School Breakfast Week: “Take Time for School Breakfast”

By Danielle Aloia, Special Projects Librarian

Starting the day with a hearty, healthy breakfast allows your body to maintain the physical and mental agility needed to function without fatigue during the course of the day. Today, the Food Research and Action Center recognizes that “school breakfast participation is linked with increased food security, improved health outcomes, and numerous educational benefits, particularly for low-income children.”1

In 1790, Germany began the first school feeding program on record. In the early 1900s, the U.K. and several other European countries passed bills to enact school lunch programs. The following table shows the nutrition requirements for school children in Switzerland, Germany, and England circa 1900:2

Recommended nutritional requirements.2 Click to enlarge.

Recommended nutritional requirements.2 Click to enlarge.

The U.S. was late to follow, not passing legislation for a school lunch program until the 1940s. However, U.S. researchers had previously looked at the nutrition status of school aged children. In 1906, a Dr. Lechstecker in New York City examined 10,707 children and found that 439 had no breakfast and 998 had just coffee or coffee and bread. In 1908, of 10,090 children studied in Chicago, 825 suffered from malnutrition.2

In the 1940s, West Virginia surveyed students from various cities about their eating habits. They found that poor breakfasts were the biggest problem. By 1947 the state established the Good Breakfast for Every Man, Woman, and Child program with the slogan “Start the Day the Good Breakfast Way.”3

Some of the findings reported by West Virginia School Children’s Diet Study.3 Click to enlarge.

Some of the findings reported by West Virginia State Nutrition Committee.3 Click to enlarge.

In 1966, the Child Nutrition Act enacted The School Breakfast Program (SBP) as a pilot project. “During the first year of operation, the SBP served about 80,000 children at a federal cost of $573,000.”4 In fiscal year 2007, “the participating schools served . . . 1.7 billion breakfasts at a federal cost of $2.2 billion.”5 Current research shows that “10.8 million low-income children participated in the School Breakfast Program on an average day in school year 2012-2013, an increase of more than 310,000 children from the previous year.”6 And “for Fiscal Year 2012, the School Breakfast Program cost $3.3 billion, up from $1.9 billion in Fiscal Year 2005.”1

Today’s programs must meet the U.S. Dietary Guidelines for Americans, 2010, which provide evidence-based nutrition standards. The government will implement new guidelines in 2015 under the Federal Rule Nutrition Standards in the National School Lunch and School Breakfast Program. “This rule requires most schools to increase the availability of fruits, vegetables, whole grains, and fat- free and low-fat fluid milk in school meals; reduce the levels of sodium, saturated fat and trans-fat in meals; and meet the nutrition needs of school children within their calorie requirements.”7

ChooseMyPlateChoose MyPlate is an easy way for people to adhere to the dietary guidelines set out by the U.S. Dept. of Health and Human Services and the Dept. of Agriculture.

Breakfast is not just for school children. Remember to take time for breakfast no matter your age.

References

1. Hewins J, Burke, Mike. School Breakfast Scorecard: 2012-2013 School Year. Washington, DC: Food Research and Action Center (FRAC); 2014. http://frac.org/pdf/School_Breakfast_Scorecard_SY_2012_2013.pdf. Accessed January 31, 2014.

2. Bryant, Louise Stevens. School Feeding; Its History and Practice at Home and Abroad. Philadelphia: J. B. Lippincott Company; 1913. Access at: https://ia700505.us.archive.org/3/items/schoolfeedingits01brya/schoolfeedingits01brya.pdf

3. State of West Virginia. Start the Day the Good Breakfast Way: A Statewide Nutrition Program Sponsored by The West Virginia State Nutrition Committee September 1947-August 1948. State of West Virginia; 1948.

4. USDA Food and Nutrition Service website. http://www.fns.usda.gov/sbp/school-breakfast-program. Accessed February 10, 2014.

5. National Research Council. School Meals: Building Blocks for Healthy Children. Washington, DC: The National Academies Press; 2010. http://www.nap.edu/openbook.php?record_id=12751&page=1. Accessed on: January 31, 2014.

6. The School Breakfast Program:  Fact Sheet. Washington, DC:  USDA Food and Nutrition Service; http://www.fns.usda.gov/sites/default/files/SBPfactsheet.pdf. Accessed February 11, 2014.

7. Nutrition Standards in the National School Lunch and School Breakfast Programs. Fed Regist. 2012;77(17):4088-4167. To be codified at 7 CFR §210 and 220. http://www.gpo.gov/fdsys/pkg/FR-2012-01-26/pdf/2012-1010.pdf. Accessed on: January 31, 2014.

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).”

Huber the Tuber, Corky the Killer, and The Mind

By Danielle Aloia, Special Projects Librarian

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

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

Huber the Tuber invades Lungland. Click to Enlarge.

Huber the Tuber invades Lungland. Click to Enlarge.

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

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

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

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

"The Author's Imaginative Model of the Inside World of the Mind." Click to enlarge.

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

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

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


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

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

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

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

Smoking and Health, 50 Years Later

By Johanna Goldberg, Information Services Librarian

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

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

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

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

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

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

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

The 387-page report made some dire conclusions:

  • Smokers are 70% more likely than non-smokers to die of coronary artery disease; 500% more likely than non-smokers to die of emphysema and chronic bronchitis; and 1,000% more likely to die of lung cancer.
  • Male cigarette smokers have a “9- 10-fold risk of developing lung cancer.” That risk rises to 20-fold for heavy smokers.
  • Cigarette smokers have a 70% higher mortality rate than non-smokers.3

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

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

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

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

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

References

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

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

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

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

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

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

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

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

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

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

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

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

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

Card 45, featuring Popeye.

Card 45, featuring Popeye. Click to enlarge.

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

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

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

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

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

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

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

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

April 2014 update:

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

Lucky Safety Card 24. Click to enlarge.

Lucky Safety Card 24. Click to enlarge.

April 2017 update:

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

References

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

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

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

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

History Night: Call for Papers

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).

Burn These Handkerchiefs

By Johanna Goldberg, Information Services Librarian

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

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

Side one of the unfolded pamphlet.

Side two of the unfolded pamphlet.

Stay healthy!

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

By Paul Theerman, Associate Director

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

AIDSWorldwideEffortSIDAUnEsfuerzo

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

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

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

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

References

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

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

Good eyes are your protection

By Rebecca Pou, Project Archivist

goodeyesareyourprotection“Wear glasses if the doctor advises you to do so.” “Don’t rub your eyes with dirty hands.” “If you suspect eye trouble, see an oculist at once.” This sound advice comes from a 1917 trifold leaflet aimed at school children and published by the Illinois Society for the Prevention of Blindness (ISPB), which was founded in 1916.

breadwinnersWhile the pamphlet contains helpful recommendations on eye health, the illustrations and design are particularly charming. Eyes peer out from the sign on the front cover, but we discover that those eyes belong to a boy in spectacles on the page beneath and the sign has cut outs. The eye holes must have been irresistible to children and are surrounded by guidelines for healthy eyes.

healthwealthhappiness

Click to enlarge.

The pamphlet stresses that proper eye care beginning in childhood confers life-long benefits, especially in a cartoon comparing two couples from an eye screening in childhood through old age. The pair that cares for their eyes flourishes in life, excelling in academics, extracurricular activities, and, in the case of the man, his profession. The other couple is plagued with nervousness and headaches, and both have trouble with work. While the pamphlet is aimed at children, the lesson is for parents as well. In her old age, the content woman is grateful to her mother for getting her the eye care she needed, while the unfortunate pair’s parents had dismissed the eye examiners’ recommendations.

goodcareorneglect

Click to enlarge.

And for anyone who might need further convincing, the Society contrasts good sight and bad sight in black and white.

goodsightpoorsight

In his landmark book, The Evolution and Significance of the Modern Public Health Campaign, published in 1923, C-E. A. Winslow asserts that education and changed behavior are central to modern public health efforts.  He says, “the fight must be won, not by the construction of public works, but by the conduct of the individual life.” In this pamphlet, the ISPB is clearly appealing to individuals, encouraging them to choose good care over neglect, preventing the difficulties in life caused by blindness and eye disease.

Almost a century after the publication of “Good eyes are your protection,” the ISPB still exists and maintains a website. While their efforts seem more expansive, consisting of education, research and programs, the organization remains “dedicated to the care, protection, and preservation of sight.”

Uncle Sam, M.D.

By Paul Theerman, Associate Director

Health Almanac, 1920 front cover.

Health Almanac, 1920 front cover.

How to get the word out? For the last two hundred years, health has been as much about education and prevention as intervention and response. And so an intrepid young doctor in the U.S. Public Health Service (USPHS) latched onto using the almanac as a public health vehicle. Health Almanac 1920 (Public Health Bulletin No. 98; Washington, GPO, 1920) was a 12-page almanac entwined in a 56-page public health pamphlet. Amid checking for the phases of the moon or the times of sunrise and sunset, one could find short pieces giving warning signs for cancer, means to prevent the spread of malaria, the necessity of registering births, and how to build a good latrine. These and many other topics were all presented by “Uncle Sam, M.D.”; the almanac was free for the asking.

Uncle Sam Image 4--July right page

Health Hints and Notable Events for July 1920. Click to enlarge.

In the distant past, almanacs became linked to health through “astro-medicine” or “iatromathematics,” that is, medical astrology. Each of the signs of the zodiac was held to influence a system of the body, from Ares controlling the head to Pisces the feet, and so for everything in between. Almanacs were calendrical and astronomical, and in addition to marking sunrise and sunset, the phases of the moon, and religious holidays, they charted the day-by-day progress of the moon through the zodiac, with its supposed medical consequences. To this technical data, the most famous American almanac, Benjamin Franklin’s Poor Richard’s Almanac, added moralistic lessons and practical advice, wittily presented. Health Almanac 1920 provided these same features within the context of progressive secular government. The publication started with inspirational statements from President Woodrow Wilson, the Secretary of the Treasury, and the Surgeon General —who together formed the chain of command for the Public Health Service! Instead of a calendar of religious seasons and saints’ days, the almanac noted national days and significant events in the history of medicine and in “The Great War,” just concluded. Everywhere were health aphorisms: “Good health costs little, poor health costs fortunes” (from the back cover), and “Large fillings from little cavities grow” (April 20). Some “health hints” were quite flatly presented: “Every home should have a sewer connection or a sanitary privy” (July 20), and “Food, fingers, and flies spread typhoid fever” (July 31). Some were just to the point: “Be thrifty” (November 15) and “Wear sensible shoes” (December 18). Throughout, the almanac highlighted the role of the USPHS in promoting health.

Uncle Sam Image 2--back cover

Health Almanac, 1920 back cover.

The Health Almanac was published in 1919 and 1920—we have the 1920 edition—as was a parallel publication called the Miners’ Safety and Health Almanac, put out by the Bureau of Mines. Both were the brainchild of Dr. Ralph Chester Williams (1888–1984), then at the outset of his successful career with the Public Health Service. Born in Alabama and a 1910 graduate of the University of Alabama Medical School, Williams entered the USPHS in 1916 and was posted to the Bureau of Mines during World War I. Pulled into the Office of the Surgeon General, he edited Public Health Reports, served as Chief Medical Officer to the Farm Security Administration, as Medical Director of the USPHS’s New York City office, and starting in 1943, as Assistant Surgeon General and head of its Bureau of Medical Services. In that capacity he oversaw a third of the operations of the USPHS, including immigration inspection and USPHS hospitals. In 1951 the Commissioned Officers Association of the USPHS published his standard history, The United States Public Health Service, 1798–1950. At almost 900 pages, it dwarfs the Health Almanac 1920, but both show their author’s dedication to getting the word out about health and, not incidentally, about the agency that helped make that happen.