Treasures of the PI Nixon Library Blog

Treasures of the P.I. Nixon

The Natural History of Human Teeth -John Hunter

John Hunter. Painted by John Jackson in 1813

John Hunter. Painted by John Jackson in 1813

Would you believe it if someone told you that there once lived a man that was involved in the dissection of over 2,000 bodies; established circulation of the placenta; traced the nerves of smell; explained causes of congenital hernias; demonstrated circulation of the lymphatic system; wrote numerous papers on treating gunshot wounds, descent of the testis, and physical digestion; described the role of inflammation in the healing process; set up the foundations for bypass surgeries; and revolutionized dentistry? As hard as it is to believe, a man like this did exist, and his name was John Hunter, a distinguished scientist and a surgeon of his day.

Early Years

John Hunter was born to his father John Hunter, in Scotland on February 13, 1728 (he observed his birthday on the 14th and died on October 16, 1793), the last of 10 children. Of his childhood John Hunter is quoted as stating, “I watched the ants, bees, birds, tadpoles and caddisworms; I pestered people with questions about what nobody knew or cared anything about.” This quote shows the curiosity that led him to become such a prolific contributor to scientific knowledge in the different branches of medicine.”

Medical Training

John Hunter had a famous brother, William Hunter FRS (May 23, 1718 – March 30, 1783), who was a Scottish anatomist and physician. He was also considered a leading teacher of anatomy and the outstanding obstetrician of his day. William Hunter played a big role in the development and eventualsuccesses of his younger brother John by putting him in charge of the dissecting room of his anatomy school after John moved to London in 1748. John worked at his brother’s anatomy school for 11 years. During this time he learned from leading surgeons of that time, such as William Cheselden and Percivall Pott, while being involved in vital research and spending most of his time studying anatomy, including comparative anatomy.

Surgical Practice

In 1760 John enlisted in the army as a surgeon after sibling tension and professional rivalry made it hard to work with his brother William. He returned to England in 1763 and set up a surgical practice and worked as a dentist, popularizing tooth transplants by taking healthy teeth from poor people and transplanting them into the mouths of rich paying patients. During this time, John Hunter realized that what was needed in the practice of surgery, and what he needed to pursue, was a total understanding of life, an understanding of both normal physiology and of the processes of disease, both in humans and in the entire animal kingdom.

Most Notable Works

This led him to delve into some of his most notable works including:

  •  Observing in his notes, his own injury of ruptured Achilles tendon.
  •  Undertaking experiments in dogs to learn about healing and repair by cutting their tendons and observing the healing process. This led him to     conclude that scaring was part of the healing process.
  •  Inoculating himself with gonorrhea pus and ending up contracting both gonorrhea and syphilis. During this time he made close observations of these diseases, learning that inflammation was necessary for the cure of a patient but that this process also did harm and thus contributed to the symptoms of the disease.
  • Demonstrating collateral circulation through an experiment in which he tied one of the carotids arteries in a stag, which caused the antler on that side to become cold and to stop growing. However, within a few weeks the warmth had returned and the antler started growing. The animal was later dissected and the collateral vessels were found. The observations for this experiment were later used to create an operation to bypass vascular aneurysms.
  •  Performing the first artificial insemination by inseminating via a warm syringe the wife of a man suffering from hypospadias.

John Hunter left a legacy of challenging his pupils to try and test medical procedures, introducing into practice only those that were proven. He also encouraged them to continually seek improvements in their methods.

The Natural History of Human Teeth

Another legacy he left was his book The Natural History of the Human Teeth, published in 1778. In the book John Hunter details how teeth develop from birth, addresses structure and composition of teeth, proposes a form of transplantation and a device for treating malocclusions, and becomes the first to scientifically introduce classifications such as cupsids, bicupsids, molars and incisors. The P.I. Nixon Medical Historical Library owns a copy of this book.

For more information on the Nixon Library and John Hunter’s book, contact Lisa Matye Finnie, Special Collections Librarian, at finnie@uthscsa.edu or 210-567-2406.

Sources:
1. Lakhani, S. “Early clinical pathologists 4: John Hunter (1728-1793).” Journal of Clinical Pathology. 44.8 (1991): 621-623. Web. 27 Feb. 2015. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC496749/>.
2. “William Hunter (anatomist).” Wikipedia. N.p., n. d. Web. 27 Feb. 2015. <http://en.wikipedia.org/wiki/William_Hunter_(anatomist)
3. “John Hunter 1728-1793.” Annals of The Royal College of Surgeons of England. 60.1 (1978): 4-5. Web. 27 Feb. 2015. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2491564/>.
4. Moore, Wendy. “Moore W (2009). John Hunter (1728-93).” JLL Bulletin: Commentaries on the history of treatment evaluation. The James Lind Library, n. d. Web. 27 Feb. 2015. <http://www.jameslindlibrary.org/illustrating/articles/john-hunter-1728-93>.
5. “Hunter, John (1728-1793).” UAB Reynolds-Finley Historical Library, n. d. Web. 27 Feb. 2015. <http://www.uab.edu/reynolds/histfigs/hunter

Images:
Jackson, John. John Hunter. 1813. Photograph. WikipediaWeb. 27 Feb 2015. <http://upload.wikimedia.org/wikipedia/commons/a/a3/John_Hunter_by_John_Jackson.jpg>. In public domain.

–Manasseh Ngigi, Nursing school student

Image of the an illustration within John Hunter's The Natural History of the Human Teeth. P. I. Nixon Medical Historical Library.

Image of the an illustration within John Hunter’s The Natural History of the Human Teeth. P. I. Nixon Medical Historical Library.

Image of the title page of John Hunter's The Natural History of the Human Teeth. P. I. Nixon Medical Historical Library.

Image of the title page of John Hunter’s The Natural History of the Human Teeth. P. I. Nixon Medical Historical Library.

Elizabeth Blackwell: First Female Physician of the Modern Era

“[women] May be useful in some departments, but in surgery, no nerve” and “…can you think of a patient in a critical case, waiting for half an hour while the medical lady fixes her bonnet or adjusts her bustle?”

Elizabeth Blackwell

Elizabeth Blackwell

In a time when women were considered inferior, not only physically, but also mentally, simply the idea of a woman with her “delicate sensibilities” attempting to practice medicine was ludicrous enough to provoke comments such as those above. This was popular sentiment, making it a truly amazing feat that Elizabeth Blackwell was able to endure these prejudices, to not only pursue an education in medicine, but also use it as a platform for social and moral reform.

Early Life

Blackwell was born in England in 1821 to Samuel and Hannah Blackwell, one of nine children. Mr. Blackwell was a liberalist and therefore very involved in social reform. These ideals led to a firm belief in providing each of his children the opportunity to develop their talents and intellect. As a result, from a young age Elizabeth Blackwell benefitted from private tutors and the influence of her father’s social ideology. Eventually her father moved their family to America and in her early adulthood Blackwell pursued her interests in education and social reform. Later in her life, Blackwell would admit that initially all things medical had disgusted her, and it was the last words of a close, dying acquaintance admitting that a female physician would have been a comfort during the course of her illness, which had Blackwell considering a career in medicine.

Geneva Medical College

Geneva Medical College

Difficulties in Obtaining Medical Training

A woman applying to medical school was unheard of at the time, and medical school in itself was an expensive novelty. Tradition had been that budding physicians learned the practice of medicine by actually practicing under the apprenticeship of an already established physician. However, none of these barriers deterred Blackwell. If anything she saw it as a challenge, and a platform to advocate for reform in women’s education. Through the resources of physician acquaintances, she was able to self-study and work till she had enough for the tuition to apply to medical colleges in New York and Philadelphia. Frustratingly, all her applications were met with rejection. A small school in rural New York however, conflicted about her admittance, laid the decision to their current students. A single ‘no’ from any of the all-male student body would bar Blackwell’s admittance. Thinking it a joke, the vote was a unanimous ‘yes,’ and it was to the school and town’s horror and dismay when Blackwell arrived for her first day of classes at Geneva Medical College in upstate New York in 1847.

Blackwell took the hostility and cold welcoming inside and outside of the classroom in stride. According to rumor, Blackwell’s presence in school turned an otherwise raucous, unruly class of boys into well behaved gentlemen, leading to more productive lectures and the best class the school had taught in years. Over time, she earned the respect of many of her colleagues and faculty for her perseverance and ability. The course lasted two years, and in 1849, Elizabeth Blackwell graduated, top of her class, and the first female physician to be formally trained in America. Her example led to more women receiving a formal medical education.

Problems in Medical Practice

Wanting to further her studies, she returned to England, and found the education system even less welcoming than America, despite her medical degree. She studied as a midwife in Paris at La Maternité and was greatly recognized for her skills as an obstetrician. While treating one of her pediatric patients for a bacterial eye infection, she contracted the eye infection and was left blind in one eye, ruining her hopes of becoming a surgeon. Later, she worked at St. Bartholomew’s hospital where she befriended Florence Nightingale, another woman active in the field of medicine. More experienced and knowledgeable, Blackwell returned to New York with the intention of opening her own practice, but met resistance from all, not allowed to rent an office or able to gain the support of fellow male physicians.blackwellquote

Role in Medical Education for Women

With the help of her younger sister Emily, who had followed in her sister’s footsteps to also become a trained physician, and another student physician she took under her wing, she opened the New York Infirmary for Indigent Women and Children in 1857, which allowed women to practice and further their training while providing care for the poor. Then, in 1868, Blackwell founded the Women’s Medical College. In addition to helping establish these institutions, she wrote several books on household health, women in medicine, medical sociology and sexual physiology, and while she never married or had any children of her own other than an adopted daughter, she wrote parenting books and advice to young girls.
Elizabeth Blackwell was truly a pioneer in the medical education of women. In her last years of practice, she taught as a professor of gynecology in the London School of Medicine, which she also helped established, before her declining health forced her to retire.

The Women's Medical College of the New York Infirmary. Anncouncement, 1868.

The Women’s Medical College of the New York Infirmary. Announcementt, 1868-69.

Sources
1. “Dr. Elizabeth Blackwell.” National Library of Medicine. Web. 5 Mar. 2015.
< http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_35.html >.
2. Lewis, Jone Johnson. “Elizabeth Blackwell First Female Physician.” Web. 5 Mar. 2015.
< http://womenshistory.about.com/od/blackwellelizabeth/a/eliz_blackwell.htm >.
3. Markel, Howard. “How Elizabeth Blackwell Became the First Female Doctor in the U.S.” PBS. 23 Jan. 2014. Web. 5 Mar. 2015. < http://www.pbs.org/newshour/rundown/elizabeth-blackwell-becomes-the-first-woman-doctor-in-the-united-states/ >.
4. Nixon, Pat Ireland. The Medical Story of Early Texas 1528 – 1853. Lancaster, PE: Lancaster Press, Inc., 1946, p. 413. Print.

Images
Dr. Elizabeth Blackwell. Changing the Face of Medicine. 5 Mar 2015
< http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_35.html >. In public domain.

Geneva Medical College. 5 Mar 2015.
< http://commons.wikimedia.org/wiki/File:Geneva_medical_college_lg.jpg >. In public domain.

The Woman’s Medical College of the New York Infirmary. [Announcement, 1868-69] New York, 1868 National Library of Medicine. 5 Mar 2015. < http://commons.wikimedia.org/wiki/File:NYinfirmary.jpg>. In public domain

Thank you for reading and please stop by!
Nicole Iwuchukwu, School of Medicine

“The lady with the lamp” and her contributions to modern nursing

Florence Nightingale, 1856

Florence Nightingale, 1856

 

The largest profession, and the profession that is consistently ranked as the most trusted profession in the United States, is that of nursing. The foundations of nursing practiced across the world were pioneered by the greatest figure in nursing history, Florence Nightingale. She helped to define nursing practice by suggesting that nurses did not need to know all about the disease process like the medical field. They needed to know how to care for a patient through the environment, helping the patient deal with symptoms and changes in function related to illness.

Early Life and Training

Florence Nightingale was born May 12, 1820, in Florence, Italy and was named after the city of her birth. She died on August 13, 1910, at the age of 90 after living a long, productive life in which her ideas and contributions helped to shape the way nursing is practiced in the western world. Florence Nightingale was born to an upper-class English family. Her father William Shore Nightingale was a wealthy landowner and her mother Frances Nightingale a socialite who hailed from a family of wealthy merchants. From a young age Florence Nightingale assisted the poor and ill people in the village neighboring her estate, and by the age of 16 she considered nursing to be her life’s calling.

In the Victorian era, nursing was considered a lowly and menial profession in England, and Florence Nightingale’s refusal to marry at age 17 to pursue it disappointed her parents. In July 1850 Nightingale enrolled for 2 weeks of training and enrolled again in July 1851 for 3 more months at the Institution of Protestant Deaconesses at Kaiserswerth, Germany. There she learned basic nursing skills such as the value of patient observation and good hospital organization.

This training and later experiences helped Nightingale form her revolutionary theories. These theories were further enhanced at Middlesex hospital for governesses, where Nightingale worked as a superintendent. She struggled there to control a cholera outbreak and the unsanitary conditions that aided in the rapid spread of the disease. She made it her mission to improve the hygiene practices of the facility, which ended up significantly reducing mortality at the hospital.

The Crimean War and the Development of Nursing Practice

The Crimean War of 1853 catapulted Nightingale and her methods to fame. During the war a scandal broke out about the lack of sufficient medical attention and the unsanitary and inhumane conditions to which injured soldiers were being subjected. The poor reputation earned by previous female nurses was the main cause of the lack of adequate staff.  In an effort to better the treatment of the injured soldiers, Secretary of War Sidney Herbert asked Nightingale to organize a corps of nurses to tend to and assist the sick and injured. On arrival in Scutari, the British base hospital in Constantinople, Nightingale found patients lying on their own excrement, rodents and other pests scurrying among them, and a complete lack of sanitary conditions, which made infectious diseases the number one killer of soldiers rather than battle wounds.

Faced with this daunting task, Nightingale implemented some concepts that are at the core of nursing practice to this day:

Paper lantern used by Florence Nightingale, 1855

Paper lantern used by Florence Nightingale, 1855

  • Infection control – She did this by cleaning the entire hospital from top to bottom and requiring proper hygiene, such as clean linens, for the soldiers. This is incredible because at the time microbes and the chain of infection was not known.
  • Self-care (requiring patients to do things for themselves in order to gain independence and promote healing) – Nightingale required the least infirm patients at the hospital to assist in cleaning it.
  • Assessment – She made rounds at night with her lamp, talking to and assessing the condition of her patients. Nursing assessments are the core of nursing, and all nursing actions are based on them. With that in mind, it’s only fitting that her habit of making assessment rounds was the reason why the soldiers nicknamed her the “the lady with the lamp.”
  • Therapeutic communication – During her rounds Nightingale talked to her patients, offering them empathy and compassion in their moment of despair.
  • Spiritual nursing – Nightingale ministered to patients who were dying, bringing them comfort in their last hour.
  • Public health advocacy – Nightingale wrote an 830 page report analyzing and proposing reforms for military hospitals operating under poor conditions.

The implementation of these concepts in the battle field hospital setting by Florence Nightingale reduced the death rate at the hospital by two thirds.

Recognition and Role in Nursing Education

After the war she returned home to a hero’s welcome and was awarded the “Nightingale Jewel,” a brooch with an engraved dedication from Queen Victoria, for her service in the Crimea. She was also granted a prize of $250,000 from the British government and used the money to establish St. Thomas’ Hospital and the Nightingale Training School for Nurses. Her work lifted the reputation of nursing from lowly and menial to a respectable profession to which many upper-class women aspired.

In 1859 Florence Nightingale published a 136 book page entitled Notes on Nursing: What it is and What it is Not. The book was meant to give hints for thought on how to nurse a sick patient rather than to serve as a comprehensive manual on how to become a nurse. The book covers topics vital to nurses today such as confidentiality, cleanliness, observation (assessment), quality and safety. The P.I. Nixon Medical Historical Library owns a copy of this book.

 

Front cover of Notes on Nursing: What it is Not. P . I. Nixon Medical Historical Library

Front cover of Notes on Nursing: What it is  and What it is Not.  P. I. Nixon Medical Historical Library

 

Title Page of Notes on Nursing: What is is and What it is No. P . I. Nixon Medical Historical Library

Title Page of Notes on Nursing: What is is and What it is Not. P. I. Nixon Medical Historical Library

 

For more information on the Nixon Library and Nightingale’s book, contact Lisa Matye Finnie, Special Collections Librarian, at finnie@uthscsa.edu or 210-567-2406.

Sources:
1. “Top 50 Occupations with the Largest Employment.” Career One Stop. Viewed 6 Feb 2015. http://www.careerinfonet.org/oview3.asp?level=overall&id=1&nodeid=5

2. “Nurses Once Again Top Gallup’s Annual Survey of Most Trusted Professionals.” Advance Healthcare Network. 13 Dec 2013. Viewed 6 Feb 2015. http://nursing.advanceweb.com/News/National-News/Nurses-Once-Again-Top-Gallups-Annual-Survey-of-Most-Trusted-Professionals.aspx

3. Potter, P., & Perry, A. (2013). Fundamentals of nursing. (8 ed., p. 44). St. Louis: Elsevier.

4. Selanders, L. (29, October 2014). Florence nightingale. Viewed 2/6/2015. http://www.britannica.com/EBchecked/topic/415020/Florence-Nightingale

5. Florence nightingale. Viewed 2/6/2015. http://www.biography.com/people/florence-nightingale-9423539

6. Notes on Nursing. Wikipedia. http://en.wikipedia.org/wiki/Notes_on_Nursing. Viewed 2/6/2015.

7. Harris, M. (2002). Remembering florence nightingale. Home Healthcare Nurse, 20(5), 291-293. Viewed 2/6/2015. http://www.nursingcenter.com/lnc/journalarticle?Article_ID=270233

Images:
Florence Nightingale, 1856. N.d. Photograph. National Army MuseumWeb. 6 Feb 2015. <http://www.nam.ac.uk/online-collection/detail.php?acc=1980-07-137-1>.

Paper lantern used by Florence Nightingale, 1855. N.d. Photograph. National Army MuseumWeb. 6 Feb 2015. <http://www.nam.ac.uk/online-collection/detail.php?acc=1962-12-29-1>.

Appreciatively,

Manasseh “Manny” Ngigi, Nursing School student

The Father of Ophthalmology

George Bartisch, a German physician, was born in 1535 in Königsbrück, a village near Dresden, Germany. He could not afford medical school, so apprenticed at the age of 13 to a barber surgeon in Dresden. This was followed by two additional apprenticeships to an oculist and a lithotomist. He acquired medical experience and became a successful wound surgeon, lithotomist, oculist and teacher of surgical anatomy. Bartisch became well known and eventually was appointed court oculist for Duke Augustus I of Saxony, settling in Dresden.

Bartisch is called the Father of Ophthalmology because he was the earliest person to write an ophthalmologic text-book in the German language and the first in history to totally remove an eye from a living human subject. In 1583 he published Ophthalmodouleia, both the first systematic work on ocular disease and ophthalmic surgery as well as the first ophthalmic atlas with its 92 full page woodcuts, many of which Bartisch drew himself. Some of the illustrations had flaps that could be lifted to provide a dissection layer by layer. They illustrate ocular diseases, surgical methods, and instruments. The explanations of each disease in this work are followed by a discussion of herbal remedies and prescriptions and surgical options for treatment.

The P. I. Nixon Medical Historical Library, located on the 5th floor of the Briscoe Library owns the first edition of Ophthalmodouleia. More information on George Bartisch may be found in the Treasures of the P. I. Nixon Medical Historical Library blog.

To schedule a visit to the P.I. Nixon Medical Historical Library, contact Lisa Matye Finnie, Special Collections Librarian, at finnie@uthscsa.edu or 210-567-2406.

Sources:

Book review by Mark J. Mannis of Ophthalmodouleia, That is the Service of the Eye, 1996 English translation by Donal Blanchard, MD. American Journal of Ophthalmology 1997, 123:146-147. http://www.history-ophthalmology.com/BartischREVIEW.html

“Georg Bartisch’s Ophthalmodouleia.” The College of Optometrist webpage at http://www.college-optometrists.org/en/college/museyeum/collections/rare_historical_books_collection/Bartisch.cfm

Shastid,, Thomas Hall. George Bartisch,” The American Encyclopedia and Dictionary of Ophthalmology, Volume 2, pp. 888-895. Chicago: Cleveland Press, 1913.

Images:

Images courtesy History of Science Collections, University of Oklahoma Libraries.

William Withering and the beginnings of modern therapeutics

Image of William Withering

Image of William Withering

 

Digoxin is a modern drug used to treat irregular heartbeat, atrial fibrillation, and congestive heart failure and to relieve symptoms of edema associated with congestive heart failure.  The Western world of medicine’s knowledge of Digoxin’s incredible ability to help treat certain heart diseases was due to the efforts of an English physician called William Withering.

Medical Training

William Withering was born on March 17, 1741, in Wellington, Shropshire and died Oct. 6, 1799, in the town of Sparkbrook in England.  He was influenced by his father, Edmund, who was an apothecary, the equivalent of a modern day pharmacist, and his uncle, Brook Hector, who was a physician. In the modern medical school, medical students participate in a residency program, which is akin to an apprenticeship, after 4 years of medical school. During Withering’s time in 1762, Withering enrolled in the University of Edinburg in Scotland after 4 years as an apprentice, the opposite of today’s system. The medical curriculum of this period was heavily focused on botany, probably playing a part in shaping Withering’s intellectual understanding of plants and human health.

After his schooling, Withering relocated to the town of Stafford, where he visited private patients and worked as a founding physician of the Stafford General Infirmary. During this time period, Withering participated in his hobby of botany and, through this, met his wife, Helena Cookes, who sketched the plants he collected. In 1779, Withering served as a founder of Birmingham General Hospital, where many poor people were treated free of charge

Experiments with Foxglove

William Withering started to conduct experiments to demonstrate the uses of the foxglove plant in 1776 after an experience with one of his patients. Withering had been treating a lady suffering from edema and had expected her to die, but he was surprised to discover that she had recovered after ingesting a folk cure prepared from digitalis, a plant commonly called foxglove. This lead him to write An Account of the Foxglove, and Some of Its Medical Uses, a book published in 1785 that gave him a lasting reputation.  The P.I. Nixon Medical Historical Library owns a copy of this book.

The book describes Withering’s clinical experience with the purple foxglove, a weed containing therapeutic substances called cardiac glycosides used in modern drugs such as digoxin.  The book basically details a 10 year clinical trial of digitalis (the modern name for the drug after the Latin name for the plant, Digitalis purpure) and was published to guard the medical community of the time period against misuse of this powerful drug.  In the book he discusses treating 158 patients with foxglove and how 101 of them experienced relief from heart failure.  He also wrote about the correct single dosage that should be used when administering foxglove, which is only slightly less than today’s modern digoxin tablet.  The method that Withering detailed for creating medicine from the foxglove plant is also the same method that modern drug manufactures use, albeit on a grander scale, to extract digitalis from the foxglove plant.

Image of William Withering's An Account of the Foxglove, and Some of Its Medical Uses. P. I. Nixon Medical Historical Library.

Image of William Withering’s An Account of the Foxglove, and Some of Its Medical Uses. P. I. Nixon Medical Historical Library.

Image of William Withering's An Account of the Foxglove, and Some of Its Medical Uses with the fold out insert showing a colored illustration of the Foxglove plant. P. I. Nixon Medical Historical Library.

Image of William Withering’s An Account of the Foxglove, and Some of Its Medical Uses with the fold out insert showing a colored illustration of the Foxglove plant. P. I. Nixon Medical Historical Library.

Appreciatively,

Manasseh “Manny” Ngigi,  Nursing School student

Sources:

“Foxglove.” WebMD. Viewed 1/23/ 2015. http://www.webmd.com/vitamins-supplements/ingredientmono-287-DIGITALIS.aspx?activeIngredientId=287&activeIngredientName=DIGITALIS .

Wilson, Philip. “William Withering.” Encyclopaedia Britannica. Viewed 1/23/ 2015. http://www.britannica.com/EBchecked/topic/646127/William-Withering .

“The lifesaving foxglove.” UCLA Mildred E. Mathias Botanical Garden. Viewed 1/23/ 2015. http://www.botgard.ucla.edu/html/botanytextbooks/economicbotany/Digitalis/index.html

“Digitalis.” Wikipedia. http://en.wikipedia.org/wiki/Digitalis Viewed 1/23/2015.

Norman, Jeremy. “William Withering and the Purple Foxglove: A Bicentennial Tribute.” Jeremy Norman’s History of Science. Viewed 1/23/2015. http://www.historyofscience.com/articles/jmnorman-william-withering.php

 

Images:

“William Withering” by After Carl Frederik von Breda – [1] [2]. Licensed under Public Domain via Wikimedia Commons –http://commons.wikimedia.org/wiki/File:William_Withering.jpg#mediaviewer/File:William_Withering.jpg

Book images are from the copy owned by the P. I. Nixon Medical Historical Library.

For questions about the Treasures of the P. I. Nixon library blog, email Special Collections.

 

 

 

 

 

 

 

 

George Bartisch: An Inventive Look Into Ophthalmodouleia

Image of George Bartisch

Image of George Bartisch

 

Buying a pair of glasses is something that has become quite common, and most times can even be done over the internet. Beyond a routine checkup, more serious ocular issues may suggest a trip to the local ophthalmologist, but even that is often quite convenient due to technology and medical advances. Typically you can be diagnosed and treated within a few visits. These simple luxuries are available to us because of the extraordinary research, practices, and innovations of a German physician, George Bartisch.

Training and Apprenticeships

Born in 1535 and growing up in a poor lower class family, Bartisch was not expected to reach the level of knowledge and expertise that he did. He longed to learn and know more, especially in the area of medicine. Because his family could not afford to send him to a formal school to satisfy his passion, he found an outlet that would suffice, and even grow, his innate knowledge about the human body, particularly the eye. He became an apprentice for a barber surgeon in Dresden at the age of 13. This was followed by two additional apprenticeships to an oculist and a lithotomist.  Through these apprenticeships, he was able to become a successful wound surgeon, lithotomist, oculist, and teacher of surgical anatomy.

Medical Beliefs

Being extremely influenced by the culture around him, Bartisch brought his knowledge of quirky superstitions, magic, astrology, and witchcraft into his research of the eye. Believing there were certain stellar constellations that were favorable for the eye was one of his assumptions. He accredited many malformations and diseases of the eye to such things as devils, spells, hexes, and curses, attributing human suffering and pain to punishment for sins by the devil. He could tie any disease which caused pain back to things he believed were sins. For example, his etiology for presbyopia was excessive use of alcohol. He took an interest in hot and cold witchcraft, treating patients according to which one he believed they were suffering from. It is improbable, however, that you would see any of these methods in practice today.
The majority of his knowledge was acquired from one of his 3 teachers, Abraham Meyscheider being one that he mentions specifically.

After he had cultivated his abilities during his apprenticeships, he became an itinerant surgeon for the regions of Saxony, Selisia, and Bohemia. Bartisch became so well-known and respected he was appointed court oculist for Duke Augustus I of Saxony and settled in Dresden. Though he was an advocate for improving ocular health and vision, he was a huge adversary of spectacles and eye glasses. Bartisch believed that it was impossible and almost insulting to try and improve such an intricate organ’s function by sliding a piece of magnifying glass in front of it. In his theories glasses proved to weaken the patient’s vision. His treatments always stemmed from a more organic viewpoint.

Ophthalmodouleia

Illustration of crown of head from page 5 of Ophthalmodouleia

Illustration of crown of head from page 5 of Ophthalmodouleia

George Bartisch, who is labeled the father of ophthalmology, left a huge footprint on this field by writing Ophthalmodouleia, an opthalmologic text-book. It was the first German book on ocular disease and surgery and included 92 exhaustive wood cuts. Many of these diagrams and illustrations were layered to act as flaps that could be lifted to emulate dissection, illustrating a variety of ocular diseases, surgery methodology, and instruments. Some of these you can find recreated in posters, paintings, and other reference books of the field.

Published in 1583, Ophthalmodouleia is overwhelming with ocular knowledge. Starting from the most basic concepts of head and face, it then travels to in depth illustration of eye anatomy. Bartisch demonstrates his breadth of knowledge as he addresses more complex topics such as strabismus, cataracts, external disease, and trauma, including his theories on diagnosing and treating cataracts by color. The intensive explanation of each disease is followed by the discussion of herbal remedies and prescriptions, which were popular in that time, and surgery options that easily make this book the Web MD of the ocular world for its time period.

Picture showing laps raised to view illustration of dura mater and brain.

Same illustration with flaps lifted to show dura matter and brain

It is an honor to have an original first edition of the actual book Ophthalmodouleia  here in our P.I. Nixon Medical Historical Library. The large elegant script and illustrious drawings can penetrate any language barrier and captivate attention in appreciation of the beauty of this work. Though the original copy is printed in 16th century German dialect, the field of ophthalmology owes great appreciation to J.P. Waynebrough for publishing Donald L. Blanchard’s English translation in 1996 as part of the History of Ophthalmology series.  The Nixon Library also owns this translation

.Photograph of Ophthalmodouleia, page 143

Photograph of Ophthalmodouleia, page 143

 

 

For more information on the Nixon Library or to set up an appointment to visit the library, contact Lisa Matye Finnie, Special Collections Librarian, at finnie@uthscsa.edu or 210-567-2406.

Come take a look,
Tressica Thomas B.S., SLP-A
DEHS Student- School of Medicine

Sources:

Blanchard, Donalld. “Superstitions of George Bartisch.” Science Direct. Survey of Opthalmalogy, 1 Jan. 2005. Web. 13 Jan. 2015. http://www.sciencedirect.com/science/article/pii/S0039625705000871

“Georg Bartisch.” Whonamedit -. Ole Daniel Enerson. Web. 13 Jan. 2015.
http://www.whonamedit.com/doctor.cfm/1297.html

Mannis, Mark. “George Bartisch.” George Bartisch. American Journal of Ophthalmology. Web. 13 Jan. 2015. http://www.history-ophthalmology.com/BartischREVIEW.html

Portrait of George Bartisch courtesy of http://en.wikipedia.org/wiki/Georg_Bartisch

 

 

Middleton Goldsmith and the Use of Bromine to Treat Gangrene

Picture of title page of Goldsmith's report

Title page of Goldsmith’s report on Hospital Gangrene

The P. I. Nixon Medical Historical Library owns a report to the Surgeon General of the United States by Civil War surgeon Middleton Goldsmith on the use of bromine to treat hospital gangrene in wounded soldiers. Published in 1863, the report is entitled A Report on Hospital Gangrene, Erysipelas and Pyaemia as Observed in the Departments of the Ohio and the Cumberland, with Cases Appended. It contains detailed case reports, a foldout table containing all of Goldsmith’s research data, and his correspondence with other surgeons on the treatment of gangrene. The overall mortality of hospital gangrene cases from the Civil War has been reported as 45.6% (The Medical and Surgical History of the Civil War, Washington, U.S. Government Printing Office, 1875-1888). However, only 8 of Goldsmith’s 304 patients receiving bromine-based therapy for gangrene died, a mortality rate of only 2.6 per cent.

Goldsmith’s work predated Joseph Lister’s 1867 paper linking microbes and surgical infections and Louis Pasteur’s groundbreaking work on microbes, also published after the Civil War. Goldsmith did not know what agent caused the gangrene, erysipelas and pyaemia he observed in the wards of his hospitals, but he theorized that they were related to each other and sought a curative agent to cure the infections and prevent the spread between patients.  Goldsmith’s data was so meticulously documented that it was easy to prove his bromine treatment had cured his gangrene patients. By the conclusion of the Civil War, surgeons throughout the country applied variations of Goldsmith’s bromine therapy regimen in the treatment and prevention of gangrene.

For more detailed information on Middleton Goldsmith’s work and Civil War experiences, see the blog entry on Middleton in the Treasures of the P. I. Nixon Medical Historical Library.

For more information on the P. I. Nixon Medical Historical Library, contact Lisa Matye Finnie, Special Collections Librarian, at (210) 567-2406 or finnie@uthscsa.edu.

Picture scanned from library’s copy of report.

Clara Barton and The Red Cross: A History of this Remarkable International Movement in the Interest of Humanity

clarabartonportrait

Portrait of Clara Barton

Clarissa Harlow Barton was born in Oxford, Massachusetts, on the 25th of December in 1821. She was the youngest of six children, and she took a keen interest in education early in her life. When she was a toddler, she was sent to school with one of her older brothers, where she developed a love for reading. When she was ten, her brother fell off the roof of their barn and had to undergo surgery. Clara was dedicated to nursing him back to good health. This event sparked her passion and love for healing others, which would eventually lead to the wonderful legacy she left behind.

Clara decided to become a teacher at the age of fifteen and worked as an educator for several years; eventually, she opened a public school in Bordentown, New Jersey, in 1853. A year after opening the school, Clara moved to Washington, D.C. and worked at the Patent Office. Many people believe that she was perhaps the first woman in the United States to hold a government job. In the early 1860s when the Civil War broke out, Barton was one of the first volunteers at the local infirmary caring for the wounded soldiers. She went on to serve the injured soldiers on the field. She collected supplies and distributed them to the Union Army. She cared for the soldiers during combat in Fredericksburg, Virginia, as well as Antietam. Many soldiers addressed her as the “Angel of the Battlefield.”

In 1869 after the Civil War had ended, Clara visited Geneva, Switzerland, and was introduced to the Red Cross organization. While on her trip, she was asked to be the representative for the American Branch. Upon returning to the United States, she began to lobby to gain some recognition for the Red Cross. In 1881, the American Red Cross Society was founded with Barton serving as President until 1904. After leaving the Red Cross, Clara remained devoted to her philanthropic passion and delivered speeches and lectures concerning public health and health interventions. She also wrote many literary pieces that focused on public health, her experiences as a nurse, and the importance of health on a global spectrum. Barton died in Glen Echo, Maryland, on April 12, 1912.

The P.I. Nixon Medical Historical Library owns a copy of The Red Cross: A History of this Remarkable International Movement in the Interest of Humanity, written by Clara Barton and published in the year 1898. The P.I. Nixon Medical Historical Library will display a Civil War exhibit on major medical figures of the Civil War from Sept. 15 – Nov. 30. Be sure to come visit our Civil War exhibit and learn more about Clara Barton and her tremendous efforts in starting the American Red Cross Society.

redcrossbook

Image of our copy of Clara Barton’s The Red Cross: A History of this Remarkable Movement in the interest of Humanity

Clara Barton was honored with a United States commemorative stamp, issued in 1948

Clara Barton was honored with a United States commemorative stamp, issued in 1948

Sources:

Founder Clara Barton. American Red Cross website http://www.redcross.org/about-us/history/clara-barton. Viewed 9/12/2014.

Clara Barton: Relief Organizer/Humanitarian December 25, 1821 – April 12, 1912. Civil War Trust website http://www.civilwar.org/education/history/biographies/clara-barton.html. Viewed 9/12/2014.

Clara Barton. Wikipedia. http://en.wikipedia.org/wiki/Clara_Barton. Viewed 9/12/2014.

 Images:

Clara Barton, dated 1904. From the Library of Congress’s Prints and Photographs division. No known restrictions on publication.

Postage stamp: U.S. Post Office; Smithsonian National Postal Museum. In the public domain.

For more information on the Nixon Library or to set up an appointment, contact Lisa Matye Finnie, Special Collections Librarian, at finnie@uthscsa.edu or 210-567-2406.

Thank you for reading my blog post.

Mehak Sumar, Nursing Student

Middleton Goldsmith and Hospital Gangrene

Middleton Goldsmith was a surgeon in the Union Army during the American Civil War working primarily in the Louisville, Kentucky area. He was born in Port Tobacco, Maryland in 1818, the son of surgeon Alban Goldsmith. His father was the professor of Surgery at Kentucky School of Medicine in Louisville in the mid-1830s, and Middleton served as his anatomy and surgical assistant. Middle enrolled in the New York College of Physicians and Surgeons in 1837 and graduated in 1840. He was a multi-talented and very popular young man who played guitar and banjo, knew Greek and Latin, and was an excellent storyteller. He cofounded the New York Pathologic Society and in 1844 became Chair of Surgery at Castleton Medical College in Vermont. After 12 years, he succeeded his father as Chair of Surgery at Kentucky School of Medicine, soon becoming the Dean of Faculty.

Army Career

Goldsmith joined the Union Army at the outbreak of the Civil War as a Brigade Surgeon and was quickly appointed Surgeon-in-Chief of all military hospitals in Kentucky and the Army of the Ohio, supervising the daily operations of multiple hospitals.

Sketch of Civil War solider patient with gangrene in arm stump

American Civil War soldier lies in bed with a gangrenous amputated arm

The picture above is a sketch of Private Milton E. Wallen of Company C, 1st Kentucky Calvary, wounded by a Minié ball while in prison at Richmond, July 4, 1863.  He was being treated for gangrene in August 1863 when Edward Stauch traveled from Washington to make this sketch.   By USG [Public domain] via Wikimedia Commons.

 

Over 700,000 combined Union and Confederate soldiers perished in the 4 years of that war – more than in all other United States conflicts up to the Vietnam War, combined. More than two thirds of those succumbed to disease and surgical infection, not to direct battlefield trauma. Surgeons faced the formidable problem of treating the infections of wounds sustained during battle, and hospital gangrene was the worst.

British surgeons with experience during the Crimean War a decade earlier recommended patients should have at least 1600 cubic feet to themselves to prevent the spread of gangrene between patients. In some Union hospitals, the space per patient was only about 175 cubic feet, less than a six-foot cube, nearly 10 times less than the British recommendation. Attempts to improve ventilation for gangrene soldiers in such crowded conditions prompted surgeons to cut holes in ceilings or walls to draw the air through. This often backfired, allowing the microbes causing the gangrene to spread to patients in other areas of the hospital.

Many gangrene treatments were tried, including hand washing between patients, whiskey, cathartics, balanced diets, and topical agents applied directly to the gangrenous wound along with debridement, which was often too late or spread the infection. Experiments with poultices of mud, flaxseed, slippery elm, or charcoal were tried. Chlorinated soda water, extremely strong sodium hypochlorite solutions, nitric acid, tinctures of iodine and iron, and turpentine were applied, often in combination and often overpowering and painful and difficult to tolerate and usually without the desired effect of curing the infection or curing it but causing even more damage to healthy tissue.

Experiments in Treating Gangrene

When Goldsmith found himself surrounded by many hospital gangrene patients in Kentucky, he focused on the problem. He reviewed many of the documented outbreaks from early in the war and theorized that the three diseases of gangrene, erysipelas, and pyaemia were in some way connected, although his lack of knowledge of the “putrefactive agent” made his task very difficult. He reviewed the curative agents then in use and concluded that corrosive acids such as nitric acid stopped the gangrene but were also very destructive of living tissues and were impossible to administer safely. He also noted other topical remedies like poultices did not arrest the infection and the consumption of coffee and whiskey did nothing.

 

Picture of pages from Goldsmith's book discussing various treatments for gangrene

Discussion by Goldsmith of various treatments for gangrene (Click to enlarge)

 

Goldsmith noticed that in hospital wards where bromine was used as an aerosolized deodorant, gangrene patients seemed to recover more than in other wards. He recommended the placement of volatile bromine in all patient wards. He developed a method of applying bromine deep into muscular layers after wound debridement then injecting bromine subcutaneously and applying it topically to exposed surfaces. A second application was only applied in cases where the gangrene odor returned.

 

In an independent report of Goldsmith’s method by another surgeon, G. R. Weeks, it was noted that of 104 patients receiving a bromine-based treatment, there were only 3 deaths, which were due not to gangrene but to pyaemia and cellulitis after the gangrene was improved. Weeks concluded the treatment was 100% successful in preventing death in hospital gangrene patients while other treatment regiments averaged around 25% mortality. Patients recovering with other treatments averaged 15 days convalesce, those with weak bromine 9 days, and pure bromine only 2 days. Similar results were reported by other observers such as John H. Brinton, another high-ranking Union surgeon.

 Report to the Surgeon General

Picture of title page of Goldsmith's report

Title page of Goldsmith’s report on Hospital Gangrene

Goldsmith thoroughly documented his investigations in his report to the Surgeon General entitled A Report on Hospital Gangrene, Erysipelas and Pyaemia, as observed in the departments of the Ohio and the Cumberland, with cases appended. This 1863 report included colorfully detailed case reports and a foldout table containing all his research data, as well as his correspondence with other surgeons. The data collected included patient’s name, rank, company, regiment, when wounded, where and when gangrene began, tissues involved in the wound, region of wound, general treatment, local treatment, when infection arrested, duration of gangrene, and hospital. His precise data collection and reporting allowed him to claim near complete eradication of hospital gangrene from his wards.  Only 8 of his 304 patients receiving bromine-based therapy died, a mortality rate of 2.6 per cent. The overall mortality of hospital gangrene cases from the Civil War has been reported as 45.6 %. By the end of the war, surgeons applied variations of his bromine treatment throughout the country.

Case report of Wilbur F. Nichols, first patient treated with Bromine for gangrene

 

Picture of table from Goldsmith's book showing results of various treatments for gangrene

Condensed Table of Results of Various Gangrene Treatments (Click to enlarge)

 

Goldsmith died in 1888.  He greatest achievement was his contribution to surgical antisepsis and his revolutionary bromine therapy. His work predated Joseph Lister’s 1867 paper linking microbes and surgical infection and preventive measures.

Note: Most of the material in this article, other than illustrations, was summarized from John Trombold’s excellent article on Middleton Goldsmith’s research on gangrene therapy. (See sources below.)  Book illustrations were scanned from the Nixon Library’s copy of Goldsmith’s book.

Come view Goldsmith’s Report on Hospital Gangrene, Erysipelas and Pyaemia in the P. I. Nixon Medical Historical Library.

~Anne Comeaux

 

For more information on the P.I. Nixon Medical Historical Library or to schedule an appointment, contact Lisa Matye Finnie, Special Collections Librarian, at finnie@uthscsa.edu or 210-567-2406.

 

Sources:

John M. Trombold, M.D. “Gangrene Therapy and Antisepsis before Lister; Civil War Contributions of Middleton Goldsmith of Louisville. “ The American Surgeon, vol. 77:1138-43, September 2011.

Wikipedia contributors, “Gangrene,” Wikipedia, The Free Encyclopedia, http://en.wikipedia.org/w/index.php?title=Gangrene&oldid=611179702 (accessed June 23, 2014).

The Louis Lapicque Papers

 

Photograph of Louis Lapicque

Louis Lapicque, 1866-1952

The Archives of the P.I. Nixon Medical Historical Library houses a collection of professional papers, research notebooks, and personal manuscripts of renowned, early 20th- century French physiologist Louis Lapicque.

Born August 1, 1866, Louis Lapicque was a pioneer in the field of neural excitability. One of his main contributions was to propose the integrate-and-fire model of the neuron in an article published in 1907. This model is still one of the most popular models in computational neuroscience for both cellular and neural networks studies and in mathematical neuroscience. The Lapicque concepts of excitability and nerve transmission form a part of the basic framework of modern neurophysiology.

Louis Lapicque completed his doctorate at the Paris Medical School. He married Marcelle de Heredia, one his notable students, on May 14, 1902. Their only son, Charles Lapicque, was born Oct. 6, 1898, before their marriage. Marcelle completed her doctoral studies under Lapicque in 1903, concentrating on the nerve impulse. Charles trained as an engineer but later gave up engineering in 1940 to become a painter.

Lapicque and his wife worked closely together for nearly fifty years in the Sorbonne Laboratoire de Physiologie, publishing over 80 articles. They devoted their life work to the study of what they termed the chronaxie of the nerve – the nerve response over time under various physiological conditions. Louis held a professorship at the Museum d’Historie Naturelle and then at the Sorbonne. From the 1910’s to the late 1930’s, he was seen as the most important French physiologist of the time. Marcelle assisted him and was eventually named associate director of the laboratory.

 

Illustration of La Sorbonne from 1893.

La Sorbonne, 1893

Professor and Madame Lapicque attracted and trained a host of pupils from France and many other countries, such as the United States and Japan. They were excellent hosts and well-loved and respected by their pupils. Together they brought physiology in France to world recognition. Lapicque’s interests were broad, but in later years he concentrated principally upon problems of excitation. He was also interested in history and published many articles about his deceased colleagues.

Photograph of yacht from 1892

Louis Lapicque was an ardent yachtsman and an accomplished navigator. He and Marcelle sailed across the English Channel to attend conferences in their yacht, rightfully named the Axon. His experience later proved beneficial during the occupation of France by Germany during World War II. Lapicque was imprisoned by the Gestapo for helping the resistance. During his three months’ incarceration, he authored his final book entitled La Machine Nerveuse, which was published in 1943 and in which he credited his wife with 40 years of collaboration, in addition to her own important individual research.

Louis Lapicque died in Paris on December 6, 1952. Marcelle de Heredia Lapicque took over the directorship of the Sorbonne Laboratoire de Physiologie until her death in 1962.

Held in the P.I. Nixon Medical Historical Library’s Archives, the Louis Lapicque Papers contain original handwritten lab books, journals of travel, a ship log for Lapicque’s yacht, manuscripts for papers, journal reprints, bibliographies of the research work of Lapicque and Alexandre Marcel Monnier, obituaries and biographical articles written by Lapicque and Monnier, and correspondence with both Lapicque and Monnier. For a detailed description of this collection, see the Guide to the Louis Lapicque Papers.

Scan of page containing data and graph from Lab Notebook Experiences du Bresil, dated 1927.

Data and Graph from Lab Notebook: Experiences du Bresil, 1927

The P.I. Nixon Medical Historical Library’s Special Collections owns a copy of Notice Sur les Titres et Travaux Scientifiques de M. Louis Lapicque. This volume published in Paris includes the original 1908 edition, as well as the two subsequent supplements from 1919 and 1928, all bound together. Its bibliographic listings reveal Lapicque’s extensive and wide-ranging scientific interests.

To obtain more information or to access this collection in the Archives, contact Mellisa DeThorne, Special Collections Assistant, at 210-567-2470 or dethorne@uthscsa.edu.

Sources:

“Lapicque, Marcelle (de Heredia) (1873-ca. 1962).” The Biographical Dictionary of Women in Science, edited by Marilyn Bailey Ogilvie and Joy Harvey. New York: Routledge, 2000, Vol. 2: L-Z, pp. 745-746.

“Louis and Marcelle Lapicque.” For Better or For Worse? Collaborative Couples in the Sciences, edited by Annette Lykkness, et. al. New York: Springer Basel, 2012, pp 66-67.

“Louis Lapicque, 1866-1952.” J Neurophysiolog 16:97-100, 1953.

Illustration of La Sorbonne, 1893 is available under Licence Ouverte courtesy of La BIU Santé.

Photograph of Louis Lapicque courtesy of académie Nancy-Metz.

Photograph of Yacht, 1892 is in the public domain and retrievable from Wikipedia Commons.