Category: Medicine, History of

JF Ptak Science Books Quick Post

This rather nicely-designed and withdrawingly-titled pamphlet really packs quite a few surprises in its rather simple but innovative approach to controlling disease and epidemics in urban settings.

Mr. Soper (1870-1948) had a long career in public health service in NYC as a sanitary engineer, and was a pioneer in a number of different areas within that discipline. That said, he is probably best remembered for his work on the typhoid epidemic(s) in New York, including the infamous 1906 outbreak in which he was able to find its root cause, located in Ms. Mary Mallon. (Ms. Mallon was a very unfortunate person, and was a doomed non-affected asymptomatic carrier of the pathogen associated with typhoid fever–she is better known as “Typhoid Mary”. Over time she would be quarantined though she would leave, taking jobs as a cook/bottle washer/laundress and such, and would wind up spreading typhus on multiple occasions. Eventually she would be kept/quarantined on North Brother Island in the East River, a place she would stay, kept out of the public, from 1915 until her death in 1938.)

In any event, Soper’s work on street cleaning was essential thinking on how to maintain health standards in tight quarters of highly-populated places. And in there, in a ghostly whisper, was the unfortunate Ms. Mallon, never far from being part of the general epidemiological conversation.  

Notes:

“(Soper) received his degree from Rensselaer Polytechnic Institute in 1895 and a PhD from Columbia University in 1899. He was the managing director of the American Society for the Control of Cancer, which later changed its name to the American Cancer Society, from 1923-1928.”–Wiki

See also the full text for “The Work of a Chronic Typhoid Germ Distributor”, George A. Soper, Ph.D.
1907 https://www.learner.org/workshops/primarysources/disease/docs/soper.html 

JF Ptak Science Books  Post 2711

I don’t intend to say anything at all, really, about the following drawings–I was attracted to them and purchased them a while ago, figuring them to be pituitary tumor removal of some sort and knew that for being done in 1930 that they were sort of early. The twelve fine pen and ink images were made by the prolific anatomical/medical illustrator Bruno Keilitz (b. 1898) and do indeed show some of the stages of the removal of a pituitary tumor. The illustrations seem to have been for an article written by Dr. Prof. Oscar Hirsch (1877-1965), who was an early and influential Viennese rhinologist who made major contributions to pituitary surgery, performing this transspheroidal procedure for Harvey Cushing in 1911, and who would go on to perform the procedure more than 500 times in his long career.¹ Cushing of course is the Big Name, though in this area of neurology I found out that Hirsch is looms pretty large as well.  I don’t know how these stand in the history of this operation, but they certainly seem interesting enough to share online, and so I do:

^Details:

• Of the 12 drawings, 9 are very closely related and show the progress and route of a transsphenoidal surgery for the removal of a pituitary tumor. I feel pretty confident that these drawings were done in 1930 (see below). These images are labeled I-VIII (including a “Ia”). These images measure about 6×8.5 inches each, drawn on a heavy stock, and done in colors. Each of these images is drawn from the same perspective and show different aspects of the surgery in progression. These drawings I-VIII are all rubbers tamped on the back with Bruno Kelitz’s name and address; two of this series are signed by Kelitz in the drawing, both of which are dated 1930. There are also some other notations in ink on the reverse that I can’t quite place, as well as some later dates, as the images seem to have been used on more than one occasion. 

One drawing in this series has an old American Medical Association label (seemingly stamped Feb 11, 1952), identifying the publication of origin (“Arch. Otol” Archives of Otolyrngology), the author (“Hirsch”), and the type of reproduction to be used when illustrating the article.

JF Ptak Science Books   Post 2694

I was strolling through a year’s issue of a somewhat obscure science journal (Bulletin des Sciences par la Societe Philomatique de Paris), grazing around looking for something significant. Quite a bit of the journal is devoted to abstracts of longer articles in the more well-known journals, though there are definitely some original articles to the Bulletin that are original. In any event I found some work by Fourier, Poisson, Biot, Laplace, and some others, but they were all abstracts of papers published weeks or months earlier (which makes it a very rapid distributor for the times), and then popped into a short piece about Berzelius’ discovery of “une nouvelle substance simple…” called Selenium, which was pretty cool, as the original announcement seems to have been just weeks earlier. And then there was a very short notice on the discovery of lithium. and then again, right in a row, was a curious-sounding thing that sounded not-quite-common: “Note sur l’emploi de quelques sels de morphine comme medicamens”. This was written by a founding father of experimental physiology and a great pharmacological agent named Francois Magendie, and I wondered why they would be devoting space like this to an application of morphine. It turns out morphine had been discovered in 1805, but that its medical application hadn’t been made until…M. Magendie, in 1818, and this was him reporting his findings on the first use of morphine to treat pain in a patient. (In this case, a young woman, in terrible pain, and desperate for sleep.)  Only about 1000 words long, but no doubt this contribution had a very wide reception.  It is interesting to go into one of these volumes without expectations, and then stumble upon something like this.

It should be pointed out that it took only four years for the first person to be convicted of using morphine to kill someone (1822, Dr. Edne Castaing), though the drug in the decade or so after that became a popular instrument of murderers. By 1831 morphine had taken on enough of a common social role as to be included in Balac’s devil’s list of stuff that kept him to busy to think of self-amusement (“…invention of powder, the discovery of the new world, printing, Jesuits, lottery, morphine acetate, gambling houses and Cholera-morbus…”, found in his novella, La Comedia du Diable (in which the lord of the underworld invites 32,000 of the damned to a dinner party no one would soon forget).  

JF Ptak Science Books  Expanding a post (#153) from 2008

This book review on the use of narcotics in treating the insane appeared in the New York Journal of Medicine for 1846.  The book, An Essay on the Use of Narcotics, and other remedial Agents calculated to produce Sleep in the Treatment of Insanity…., was by Joseph Williams, M.D., and was published in London in 1845.  The theory behind the sleep treatment was that the basic mechanism of insanity was “cerebral inflammation” or “excessive vascular action” in the brain—inducing deep sleep, evidently, was a good way to combat the over-active brain.

The article itself comes at an odd time in the history of the treatment of the insane.  It came almost 40 years after the establishment of  McLean Hospital (first known as the “Asylum for the Insane,” a division of the Massachusetts General Hospital), which opened on Oct. 1, 1818, and was the first hospital dedicated to the treatment of the insane in the U.S.  It came 70 years after the great advances of Benjamin Rush, who elevated the “Mental Patient” from chains on the floor to the status of medical or nervous illness or disease.  The use of narcotics over this period seems to have surged and waned.  In 1879, in an article in the New York Times, the reputation of the Asylum for the Insane on Ward’s Island in NYC was considered—and one of the high points was that it had (largely) discontinued the use of narcotics. (There were still problems, of course, what with the asylum being overcrowded, housing 1100 in an institution meant to house 700, and where the chores and even nursing positions were staffed by the inmates, who were feed on 32 cents a day.)  As late as 1921, though, Jacob Alter Goldberg notes in his Social Aspects of the Treatment of the Insane, that there was a new, sharp increase in “toxic narcotic” treatments of the insane.  Of course, I guess one could replace “narcotic” with some sort of other misplaced treatment, like shock therapy, or Freudian mélanges, or something.  Each age must necessarily have their entry in the encyclopedia of embarrassments
. 

In this article we find sleep assaulted by the use of the following:  purgatives (“to subdue vascular action when the propriety of bleeding is doubtful’), emetics, opium (to be used “in cases of high nervous excitability and in puerperal mania”), morphia (“the most valuable remedy for calming excitement”), hyosciamus (“to produce sleep, tranquilizing the irritability of the insane”).  It is weird to see that the last sentence in the description of hyosciamus reads “some fatal cases have occurred from exhibiting henbane as an enema”.  A narcotic enema?  Still to come in the review is conium (“I have used it frequently and in large doses…it is chiefly valuable as a deobstruent and alternative”, followed by camphor, Belladonna, hydrocyanic acid, colchirum, stramonium aconite, and others.  “Warm baths’ makes an appearance (“90 degrees may be considered to be the best temperature for a warm bath for the insane”), as do cold baths, and the applications of ice caps. 

I’m not so sure about what to make of it all, the sleep treatment of insanity I mean—after all, Joseph Lister only makes his epochal pronouncements on cleanliness in the operating theatre 15 or so years after this paper, which seems today to be the most rudimentary thing that one could do in treatment in the surgical room, so treating extra blood in the brain through drug-induced sleep doesn’t seem all that far away from the realm of possibility back there in early Victorian England.

I don’t think I’ll forget the toxic narcotic enema any time soon, though.  Or the word “deobstruent”.