Guest Post: Wellcome Film added to the Medical Heritage Library

A collaboration among some of the world’s leading medical libraries, the Medical Heritage Library (MHL) promotes free and open access to quality historical resources in medicine. Our goal is to provide the means by which readers and scholars across a multitude of disciplines can examine the interrelated nature of medicine and society, both to inform contemporary medicine and strengthen understanding of the world in which we live.

The MHL is therefore delighted to announce the Wellcome Library as a new content contributor, with the news that Wellcome Film has been added to the MHL’s online content.

An online digital collection of moving images from the collections of the Wellcome Library, Wellcome Film chronicles the history of medicine over the last hundred years and has been freely available in Internet Archive since 2010. The content of Wellcome Film includes rare footage of Sir Henry Wellcome (1853-1936) filmed at the archaeological digs he funded in the Sudan in 1910s, alongside films exploring the development of medicine in the twentieth century, including specific surgical techniques and drug treatments.

As a content provider, the Wellcome Library becomes the latest historical institution to make its collections available through the MHL. The MHL was established in 2010, with funding from the Alfred P. Sloan Foundation via the Open Knowledge Commons, to digitize 30,000 rare medical books. Now, over two years later, nearly 40,000 books, videos, and audio recordings are freely available online, with content provided from many of the leading history of medicine libraries (a full list of our content providers is available on our website).

Author: Michael North, Head of Rare Books & Manuscripts, National Library of Medicine

Guest Post: Bathing with Sheeps' Heads: The Sick Child in Early Modern England

Dr Hannah Newton is a Wellcome Trust Fellow at the University of Cambridge. Here, she provides insights into the treatment and experience of childhood illness in the early modern period, and overturns three enduring myths about the history of childhood.

In the late-seventeenth century, the London gentlewoman, Katherine Jones, described how to make ‘A Good Bath…for Children that have the Rickets’. She instructed, ‘Take five sheeps heads and livers, bruise them and boyle them in water a whole day’. Next, add a handful of ‘Rosemary, Bays, Wormwood, Fatherfew, Smallage, Mallows, knotgrass and red fennel’. When these were ‘boyled enough…put it into the Bathing tub, and let the child stay in as long as it can Endure according as you think fit’. She warned, ‘When the child comes out of the Bath, put it to bed and have a great care it take no cold’.

I encountered this recipe whilst leafing through the fragile pages of Katherine Jones’ collection of culinary and medicinal recipes, now housed in the Wellcome Library, and available for digital download from the website. It sparked a series of questions in my mind. How might Katherine’s child have felt about taking a bath bobbing with the heads of dead sheep? Were children’s medicines the same as those of adults? How did young patients respond emotionally to illness and the prospect of death? What role did mothers and fathers play in the care of ill children? These questions are addressed in my new book, The Sick Child in Early Modern England, 1580-1720. At this time, the illness or death of a child was common – almost a third of the young died before reaching the age of fifteen – and yet historians have rarely touched upon this subject. Taking the perspectives of doctors, parents, and children themselves, my book investigates the perception, treatment, and experience of childhood illness in England between approximately 1580 and 1720. It exposes three myths in the history of early modern childhood, outlined below.

Myth 1: Children were miniature adults.

According to popular legend, there was no concept of ‘childhood’ in medieval or early modern societies. In old paintings, children resemble little adults, dressed in the style of their elders. This view, which has largely fallen out of favour amongst historians, has seeped into the history of medicine – it is assumed that before the late nineteenth century, children and adults were treated using identical medicines. However, an examination of medical texts, recipe collections, and doctors’ casebooks, sheds doubt on this notion. The medical author ‘J.S’, declared in 1664, ‘children are to be cur’d in a different manner in them then they are in other Ages’. Their bodies resembled ‘soft wax’ – they were weak, warm, and full of moisture. This unique physiology meant that ‘a special regard is to be had to the Methods and Medicines, for Children by reason of the weakness of their bodies, cannot undergo severe methods or strong Medicines’. Instead of using the usual remedies of the time – vomits, purges, and bloodletting – children were to be treated with milder medicines, such as topical ointments and baths, and non-evacuating internal medicines. Of the 482 medicines for children that were listed in the collections of manuscript culinary and medical recipes that I analysed in the Wellcome Library and British Library, less than 4 percent were for emetics and bloodletting, and only about 15 percent were for purges and enemas. Evacuative treatments were to be avoided because they were ‘unpleasing, ful of pain and molestation to Children’, stated the physician Francis Glisson in 1651. Of course, there were occasions when these treatments were used – older children were more likely to be given vomits and purges than infants, and when the child was gravely ill, practitioners were sometimes prepared to risk administering a more aggressive remedy on the grounds that it might save the child’s life. But on the whole, gentler treatments were preferred.

As well as giving children different treatments, doctors and laypeople thought it was necessary to ‘limit…the strength, quality and quantity of the medicine’ by adapting the treatments in various ways. Doses were lessened for children, and the more powerful ingredients were often omitted. Mary Poppins’ technique of ‘adding a spoonful of sugar’, was another common practice. Francis Glisson noted that he sought to make the medicine ‘grateful & pleasing to the sick Child, & such as trouble not its Pallate’. The recipe book of Anne Glyd suggests that a medicine for ‘chin cough’ should be put into ‘hon[e]y’ or ‘what ever the child likes best’. Doctors knew that ‘children will not take bitter things’, and therefore either left these ingredients out, or disguised them by putting them into the child’s normal food or drink. To persuade children to submit to treatment, bribery was sometimes used. John Yorke complained that his nephew James ‘is…so refractory [about] taking what is proper for him’, that ‘[it is] a hard taske to govern him’. Yorke had to ‘use all my perwasion’ to get the child ‘to take what the Dr order’d’. Eventually through promising him a copy of Robinson Crusoe, the child agreed to take the medicine.

Myth 2: Parents did not love their children in the past.

It is often suggested that high rates of death in the early modern period discouraged parents from investing too much affection in their children. Fathers in particular, have been depicted as unemotional, aloof figures at this time, who spent little time with their children, and rarely showed much grief at their deaths. Contemporary diaries and letters provide a very different picture. During illness, fathers and mothers tended their children with devoted care. In 1679, the Anglican clergyman Isaac Archer recorded that he ‘sate by’ his six-year-old daughter Frances with his arm around her, and ‘helpt it all night’, offering her words of comfort. Witnessing one’s child suffer pain, grow weak and pale, and eventually die, provoked the most painful passions imaginable in parents. In 1647, the Yorkshire gentleman Ralph Verney nursed his eight-year-old daughter Pegg, who was suffering from a cancerous ulcer. He told his uncle, Dr Denton, ‘Poore childe you doe not know what miserie she hath endured’: she was so weak she ‘she cannot turne her selfe in her Bed’. He concluded his letter, ‘oh Dr I am so full of affliction that I can say noe more but pray for us’. When death finally arrived, the grief of parents was often so intense that they found it difficult to express. When Ralph Verney’s wife Mary found out that Pegg had died, she told him, ‘I am nott able to say one word more but that at this time there is nott a sadder creature in the world than thine own Deare M’. It appears that both mothers and fathers loved their children with the same intensity that we expect from parents today.

Myth 3: It is impossible to access the child’s experience.

It is notoriously difficult to investigate the experience of childhood in the seventeenth century. Children rarely left written records. However, there is one context in which their voices do survive: illness. Acutely aware of the likelihood of death, parents recorded the thoughts, words, and actions of their sick children in detail. The resulting evidence provides rare and intimate insights into the lives and deaths of early modern children. At eight o’clock one October evening in 1625 when Grace Wallington was washing the dishes, her three-year-old daughter Elizabeth asked her, ‘What doe you heere?’ Later that night when she was in bed, she said to her father Nehemiah, ‘Father I goe abroode tomorrow and bye [buy] you a plomee pie’. The reason these everyday sentences were recorded by Elizabeth’s father was that, ‘These were the last words that I did heere my sweete child speeke’, for the next day, she died. Some forty years later, John Vernon recalled the words of his dying son, twelve-year-old Caleb: he had spoken of his pet bird, saying ‘I will give it to my Sister Betty, who hath none, for Nancy [another sister] hath one already’.

Although these accounts may have been edited and censored by their parents, they do nonetheless shed light on children’s preoccupations. Children’s words also reveal their feelings for their parents. In the 1670s, six-year-old Jason Whitrow took his mother ‘by the hand, and said, Mother, I shall dye, oh that you might dye with me, that we might both go to the Lord together’. Daughters’ feelings for their fathers could be similarly deep. Thomas Camm described how his eight-year-old daughter Sarah lay in his arms during her illness in 1682, and told him ‘Oh! my dear Father, thou hast been very tender and carefull over me, and hast taken great pains with me in my Sickness…we shall meet in Heaven’. Christian beliefs about heaven were a source of unquantifiable comfort to all family members. While children rarely left written records, some sources do survive. When I was reading a recipe book in the Wellcome Library, I came across something very exciting: a child’s picture. It shows a woman cooking, perhaps boiling herbs for a medicine. Virtually indistinguishable from a modern child’s drawing, it brings the past to life.

Images:
- Katherine Jones, Lady Ranelagh, Collection of medical receipts, c. 1675-1710, Wellcome Library, MS.1340, 114v.
- Collection of cookery and medical receipts: written mainly by two compilers, c.1685-c.1725, Wellcome Library, MS.1796, 125v.

The Sick Child in Early Modern England, 1580-1720 (OUP, 2012) is available now. More information on the Wellcome Library's digitised recipe manuscripts is available through the Wellcome Library website.

Author: Dr Hannah Newton

Lecture Announcement - Sustaining Plague Mortality in Late Medieval Milan

The Wellcome Library and the National Endowment for the Humanities 2012 Summer Seminar, ‘Health and Disease in the Middle Ages’, are delighted to announce details of a lecture by Ann G. Carmichael, M.D., Ph.D. (Associate Professor emerita, Indiana University, Bloomington, USA):

Sustaining Plague Mortality in Late Medieval Milan: Environmental Patterns and Non-Plague Causes of Death

3pm-4pm, 20th July 2012
Wellcome Collection Conference Centre
183 Euston Road
London
NW1 2BE

The lecture is free to attend. To reserve a space, please email Ross MacFarlane (r.macfarlane@wellcome.ac.uk)

Abstract: This talk will parse diagnoses of cause of death in Milan during the Sforza era, 1450-1524, using surviving urban mortality registers. With some lacunae, records that span three generations provide extraordinary detail for this time period. Diagnoses were recorded by the dukes’ Health Office, from oral and written reports made by physicians and surgeons in the metropolitan zone. Partial records survive from three severe plagues, from some epidemics of mixed plague and general crisis mortality, and from a few years of distinctively non-plague epidemic mortality. In all years, reporting diagnosticians were required to provide explanation for the death of every individual over age two years at death, if only to differentiate suspected cases of plague from non-suspect mortality. Every victim was further named and identified by parish, sector of the city, or other geographical locator. Often the physicians and surgeons offer far more detail than this minimum. From aggregate analysis of these records (a set of over 140,000 individual cases), the talk will explore questions that historians must now confront, now that we know late medieval plagues included deaths from Yersinia pestis. Plagues were multi-year crises, thus what human actions and environments helped to sustain plague mortality? What larger temporal and spatial patterns can we discern in the cases that these diagnosticians identified as plague deaths? What social and physical aspects of the natural and built environments were associated with higher plague mortality? In what ways did non-plague epidemics differ?

Image: From Fasciculus medicine, 1495 (EPB Incanabula 3.e.13 (SR))

Guest Post: Bad Vibrations: The History of the Idea of Music as a Cause of Disease

Dr James Kennaway is a Wellcome Trust Research Fellow at the Centre for the History of Medicine and Disease at Durham University. Here he describes the development of fears that music can make listeners ill.

Everyone has songs they can’t stand, and some of us are even tone deaf, but most people think of music as a very positive and healthy part of their lives. In the context of music therapy, it is even supposed to have medical benefits. However, my own research has revealed a darker side of music. For the last two hundred years many doctors, critics and writers have suggested that certain kinds of music have the power to cause neurosis, madness, hysteria and even death. My new book Bad Vibrations: The History of the Idea of Music as a Cause of Disease outlines the development of theories that music can be seriously bad for your health, drawing on many happy hours spent looking at the books and archives held at the Wellcome Library.

By the eighteenth century, music was increasingly regarded less as an expression of cosmic harmony and more as a form of nervous stimulation. And like other dangerous modern stimulants such as novels or coffee, music, it was believed, could be the root of a whole range of illnesses. The glass harmonica, which works on the same principle as rubbing a finger around a glass of water, and makes a similarly eerie sound, was regarded as especially dangerous. Its popularity was such that Mozart composed for the instrument, but the idea that the instrument caused dangerous tension in the nerves was commonplace. In 1786 the German composer and harmonica player Karl Leopold Röllig suggested it could ‘make women faint; send a dog into convulsions, make a sleeping girl wake screaming through a chord of the diminished seventh, and even cause the death of one very young’. There are accounts of the instrument being banned by physicians who cited possible ill effects including prolonged shaking of the nerves, tremors in the muscles, fainting, cramps, swelling, paralysis of the limbs’ and seeing ghosts.

The first serious medical panic about a specific composer’s work related to Richard Wagner. His patron King Ludwig II of Bavaria, who would later succumb to a peculiarly Wagnerian form of madness, drowning with his psychiatrist in mysterious circumstances, reportedly passed out during a performance. Even more dramatically, the first singer to perform the role of Tristan, Ludwig Schnorr von Carolsfeld, died in a Tristan delirium at the age of 29. Von Carolsfeld was not the only person to apparently ‘die’ of Tristan. Aloys Ander, who had played Tristan in the abortive Vienna production, died insane in 1865. Such was the atmosphere of elicit eroticism surrounding Wagner’s work that the French writer Léon Bloy suggested that Wagner’s innovative idea of turning off the lights in the theatre was in order to allow secret groping in the audience. The American psychologist Aldred Warthin at the University of Michigan claimed that he had been informed by colleagues of quasi-hypnotised listeners being brought to orgasm by the composer’s music, but reported that he could not replicate this result in his experiments. He did however suggest that such Wagnerian trances ‘may be attended by danger’. ‘The symptoms of collapse developed at times’, he wrote, and ‘the accompanying emotional shock, might be increased beyond the point of safety’.

Other observers suggested that the sexual power of Wagner’s music could be related to what was seen as the medical condition of homosexuality. The famous sexologist Richard von Krafft-Ebing, whose papers are held at the Wellcome Library, interviewed several men who said that listening to Wagner had made them homosexual. And in his 1907 book The Intersexes Xavier Mayne included a questionnaire in order for the reader to discover if he was ‘at all Uranian?’, a euphemism for homosexuality. Along with more obvious questions such as, ‘Do you feel at ease in the dress of the opposite sex?’, it asked, ‘Are you particularly fond of Wagner?’ Since it was widely believed that homosexuals, despite their innate musicality, were unable to whistle, it also asked, ‘Do you whistle well, and naturally like to do so?’

In general, however, the warnings about the effect of sexual excitement were generally aimed at women. As I learned from the Wellcome Library’s collection of old psychiatric and gynaecological textbooks, physicians argued that even piano lessons could have disastrous consequences for female health. In 1900 the doctor J. Herbert Dixon wrote that it could lead to ‘pronounced neurasthenia’ with symptoms such as ‘headaches, neuralgia, nervous twitchings, hysteria, melancholia and madness’. The consequences of modern musical over-stimulation for female fertility were a common topic of debate during the final decades of the nineteenth century. Some gynaecologists argued that musical stimulation could over-excite the female reproductive system, causing premature puberty and excessive menstruation. The Argentine psychiatrist José Ingegnerios described a case in 1907 that demonstrated, he believed, that female ‘morbid musical feeling’ peaked when the women concerned were menstruating. He also reported the case of a ‘melo-sexual’ young woman who achieved ‘complete sexual satisfaction’ from playing the piano, which had led to her ‘sexual neurasthenia’.

In the poisonous atmosphere of the Weimar Republic, anti-Semitism came to play an increasing role in attacks on ‘sick’ music. The Nazi takeover of power in 1933 was regarded by many critics of ‘degenerate music’ as the basis for a restoration of musical ‘health’ and liberation from the ‘bacillus of putrefaction’ of bad music. To this end, all foreign music sold in Germany had to be approved by the Reich Ministry for Propaganda. The combination of racism, reaction and misused psychiatry in music that had developed through the Weimar Republic and into the Nazi era reached a peak with the Degenerate Music exhibition in Düsseldorf in 1938. Musical ‘hygiene’ had become state policy, leading to thousands being silenced, exiled or murdered.

Race has played a major role in most medical panics about music since ragtime. Already in 1904, an American critic commented on the popularity of the argument that the ‘peculiar accent and syncopated time’ of ragtime could have a ‘disintegrating effect on nerve tissue and a similar result upon moral integrity’. The association of ragtime with nervousness was such that a whole sub-genre came into being, the ‘nervous rag’, including examples like Paul J. Know’s ‘Every Darkey has a Nervous Spell’ (a song about stealing chickens). When jazz hit the mainstream after the First World War there was a wave of anxiety about its effects on the body, sometimes involving the authorities on public health grounds. The Health Commissioner of Milwaukee, Dr George C. Ruhland opined that jazz excited ‘the nervous system until a veritable hysterical frenzy is reached. It is easy to see that such a frenzy is damaging to the nervous system and will undermine the health in no time’. The orchestra leader at Napa asylum near San Francisco stated that, ‘from my own knowledge that about fifty percent of our young boys and girls from the age 16 to 25 that land in the insane asylum theses days are jazz-crazy dope fiends and public dance hall patrons’.

After the Second World War, the influence of Pavlov’s concept of the conditioned reflex combined with an atmosphere of Cold War paranoia, led to a panic about the supposed ability of music to ‘brainwash’ listeners, causing mental illness and political trouble. The term "brainwashing" emerged during the Korean War, when it was feared that Communists had developed powerful forms of mind control. The CIA then promoted the term to explain the behaviour of American POWs and began its own research into such techniques, some of which used music. The prominent English psychiatrist William Sargant, whose papers are kept in the Wellcome Library, advanced a Pavlovian account of musical manipulations in his book Battle for the Mind, which portrayed rock ‘n’ roll as a dangerous threat to the mind. As I discovered from Sargant’s own copy of the magazine held at the Wellcome Library, he later argued in an interview in Newsweek that Patty Hearst had been turned from an heiress kidnap victim into a politically motivated armed robber by loud rock music.

In America right-wing evangelical Christians have used the idea of rock music as a sinister form of brainwashing to argue that it was literally a Communist plot. Author David Noebel argued that, ‘The Communist scientists and psycho-politicians have devised a method of combining music, hypnotism and Pavlovianism to nerve-jam the children of our nation without our leaders, teachers or parents being aware of its shocking implications’. ‘If [such] scientific programmes [were] not exposed,’ he warned, ‘degenerated Americans will indeed raise the Communist flag over their own nation’. He provided ingenious if paradoxical reasoning to explain why Communist states themselves banned rock music although it was their own sinister invention - it just showed that they know how dangerous it really was! Along with well-worn themes relating to sex and drugs, Noebel also brought to light a less common aspect of music’s dangers – the threat posed to plants. He reported an experiment conducted by Mrs Dorothy Retallack of Denver that demonstrated, he claimed, that avant-garde classical music made plants wilt and Led Zeppelin made them die.

The American anxiety about musical brainwashing that developed in the context of the Cold War in the 1950s was in part shifted onto another supposed worldwide conspiracy during the Reagan era - Satanism. During the 1980s and 1990s a full-scale moral panic swept the country, linking the pseudo-science of brainwashing, the literal belief in a supernatural satanic threat and the musical genre of heavy metal. A wide range of books with titles like The Devil’s Disciples, and (my personal favourite) Hit Rock’s Bottom accused certain bands of brainwashing innocent American teenagers with subliminal messages which turned them towards devil worship, sexual immorality, murder and suicide.

One apparent element of this diabolical plot was the use of so-called ‘Backmasking’, hidden messages in the music that only made sense to the conscious mind when played forwards, which, it was argued, could influence listeners subliminally and thus damaging their mental health. Bands like The Beatles popularised backmasking techniques pioneered by 1950s’ musique concrète composers, sparking conspiracy theories relating to what the messages really said. Self-proclaimed experts often disagreed about what dangerous message was hidden in the music, and exposed themselves to ridicule with their analysis of backmasking tracks. One well-known preacher in Ohio publicly burned a recording of the theme tune to the TV series Mr. Ed (which featured a talking horse) because he said it had ‘Someone sing this song for Satan’ backwards.

Just as the novel became more respectable as the cinema became the bugbear in the early twentieth century, and the cinema was replaced by the ‘video nasty’ in the 1980s only to be replaced in turn by the Internet, so each new musical medium has been viewed by many as especially ‘modern’, immoral and bad for the health. In the last couple of years a new medical/moral panic about the danger of sound has taken the place of backmasking in the public imagination: ‘i-dosing’. The Daily Mail was among the first to hype this potential new moral panic, with an article describing ‘the world of “i-Dosing”, the new craze sweeping the internet in which teenagers used so-called ‘digital drugs’ to change their brains in the same way as real-life narcotics’. I-dosing involves so-called binaural beats, a tone of slightly varying frequencies is played to each ear and the listener can perceive an extra low beat.

More real - and much more worrying - is the deployment of music and sound in warfare. Like waterboarding, the use of music to ‘break’ a prisoner leaves no visible scars that might cause an outrage if they were shown in the media. As early as May 2003 the BBC was reporting that the US army had played Metallica’s ‘Enter Sandman’ and Barney the Dinosaur’s ‘I Love You’ to ‘uncooperative’ detainees at high volume in shipping containers.  It seems that although almost all the panic about music’s effect on health over the past couple of centuries has been disproved, this more modern application of music may be seriously bad for the health after all.

This post is based on a radio programme (available online) based on Dr Kennaway's research.  For more on recurring fears about musical hypnosis and brainwashing, see James Kennaway, 'Musical Hypnosis: Sound and Selfhood from Mesmerism to Brainwashing', Social History of Medicine, (2012) 25(2): 271-289.   (PDF available through open access). Bad Vibrations: The History of the Idea of Music as a Cause of Disease is available now.

Images:
- Dandies at the opera, one of them swooning, overcome with emotion. Coloured etching by I.R. Cruikshank, 1818 (Wellcome Library no. 12030i)
- Richard von Krafft-Ebing. Photogravure. (Wellcome Library no. 13018i)
- William Walters Sargant, identity card, 1947 (PP/WWS/A.19)
- Pierre Schaeffer, early exponent of musique concrète (photograph in Wikimedia Commons)

Birth: a changing scene. Part I: Images of home birth in the Wellcome Library

Library Assistant Anna Ostrowska shares with us some of her research for her recent Wellcome Library Insight Session.

With current home birth rate in the UK standing at meagre 2.39%, it is easy to forget that less than a hundred years ago most British births took place at home. The figure was around 80% in the 1920s and dropped to 35% only in 1957, after hospital birth became both safe (sulpha drugs had proved effective against puerperal fever since the 1930s) and affordable.

The promotion of hospital birth as the only safe and reasonable option was confirmed by the Department of Health’s ‘Peel Report’ in 1970, which asserted:

“We consider that the resources of modern medicine should be available to all mothers and babies, and we think that sufficient facilities should be provided to allow for 100% hospital delivery. The greater safety of hospital confinement for mother and child justifies this objective.”

“The greater safety of hospital confinement” has not been supported by conclusive research and no-one asked the mothers where they would like to go into labour.

There is an abundance of representations of home birth in the Wellcome Library, both historical and contemporary, and among other things they tell the story of changing attitudes towards pregnancy and birth.

This image from Jakob Rueff’s De conceptu et generatione hominis…, published in 1554, is a typical sixteenth century lying-in scene with a bath and cradle. It depicts a ‘natural birth’: one given at home and normally in the company only of other women, traditionally seen as having special understanding of this female ‘mystery’. The women were mothers themselves and this experience legitimated their presence: having survived childbirth, they could provide both psychological and practical support to the woman in labour.

The female midwife orchestrated the ceremony with considerable authority. Let’s make no mistake about it, some of the midwives could be quite bossy! You can read a previous Wellcome Library blog post on one contemporary depiction of a triumphant midwife here.

That birth was indeed a women-only affair found its reflection in language. Until the seventeenth century no word existed to signify a male birth attendant and the modern word ‘obstetrician’ (first used in English in 1828) comes from the Latin word for a midwife, obstetrix. Perhaps not that surprisingly, when used as an adjective from the seventeenth century onwards, ’obstetrical’ was normally a metaphor pertaining to men ‘delivering’ ideas, texts or lectures.

The frontispiece of another sixteenth century book, edited by Walther Ryff, Frawen Rosengarten. Von vilfaltigen sorglichen Zufällen und gebrechen der Mütter und Kinder... also reinforces the perception of birth as women-only event. We can see a woman giving birth on a birth stool, assisted by the midwife, as well as another one lying in bed after delivery with a newborn baby on her side with curtains tucked back so we can see; in the front attendants are enjoying the meal; there is another child in a walker. On a closer inspection, this well-populated scene includes thirteen women, a newborn infant, four small children and no grown-up men. Interestingly enough, even today some midwives and mothers-to-be opt for removal of all men from the birth chamber.

Hard work as it was, attending birth included elements of leisure too: the English word ‘gossip’ comes from ‘godsiblings’ or ‘god-parents’, originally signifying female friends and relatives invited to help a woman in labour. The beautiful delicate watercolour by an unidentified seventeenth century Netherlandish painter, possibly a woman, A kraamkamer (birth-room), shows one of the women handing round sweetmeats to gossips, a custom which still exists in the Netherlands to mark the baptism of a baby. Today the sweetmeats are ‘beschuit met muisjes’ (rusk with mousse, the mousse being aniseed with a sweet coating - pink for a girl and blue for a boy).

Despite apparent total feminisation, our holdings show that the birth scene was not always men-free. This eighteenth century French etching shows a Breton woman relaxing after giving birth, with her husband present among female gossips.

A husband attending birth could even prove useful, such in this engraving where he holds his wife in a position on an obstetrical stool, with a midwife awaiting the appearance of a newborn and another female attendant dressing the first baby.

A similar formation is pictured in this oil painting, probably by a French painter from the beginning of the nineteenth century, currently on display in Wellcome Collection's Medicine Man gallery. In this case the rendition is both much more visceral (note the graphic depiction of the mother’s genitals and blood) and more allegorical (the maid is possibly a personification of Hygiene).

However, aside from husbands, male medical practitioners - as early as the second century AD - attended births. Unlike female midwives, whose job was to assist ‘nature taking its course’, they were present only at complicated births, especially when the child didn’t present head-first. A surgeon could perform a Caesarian section after a mother's death or to remove a dead foetus, while physicians prescribed medicines.  Male practitioners were thus associated with death or difficulty at births.

This perception changed with the onset of the ‘obstetric revolution’ in the seventeenth century and the appearance of the unseemly figure of the man-midwife.

Author: Anna Ostrowska

Images:
- Jakob Rueff, De conceptu et generatione hominis, 1554 (Wellcome Library, EPB / B 5611/B)
- Walther Ryff, Frawen Rosengarten. Von vilfaltigen sorglichen Zufällen und gebrechen der Mütter und Kinder, so inen vor, inn, unnd nach der Geburt begegnen mögenn. Dabei auch aller Bericht der Pflege unnd Wartung, Frawen, Jungfrawen, und Kindern dienlich und von nöten. New ann Tag geben, 1545 (Wellcome Library, EPB / D, 7099/D)
- A kraamkamer (birth-room), 16-- (Wellcome Library no. 44688i)
- A Breton woman relaxing in a cupboard-bed after giving birth, she is surrounded by a group of Breton women and her husband. Etching, 17-- (Wellcome Library no. 17353i)
- A seated Greek woman on an obstetrical stool being held in position by her husband whilst giving birth aided by a midwife, another attendant dresses the first baby. Line engraving by A. Tardieu after N. Maréchal (Wellcome Library no. 16911i)
- A mother giving birth to a baby. Oil painting, 1800 (Wellcome Library no. 44694i)

Guest Post: Little Ilford School ‘Science Club’

In our latest posting from the Science Club, Rebekah and friends report on a day in the Wellcome exploring X-rays:

'On Wednesday 18 April we accompanied some of the year nine students on a trip to the Wellcome Collection.  We were led to the Wellcome Library and directed to a room with a double glass door and into a place which blocked out the environment of the library and enclosed us in peace and serenity.

We had the opportunity to look at artefacts and archives which the public did not have access to.  The artefacts were handled carefully and we got a chance to analyse them and see them in detail.

Our individual research was about the history of X-rays.  We got a chance to look at German physicist Wilhelm Conrad Röntgen's life and the first X-ray, which was created by him.

On 8 November 1895, he was believed to be experimenting with Crooke’s vacuum tube equipment.  When the cathode ray beam he generated hit the interior wall of the vacuum tube, he noticed an image on a screen nearby.  The rays generated by the tube could penetrate many kinds of matter.

After he had discovered this Röntgen took the first X-ray. The hand in the X-ray belonged to Anna Bertha, his wife. The X-ray clearly showed the bones in her hand, and the black blob on the fourth finger is a gold ring which absorbs the X-ray. Some believe it’s her wedding ring.

The photograph was then shown to the general public. Röntgen named his invention X-radiation, now known as the X-ray.  It was later reported that his wife was not very impressed with the photography.

Röntgen’s findings became the beginning of a revolutionary change in our understanding of human anatomy.  His invention of the X-ray was a huge step forward in the history of medicine.  Inner parts of the body can now be made visible without the need to cut flesh open.

We would like to thank the women who took the time to educate us on the history of medicine.' [You’re welcome]

Posted on behalf of Rebekah and friends

Image: Print from early radiograph (X-ray photograph), possibly showing the hand of Röntgen's wife, 22 December 1895 (Wellcome Library no. 32971i)

Guest Post: Little Ilford School ‘Science Club’

In the second post from our Year 9 friends at Little Ilford School, here are Edward and Farzana reflecting on their visit and the four humours: 

'During the 17th century medicine was still handicapped by wrong ideas about the human body. Most doctors thought that there were four fluids or 'humours' in the body, blood, phlegm, yellow bile and black bile, which had to stay in balance for a person to stay healthy or become healed from their illness. 

These four humours all had a different meaning that relates to illness.  For example, blood was created in the liver, and was warm and moist, but black bile (from the gall bladder) was cold and dry. Blood could be extracted to try to balance the four fluids.

Each humour was also like a different emotion: sanguine (blood) means pleasure-seeking, sociable, amorous; choleric (yellow bile) means ambitious, leader-like, bad-tempered; melancholic (black bile) means introverted, thoughtful, sleepless; and lastly phlegmatic (phlegm) means relaxed, quiet, unemotional.

Our reaction to learning about the four humours was shock - since technology and our knowledge of the human body has developed over the centuries, we have learnt about how illnesses are caused.  We found it shocking but fascinating because we didn’t think that in the olden times people thought illnesses were caused by their bodies’ fluids not being in balance.  We thought that people in the past thought God was punishing them for their sins and evil they had committed.

We also learnt about how the Wellcome Trust was founded and how it came to be. There was a man called Henry Wellcome who loved to collect artefacts, so he went around the world to find as many artefacts as he could and he ended finding so many and building massive collections.  He then set up a museum for his artefacts.

But not only was it a museum, it also funded people to learn about the body, and people who were funded by the Wellcome Trust made massive breakthroughs in research on the human body.  It has helped people around the world.'

Posted on behalf of Edward and Farzana

Images: Drawing of Sir Henry Solomon Wellcome by F. Reynolds, 1901 (Wellcome Library no. 95891)

An ill man being bled by his doctor, 1804 (Wellcome Library no. 12046i)

Damaging the Body: Changing Models of Alcohol Harm

The second seminar in the series Damaging the Body: Physical Harm and the Self, 1850 - 2010, will take place in the Wellcome Library this Friday evening.  Details:

Friday 20 April, 6pm

Dr James Nicholls (Bath Spa University)

It All Adds Up: Changing Models of Alcohol Harm

Abstract: 
A few weeks ago the Coalition announced its intention to follow Scotland and introduce minimum unit pricing for alcohol in England and Wales.  Minimum pricing is the latest development in state efforts to reduce alcohol harm that go back centuries.  Taking a long historical perspective, this paper will look at how government policies on drink have reflected changing ideas about the nature of alcohol, and how these ideas relate to wider notions of risk, freedom and physical wellbeing.


The seminar will take place in the Wellcome Library, 2nd floor, 183 Euston Road, NW1 2BE. Please deposit bags and coats in the ground floor cloakroom and meet in the 2nd floor foyer. Doors at 6pm prompt, the seminars will start by 6.15.

The Damaging the Body seminars have been organised by the UCL Centre for the History of Psychological Disciplines in conjunction with the University of the West of England. The aim of the seminars is to provoke interdisciplinary discussion of the ways in which the creation of more diverse histories of bodily damage in the nineteenth century and beyond might open up wider concerns. 

Image: A drunken woman standing in the street in St Giles's, London. Coloured etching by T.L. Busby, ca. 1826 (Wellcome Library no. 726192i).

Wellcome Library Masterclass: Interpreting Caricature

At this new Wellcome Library event, attendees will be introduced to items from our collections, interpreted by acknowledged experts.

On the 27th April (2.30pm-4pm), our speakers will select a number of works from the Wellcome Library's collections on the theme of Medicine and Caricature, and unpick the meanings and details contained within these artworks. The session will also include a discussion of the selected items with attendees.

The event will be of particular interest to those with a strong research interest in the History of Art, History of Medicine or Visual Culture.

Speakers:

Prof Ludmilla Jordanova, Professor of Modern History, Kings College London

William Schupbach, Iconographic Collections Librarian, Wellcome Library

The session is free, but pre-registration is essential and numbers are limited to 15. Please email Tracy Tillotson (t.tillotson@wellcome.ac.uk) to book a place.

Image: Burdett, Peel, O'Connell and Wellington in the roles of the body-snatchers Burke and Hare, suffocating John Bull with a rope; representing the extinguishing by Wellington and Peel of the constitution of 1688 by Catholic Emancipation. Coloured etching by A. Sharpshooter, 1829 (Wellcome Library no. 663317i).

New seminar series: Damaging the Body

We are pleased to announce the details of a new academic seminar series, Damaging the Body: Physical Harm and the Self, 1850 - 2010, to be held at the Wellcome Library and organised by the UCL Centre for the History of Psychological Disciplines in conjunction with the University of the West of England.

The aim of the seminars is to provoke interdisciplinary discussion of the ways in which the creation of more diverse histories of bodily damage in the nineteenth century and beyond might open up wider concerns.

Details:
Friday 23 March, 6pm
Åsa Jansson (Queen Mary, University of London)
Melancholia and 'Suicidal Propensities' in Victorian Medicine: Statistics, Diagnostics, and Classification

Friday 20 April, 6pm
Dr James Nicholls (Bath Spa University)
It All Adds Up: Changing Models of Alcohol Harm

Wednesday 2 May, 6pm
Dr Katherine Watson (Oxford Brookes University)
Loss of Face: Vitriol Throwing in Nineteenth- and Twentieth-Century Britain

All seminars will take place in the Wellcome Library, 2nd floor, 183 Euston Road, NW1 2BE. Please deposit bags and coats in the ground floor cloakroom and meet in the 2nd floor foyer. Doors at 6pm prompt, seminars will start by 6.15.

Image: A woman diagnosed as suffering from melancholia with fear, or fear of everything, and with a propensity to attempt suicide. Lithograph, 1892, after a drawing made for Sir Alexander Morison (Wellcome Library no. 38637i).

Saving Oxford's Medicine

Launched last year, Saving Oxford Medicine is an initiative from our friends at the Bodleian Library to survey, catalogue and promote the archives of past and present members of the Medical Sciences Division of Oxford University. You can check out the project blog here. 

We have been very excited to read about what the project team is working on. The inter-connectedness of our interests and our collections is immediately apparent - ranging from  penicillin research (see the Abraham papers at the Bodleian and the Chain and Heatley papers at the Wellcome) to the life and work of the pharmacologist and physiologist Edith Bülbring (see here for papers at the Bodleian and here for those at the Wellcome).

Supported by the Wellcome Trust’s Research Resources in Medical History grants scheme, a major project to open up the papers of the geneticist Sir Walter Bodmer is now also well underway. We are looking forward to hearing more about this, and other fabulous Oxford medical collections, in the future. 

Image: Bodleian Library, Oxford: bird's eye view with key and coat of arms. Line engraving (Wellcome Library no. 21002i). 

Author: Jenny Haynes

Online resource: Journal of the American Medical Association – all back issues now available

The Library is delighted to announce that we recently purchased access to the complete back files of the Journal of the American Medical Association (JAMA), right back to the first issue.

Published continuously since July 1883, JAMA is an international, peer-reviewed journal - the most widely circulated medical journal in the world. Its main aim is to promote the science and art of medicine, and the betterment of public health.

The journal has published a number of landmark studies, such as 'The Etiology of Yellow Fever' (16 Feb 1901); 'The Etiology of Scarlet Fever' (Jan 26 1924); 'The Treatment of Meningococcic Meningitis with Sulfanilamide' (24 April 1937) and 'Live, Orally Given Poliovirus Vaccine' (6 Aug 1960) [1]

The Wellcome Library also subscribes to the current issues of JAMA, so our coverage is complete from 1883 to the present day. Our registered readers can therefore now access the journal from both within and outside the Library.  More details on this resource - and others Wellcome Library readers have remote access to - are available on our website.

[1] A selection of key papers from JAMA - with commentaries from later practitioners - is Harriet S. Meyer, George D. Lundberg (eds). Fifty-one landmark articles in medicine : the JAMA centennial series (Chicago, 1985)

Author: Aileen Cook

Image: Cover of JAMA The Journal of the American Medical Association, Vol. 193, No.6, August 9, 1965 (from Osler's Web, John P. McGovern Historical Collections and Research Center, Houston Academy of Medicine)

Item of the Month, January 2012: Everard Digby's De Arte Natandi

As the Olympic Games move ever nearer and as swimming is a sport for which Team GB has high hopes of medal success, we've dived into our collections and pulled from their depths one of the most influential works on swimming ever written.

Published in 1587, De Arte Natandi ("The Art of Swimming") is the first swimming treatise published by someone from these islands.

It was written by Everard Digby, a Cambridge Don more noted by his contemporaries for a number of theological works.

De Arte Natandi is a tremendously important book in the history of swimming.  Albeit a short work, the first half of the book covers the theory of swimming; the second half, techniques.  Aided by over 40 woodcuts, listed are over forty different strokes and manoeuvres described "more methodically than anyone else had ever done" [1]. 

The work is alive to the dangers of swimming outdoors: Digby makes careful note of the safest methods of entering rivers, warning against jumping in feet first (particularly if the water has a muddy bottom to which your feet would stick) and advocating a slow and patient entry.  Swimmers are also advised to have a companion with them, to help if they get into difficulties.  Digby also advises on the different kinds of water that can be swum in, advising against swimming in murky ponds (in which animals may have been washed).
 
Digby sees swimming as something natural to humans, arguing that man excels in the water over all the other beasts (and so fits with the prevailing view that man's place was at the head of the great chain of being).  Digby doesn't discuss group swimming nor racing and rather sees swimming as a rather solitary exercise.  With this focus - and particularly with its depiction of swimming in rivers - one can perhaps see Digby as a forerunner of the late writer and wild swimmer Roger Deakin (author of Waterlog: A Swimmer's Journey Through Britain).
 
Through highlighting the dangers of entering the water, Digby's book is particularly relevant in light of recent research into the large number of deaths from drowning in Tudor England (as explored in recent article in BBC History Magazine [2]).  In some ways, De Arte Natandi is as much safety manual as exercise guide.
 
It has been argued that Digby saw himself with De Arte Natandi writing a canonical work: perhaps seeing himself as the Hippocrates or Galen of swimming.  Digby's work greatly influenced what's seen as the two most important English and French titles on swimming in the 17th Century, so much so that the author of Digby's Dictionary of National Biography entry claims that he "may be said to have influenced the understanding and teaching of swimming for the next 200 years".
 
So, when July rolls around and we ready ourselves to cheer Rebecca Adlington and co diving into the uniform and clear waters of the Olympic Aquatics Centre, remember De Arte Natandi and spare a thought for Everard Digby carefully stepping into the rivers of Tudor England and performing some of the  manoeuvres illustrated in this book.

All the illustrations from De Arte Natandi are available on Wellcome Images.  Search for the work here or click on the thumbnails from its record in the Wellcome Library catalogue.

[1] Nicholas Orme, Early British swimming, 55 BC-AD 1719: with the first swimming treatise in English, 1595 (University of Exeter, 1983)

[2] Steven Gunn and Tomasz Gromelski, 'Drowning in Tudor England', BBC History Magazine, Christmas 2011, pp47-49

The discovery of insulin

Today marks the 90th anniversary of the first time insulin was used on a human patient.

A brief summary of this event runs as follows: the insulin was injected into a 14-year old diabetic, Leonard Thompson, at Toronto General Hospital. Insulin had been discovered in 1921 at the University of Toronto by Canadian doctor Frederick Banting and American biomedical scientist Charles Best. Thompson's condition had worsened in late 1921 and when he was admitted to hospital he weighed only 65 pounds. With the risk of him slipping into a diabetic coma, Thompson's father let the hospital try the new pancreatic extract for the first time.

As a biography of Thompson on the Science Museum's Brought to Life website notes:

"The extract was an impure form of insulin. Thompson had an allergic reaction, and it had little effect.

A few days later Thompson was injected with a purer form of insulin. This was extracted by the chemist James Collip. Thompson’s blood sugars gradually returned to normal and his diabetic symptoms began to disappear. News of Thompson’s recovery spread, inspiring people with diabetes and their families to write letters to Banting and Best asking for urgent treatment".

So, a medical breakthrough: treatment for diabetes was revolutionised and a terminal disease became treatable. Banting received the Nobel Prize in Medicine in 1923 and as a result of these developments, the lives of millions were changed for the better.

What this quick summary skates over, however, were the politics and powerplays that went on behind the scenes, with disagreements over who could claim success for the development of insulin. What role was played by Prof John Macleod, Professor of Physiology at the University of Toronto, who granted Banting a laboratory at the University to conduct his research (it was with MacLeod, not Best, that Banting shared his Nobel Prize)? And what of Collip, who purified the insulin?

The most detailed account of these discoveries is The discovery of insulin by Michael Bliss (2007 ed), but the Wellcome Library also holds a file of papers which casts an interesting light on these debates.

This comes in the form of copies of letters passed on to the Wellcome Library in 1959 by Sir Henry Dale - Chairman of the Wellcome Trust and also one of the most respected scientists of his time. The letters include accounts of the discovery of insulin by both Banting and MacLeod and illustrate their divergent views. The file also includes a summary of its contents written by Dale himself, offering his own perspective on events.

Leaving aside the actual details of these letters, we'd merely like to flag up this file as an example of how medical breakthroughs have rarely been the result of the efforts of one lone scientist, and that disagreements over recognition by both public and peers can cloud the achievements of scientists.

It's also noteworthy that the papers, whilst focusing on the discovery of insulin and setting out the achievements of Banting, MacLeod, Collip and Best, make very little mention of the use of insulin to treat Leonard Thompson.

Image: Leonard Thompson, from the site 'The Discovery and Early Development of Insulin' from Digital Collections of the University of Toronto

Guest Post: Exploring Health and Medicine in Early Modern Wales

Dr Alun Withey is an academic historian of early modern medicine, technology and the family. Here, he describes the inspiration and contexts of his new book, Physick and the Family: Health, Medicine and Care in Wales, 1600-1750, which includes research carried out in the Wellcome Library.

I never set out to be a medical historian. Whilst studying for my History BA, I was struggling to find a topic for my dissertation. I knew I wanted to do something connected to Wales and the seventeenth century, and settled upon the Civil Wars. I visited a local record office, and was introduced to a source that nobody had done much work on…a commonplace book. Amongst the notes and jottings were several medical remedies that looked interesting to the untrained eye. My curiosity was piqued and I decided to look into it further. Seven years, and a PhD later, I’m still looking!

Welsh medical history, at least in terms of the early modern period, has often been overlooked. In 1975, the editor of a collection of essays on the subject concluded that there were problems caused by a lack of medical sources for Wales. Such work that had been done tended to concentrate on the folkloric and magical elements of medicine in Wales, doubtless an important element of Welsh heritage, with the legendary ‘Physicians of Myddfai’ and their remedies garnering a lot of attention. The problem with ‘folklore’, however, is that it is a loaded term; Although magical remedies, symbolism and the ‘cunning man’ were important components, I felt that they also somehow contributed to a rural caricature, and made Wales seem remote, cut off from the wider world by its language and sometimes awkward terrain.

Physick and the Family, the first academic monograph on early modern Welsh medical history, set out to give what I see as the other side to the story of Welsh medicine. In doing so I not only wanted to write a new medical history of Wales, but also to use Wales as a test-bed to address much broader questions in medical history. In this sense, a new study wouldn’t just fill in gaps, but could provide a credible new investigation of the experience of sickness, health and care in the early modern period.

In many ways, the sources, dictated what questions could be addressed and answered. Contradicting the earlier view about Welsh sources, it soon became clear that there was actually a wealth of source material – much of it untapped. The book draws upon Welsh remedy collections, of which a good number survive – one especially rich example surviving in the Wellcome Library, known as the ‘Welsh Leech Book’ (MS.417). A study of the types and derivations of Welsh recipes proved insightful into the movement of medical knowledge both into, and within, early modern Wales, and not least in changing medical terminologies in the Welsh language. Diaries and letters yielded much useful information about sickness, the ways in which people described their symptoms, and also important factors such as the social rituals and conventions of sickness and the sufferer.

But the book also uses different types of source material, and it was often this that yielded the most interesting and surprising results. A detailed study of probate inventories, for example, looked at evidence for medical paraphernalia in the early modern home, but also for evidence, in shop inventories, of medicines for sale. From studies of shop inventories in three Welsh counties, it is clear that even small, remote village shops often sold a range of medical goods.

Other records such as those of the Old Poor Law were revealing in matters of care. Who, for example, cared for the sick, and what measures did the parish take to look after its own sick poor? The survival of some astonishingly detailed poor law records for one particular Welsh parish, allows for a detailed case study of the often sophisticated structures of care available to the early modern patient.

The book is intended to have a broad appeal, and not just to those inside the Welsh borders. It has been written to speak to anyone with an interest in medical history certainly, but also in social history more widely, since it is at heart a book about the experiences of ‘ordinary’ people. But as a regional history, it also encourages a more nuanced view of the early modern medical world, and one that takes into account the often important variations that could be caused by topography and geography, as well as language and literacy.

I said earlier that this was the first book of its kind; technically it is. But it is also worth mentioning a hidden gem in the Wellcome Library archive. In the 1920s an eminent physician, Dr David Fraser-Harris, was busy compiling his ‘History and Lore of Kymric Medicine’ – a richly detailed study of Welsh medical history and one in many ways far ahead of its time. Sadly, he died before it was completed and it now survives only in many boxes and unfinished drafts. In seeking to say something new about Welsh medicine we obviously shared a similar goal. I hope that he would have approved of my modest efforts some 90 years later.

Author: Alun Withey