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!

 

Murder and Mayhem: Mathieu Orfila and the Lafarge Trial

V0004364 Pierre Matthieu Joseph Bonaventure Orfila. Lithograph by A.
Wellcome Image

Who was Mathieu Orfila?

In 1840, Mathieu Orfila, was summoned to the Lafarge murder trial in Paris. The Marsh test had proven inconclusive due to improper handling, and prosecution sought an expert. What made Orfila different? His methods. Piece by piece, he put the case together, eliminating all other possibilities. Orfila is also credited as one of the first to use a microscope to assess stains of blood and bodily fluids. His work refined forensics as a science.

Patient and meticulous, Orfila worked to make chemical analysis part of forensic medicine. He also made careful studies of asphyxiation, the decomposition of bodies, and exhumation. Orfila’s first treatise, Traité des poisons, greatly enhanced and built upon the work of other toxicologists (and quickly surpassed them). Published in 1813, the treatise earned him the title Father of Forensics. By the time he was called to the Lafarge case, Orfila was considered the greatest toxicologist in the world.

The judge ordered Charles Lafarge’s body to be exhumed, though months hadLaFarge_ill gone by. The evidence was literally “under their noses,” and several jurors fainted at the stench as Orfila conducted the chemical test inside the courtroom. This way, everyone could witness his methodology. After painstaking work, he demonstrated definite traces of arsenic in the body, and showed that it did not come from the surrounding soil. The verdict was in: Mme. Lafarge was found guilty of murdering her husband!

Forensics: The Science of Sherlock and Steampunk

Goggle2FORENSICS and the STEAMPUNK AESTHETIC

Generally speaking, reactions to the term “steampunk” tend to be of two types: overwhelming enthusiasm or a quizzical expression. What on earth is it? Steampunk is usually defined as a sub-genre of science fiction that features technology and is set during the Victorian era and the industrialization of the West. What kind of technology? Steam-powered, electrical, and mechanical (the gears of clockwork are almost ubiquitous). However, there are other technologies–and other fields of inquiry–on the rise during the period, and these influence the aesthetic of the genre. In today’s post, and as part of our series, we will discuss the rise of forensics, the science that frequently features in crime fiction and even in steampunk.

S. Paget, Sherlock Holmes
S. Paget, Sherlock Holmes

There are a number of films (once books) that classify as steampunk, including Legend of Sleepy Hollow, League of Extraordinary Gentlemen, and Sherlock Holmes. In Legend, our hero is a forensic expert, using gadgets to determine cause of death (and wearing some funky eye-wear–goggles are a hallmark of steampunk.) In Sherlock, of course, Mr. Holmes uses analytical observation to determine the cause of death (and the perpetrator of the crime). Even League has a number of medical-science cross-overs, including the Jekyll and Hyde serum. In many respects, the science in these films reflects new understandings of forensic pathology as it developed in the Victorian age.

FORENSICS and the SCIENCE of DEDUCTION

OurGoggles
Goggles

The science of deduction gained public popularity in part because of Arthur Conan Doyle’s beloved Sherlock Holmes, but forensics have been around for centuries. In the year 1248, a Chinese text (Hsi DuanYu (the Washing Away of Wrongs) described how to tell from physical evidence whether a victim was strangled or drowned. That, in essence, is what forensic deduction is all about. It’s where science, technology, and crime-solving meet.

The 2009 and 2012 Sherlock Holmes movies incorporated forensic technology in different ways. When Sherlock examines a body, he is looking for evidence that will tell him time of death, place of death, and cause of death. Dr. Watson, as a physician, is able to answer some of these questions, too–and today, forensic pathologists are medical doctors. In more modern renderings of Sherlock Holmes’ deductive powers (including the recent BBC Sherlock series), he is also a chemist. Today, deduction is the work of several specialists, from the medical examiner and coroner to pathologists, chemists, and experts of forensic science. (We can’t all be lucky enough to have every talent at once like Mr. Holmes!)

FORENSICS and the HISTORY of MEDICINE

Dittrick image, L Travis
Dittrick image, L Travis

Numerous technological innovations for forensics came from medicine and from medical doctors. An upcoming exhibit at the Dittrick museum will explore early pioneers, like Dr. James Marsh and Dr. Methieu Orfila, whose methods and experiments set the stage for modern criminal forensics. It will also take a look at a local “Sherlock,” Dr. John George Spenzer, a blood and poison expert who helped crack cases for the police. Along the way, we will consider some of the technological innovations that made forensics possible. For instance, the goggles we see in movies were actually used in laboratories. In addition, though the microscopes and lab equipment may look like scenes from science fiction, they are actually scenes of medical science and innovation. The history of medicine as told through the Dittrick Museum collection showcases these innovations, from our static generator and x-ray machine to microscopes, lab equipment, and even the 19th- century doctor’s office. The mechanics, machines, and microscopes of a by-gone era seem both fascinating and foreign today, but help to contextualize our leap into the modern world.

We hope you will continue to tune in for our series on forensics, and that you’ll visit the museum later this spring to see the artifacts and objects from forensic medical history!

Early Forensics: The Problem of Arsenic

L0057809 Blue ridged glass bottle for arsenic, Europe, 1701-1935In the early part of the 19th century, a fine, white powder was all the rage among murderers (and some would-be beneficiaries). It was easy to acquire and easy to administer, too. Tasteless and colorless, it might be added to food or water and ingested. It was even called the “inheritor’s powder” because it aided in the rapid passing of the rich and elderly.

What was arsenic doing on shelves to be purchased, you might ask? In the 19th century, arsenic was used in wallpaper, beer, wine, sweets, painted toys, insecticides, clothing, hat ornaments, coal, and candles (A further list of uses may be found in James C. Whorton’s The Arsenic Century: How Victorian Britain Was Poisoned at Home, Work, and Play). But of course, arsenic is still used today, frequently an V0011589 An unscrupulous chemist selling a child arsenic and laudanumingredient in ant poison and insecticides; Michael Swango, a 20th century Dr. Death, used arsenic to sicken his colleagues before going on to kill his patients with other drugs. Swango got caught–but early 19th century poisoners did not. Why?

As usual, the devil’s in the details. The 19th century might have been subject to a plague of poisonings, but it had other plagues, too. Cholera, for instance, was a frequent cause of death. Cholera affects the small intestine, and the more common signs are diarrhea and vomiting… which are also the signs of arsenic poisoning. In 1831, an outbreak in the UK claimed 52,000 lives. Who would notice a few poisonings in the midst of all that?

Well, in turns out someone would. His name was James Marsh. A chemist, Marsh was brought in for the sensational case of George Bodle’s death, wherein an entire family and servants fell ill (though only the patriarch died) in 1833. The test that March developed was complex, but he had found that adding bodily tissues to a glass vessel with zinc would produce a gas; if heated and ignited, it would turn to arsenic and water vapor (which would be seen as a metallic film on a ceramic vessel). Earlier discoveries has been made by Carl Wilhelm Scheele and Johann Metzger, but Marsh’s was the first time the body itself could yield solid clues.

The Marsh test was taken further yet by a French case, the poisoning of Charles Lafarge. Marie Lafarge was charged with the murder and the trial polarized French society. Botched Marsh experiments nearly saw her go free, until toxicologist Mathieu Orfila–and his extraordinarily methodical and scientific methods–proved beyond doubt that the she had murdered her husband.

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Edward Salisbury Dana’s Microscopic examination

Salvarsan

By the end of the 19th century and into the 20th, arsenic lost favor. It had become too easy for forensic toxicologists to find it. In 1880, Edward Salisbury Dana’s Microscopic examination of samples of commercial arsenic, and the practical results to which it leads was published in New Jersey. Here in Cleveland, as part of the Western Reserve medical school in 1882, Oliver Franklyn Gordon even wrote his final thesis on arsenic, adding to a large and increasing literature on the subject. That doesn’t mean arsenic fell out of favor in general, however; Salvarsan 606, used to treat syphilis, was an arsenic compound–and of course, it’s still the bane of the invasive and unwanted ant colony.

Forensic science had a long history before CSI and other detective shows made it popularly regarded. Here at the Dittrick, we hope to explore more of this rich history for a spring exhibit: Steampunk, Sherlock, and Forensics. We will be posting additional details as soon as they become available; look for more in March!