Recent Posts

The Dittrick Museum and #ColorOurCollections!

Once again the New York Academy of Medicine has brought us the #ColorOurCollections! From February 6th though 10th, libraries, special collections, archives, and other cultural institutions are sharing coloring content based on collection items. You can view a list of participating institutions here, but for a taste of medical history, including anatomy, dissection, flora, and even early smelting techniques (hey, you have to make medical tools somehow), download the Dittrick Coloring Book!

Better yet, post your creations to Instagram and show off your skill! We may just feature your work on the blog!

HAPPY COLORING!

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A Change of Heart: Cardiology in Cleveland

newspaper-clipping-webAmerica’s Number One Killer?

Heart attack, or cardiac arrest, became a leading cause of death after the turn of the century. People had always suffered from cardiac problems, but they usually died from other causes, especially infectious diseases, long before reaching the age when heart problems threatened their well being. As medicine advanced and people lived longer, heart disease became a serious health issue. Today, of course, we think of it as one of the United States’ top “killers”–and most are familiar with defibrillation “paddles” and the command “Clear!” But did you know that the defibrillator began here in Cleveland? Claude Beck (1894-1971) pioneered heart surgery, especially operations to improve circulation in damaged heart muscles. He also devised ways to revive heart attack victims with the use of carefully controlled electricity, or “defibrillation.

Claude Beck: Developer of the first heart defibrillator in Cleveland, Ohio.

Beck trained at Johns Hopkins and joined University Hospitals Case Medical Center in 1924 as resident and Crile Research Fellow in Surgery. While performing cardiac surgery in Cleveland, Beck noted that the heart sometimes went into “ventricular fibrillation.” This means the heart muscles twitched and contracted rapidly, disrupting the normal rhythmic heartbeat. Beck could massage the heart, but this did not always stop the fibrillation and the patient would die on the operating table. Desperate for a remedy, he learned that a colleague at Western Reserve, the physiologist Carl J. Wiggers, had maintained circulation in laboratory animals by manual massage followed by electrical shock. Excited by this idea, Beck went to work–and in 1947 he successfully revived a patient for the first time with his “defibrillator.” His device saved many lives, and Beck had more to offer. He spent his life working under Dr. Harvey Cushing and with other cardiovascular “greats” like Elliott Cutler and Donald Eiffler to change the future for heart patients.

Did You Know that CPR is CLEVELAND PROUD?
The defibrillator isn’t Cleveland’s only cardiac first. With the help of the Cleveland Heart Society, Beck and colleagues developed cardiopulmonary resuscitation (CPR) techniques. In less than twenty years, they trained more than 3,000 doctors and nurses. Dr. Beck later created a short teaching film in which he introduced a group of 11 patients who were successfully resuscitated, and in 1963, he and colleagues added a course in closed-chest cardiopulmonary resuscitation for lay persons. Beck created 16mm films to aid in training new CPR practitioners; these films provided images, diagrams, demonstrations, and even interviews with survivors!

Big Risks and Big Pay-offs

Sometimes medicine really is “practice.” With the first heart surgeries, the future was uncertain. How far could we meddle with this delicate organ? The “Beck I” surgery involved a technique for increasing circulation of blood to the myocardium by inducing adhesions between the heart and the pericardium through various methods including sutures. While seemingly damaging to the heart, the adhesions resulted in more muscle contact, so more blood could be available to the heart. “The Beck II” surgery went further by creating a vein graft between the Aorta and Coronary Sinus, pioneering revascularization of the heart. The first Beck I surgery on a human being took place in 1935, and the Beck II in the late 1940s. But the introduction of  machines like the Kay-Cross Oxygenator pushed surgery even further by circulating blood for the patient even when the heart was stopped!

A team of cardiac physicians and specialists (including Kolff, Effler, and Sones) performed the first stopped-heart surgery in Cleveland for bypass surgery. Another Cleveland doctor, Rene Favaloro, would establish the standard technique for the procedure at Cleveland Clinic, and it would soon be repeated successfully in other hospitals across the United States. With the introduction of coronary arteriography (where the doctor could see live moving images of the heart) by Mason Sones in 1958, doctors could directly treat coronary blockage. Then, in 1968, Dr. Effler and his colleagues performed the first cardiac transplant in the Midwest!

These doctors took great risks, and not every surgery could be successful. Even so, great strides were made, and Cleveland remains a center for heart disease treatment—much of it made possible by the introduction of the Beck defibrillator for restarting a stopped heart.

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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
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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
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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]

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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!

How Did President Garfield Die? [Part 4]

Continuing our series on Garfield’s death – join us for the talk Thursday.

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Thursday: (Harper’s Weekly)

On September 19, 1881, President Garfield died in a New Jersey seashore cottage. He only survived 79 days after the shooting, with his weight falling from 225 pounds to only 130 pounds from July to September. Over a dozen doctors had participated in Garfield’s treatment, including many distinguished surgeons like David Hayes Agnew of the University of Pennsylvania, and Frank Hamilton of Bellevue Hospital Medical College. However, Dr. Bliss would  not allow any others to provide their input. His lack of understanding on the antiseptic methods resulted in poor care that would lead ultimately to Garfield’s death. The wood engraving above was published 5 days after the President’s death; a double page spread (and hand colored), it depicts Garfield lying in the state, adorned with white roses.

How Did President Garfield Die? [part 3]

Continuing our series on Garfield’s death–join us for the talk Thursday, and read more at the Plain Dealer, cleveland.com!

wednesdayWednesday: (Harper’s Magazine, Volume 25, 628)

On September 17, 1881, Harper’s Weekly published these scenes with the following titles: “Removing the President from the White House” and “Removing the president from the Express Wagon to the Railway car.” He had already been bedridden some time and through the hottest months. When September arrived, the President demanded to be removed from to the seaside; Dr. Bliss tried to forbid it, but Garfield insisted that he was not asking permission. Carefully removed to a train, he was transported to the Francklyn Cottage in Elberon, New Jersey, with loyal followers throwing straw on the tracks to make the ride easier.  Garfield had always found comfort and peace in seeing the ocean; however, the fresh airs and tranquility did not aid to his recovery. In the following weeks the President’s conditioned worsened.

Posting by Celia Wan, Dittrick Museum Intern

How Did Garfield Die? (part 2)

Continuing our series from Monday–come hear more at Thursday’s EVENT!

tuesdayTuesday: (Picture source: Kouwenhoven, John Atlee. Adventures of America, 1857-1900: A Pictorial Record from Harper’s Weekly. New York: Harper & Brothers, 1938. Print.)

In this wood engraving published on August 13, 1881, President Garfield appears lying on the bed while Alexander Bell, the father of the telephone, looks for the bullet with an electronic detector. Bell’s device failed to find the bullet, but in part this was due to Dr. Bliss, who prevented Bell from being more thorough. Other industrial inventions were also applied to relieve the pain felt by Garfield. For example, the president’s room was “air-conditioned” by fans that blew air over ice. Even so, none of these industrial miracles could overcome the fatal infection brought on by doctors’ dirty, unsterilized fingers and instruments. At the end of August, President Garfield’s health had seriously declined.

Posting by Celia Wan, Dittrick Museum Intern