Sexual Health Week

This week is in the UK, an awareness event promoted by FPA, a charity for promoting sexual health and open discussion. Here at the Dittrick Museum of Medical History, we house the Percy Skuy collection of historical contraception devices, and seek to tell the story not only of contraception in America, but also the long-standing fight for birth control (and continued issues of access).

James Ashton, The Book of Nature, Dittrick Museum Skuy Gallery

At the front of the gallery, we take a look at the reproductive and sexual body, from Aristotle’s Masterpiece to books by James Ashton and Charles Knowlton. Knowlton’s Fruits of Philosophy (1832), deemed “obscene” for its frank discussion of sex for pleasure and birth control, landed him in hot water. He was arrested twice, but the book lived on, and helped to change the conversation around a “taboo” topic.

Other sections of the museum describe the notorious Comstock Act of 1873 (Act of the Suppression of Trade in, and Circulation of, Obscene Literature and Articles of Immoral Use), made contraception illegal in the USA, and which led to harrowing health

Diverse formulations and packaging of birth control pill products.

consequences from unwanted pregnancy to venereal diseases. Black market devices and pills offered unreliable and sometimes dangerous alternatives, and Comstock’s definition of  obscenity and pornography meant books were burned and useful, frank conversation repressed. Thought the act was at last repealed, vestiges of the law remained into the 1990s. [1]

Arguments about who had a right to control women’s reproduction, and what sexuality was for (that is, pleasure or merely procreation) continue today. Through the Skuy Gallery, we at the Dittrick hope to do our own small part in encouraging open discussion of healthy sexual practice. Come and see up–or visit out online exhibits here.

[1] Comstock Act, The Editors of Encyclopædia Britannica, <https://www.britannica.com/event/Comstock-Act&gt;

Juno, the Transparent Woman, and #WomensHistoryMonth

In thanks to Linda Shusterman for donating Juno’s “pussy-hat”!

Juno is sporting her “pussy-hat” in celebration of #WomensHistoryMonth!

We have written before about our wonderful “greeter,” Juno, the transparent anatomical model. She has become a mainstay here, but Juno is a well-traveled woman! In the 1920s, the Deutsches-Hygiene-Museum in Dresden, Germany, created a fully operable model of the human body, depicting “the human body as a machine.” Despite becoming part of East Germany after WWII, the museum continued to make these models and some of the employees managed to leave East for West, helping to create the Köln Krankenhaus Museum. It was here that Juno was “born”; Franz Tschaikart of Cologne, Germany, crafted her on commission from the original German Hygiene Museum.

Juno-warehouse
Jim Edmonson, curator, inspecting Juno

In 1950, a friend of the Cleveland Health Education Museum paid $15,000 to bring Juno to Cleveland. She first appeared in public on November 13, 1950, and a contest was held to name her. ‘Juno’ took her name from the Roman queen goddess of women–and dutifully helped explain the female body to museum goers until the health museum closed in 2007. In 2011, Juno moved to her present home in the Dittrick’s museum collection after being long entombed in her original packing crate. As the first transparent woman made in West Germany after the war, she has been–and remains–a kind of ambassador.

Sadly, CHEM (later known as HealthSpace Cleveland) closed in 2006 and a vestige of its exhibits and staff came over to the Cleveland Museum of Natural History in 2007. There they now now offer programming and exhibits to help understand the physiology and frailty of the human body, the sources of disease and the grounding of wellness.

Our Juno greets visitors as they enter, standing as a testament to transparent pedagogy–and, in her new hat, proving that being partly “invisible” can’t keep her from making a statement. This hat was worn by a friend of the museum at the #WomensMarch in DC, and donated here as an artifact of a profoundly historic moment in US history.

Interested in Juno and her male counterparts? Take a look at the Wellcome’s Object of the Month. You might also enjoy Klaus Vogel’s article: “The Transparent Man – Some comments on the history of a symbol,” in Robert Bud, et al, Manifesting Medicine: Bodies and Machines [Artefacts, Studies in the History of Science and Technology , Vol 1], Amsterdam, the Netherlands : Harwood Academic, 1999.

REFERENCES:
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[1] http://blog.wellcomecollection.org/2013/12/03/object-of-the-month-the-transparent-woman/–accessed 11 December 2013

[2] www.dhmd.de/fileadmin/user_upload/uploads_drei/pressematerial/Permanent_Exhibition.pdf – accessed 30 August 2013.

Under the Lid with #BrainAwarenessWeek

For #BrainAwarenessWeek, we go to Georg Bartisch, 16th century surgeon and inventor, and his  Ophthamoduleia (”eye-service”), published in 1583. But in looking so closely at disorders of the eye, Bartisch necessarily became incredibly interested in the brain. The incredible wood cut prints show the delicate internal parts through the use of book-flaps. Layers of paper could be lifted away to reveal more detailed anatomy!

Many books contained such flaps, including the work of Vesalius, often considered the father of anatomy. (An excellent point about flap books may be found here, from the Bodleian). Bartisch performed surgeries on the eyes, and even advised his students on how best to hold patients down for the procedure. (Eye surgery would continue to be a horribly painful affair until 1884, when Austrian ophthalmologist Carl Koller realized that a few drops of topical cocaine solution rendered the eye immobile and numb).

While Bartisch does not focus on brain surgery, he nevertheless saw anatomy of the brain cavity as crucial for understanding disorders of sigh. One of the more interesting features of Bartisch’ text involves the beautifully rendered brain flaps. They could be colorized for greater effect, but the Dittrick’s copy appears as they might have hot of the block press. Stunning detail, rendered plain through innovative “paper” anatomy, Bartisch provided a glimpse “under the lid.”

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REF:

Bartisch, George. Ophthalmodouleia, das ist, Augendienst. Newer und wolgegründter Bericht von Ursachen und Erkentnüs aller Gebrechen, Schäden und Mängel der Augen und des Gesichtes. [Dreszden, Matthes Stöckel] 1583

Seeing Small: How the Microscope Changed Everything

microgaphia-flea-webWhen Dutch spectacle-makers first crafted the microscope around 1600, they revealed a hidden world of tiny organisms! Who could imagine such monsters lived out of sight? But the early microscope only offered low magnification and blurry images; it would take improvements by Robert Hook to turn a novelty enjoyed for its curious revelations into a serious scientific tool.

Who Was Robert Hooke?
English philosopher Robert Hooke’ published Micrographia: in 1665 and brought microscopy into public view in sensational fashion.  The profusely illustrated book ranged widely from the construction of microscopes themselves, to the spectrum of color, the crystal structure of objects, and the anatomy of insects. Here Hooke described and illustrated a thin cutting of cork that he said was “all perforated and porous, much like a Honey-comb.” Its porous structure reminded him of small monastic rooms, or cella (in Latin), so he called them “cells,” the basic unit of life. Despite some early observations of bacteria and cells, the microscope impacted other sciences, notably botany and zoology, more than medicine. Important technical improvements in the 1830s and later corrected poor optics, transforming the microscope into a powerful instrument for seeing disease-causing micro-organisms.

Lister and the Achromatic Microscope
lister-type-microscope-web
In 1830 wine-merchant and amateur scientist Joseph Jackson Lister* introduced microscope lenses that eliminated blurring and color distortion afflicting higher power microscopes. Lister’s breakthrough, the ‘achromatic’ lens, transformed the microscope into a powerful tool capable of much higher magnification. It just so happens that the Dittrick has the same time of microscope on display! The enormous improvements converged with the emergence of bacteriology driven by the work of Pasteur and Koch, and by the 1880s, the microscope became an essential tool of doctors in the daily practice of identifying pathogens. This pioneering work allowed for easy identification of epidemic and endemic diseases; once doctors understood what caused illness, they could combat its spread through quarantine, disinfection, vaccines, and antibiotics. Public health was born!

The Cleveland Connection
allens-scope-tracing-web
Dudley Peter Allen (for whom the Allen Memorial Medical Library is named) acquired an Edmund Hartnack type of microscope (c1881) in Berlin during his medical ‘grand tour’ of Europe (1880-82). Allen learned first-hand of exciting advances in antiseptic surgery and the medical sciences, including landmark work in bacteriology by Robert Koch (who also owned a Hartnack microscope). Allen used this microscope to study prepared pathology specimens, particularly at the laboratory of Clemens von Kahlden, a pathologist and expert in microtechnique in Freiburg, Germany. Better yet, he traced the specimens and returned to Cleveland with full color notebooks illustrating various disease specimens, ranging from infectious diseases like tuberculosis to various neoplasms or cancers.

Imagine a world where we could not identity disease-causing bacteria or cancerous cells? Pathology, bacteriology, even forensics and genetics, all owe a deep debt to the humble microscope. What began as a bead of glass for magnifying became the complex scopes that allow us to see even the smallest particles of our world!

How did Garfield Die? [Part 5]

Friday.jpg

Friday: (Harper’s Magazine, Volume 25, 673)

On September 26, 1881, President Garfield’s body arrived in Cleveland, Ohio, (not far from his home in Mentor). The engraving above shows Garfield’s catafalque, solemnly escorted by honor guards and mourning citizens. Many felt they had lost more than a man; they had lost the promise of equity he represented. At the autopsy after Garfield’s death, people found that the bullet did not strike any major organs, arteries or veins. Today, historians of medicine generally agree that Garfield’s wound was not lethal, but caused by infection introduced, sadly, by his own physician. In the wake of the catastrophe, germ theory gained wider acceptance–and so, perhaps due to Garfield’s sad but high-profile case, more lives were later saved by antiseptic medicine. Garfield was permanently buried at Lakeview Cemetery in Cleveland, and his monument still stands as a testament to this chapter of medical history–the transition to modern antiseptic!

For the LOVE of Medical History

For our final #MuseumWeek post we’re talking about why we LOVE medical history and why we hope that love is contagious! #loveMW


It’s not uncommon for the Dittrick Medical History Center to be referred to a bit like a cabinet of curiosities,  a niche museum, or perhaps more kindly, a “hidden treasure.” Although we’ve always worked to make collections accessible and major public engagement efforts are underway, we still often have to make the case for the (sometimes not so) implicit question “Why should I care about medical history?”

The answer tends to go a little like this:

Medical history is the history of how we come into the world. Our Re-conceiving Birth gallery is not only about doctors, nurses, and midwives — it examines the experiences of women and babies from the 18th century to the 1940s. Beyond the particular questions of labor position, pregnancy diet, and types of forceps, this gallery calls visitors’ attention to larger, still pertinent questions: Is birth a normal or pathological event? Who’s experiences and knowledge are important during labor? Should birth hurt? How are difficult decisions made when both the mother and infant are at risk?

By framing these questions through history, we hope to add to modern debates that these are not new concerns and that “traditional” approaches are not singular or homogenous.

Medical history is the history of how we change and respond to our environments. Humans have faced a range of emerging health concerns through travel to new places, movement into cities, changing diets, and exposure to industrial hazards. Many of the museum’s exhibits examine both the impact of these shifts, such as crowded city-dwelling facilitating the transmission of infectious diseases, and how we respond to these novel health environments. For example, Cleveland was racked by a deadly and disfiguring smallpox epidemic in 1901 and 1902, which was halted through a coordination of efforts to develop and widely distribute a safe vaccine.

These stories speak to the dynamic relationship between humans and their environment and cautions against assumptions that medical progress has eliminated any risk of new health challenges.

Medical history is the history of how we manage pain and suffering. When visitors arrive at the museum, they are greeted with display cases that detail “If you were sick in…” various years throughout history. These exhibits contextualize both the conditions and therapeutics Americans encountered in 1810, 1860, and 1910 including purgatives and emetics of humoral medicine and the sanitizing devises and techniques developed under germ theory. The types of surgeries, pharmaceuticals, and instruments used by practitioners and the popular advertisements for health restoring or ensuring products reveal the way the body and illnesses are understood.

Conceptions of the body and what it means to be healthy are not static, but reflect contemporary challenges and concerns. For example, medicine during WWI developed ways to address mass trauma in the form of gunshot, shrapnel and shell wounds and fractures through pain-free, sterile surgeries that prevented patient shock and hemorrhage. Meanwhile, home front practitioners sought to ensure the continued well-being of citizens living under rations. We’re taking a closer look at these wartime public policies and their attempts to ensure health on April 7th.

Medical history is the history of how we mediate sexual relations and family size. The museum prominently features the Skuy Collection on the History of Contraception, the world’s largest and most comprehensive collection of historical contraception artifacts. This space provides a chronological look at the way fertility has been understood and managed, starting with early texts like the 17th century Aristotle’s Masterpiece, through the 19th century Comstock Laws, the development of the birth control pill, to modern contraceptive devices. Controlling fertility is not a modern pursuit, but has been shaped through history by contemporary social and cultural values regarding family size, appropriate sexual behavior, and the alignment (or not) between biomedicine and popular beliefs about reproduction.

Today’s discussions about access to fertility controlling pharmaceuticals and procedures is part of a longer history of politicized decisions about what is best for certain bodies and for the general public at large. The gallery highlights that “best medical practices” have been occasionally overruled by social pressures against contraception, as well as how a lack of oversight in the development and use of some contraceptive technologies lead to suffering or death of unprotected citizens.

Medical history is the history of how and why we die. Even the way death is depicted — as a failure of medical treatment or an inevitable end — is shaped by the unique historical ways health has been understood. For example, diphtheria, once a deadly disease for children in the late 19th century, became both relatively treatable and preventable within a few decades through use of diphtheria antitoxin and large-scale immunization efforts.

Other exhibits tell about the detective-like work of medical practitioners in discovering the causes of death. For example, development of the stethoscope allowed physicians to hear inside the body, however what they heard was not immediately clear. Doctors used the stethoscope to listen to ill patients’ breathing and heartbeats in the early 19th century and attempted to treat their conditions. When the patients almost invariably died from their diseases, the practitioners conducted post-mortem  examinations to match the sound they’d heard with internal abnormalities. The Blaufox Hall of Diagnostic Instruments illustrates how this process led to an improved ability to diagnose pathologies in living patients while providing directed treatment for their particular needs. Understanding why and how we die improves how we interpret our bodily experiences into symptoms and causes for concern.

Our forensics collections offer a different way of understanding causes of death. New methods to detect poisons or cause of death not only reveal how our bodies function, but also speak to larger stories about personal relationships and the integration of science into courts of law.

Basically, medical history is the history of people. Through a shared focus on the biological, environmental, and social aspects of people’s lives, engaging with medical history not only allows for a more nuanced perspective on how people have lived, but tells us something about the diversity of challenges and responses that await us.

 

#ZoomMW! Focus on Forensics

bloodsp2For today’s Museum Week post, we #Zoom in on the forensic collection of John George Spenzer–with the help of research assistant Elizabeth Fregaso. What she has discovered about our erstwhile toxicologist attests to the power of minutia, not only in solving crimes, but also in the day-to-day life of Cleveland’s “Sherlock.”

Elizabeth Fregaso, Case Western Reserve University

spenzer_cane_5x7-5Born in 1864, Spenzer (fellow with the cane) had quite the drive to achieve, even from a young age. Though he was born in the United States, he moved to Germany at 15 years old, when American law at the time deemed him too young to obtain his degree. He completed his education abroad and, from there, he moved to Cleveland and became a professor at what is now Case Western Reserve University. It was while here that he became known as “Cleveland’s Sherlock Holmes”, having a hand in multiple sensational criminal trials. Among his achievements were providing definitive evidence in the 1916 trial of Josh Kiser as well as identifying toxic chemicals in the Cuyahoga River that led directly to federal efforts to understand pollution during an age when many companies were permitted to use rivers as industrial waste dumps.

The majority of the Spenzer collection that I interacted with was composed of notes on various topics relevant to Spenzer’s known areas of expertise: medical jurisprudence and forensic investigation. All the material were contained in printed-slides-3_8x5binder upon forest-green binder and on paper so thin it could have been used for tracing. Most of the copied articles were excerpted from published textbooks; the one he favored most seemed to be Eduard Von Hofmann’s Atlas of Legal Medicine. Apparently, Spenzer was a man on a mission to catalogue everything that piqued his curiosity, a continual quest to hone his skills and build on his professional knowledge. There must have been about 100 pages per binder per subject, and there were even accompanying illustrations. In watercolor.

Title Page_cropPretty impressive, eh?

Well, clearly he thought so too, because he went a long way in convincing his readers (or maybe just convincing himself) that he was striving for nothing less than perfection. Check this out: in many of the binders and positioned before all the content, there was a manufacturer’s tag clipped in the very front firmly attesting to the “mechanical perfection” of the binders.

As for the content itself: Spenzer collected miscellanea on a variety of topics that today would be intimately familiar to any forensic scientist. Fingerprinting, ballistics, hangings, drownings, electrocution… just a handful of the subjects he collected materials on. Though I haven’t cataloged it yet, there was an entire binder on the infamous Rasor trial. A sensational case for its time, Guy Rasor was accused of murdering his lover, Ora Lee. It was a case in which Spenzer was personally involved as an expert witness – and enjoyed making the ‘expert’ part known, especially. Take a look at this exchange, which I transcribed from a photo I took in order to use as a reaction image whenever I thought a friend was wrong about something in a text conversation:

SPENZER: A heart-shaped piece was cut out of the right-hand pocket.

ATTORNEY: And by whom?

SPENZER: By myself. From this point below and posterior to the left-hand pocket a rhombohedral piece was removed.

JUDGE: Will you put it in United States, Doctor?

SPENZER: A rhombohedral, your Honor, is a certain, definite shape, like a square is a shape, or a rectangle.

ATTORNEY: The trouble is we don’t understand that, Doctor.

SPENZER: A faulty education.

I’m definitely no Sherlock Holmes, but I’ll go out on a limb here and deduce from this particular exchange that Spenzer could be a bit of a Holmesian know-it-all when he wanted to be.

I did get to catalogue an entire binder on the Crippen trial, a case in which Spenzer was not directly involved. You wouldn’t think it though; from the sheer amount of materials he collected on this trial’s proceedings, he was certainly an interested third party. Doctor Harvey Crippen is accused of murdering his then-wife Cora and disposing of her body in the basement. The two expert witnesses in the case are entirely at odds about what the chemical evidence means. In fact, much of the transcript Spenzer had on record was argument on each scientist’s methodology, as the judge and attorneys attempted to figure out how two radically different conclusions could be reached from the same evidence.

bloodspThis binder stood out to me. Unlike the other binders, it wasn’t just a collection of useful and interesting tidbits. It was one of only two I had gone through – the other being “The Forensic Detection of Blood” — that appeared to be set up as a textbook, complete with a table of contents, multiple sources, and original commentary. Of course, much of this commentary was thinly veiled criticisms of the investigators involved and laments on how, if it were him on the case, he would have done things differently. But the main idea is that much of the language was directed at a third party, as if someone were meant to read these notes in the future as instructive exercises on chemical toxicology, and its limits. It would seem not all of the work was private; some of it was meant as a field guide for future generations of forensic scientists.

A last feature of note: nearly every entry had hand drawn ink and watercolor illustrations accompanying them – save for those with parent articles that had none. These illustrations came in either color or in black and white, but were always copied meticulously from the source material. In my opinion, the most charming of these illustrations wOhio-vs-Murray7x5ere the ones on the spines of each binder, indications of the specific binder’s subject materials. With little touches like that, beginning an impressive new tome always gave me the definite feel of cracking open an actual textbook.

A name commonly showed up alongside these illustrations: “Louis Karnosh”, about whom surprisingly little can be found on Google, besides that he was a practicing MD in the Cleveland area around Spenzer’s time and was 44 by the time of the 1940 census. It’s fairly reasonable to assume that he was involved in the reproduction of these images somehow – possibly Spenzer did the lineart and Karnosh supplied the watercolors? In any case, there’s no confirmation on what role he played exactly, but the pictures are quite detailed and, despite showing graphic images of violent crimes, are rather beautiful. However Dr. “Louis Karnosh” of Cleveland was involved, he deserves a little bit of the limelight.

Speaking of the limelight, it is here that we may be witness to a rare expression of humility on the part of our good Dr. Spenzer: deferring a portion of his personal, work-related project onto someone with known skill that he considered worthy of inclusion in his Perfection Collection. As anxious as he was to make his own expertise known – and not without good reason, of course — he was not above acknowledging the skill and expertise of others. […] See the original post here.

…As Elizabeth aptly points out, our friend Dr. Spenzer understood the value of detail in both his life and his work. The archive remains an incredible treasure that we continue to unpack!