Patient Photographs and Medical Collecting

Heidi Knoblauch, the author of today’s guest post, is our 2014–2015 Klemperer Research Fellow. She is a Ph.D. candidate in the History of Science and Medicine Department at Yale University.

Tucked away in the New York Academy of Medicine’s special collections is a small green metal box, simply labeled “daguerreotypes.” The box contains twelve photographs and one painting. A few are images of doctors, but most are of patients.

The small green metal box, simply labeled “daguerreotypes.” Photo by Heidi Knoblauch.

The small green metal box, simply labeled “daguerreotypes.” Click to enlarge. Photo by Heidi Knoblauch.

You would not necessarily know these photographs were of patients unless you looked closely for a misshapen nose, outline of an excision, or nondescript facial scars. The subjects’ posing more closely resembles 19th-century photographic portraits circulated between family members than the poses we currently associate with a clinical image. These poses are accentuated by the fact that most of the photographs are housed in hinged frames with gold matting.

These photographs straddle the line between the medical and the personal that was becoming more defined during the 19th century. They blend intentional subjectivity with a new technology used to make what contemporary physicians described as a “more perfect record.”

During the 19th century, medical men collected photographs of patients and pasted them into personal scrapbooks, case records, and put them on display. These personal collections of notable cases represent not only the use of photographic technologies in consultation, but also the continuation of an engrained practice of collecting that began long before the advent of the daguerreotype. Like all archives and collections, they highlight the inclusion of things meant to be remembered and exclusion of things meant to be forgotten.

Another view of the special collection. Photo by Heidi Knoblauch.

Another view of the special collection. Click to enlarge. Photo by Heidi Knoblauch.

Tracking the social practices associated with amassing medical collections is crucial for understanding this small box of photographs, almost all of which lack identifying information. These photographs have the potential to help us sketch out the formation of communities of collecting and exchange during the middle of the 19th century and to think about how doctors interpreted their relationships with their patients.

The famed surgeon Valentine Mott was one of many physicians who collected surgical and pathological specimens—including the images in the small green box. His museum, which was located at the University Medical College, was composed mainly of pathological specimens from surgical operations, collected in part from his students, who submitted dissections through an annual competition. Like many of his contemporaries, Mott thought collecting would advance the surgical art. In 1858, he declared that his collection was “believed to be the largest that any American surgeon had the occasion to form.”

Mott also sought photographs from his students. Although most of the examples in the small box are unmarked, one of Mott’s students, Edward Archelaus Flewellen, labeled a photograph he sent Mott: “A.P Jackson, Thomaston, Georgia. A supposed case of subcutaneous aneurism by anastomosis. Referred to Dr. Mott by E.A. Flewellen.”

In 1856, Flewellen sent a letter with this daguerreotype to his instructor to obtain a consultation for his patient. Flewellen told Mott that he “did this reluctantly” because he was sure that Mott was “taxed by frequent consultation by many of the thousands of students who have had the pleasure and benefits of [his] instruction.” But, Flewellen added, he believed that Mott would find this an interesting and rare case.

Dr. Edward Archelaus Flewellen's note and photograph, sent to Dr. Valentine Mott. Photo by Heidi Knoblauch.

The note and daguerrotype Dr. Flewellen sent to Dr. Mott. Click to enlarge. Photo by Heidi Knoblauch.

Flewellen’s patient, A.P. Jackson, was a 33-year-old mechanic from Georgia who developed a tumor over his right eye when he was very young. Flewellen described the case in great detail, saying that he had watched the tumor grow for the past five years. Flewellen asked Mott what surgical treatment he would recommend to “rid this poor young man of this hideous deformity” and then promised to send Mott another daguerreotype of Jackson if the surgery was successful so Mott could contrast the before and after photographs. There is no record of Mott replying to Flewellen.

Patient photographs began to represent a new type of scientific aesthetic practice, aligned with graphs and charts, during the 1870s. Patients contributed photographs to their case records during the 19th century, but by the 1890s patients became less willing to actively participate in creating a photographic record of their disease. Today, many patients—especially in genetics, plastic surgery, and dermatology departments—have their photographs taken by a physician or technician (with a digital camera of course) to include in their electronic medical record. Yet employing a professional photographer to take a photograph with the express purpose of mailing it to a physician would seem odd to most people today.

Concerns about privacy surfaced at the end of the 19th century, which changed the way patients thought about photography in the clinic. Standards for clinical photography emerged during the 1920s and, because of this, we would find it strange to have a clinical photograph taken with a piece of bone or a bullet. Photographs are now more sterilized than they were in the 19th century and, unlike in the case of Flewellen, patients are rarely told to dress up before being photographed. The culture of photography has changed and, with it, the way physicians use photographs has shifted.

Valentines for a Valentine

By Arlene Shaner, Acting Curator and Reference Librarian for Historical Collections

In honor of Valentine’s Day, these two “valentines” seemed appropriate items from our collection to share this week.

Micrography valentine for Valentine Mott

Valentine 1. Click to enlarge and marvel at the minuscule script.

Dr. Valentine Mott

Dr. Valentine Mott

Pioneer American surgeon Dr. Valentine Mott (1785-1865), NYAM’s third president (1849), was the recipient of these two examples of micrography, created by David Davidson. Mott was born in Glen Cove, Long Island, and attended medical school at Columbia College. As a student, he also trained under a cousin, Dr. Valentine Seaman. After receiving his degree in 1806, he sailed to Europe, where he studied with Sir Astley Cooper in London, and then spent time in Edinburgh. When he returned to New York in 1809, he began to lecture in operative surgery at Columbia. By 1811, he had been appointed a professor of surgery, and in 1818 he was the first doctor to successfully perform surgery on the innominate artery, two inches away from the heart, to repair an aneurysm in the right subclavian artery. His patient survived for 26 days before succumbing to a secondary infection. For the rest of his career, he divided his time between the United States and Europe, serving on the medical faculties of the Rutgers Medical College, Columbia’s College of Physicians & Surgeons, the University Medical College and the Medical Department of New York University, and performing an extraordinary number of surgical procedures.

Micrography valentine for Valentine Mott

Valentine 2.

Aside from the charming but obvious play on Mott’s name and the tenuous connection to his surgery on the innominate artery, there is nothing on these “valentines” that explains why Davidson chose to make them. Davidson remains a bit of a mystery himself. Born in Russian Poland in 1812, he immigrated first to England and then to the United States, where he settled on the Lower East Side for awhile before moving on to Baltimore and finally to Boston. Davidson describes himself as an “Artist in Penmanship” at the Stuyvesant Institute on one of the valentines, and he was the creator of a number of different micrographic specimens, including portraits of famous figures and renderings of important buildings. Micrography, the art of using miniscule script to create abstract shapes or representations of objects, is a Jewish art form that dates back to the tenth century. In micrography, the writing itself is so small that the words themselves are not apparent except under close examination. Davidson is credited as one of the first practitioners of micrography in the United States. Various sacred writings were used in the execution of micrography, and for some of his creations Davidson used Hebrew texts, but for these two valentines he used English versions of the Book of Jonah and of a number of Psalms.