From Our Partners: Dr. Brooks’ Sanatorium

~by Caitlin Angelone

This month we are heading to New Canaan, Connecticut. The original building that later held Brooks’ Sanatorium was built in 1898 by a wealthy summer resident, Ellen Josephine Hall. Hall purchased the 11 acre property with the intention of opening a sanatorium for her nephew, Dr. Charles Osborne. They left town and the building was sold to Dr. Myron J. Brooks and his wife, Marion.

The Brooks’ Sanatorium opened shortly after, specializing in the recovery of tuberculosis patients and other lung diseases. The sanatorium boasted it was “not for the care, but…for the modern and scientific treatment of Disease of the Lungs.” Aerotherapy (use of hot air and climate to treat diseases), hydrotherapy (use of water for pain treatment), suralimentation (forced feeding of nutrients), and inhalation-therapy (use of nebulizers with drugs to treat lungs) were practiced regularly along with detailed attention to sanitation practices. Dr. Brooks became New Canaan’s health officer and medical examiner during World War l and kept the title until 1929.

He closed his practice during this time and made it a private residence, living there until the death of his wife in 1935. After his death in 1937, local developers bought the land and named the road, Brooks Road, after the doctor. Since then, the home has been the Buttonball Inn, Three Hundred Inn, and Carlton Manor Inn.

In 1956 it was sold as a private residence and has remained a private residence since, with its caretakers paying special attention to its rich history.

Sources:

Brooks’ Sanatorium. (Medical Trade Ephemera Collection) Historical Medical Library of The College of Physicians of Philadelphia, Philadelphia, PA.

Dinan, Terry. “South Avenue Landmark: Brooks Sanatorium, Reincarnated.” New Canaanite, April 8, 2018. Website. March 29, 2018. https://newcanaanite.com/south-avenue-landmark-brooks-sanatorium-reincarnated-1936

From Our Partners: Rawley Springs and Massanetta Mineral Springs Company

This is one of a great series of posts from the College of Physicians of Philadelphia Historical Medical Library blog called #TravelTuesday. This post by Caitlin Angelone.

Rawley Springs is an unincorporated community in Rockingham County, 9 miles west of Harrisonburg, Virginia, and was once known for its lavish medical resort. European men began to settle the land in the early 19th century. One of the earliest settlers was Benjamin Smith, who sent his wife Elizabeth to the springs for her health in 1810. Doctors were perplexed on what was causing her illness, but within six weeks of staying at the springs and drinking the water she was cured. Shortly after, people began to set up summer camps by the springs. Joseph Hicks is credited for purchasing land and officially advertising the small village as a resort community in 1824.

The chalybeate waters of the spring are high in iron and salts, acting as a natural tonic which has been bottled and marketed as a cure all for disease, including maladies peculiar to females, liver disease, and diseases by poverty of the blood and nervous system. The springs usually remain around “earth temperature” which is 54 degrees, making it a popular destination for a summer dip or a place to escape the diseases of summer in larger cities. The B & O and A & M Railroads reached nearby Harrisonburg, or people also had the option of taking the Rawley Springs Turnpike, which was $3.00 for a one-way trip.

Rooms cost $2.50 a day, $15 for a week, or $50 for a four week stay. The resort also housed a post office, toll house, pottery shed, and distillery.  The grand dining hall could host dinners for up to 389 people and was a local attraction for a night out.

In 1886, 2 days before the grand season re-opening on June 10, a fire destroyed the dining room along with two of the three hotels. The resort struggled, but rebuilt its dining hall with the insurance money collected. The resort continued to struggle, and was sold to Massanetta & Rawley Springs Company in 1914, and the same year another fire destroyed the rest of the remaining buildings. The company did not rebuild and instead divided the land in 1918, which was sold for smaller cottage homes.

Today, Rawley Springs remains a popular attraction. The large and risky rock formations make it popular for hikers, while places like the “Blue Hole” in the Dry River still attract people for fishing and swimming.  Commercialization of the area is not allowed, meaning there are no longer hotels and resorts on the land. All buildings of the former resort have been destroyed, and only stone land markers remain outlining the hotels. Private homes still remain and are actively used for summer homes by nearby Harrisonburg residents.

Sources:

Rafuse, Diana. “A Brief History of Rawley Springs.” 2007.

Rafuse, Diana. “Mixing Pleasure and Profit at the Springs: The Harrisonburg-Rawley Connection.” The Harrisonburg-Rockingham Historical Society Newsletter. Vol. 31, No. 2, 2009.

Rawley Springs. (Medical Trade Ephemera Collection) Historical Medical Library of The College of Physicians of Philadelphia, Philadelphia, PA.

“Rawley Springs, Virginia.” Harrisonburg, 1995. Website. 11/29/18.  http://www.harrisonburg.org/rawley/

From Our Partners: “From Hysteria to Anorexia Nervosa: An Evolution of Medical Terminology”

– by Julia Jablonowski

Most people in our contemporary society are familiar with anorexia nervosa –more commonly known as just “anorexia.” Yet few know the development of medical thought and the advancement of medical etymologies in the Victorian era that led to the emergence of what we know today as anorexia nervosa.

Prior to the pathological conception of anorexia nervosa, its fundamental symptoms, which are grounded in self-inflicted food aversions, were not thought of as an independent disorder until the nineteenth century. A common diagnosis that was used in the days before anorexia nervosa was hysteria, a disease historically exclusive to the female gender.[1]

In the Victoria era, a woman was societally understood to be passive, feeble, emotional, and fragile.[2] These beliefs as espoused by Victorian culture created a space in which women were understood to be societally, and medically, more susceptible to illness. From mood swings to fevers, light-headedness to exhaustion, it seemed that almost any physical or mental affliction residing within the body and psyche of a woman could be met with the diagnosis of hysteria. Other symptoms included a vast array of nervous and erratic behavior projected by women in the form of fatigue, food refusal or self-starvation, depression, bodily pains, anxiety, and the general feeling of unwellness.[3]  Because of the broad symptoms of hysteria, it was applied to a large expanse of medical, mental, and emotional cases troubling the fragile Victorian female.

This identification of food refusal and self-starvation developed into an area of independent study in the nineteenth century, largely due to the high mortality rates of mental asylum patients in the United States and the United Kingdom.[4]  An English physician, Robley Dunglison, moved to America in 1825 to become a professor of anatomy and medicine. [5] [6] While in the United States, Dunglison was instrumental in the establishment of Pennsylvania’s first state asylum where proper provisions were made to treat the insane poor of Pennsylvania.[7]  Coincidentally or not, Dunglison’s position within the development of institutional asylums had a large impact on the evolution of the vocabulary we associate with self-inflicted food refusal.

In 1856, Dunglison published Medical Lexicon: A Dictionary of Medical Science. This medical dictionary defines a premature understanding of the word anorexia, then referred to as “anorex’ia,” which he defined as the “absence of appetite, without loathing.”[8] Dunglison’s dictionary elaborates on this new term, continuing the journey of the disorder’s etymological advancement, mentioning “anorexia exhausto’rum,” which is the “frigidity of the stomach.”

Anorexia began to be noted as an individual disorder rather than a symptom of a larger disease such as hysteria, due to the level of accountability asylums where held to in the public spheres of the U.S. and Britain. Anorexia began to be distinguishable as its own malady because of the level of transparency promoted by medical journals and newspapers that reported on mortality rates in such institutions.[9] In American asylums, the superintendents were held accountable through the spectacle of death by starvation, which was a frightening source of mortality to the public.[10] An asylum’s mortality statistics were published in professional medical journals, as well as abstracted in newspapers for society’s lay people.[11] A high mortality rate communicated immense failure on the part of the asylum. British asylum keepers were becoming increasingly aware of this transparency and the repercussions that followed when people began to catch on to the increasing numbers of premature patient deaths due to self-starvation in an institution meant to care for the ill, thus allowing for the disease to gain special attention. [12]

The attention drawn to this disease was largely addressed by two medical professionals: Parisian neuropsychiatrist, Ernest Charles Lasègue, and London physician, Sir William Withey Gull. Lasègue, a contemporary of Gull, was responsible for the term “l’anorexie hysterique” –hysterical anorexia.  Gull combated this name and proposed the name anorexia nervosa, which he publicly expressed in August 1868 in his address at Oxford University.[13] The significance of this terminological substitution of “nervosa” for “hysterique” was crucial to Gull because hysteria, as understood by Victorian medicine, was exclusively a woman’s plague. Although anorexia mostly affected the female population, Gull noted that it, too, plagued men, thus leading to the necessary use of the word nervosa, which focuses on anorexia’s association as a nervous, mental, and genderless disease.[14]

When defining the term anorexia nervosa in his address at Oxford, Gull explained:

“The want of appetite is, I believe, due to a morbid mental state. I have not observed in these cases any gastric disorder to which the want of appetite could be referred. (…) We might call the       state hysterical without committing ourselves to the etymological value of the word, or maintaining that the subjects of it have the common symptoms of hysteria. I prefer, however, the more general term ‘nervosa,’ since the disease occurs in males as well as females, and is probably rather central than peripheral.”[15]

This gender-inclusive research of Sir William Withey Gull, in addition to the growth of mortality rates –and public embarrassment—being suffered by asylums, shifted the understanding of self-starvation in medicine. This shift thus demanded intellectual and terminological changes to be made, resulting in the emergence of anorexia nervosa.

Notes:

[1] Cecilia Tasca, Mariangela Rapetti,, Mauro Giovanni Carta, and Bianca Fadda, “Women And Hysteria In The History Of Mental Health,” Clinical Practive & Epidemo=iology in Mental Health, 8, (2012): 110-111.

[2] “The Hysterical Female,” Restoring Perspective: Life and Treatment at the London Asylum,  https://www.lib.uwo.ca/archives/virtualexhibits/londonasylum/hysteria.html.

[3] “The Hysterical Female,” Restoring Perspective: Life and Treatment at the London Asylum,  https://www.lib.uwo.ca/archives/virtualexhibits/londonasylum/hysteria.html.

[4] Joan Jacobs Brumberg, Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease.

[5] “Professor and Physician: Robley Dunglison, M. D.; The Dunglisons Reach the University of Virginia,” The University of Virginia, http://exhibits.hsl.virginia.edu/dunglison/at_uva/.

[6] “Professor and Physician: Robley Dunglison, M. D.; From Kewsick, England to Charlottesville, Virginia,” University of Virginia, http://exhibits.hsl.virginia.edu/dunglison/keswick/.

[7]  An Appeal to the People of Pennsylvania on the Subject of an Asylum for the Insane Poor of the Commonwealth, (Philadelphia, 1838).

[8] Robley Dunglison, M.D., LL.D., Medical Lexicon: A Dictionary of Medical Science, (Philadelphia, Blanchard and Lea., 1856), 80.

[9] Joan Jacobs Brumberg, Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease, (Cambridge, Massachusetts, Harvard University Press, 1988), 101.

[10] Joan Jacobs Brumberg, Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease, (Cambridge, Massachusetts, Harvard University Press, 1988), 101

[11] Joan Jacobs Brumberg, Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease.

[12] Joan Jacobs Brumberg, Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease, (Cambridge, Massachusetts, Harvard University Press, 1988), 101.

[13] Gull, William Withey. “V.-Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica).” Obesity Research 5, no. 5 (September 1997): 498–502

[14] Gull, William Withey. “V.-Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica).” Obesity Research 5, no. 5 (September 1997): 498.

[15] Gull, William Withey. “V.-Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica).” Obesity Research 5, no. 5 (September 1997): 501.

Sources:

An Appeal to the People of Pennsylvania on the Subject of an Asylum for the Insane Poor of the Commonwealth, (Philadelphia, 1838).

Dunglison, Robley M.D., LL.D., Medical Lexicon: A Dictionary of Medical Science, (Philadelphia, Blanchard and Lea., 1856), 80

Gull, William Withey. “V.-Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica).” Obesity Research 5, no. 5 (September 1997).

Jacobs Brumberg, Joan, Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease, (Cambridge, Massachusetts, Harvard University Press, 1988).

“Professor and Physician: Robley Dunglison, M. D.; The Dunglisons Reach the University of Virginia.” The University of Virginia. http://exhibits.hsl.virginia.edu/dunglison/at_uva/.

“Professor and Physician: Robley Dunglison, M. D.; From Kewsick, England to Charlottesville, Virginia.” University of Virginia. http://exhibits.hsl.virginia.edu/dunglison/keswick/.

Tasca, Cecilia, Rapetti, Mariangela, Giovanni Carta Mauro, and Fadda, Bianca “Women and Hysteria In The History Of Mental Health,” Clinical Practive & Epidemo=iology in Mental         Health, 8, (2012).

“The Hysterical Female.” Restoring Perspective: Life and Treatment at the London Asylum.  https://www.lib.uwo.ca/archives/virtualexhibits/londonasylum/hysteria.html.

From Our Partners: “Finding the Flu: Crisis and Documentation”

~From the College of Physicians of Philadelphia blog, Fugitive Leaves and Beth Lander, College Librarian.

On September 7, 1918, 300 sailors arrived in Philadelphia from Boston, where, two weeks earlier, soldiers and sailors began to be hospitalized with a disease characterized as pneumonia, meningitis, or influenza. The sailors were stationed at the Philadelphia Naval Yard.

On September 11, 19 sailors reported to sickbay with symptoms of “influenza.” By September 15, more than 600 servicemen required hospitalization.

Physicians and other public health workers in Philadelphia first met on September 18 with city officials to discuss what they perceived as a growing threat. Public health officials demanded that the city be quarantined – all public spaces, including schools, churches, parks, any place people could congregate, should be closed. City officials did not want to create panic. They were more concerned that local support for President Wilson’s efforts in World War I should not be disturbed. Anything that would damage morale – or the city’s ability to raise the millions in Liberty Loans required by federal quota – was unacceptable.

The Board of Health declared influenza a reportable disease on September 21, which required physicians to report any cases they treated to health officials. The Board advised residents to stay warm and keep their feet dry and their bowels open. The Board also suggested that people avoid crowds.

Against the calls for quarantine, the city hosted a Liberty Loan parade on September 28. The two-mile route south on Broad Street was complete with marching bands, Boy Scouts, women’s auxiliary groups, soldiers, sailors, flags, and patriotic fervor. It is estimated that more 200,000 people attended the parade.

 

Liberty Loan Parade, September 28, 1918.

 

Within 72 hours of the parade, every bed in Philadelphia’s 31 hospitals was full.

We are saturated with information today. We not only consume it, but we create it through social media posts, YouTube videos, blogs, and so on. A May 2018 article in Forbes magazine notes a terrifying thought (at least for a librarian): “Over the last two years alone 90 percent of the data in the world was generated.” Few public events today escape immediate documentation.

Researchers who are examining the 1918 influenza pandemic expect to find rich sets of primary sources at the Historical Medical Library. Unfortunately, their expectations are met with disappointment.

A simple search on the term “influenza” in the Library’s OPAC (online public access catalog) shows 688 hits across both Library and Mütter Museum collections regardless of publication or creation date. Library collections, while greater in number, are mostly secondary sources, with only a small number (19) published in the years between 1918 and 1925.

The most significant primary source in the collection of the Historical Medical Library is a scrapbook of newspaper clippings contemporary to the pandemic in Philadelphia. The majority of the clippings are not dated. A small number have enough of the masthead visible to safely assume that some, if not all, of the clippings were taken from the Philadelphia Evening Bulletin. The clippings are pasted edge to edge, roughly clipped, and assumed to be in date order. There is no provenance available to determine who created the scrapbook – it was acquired by the Library on October 19, 1919, through the Medical Library Association’s Exchange program, which encouraged medical libraries throughout the United States to swap items outside of their own collecting scope.

 

[Scrapbook of newspaper clippings (September 14, 1918 to March 1, 1919) concerning the influenza epidemic in Philadelphia, 1918-1919]. Historical Medical Library, Z10 d7

Why, then, are there so few extant primary sources about the influenza pandemic in the collections of The College of Physicians of Philadelphia?

The Historical Medical Library was founded in 1788, one year after the founding of The College of Physicians, which is the oldest medical fellowship in the United States. The Library was developed mostly through donations of books, manuscripts, and archival collections, but also through small acquisition funds and, in the late 19th and early 20th centuries, the aforementioned Exchange program. The collection reflects the interests of the Fellows of the College at any particular time in the history of the College. The evolution of medical specialization is particularly evident in the subject of books acquired; the development of the manuscript collections reflects the interests and work of those Fellows most closely affiliated with the College.

The College offered Fellows the opportunity to publish works in the Transactions & Studies of The College of Physicians of Philadelphia, which was issued between 1793 and 2002. Again, the Transactions reflect contemporary medical practice and concerns, as well as the research and teaching of Fellows.

The College was prominent in public health in Philadelphia since its founding. In November 1787, a month after the founding of the College, Benjamin Rush composed what was called a “memorial” to the Pennsylvania State Assembly promoting temperance as a measure of public health. In 1848, the College acted to mitigate urban overcrowding, intemperance, tainted food and water, poor sanitary conditions, and the solitary confinement of prisoners in city jails. After the Civil War, the College addressed issues related to industrialization, street cleaning, and the creation of public sewers and indoor plumbing. In 1883, a report was submitted to the state legislature stating “Philadelphia is now recognized as the worst-paved and worst-cleaned city in the civilized world.”

In 1912, the College created the Committee on Public Health and Preventive Medicine, one of a number of official committees that had promoted public health issues over the years. This Committee addressed long working hours for women and children, the use of night soil as a fertilizer, keeping hogs within the city borders, compulsory vaccination against smallpox – and clean streets.

One would assume that an institution committed to an active public health role within one of the country’s largest cities would have a prominent response to the 1918 influenza pandemic. Instead, between 1917 and 1925 the words flu, influenza and epidemic appear only infrequently in any College records and College publications. (Transactions published in fall 1918 and early 1919 mention a symposium that occurred at the College on complications of influenza in the “current epidemic” and lament the nursing shortages that plagued hospitals during the epidemic). It is almost as though the pandemic never happened.

There is no pat answer as to why the pandemic did not merit much official attention of the College. Perhaps it was because of World War I –three-quarters of Philadelphia’s medical staff, physicians and nurses, were already serving in hospitals in France and England by the fall of 1918.

 

Officers of Mobile Hospital No. 8, Deux-Noeuds, Oct. 27, 1918. George W. Outerbridge papers (MSS 2/138), 1916-1919. Historical Medical Library of The College of Physicians of Philadelphia.

 

Perhaps this lack of primary sources that we would typically find around an event – the letters, images, and diaries that would document individual or even corporate response to something like the pandemic – is symbolic of a sudden, overwhelming loss of structure, both familial and societal. Five days after the Liberty Loan parade, city leaders in Philadelphia shut down all public institutions and meeting places, even public funerals. Isolation and ignorance combined with rising rates of illness and death, filling Philadelphia residents with a pervasive sense of fear and dread. This shock left people in stasis, unable to process – or document – what was happening at the moment, leaving death certificates as the largest, most complete set of primary sources about the pandemic.

This lack of documentation may also be due to that lack of trained medical staff available in Philadelphia at the time – if you are scrambling for support, medicine, food, and water in the hope of forestalling death, are you going to stop to take a picture, or write a letter?

On September 29, the College will commemorate the 100th anniversary of the pandemic with a day of reflection in the Mütter Museum. In the fall of 2019, the Mütter Museum will debut Spit Spreads Death a permanent exhibit that will highlight that most complete set of extant sources: death certificates. About 20,000 Philadelphia death certificates from 1918-19 will be compiled in a searchable database, available to visitors in a touch map capable of bringing the impact of the past outbreak to present locations (and residents). This dataset will be joined with extant objects and photos, remembrances, public programming, and historical and public health information to form a cohesive chaos that will let visitors explore the fear, loss, and confusion that defined a city in the autumn of 1918. In so doing, the College will create a new material history of the influenza pandemic.

Heart’s Ease

~Courtesy Chrissie Perella and Beth Lander, MLS, College Librarian, Historical Medical Library.

What is a recipe?  Is it instructions from which one can prepare a meal, a snack, a dessert?  Or is it how to mix the best cocktail?  Or how to cure acne?  Or how to care for a bee sting?  What other knowledge does one need to properly take advantage of the advice in a recipe?  Recipes found in medical books are no different than ones found in food cookbooks; it’s just that the desired outcome is different than a crowd-pleasing cake.

The Historical Medical Library holds over 20 manuscript recipe (or “receipt”) books, dating from the 17thcentury up through the early 20th century.  The majority of our recipe books are medical in nature, but many include food, drink, and household cleaning recipes as well.  I’ve even seen recipes for ink in a couple of our 19th century books.

However, the recipe book I’ve chosen to look at for The Recipes Project’s virtual conversation does not contain any ‘extras’ – it is filled with strictly medicinal concoctions.  MSS 2/258 (Lancaster County recipe book) is dated to circa 1854 and attributed to an unknown physician from Lancaster County, Pennsylvania.  I chose this particular book because I found it interesting that no food, drink, or household cleaning recipes are included.  Other unusual features are a table of weights; a conversion table for liquid measures; a summary of “Doses of medicines for the different ages;” a chart of pulse rates, categorized by age; and my favorite, “The regulation of doses of Laudanum for Children.”

“Table of weights adopted by the Pharmacopoeias” and table of “Liquid measure.”

“Doses of medicines for the different ages”

“The regulation of doses of Laudanum for Children” and “Pulse.”

The second section of MSS 2/258 reminds me strongly of student lecture notes.  The next 5 pages include explanatory paragraphs about topics such as the circulatory system, irritation or inflammation, and “The Dangerous effect of bleeding.”

 

It is dangerous to bleed a person immediately after receiving a fall in such accidents a shock is given to the great nervous centres, which bleeding would augment or bring on the fate of the patient, if it be employed before reaction has taken place. D.mm.m.ii.164-5

The Dangerous effect of bleeding.

Following the notes are recipes from both botanical and eclectic medical sources, which are often cited.  One of my favorite citations is for a recipe for plasters: “This is the recipe of the plaster so long kept secret and remaining in the family of Doctor and Mrs. Carpenter.”

One has to wonder how our physician was able to get the secret plaster recipe from Dr. Carpenter.  Another recipe in the book caught my eye because of its name: “Heart’s Ease.”  I was curious to see whether this was some sort of tonic or tea, and if it was for what we may term depression/heartache/etc.  I found some familiar ingredients (not ALL uses are enumerated here): valerian, used for insomnia as well as depression and conditions related to stress; saffron, for insomnia and depression; bergamot, used in aromatherapy to reduce anxiety; and the all-powerful lavender, useful for insomnia, depression, anxiety, and fatigue.  Surprisingly, aloe

s socotrine is listed; it is described in Boericke’s Materia Medica (1901) as

An excellent remedy to aid in re-establishing physiological equilibrium after much dosing, where disease and drug symptoms are much mixed. There is no remedy richer in symptoms of portal congestion and none that has given better clinical results, both for the primary pathological condition and secondary phenomena. Bad effects from sedentary life or habits. Especially suitable to lymphatic and hypochondriacal patients. The rectal symptoms usually determine the choice. Adapted to weary people, the aged, and phlegmatic, old beer-drinkers. Dissatisfied and angry about himself, alternating with lumbago. Heat internally and externally. Has been used successfully in the treatment of consumption by giving the pure juice.

Also listed is “Musk – best common” which is apparently good for stroke, coma, nerve problems, seizures (convulsions), heart pains, and sores.

Well, it was fairly clear to me that either calming and soothing tinctures, teas, and tonics have greatly changed over the past 150 years or so, or I was way off on what this concoction was used for.  It turns out that “heart’s ease” is not meant to relieve anxiety, sadness, or anything like that, but for “the treatment of diseases of the heart palpitations.”  The tincture is described as a “stimulating antispasmodic.”  A stimulating antispasmodic works to prevent or calm spasms by stimulating the higher nervous system.

Recipes like the one above, and recipe books like MSS 2/258, can tell us much about the time in which they were written – what ingredients were familiar and available to the author, what medical or natural philosophy books the author studied or referenced, what ailments were common or considered important to know how to treat, and sometimes even short case studies about the effectiveness of a particular treatment.

What I find most fascinating, perhaps, about many of the Library’s recipe books is that they are non-discriminatory when it comes to choosing recipes: a treatment for kidney stones will be followed by a recipe for roast mutton; something to stop the flux will be followed by hair tonic.  But MSS 2/258 is different in that it includes only medical recipes.  The nature of the book is more formal and less chatty than some in the collection: I’m thinking specifically of MSS 2/351, (Elizabeth Paschall Coates receipt book), which includes notes like this in recipes:

“Susannah Fowler an old Acquaintance of mine from her Childhood & a person of Good Reputation had a verry bad fellon Coming on her finger. . . this She Says was practised by a woman as a very Grate Secret I Dispersd one for our Girl Rose in 6 or 8 Dressings. . .”

While we know a bit about Elizabeth Paschall Coates, we know nothing about our Lancaster County physician.  Where did he attend medical school?  Did he have his own practice or did he work in a hospital?  The way his recipe book is laid out and the contents it includes suggest that he was a meticulous, thorough person, and therefore was probably a decent doctor.  Perhaps he didn’t include food, drink, or household cleaning recipes because he liked everything well organized and in its place – do recipes for bread, punches, or inks belong with medicines?

Even in strictly medical recipe books one will find many answers to the question “What is a recipe?” and perhaps more questions, as well.

Freeing the LAMS from the Silos; or, How We Learned to Love MARC for the Sake of BIBFRAME

On April 1st, the College of Physicians of Philadelphia released what we lovingly refer to as the “Digital Spine,” one of the few MHL_image_1catalogs in the United States that merges descriptions of, and access to, library, archival and museum collections.

Approximately 145,000 bibliographic records for collections in the Historical Medical Library and approximately 28,000 records for objects in the Mütter Museum will be merged in a single, cross-searchable database.  To sample this integration, go to https://cpp.ent.sirsi.net/client/en_US/library and search for “foreign bodies.”

MHL_image_2

 

 

 

Museum records are slowly being released into the online public access catalog (OPAC).  One of the biggest problems with integrating these two collections is the lack of standardization for describing museum objects (of any kind).  In library description, we have “title.” In museum description, something akin to a title can be found in “Remarks” or “Description” or “Object Description” or “Object Name.”  Building crosswalks between library and museum descriptions is an engaging activity.

MHL_Image_3

 

Another problem is the interim use of the MARC format to catalog museum objects.  The long-term goal of the Digital Spine project is to expose collections metadata to crawling by search engines.  In order to do this, we had to start with MARC, which seems antithetical, since MARC is not a structure that is understood by search engines. The College selected SirsiDynix as the vendor for this project because of SirsiDynix’ recent release of its BLUEcloud LSP.  BLUEcloud Visibility pulls a library’s records and transforms them using BIBFRAME, which exposes catalog records as linked data.  Here, for example, is part of the “Person” record for Chevalier L. Jackson, the “father” of American laryngology, whose foreign body collection, items referenced above, is one of the first museum collections to be released into the OPAC.

 

MHL_image_4

 

In the near future, we anticipating spending a lot of time tidying museum records and releasing them to the OPAC; retrospectively cataloging original library material that never made it into the original conversion to electronic format; and working with SirsiDynix to create an archives “module” to accommodate hierarchically described collections.  In the long term, we plan to expand the reach of our metadata as linked data – how extensible can we be?  In answering that question, we will truly free the LAMs from the silo.

 

 

Female Trouble: Headaches and the Modern Woman

Who among us has not experienced the dreaded throb of cranial pain that accompanies stress and anxiety? Headaches seem to be the physiological manifestation of modern life’s tensions: perhaps more so than aches in any other part of the body, pain in the head symbolically ties together physical, mental, and emotional distresses.[1] In popular culture, headaches are also seen as a particularly female trait – think of the old misogynistic joke about a woman pleading a headache as an excuse to avoid a man’s sexual advances. While acting as humor on the basis of supposed female frailty and sexuality, the alleged headache functions to indicate the inner conflict the woman has between the different demands she faces because of her gender and her will as an individual. Managing these clashing societal demands and personal desires is, as it were, a headache.

In my reading of popular nineteenth-century American novels by women, I have noticed an emphasis on women’s headaches as an indicator of the stresses of the modernizing world. Headaches emerge as a recurring trope in these novels about women navigating new gender roles amidst changing ideas about women’s self-actualization both in the home and in the workplace. For instance, in Sara Payson Willis’s semi-autobiographical novel Ruth Hall: A Domestic Tale of the Present Time (1854), she chronicles her titular protagonist’s climb from poor widowhood to successful writer. A proxy for Willis, a.k.a. Fanny Fern, the highest-paid columnist in the United States, Ruth is plagued by headaches throughout the narrative. Elizabeth Stuart Phelps, known as the author of one of the great bestselling novels of the century, The Gates Ajar, also channeled her personal and professional frustrations in The Story of Avis (1877). Avis wants to be an artist, but the constraints of the domestic sphere force her to temper her ambitions. In both novels, the headache is a ubiquitous refrain at points of tension between these women’s private lives and the various public demands they face. But what relation did these headaches as metaphor have to contemporary medical understandings of the phenomena? How might nineteenth-century medical literature allow us to better understand these ongoing cultural stereotypes about women’s headaches?

I researched these questions at the Historical Medical Library of the College of Physicians of Philadelphia as a proud recipient of a travel research grant from the F.C. Wood Institute for the History of Medicine. Texts I hoped to investigate that are in the Library’s collection included both standard and homeopathic medical publications such as Treatise on Headaches: Their Various Causes, Prevention, and Curse (1855), Nervous Headache: For Medical Profession Only (1880), and Headache and Its Material Medica (1889).

Unexpected hazard of research: turns out that it can be a challenge for a modern reader like myself to resist sympathetic pangs of pain when you spend hours reading detailed medical descriptions of headaches! Often referred to as the “nervous headache,” the “sick headache,” and the now obsolete term “megrim,” the medical literature consistently links the phenomenon to imbalances and abnormalities – such as being a woman. I joke not! It is often a vague historical truism that “people were sexist back then,” but it can be paradigm-shifting to read the specifics of how credentialed, authoritative professionals actively engaged in pathologizing women’s existence.

Female susceptibility to headaches apparently had to do with everything from the nebulous affliction known as “hysteria,” to menstruation, to mental and emotional excesses, to excessive education and literacy. Henry G. Wright, MD, in his Headaches: Their Causes and Cures (1856) alleges that women tend toward headaches for reasons ranging from “over-nursing a child” to exertion from reading “the contents of the circulating library from sheer want of better employment.” As for male sufferers of headaches, doctors associated their pain with emasculating deviancy such as masturbation, sedentariness, and “nervous” traits of emotional disturbances and anxiety. According to James Mease, MD, in On the Causes, Cure, and Prevention of the Sick-Headache (1832), “This disease is the result of our advanced state of civilization, the increase of wealth and of enjoyments in the power of most people in this country, and, I may add, of the luxurious and enervating habits in which those in easy circumstances indulge.” Western civilization itself is feminized.

During my visit I also found other striking materials that indicate how the spread of medical knowledge grew with the further development of print technologies. There was a mass-produced pamphlet aimed at medical professionals that advertised a “nerve tonic” for headaches and other nervous ailments based on coca, known for its role in the drug cocaine. On Nervous or Sick-Headache (1873) by Peter Wallwork Latham, MD, included reproductions of colored plates that demonstrated the effect of severe headaches with aura on vision.

One thing that must be stressed: the women who were the subjects of these medical treatises were white and from the middle, if not upper, classes. The pain of poor women, women of color, and other marginalized groups did not merit the same medical attention and were sometimes not considered to exist. In his same text, Dr. Mease alleges that headaches are “unknown among the natives of our forests.”

Finally, I hope to put this discussion of women’s headaches into a broader conversation about pain in medicine. The generous time afforded to me by the F.C. Wood Institute grant enabled me to peruse many other research interests related to women and medical science. I went through materials related to J. Marion Sims, MD, considered the father of American gynecology. He built his career on developing surgeries to fix fistulas – by practising on enslaved black women. In his writings, there was no mention of their pain.

In 2015, the journal Pediatrics, published by the American Medical Association, highlighted an editorial that reviewed a broad range of scientific studies on racial discrimination and pain treatment in medicine from the 1970s onward. Perhaps the question for us should not only be what the causes and manifestations of pain are, but also whose pain gets recognized.

[1] For more on the history of pain and medicine in America, I recommend Martin Pernick’s A Calculus of Suffering.

~This post courtesy Beth Lander and Christine “Xine” Yao. Ms. Yao just earned her PhD in English at Cornell University.  Later this year she will begin her position as a SSHRC Postdoctoral Research Fellow at the University of British Columbia.  She received an F.C. Wood Institute Travel Grant from the College of Physicians of Philadelphia in 2015.