Biscuit and Oleo margarine in the Progressive Era, Wonder Bread and Dwight Eisenhower in the 1950s, the Volkswagon Beetle in the 1960s, and so forth. The annals of medical advertising begin promisingly with a chapter on patent medicines but then basically peter out.

“The obvious anxieties that preoccupy many middle-aged minds often obscure a coexisting depression.” From JAMA, volume 209, number 1 (September 22, 1969). Click to enlarge.

Obviously any such history would need to be based, in part, on the records of a medical advertising company or the in-house marketing arm of a pharmaceutical company. But they also require access to the advertisements themselves, in the context in which they appeared—i.e., among other places, in medical journals.

It’s not just historians of medical marketing who need the advertisements. Anyone interested in the history of medicine, or of medicine’s relationship to society at large, should care about them. The ads and the articles talked to each other, either through their joint acceptance of larger cultural beliefs or through vigorous debate when professional and profit-seeking agendas clashed. Advertisements also provide a bridge to connect such medical histories to broader developments, via the same links that contemporaries deplored. “They sell medicine like soap!” raged witnesses before Congress in the 1950s, believing that this was argument enough to win the day. This same observation, less polemically framed, might tell us as much about soap and the consumer culture as it does about medicine.

"In many cases the result of 'empty-nest snydrome.' From JAMA, volume 232, number 2 (April 14, 1975). Click to enlarge.

“In many cases the result of ’empty-nest syndrome.'” From JAMA, volume 232, number 2 (April 14, 1975). Click to enlarge.

This is why it was a historic mistake to cut out the ads. And it’s a mistake that we may still be making: today’s online databases offer a la carte articles without the surrounding advertisements, nearby articles, particular layouts, cartoons, etc. (Medical journals used to have cartoon pages; editorial policy apparently insisted that these mostly be nasty pokes at women patients. These pages, too, were often sliced out by well-meaning librarians.)

As I noted before, the New York Academy of Medicine was the only library I have found that did not cut out the advertisements. And even there policy changed for a while in the 1970s. I still don’t know why they had the prescience to spare the advertisements, but we are lucky that they did. It makes for a precious collection that is unlikely to be made obsolete in the digital era.

Shadow Journals: The Story of Medical Advertising (Part 2 of 3)

Posted on October 17, 2013 by nyamhistofmed

Today we have part two of a guest post written by David Herzberg, Ph.D., who will present “The Other Drug War: Prescription Drug Abuse and Race in 20th-Century America” on Tuesday, October 22. Read part one here and part three here.

This story of medical journal advertising is typically cast as what historians call a “declension narrative,” a tale whose main arc tracks a decline from the honorable virtues of past generations to the immoral venality of today. In this telling, commerce and marketing slowly colonized the therapeutic endeavor, transforming from the noble pursuit of health into an untrustworthy, buyer-beware precinct of the larger consumer culture.

But this story can also be told very differently.

After all, there had always been advertisements in the medical journals, and subscribers had always been able to see them—they had no librarians to slice-and-dice for them. Subscribers read the articles in the context of having also seen the ads.

“For the ‘Cheater Eater.'” From JAMA, volume 207, number 11 (March 17, 1969). Click to enlarge.

What might they have drawn from the experience of flipping through the unexpurgated journals? Well, historians have had a field day analyzing the messages of particular ads or particular articles. But the overall structure of the journals also sent its own message. When subscribers flipped past the bundle of advertisements before the table of contents to the ad-free material within, they saw to their satisfaction that commerce had been carefully contained where its self-interested values would not contaminate the real work of medicine—the empirical pursuit of truth, the professional sharing of new ways to alleviate illness and suffering, etc.

And yet, as historians have repeatedly demonstrated, commerce, especially the pharmaceutical kind, had long been a powerful force in medicine. From Parke-Davis’ hyping of cocaine in the 1880s, to Smith Kline French’s careful orchestration of research on amphetamine in the 1930s and 1940s, to Carter Product’s “launching” of minor tranquilizer Miltown with a public relations campaign worthy of a Hollywood starlet, drug companies and their marketing departments are ubiquitous in the history of medicine if you look for them. Their influence was only heightened, ironically, by their loud protestations that their marketing campaigns had no influence on physicians’ therapeutic decisions—doctors, they said, were obviously far too smart and well educated to be swayed by Madison Avenue gimmickry. Few physicians were inclined to argue with such logic, and so the marketing hoopla remained paradoxically below the radar, relatively free of scrutiny or regulatory oversight.

“A sleeping pill for night squawks.” From JAMA, volume 207, number 10 (March 10, 1969). Click to enlarge.

From this perspective, we might all have breathed a sigh of relief when the 1950s rolled around and medical journals finally came clean, giving advertisements the pride of place they had long ago earned and beginning the process by which Americans would come to recognize, and grapple with, the centrality of commerce in their medical system. It is no accident that formal regulatory control of medical advertisements was finally given to the FDA less than a decade later.

Shadow Journals: The Story of Medical Advertising (Part 1 of 3)

Posted on October 15, 2013 by nyamhistofmed

Today we have part one of a guest post written by David Herzberg, Ph.D., who will present “The Other Drug War: Prescription Drug Abuse and Race in 20th-Century America” on Tuesday, October 22. Read part two here and and part three here.

It’s a historian’s nightmare: librarians spent the better part of a century diligently cutting out and throwing away some of the most important parts of the journals they received each week before binding and shelving them. Precious historic material—capstone work by some of the nation’s brightest and most creative minds—was destroyed by the very people devoted to preserving it, and destroyed only more thoroughly because of those peoples’ good intentions and zealous work ethic. Why would they have done such a terrible thing?

This is no hilariously nerdy horror movie. It really did happen all across America for most of the 20^th century. As far as I can tell, the New York Academy of Medicine stood almost alone in deciding—who knows why—not to rip out the advertisements in their medical journals. We owe them sincere thanks for this.

“‘Deprol helps brighten the depressed patient’s world.” From JAMA, volume 204, number 4 (April 22, 1968). Click to enlarge.

It’s pretty clear why most librarians cut out the ads, and it wasn’t just to preserve space on their shelves. Back in the day, the medical profession prided itself on being insulated from crass commercialism, and major journals like the Journal of the American Medical Association not only insisted on approving each advertisement, it also lumped together all the ads in an easily removable bunch before and after the main body of the journal. Ads were thus clearly identifiable as separate and unrelated to the pristine knowledge housed in the journal’s interior. Why would a good medical librarian save them?

We all know what happened next. Sometime during the consumer culture revolution of the 1950s, when commerce stopped being crass and instead became a beacon of liberty in the fight against communism and a practical organizing principle of most American institutions, consultants advised the American Medical Association to embrace journal advertising. Ads began to proliferate, and they became bigger, more colorful, and ever more dependent on emotionally charged images to convey the kinds of before-and-after miracles of Madison Avenue. Then, one day, they broke out of their quarantine and began to appear in between articles throughout the journal. Advertising became so ubiquitous, and so important, that a separate “Index of Advertisers” was provided in the back of JAMA to help readers locate the ads just like the table of context helped them locate the articles. In a sense, the ads became a shadow journal alongside the articles, providing more digestible (and typically more optimistic) reports from the cutting edge of medicine.

Triavil: Tranquilizer-antidepressant for the anxiety/depression complex.” From JAMA volume 194, number 8 (November 22, 1965). Click to enlarge.

It was only a matter of time until ads became so thoroughly enmeshed that it was no longer possible to cut them out without also removing parts of articles. Librarians continued to try, however: as late as the 1970s and 1980s, they diligently sized up each page and sliced out whatever advertising they could. Those decades are especially frustrating for historians, if you ask me. We can see the appetite-whetting first and last page of, say, an eight-page mega-advertisement on Valium and “the modern man,” but the meat of the sandwich was long ago pilfered.

Books, Health and History

The New York Academy of Medicine

Tag Archives: medical journals

The Medical Journals of U.S.-Occupied Haiti

Through The Grapevine: writing for Alcoholics Anonymous

References

[1] Anonymous. “Grapevine’ in Bow.” The Grapevine. June 1944. Vol 1, No. 1.

[2] Anonymous. “—the story of your magazine—“ The Grapevine. December 1948. Vol 5, No. 7; Bill W., “The Shape of Things to Come,” The Grapevine. June 1944. Vol. 1, No. 1.

[3] Grace O. “Women in A.A. Face Special Problems.” The Grapevine. October 1946. Vol. 3, No. 5, P. 1, pp 6 – 7, 10.

[4] Leslie Jamison. The Recovering. New York: Little Brown, 2018.

[5] Pnina Levi. “Gender and Alcoholism: Pioneering alcoholic women’s contribution to Alcoholics Anonymous, 1937 – 60.” Social History of Alcohol and Drugs. 2015. Vol. 29, pp. 112-35.

[6] Anonymous. “Lady A.A.’s Get Their Heads Together.” The Grapevine. May 1949. Vol. 5, No. 12, p. 11.

[7] See, “I’ve Changed My Tune,” “My Son and I and AA,” “Adding Up the Score,” “A Lady’s Gripe,” “I’ve Got What I Want for Christmas,” all from The Grapevine. December 1955. Vol. 12, No. 7.

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Shadow Journals: The Story of Medical Advertising (Part 3 of 3)

Shadow Journals: The Story of Medical Advertising (Part 2 of 3)

Shadow Journals: The Story of Medical Advertising (Part 1 of 3)