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History of the Division of Medical Sciences Part 1

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History of the Division of Medical Sciences.

by Sami Khalaf Hamarneh.

_In The Museum of History and Technology_

_This paper traces, for the first time, the history of the Division of Medical Sciences in the Museum of History and Technology from its small beginnings as a section of materia medica in 1881 to its present broad scope. The original collection of a few hundred specimens of crude drugs which had been exhibited at the centennial exhibition of 1876 at Philadelphia, has now developed into the largest collection in the Western Hemisphere of historical objects related to the healing arts._

THE AUTHOR: _Sami Hamarneh is the curator of the Division of Medical Sciences in the Smithsonian Inst.i.tution's Museum of History and Technology._

By the early 1870's, leading figures from both the health professions and the general public had begun to realize the necessity for having the medical sciences represented in the Smithsonian Inst.i.tution. The impetus behind this new feeling resulted from the action of a distinguished American physician, philanthropist, and author, Joseph Meredith Toner (1825-1896), and came almost a decade before the integration of a new section concerned with research and the historical and educational aspects of the healing arts in the Smithsonian Inst.i.tution.

In 1872, Dr. Toner established the "Toner Lectures" to encourage efforts towards discovering new truths "for the advancement of medical science ... for the benefit of mankind." To finance these lectures, he provided a fund worth approximately $3,000 to be administered by a board of trustees consisting of the Secretary of the Smithsonian Inst.i.tution, the Surgeon General of the U.S. Navy, the Surgeon General of the U.S. Army (only in some years), and the president of the Medical Society of the District of Columbia. The interest from this fund was to compensate physicians and scholars who were to deliver "at least two annual memoirs or essays" based on original research on some branch of the medical sciences and containing information which had been verified "by experiments or observations."[1]

The Secretary of the Smithsonian Inst.i.tution agreed to have these lectures published by the Inst.i.tution in its Miscellaneous Collections.

The first lecture given by the a.s.sistant Surgeon of the U.S. Army, "On the Structure of Cancerous Tumors and the Mode in which Adjacent parts are Invaded," deserves credit even by current standards of scientific research.[2] Only 10 lectures were given between 1873 and 1890 (see bibliography), despite the recommendation for at least two every year.[3]

[Ill.u.s.tration: Figure 2.--DR. JOSEPH M. TONER, a leading physician in Was.h.i.+ngton, D.C., and founder of the "Toner Lectures" for the promotion and advancement of medical education and research. In 1873, Dr. Toner became president of the American Medical a.s.sociation and, in 1874, he became president of the American Public Health a.s.sociation. He was a physician to St. Joseph's Male Orphan Asylum and St. Ann's Infants'

Asylum in Was.h.i.+ngton, D.C. In addition, he was instrumental in establis.h.i.+ng Providence Hospital in the District of Columbia. He also provided a workable plan for the American Medical a.s.sociation's library in Was.h.i.+ngton, D.C. (1868-1871). Among his several publications are: _Contributions to the Annals of Medical Progress and Medical Education in the United States before and during the War of Independence_ (Was.h.i.+ngton: Government Printing Office, 1874) and _Medical Men of the Revolution_ (1876). In 1882, he donated his large library, consisting of 44,000 books and pamphlets on topics related mainly to medicine and history, to the Library of Congress. (_Photo courtesy of National Library of Medicine._)]

A more direct factor, which not only contributed to the establishment of a section on the healing arts, but also had a greater effect upon the Smithsonian Inst.i.tution than any other event since its founding, was the 1876 centennial exhibition in Philadelphia.

This magnificent international fair commemorated the hundredth anniversary of the adoption of the Declaration of Independence. The finest exhibits of 30 foreign countries and various States of the Union partic.i.p.ating in the fair were finally donated to the Smithsonian Inst.i.tution as the official depository of historical and archeological objects for this country. As a result, the Inst.i.tution's collections increased to an extent far beyond the capacity of the first Smithsonian building. This led to the erection of the National Museum, known for the last two decades and until date of publication as the Arts and Industries building, which was completed on March 4, 1881, and was used that evening for the inaugural reception of incoming President James A.

Garfield.

Section of Materia Medica (1881-1898)

Throughout the 19th century, the study of _materia medica_ (dealing with the nature and properties of drugs of various kinds and origins, their collection and mode of administration for the treatment of diseases, and the medicinal utilization of animal products) held an increasingly important place among the medical sciences. In the United States, as in other civilized countries, this topic was greatly emphasized in the curriculum of almost every school teaching the health professions.

Today, the subject matter contained in this branch of science is taught under the heading of several specialized fields, such as pharmacology, pharmacognosy, and drug a.n.a.lysis of various types. However, when the decision was made in 1881 to promote greater knowledge and interest in the healing arts by creating a section devoted to such pursuits in the U.S. National Museum, the t.i.tle of Section of Materia Medica was adopted. Added to this, was the fact that the bulk of the first collections received in the Section was a great variety of crude drugs, which const.i.tuted much of the material then taught in the academic courses of _materia medica_.

The new Section was included in the Department of Arts and Industries, then under the curators.h.i.+p of a.s.sistant Director G. Brown Goode. From its beginning and for two decades, however, the Section of Materia Medica was sponsored and supervised by the U.S. Navy in cooperation with the Smithsonian Inst.i.tution. For this reason, the Navy decided not to establish a similar bureau for a health museum as did the Army in starting the Medical Museum (of the Armed Forces Inst.i.tute of Pathology) in 1862 through the efforts of Dr. William Alexander Hammond. The Smithsonian did, however, provide a clerk to relieve the curator of much of the routine work. The Section's early vigorous activities were the result of the ingenuity of the first honorary curator, Dr. James Milton Flint (1838-1919), an a.s.sistant Surgeon of the U.S. Navy. From the establishment of the Section, in 1881, to 1912, Dr. Flint was curator during separate periods for a total of nearly 25 years. For three of his tenures (1881-1884; 1887-1891; 1895-1900), he was detailed to the Smithsonian Inst.i.tution by the Surgeon General of the U.S. Navy. During the interim periods, other naval doctors were detailed as curators.

Finally, in 1900, Dr. Flint retired from the Navy with the rank of Rear Admiral and volunteered to continue his services to the National Museum.

The proposal was gladly accepted and he continued as a curator until his retirement from the Smithsonian Inst.i.tution in 1912.

[Ill.u.s.tration: Figure 3.--REAR ADMIRAL JAMES M. FLINT, U.S. Navy surgeon and first honorary curator of the Section of Materia Medica. (_Photo courtesy of the Library of Congress._)]

The Section commenced with a wealth of material. After the close of the 1876 centennial exhibition, its _materia medica_ collection had been stored with the other collections in a warehouse, awaiting an appropriation by Congress for transfer and installation. This collection was gradually brought into the new National Museum after that building's completion in 1881. Many other _materia medica_ specimens were transferred from the Department of Agriculture. In addition to these large collections of crude drugs, generous contributions came from several prominent pharmaceutical firms such as Parke, Davis & Company of Detroit, Michigan; Wallace Brothers of Statesville, North Carolina; and Schieffelin and Company of New York City. These manufacturing houses are mentioned here because they and their agents abroad were the first to take interest and donate to the Section, complete a.s.sortments of contemporary remedial agents then in common use throughout the United States and Europe, besides many hundreds of "rare and curious drugs."

Thus, in spite of difficulties encountered from bringing several collections into the building at one time, the _materia medica_ exhibition got off to a good start.

It was Dr. Flint, the first curator, who stated in 1883 that remedial agents used by a nation or a community are as indicative of the degree of their cultural development and standard of living as is the nature of their food, the character of their dwellings, and their social and religious traditions. Therefore, he felt that collections of drugs and medical, surgical and pharmaceutical instruments and appliances should not be thought of or designed as instructive to the specialist only, but should also possess a general interest for the public. Because of these objectives, Dr. Flint added, this section was conceived as a departmental division for the collecting and exhibiting of objects related to medicine, surgery, pharmacology, hygiene, and all material related to the health field at large.[4]

During his first term of curators.h.i.+p (1881-1884), Dr. Flint devoted much of his time to sorting, examining, identifying, and cla.s.sifying the _materia medica_ specimens.[5] In 1881, he issued a memorandum of instructions to be followed by collectors of drugs and urged them to give detailed and accurate information regarding acquired specimens so that they might be "more than mere museum curiosities." In addition, in 1883, he prepared a brief manual of cla.s.sification of the _materia medica_ collection in the Museum as well as a useful, detailed catalog of informational labels of the individual objects on exhibition. The unpublished catalog is still the property of the Smithsonian Inst.i.tution Archives, Division of Medical Sciences' Library.

It was Dr. Flint's ambition to obtain a comprehensive, worldwide collection of all substances used as remedies. Then, in order to identify drugs from foreign countries, he tried to collect ill.u.s.trated works on medical botany and printed pharmacopoeias of all nations having them. He rightly defined an official pharmacopoeia as "a book containing directions for the identification and preparation of medicines prepared and issued with the sanction of a government or organized and authorized medical and pharmaceutical societies. Its purpose is to establish uniformity in the nomenclature of remedies and in the character and potency of the pharmaceutical preparations. It is enacted by legislation, and thus becomes binding on all who prepare drugs or sell them for medication." By soliciting the help of various American consuls and Navy officers abroad, about 16 such official pharmacopoeias were collected, making an almost complete international representation of all available, official, drug standards. With these sources of information, Dr. Flint compiled and arranged an international list of _materia medica_ specimens, indicating the authorized preparations of each. By so doing, the first curator of this Section took the initiative at least in proposing and, to some extent acting, on the preparation of an international pharmacopoeia of drugs used in existing authorized formularies giving "official synonyms, and tables showing the const.i.tuents and comparative strength of all preparations."[6] This undertaking is of special importance in the history of American pharmacy, since it was probably the first attempt of its kind in the United States.[7] In addition, colored plates and photographs of medicinal plants were collected, forming the nucleus of the Division's current collection of pictorial and photographic material related to the history of the health field.

Dr. Flint also put on exhibition 630 Chinese _materia medica_ specimens from the 1876 Philadelphia centennial. These had been collected originally by the Chinese Imperial Customs Commission for the centennial and were subsequently given to this country.

In 1881, the numbered objects in the Section's register amounted to 1,574 entries. In the following year, 1,590 more specimens were added, most of them drugs in their crude state. By the end of 1883, the total collection had reached 4,037, out of which 3,240 individual drugs in good condition were cla.s.sified and put on display. Of these, about 500 specimens with beautiful ill.u.s.trations of parts of their original plants had been mounted for exhibition. The drug exhibitions also included materials transferred from the Department of Agriculture in 1881, which originally had been brought from Central America and South America for the 1876 centennial exhibition, a variety of opium specimens from Turkey, and a number of rare drugs listed in the official formulary which were acquired from the Museum of Karachi in what was then India.

Dr. Flint commented in the _Smithsonian Annual Report_ for 1883 that the collection of cinchona barks was especially complete. It was comprised of specimens of nearly all the natural cinchona barks of South America and every known variety of the cultivated product from the British government plantations in India. In addition, there were specimens from Java, Ceylon, Mexico, and Jamaica. The Indian and Jamaican barks were accompanied by herbarium specimens of the leaf and flower (and, in some cases, the fruit) of each variety of tree from which the bark was obtained.[8]

In an attempt to protect specimens liable to attack by insects, a small piece of blotting paper moistened with chloroform was inserted underneath the stopper in each bottle. Later on, b.i.+.c.hloride of mercury was found to be a better insecticide.

These early collections of the Section were brought into admirable condition and received compliments for their organization and completeness. In the _Smithsonian Annual Report_ for 1883, the collections were praised as "superior to any other in the United States and scarcely excelled by any in Europe."

[Ill.u.s.tration: Figure 4.--DR. HENRY GUSTAV BEYER, the second honorary curator of the Section of Materia Medica (1884-1887). (_Photo courtesy of American Physiological Society._)]

In spite of the apparent emphasis on the displaying of drugs, the first curator of the Section had envisioned that the exhibits eventually would embrace the entire field of the healing arts. In the _Smithsonian Annual Report_ for 1883, Dr. Flint noted that "in the establishment of a museum designed to ill.u.s.trate man and his environment, it is proper that the materials and methods used for the prevention and cure of disease should have a place." However, his plans were temporarily interrupted when his first term as honorary curator ended in 1884.

On June 4, 1884, Dr. Henry Gustav Beyer was detailed by the Department of the Navy to become the second honorary curator of the Section of Materia Medica. As a young man, Dr. Beyer (1850-1918) had come from Saxony, Germany, to the United States and, in due course, became a naturalized citizen. He was graduated from the Bellevue Hospital Medical College of New York City in 1876.

Because of his interest in physiological experimental research, Dr.

Beyer enrolled at the Johns Hopkins University, where he was awarded a Ph. D. degree in 1887. Unlike his predecessor, Dr. Beyer was primarily interested in carrying on research on the physiological action of certain drugs and in pharmacology. This was evident from the original scientific papers mentioned in the _Smithsonian Annual Reports_ and published by him during the period of his curators.h.i.+p from 1884 to 1887.

Despite the pressure of his postgraduate studies at Johns Hopkins University, Dr. Beyer helped in arranging and cla.s.sifying the _materia medica_ collection without trying to extend materially the scope of the Section.

After the term of Dr. Beyer expired in 1887, Dr. Flint returned to take charge of the Section. Surprisingly, at this time, it seems that he showed less enthusiasm and devotion to the work of the Museum which he had previously served so well. It could have been a disappointment resulting from a lack of evidence of any real progress in the Section since he had left it three years before. Whatever the reasons may have been, the _Smithsonian Annual Reports_ show that only a few hundred specimens were added to the _materia medica_ collections between 1887 and 1890, bringing the total to 5,915 preserved in good condition.

Further curtailment of the Section's activities began in November 1891 when Dr. Flint was again transferred to other duties for the U.S. Navy.

From November 1891 to May 24, 1895, curators.h.i.+p of the Section was charged to five physicians of the U.S. Navy: Drs. John C. Boyd (from November 1891 to April 6, 1892); William S. Dixon (April 1892 to January 5, 1893); C. H. White (January 1893 to July 15, 1893); C. U. Gravatt (July 1893 to January 22, 1894); R. A. Marmion (January 22, 1894 to June 15, 1894); and to Medical Inspector Daniel McMurtrie (June 1894 to May 24, 1895). During this interim of nearly three and a half years, there were neither literary contributions nor additions made to the collections of the Section that were of any significance. The reason is obvious, for all of these curators averaged less than seven months of service which is not enough time, even for a well-trained individual, to accomplish very much in a museum. Therefore, it is easy to imagine that when the Secretary of the Navy detailed Dr. Flint for a third time to take charge of the Section, he was rather discouraged. Nevertheless, at the Cotton States and International Exposition in Atlanta, Georgia, from September 18 to December 31, 1895, the _materia medica_ was represented by two displays: one on mineral waters and amounts of solid const.i.tuents in pure state; and another showing the quant.i.ties of minerals after a.n.a.lysis of the composition of the human body.

A similar project was undertaken in 1897 at the Tennessee Centennial Exposition (May 1 to October 31) in Nashville, where there were two displays of _materia medica_. One showed several kinds of the cinchona barks and the medicinal preparations made from them, and another containing the commercial varieties of the alkaloids of opium.

At this time, Dr. Flint's attention turned to a new phase of medical exhibition. He felt the need for a program of exhibits on the practice and the historical development of the healing arts. A change of the Section's name was deemed necessary and, thus, in 1898 the more comprehensive t.i.tle of Division of Medicine was adopted.

Division of Medicine (1898-1939)

The statement by L. Emmett Holt of the Rockefeller Inst.i.tute for Medical Research, that before 1906, the Smithsonian Inst.i.tution was never a beneficiary to medicine in any form,[9] is not entirely applicable. The previous discussion has clearly shown that the U.S. National Museum's cooperation with the Navy contributed materially towards encouraging and promoting medical knowledge. Furthermore, Dr. Flint tried to bring many of his plans for this medical division of the Museum to a practical fulfillment. He devised a program for presenting medical history in a way which would be of interest both to the public and to the profession.

In order to best ill.u.s.trate the history of the healing art, he divided his subject matter into five provisional cla.s.sifications according to the _Report upon the Condition and Progress of the U.S. National Museum_ during 1898:

1. Magical medicine including exorcism, amulets, talismans, fetishes and incantation;

2. Psychical medicine including faith cures, and hypnotism;

3. Physical and external medicine including baths, exercise, electricity, ma.s.sage, surgery, cautery, and blood-letting;

4. Internal medicine including medications and treatment used by the ancient Egyptians, Greeks, Hindus, Arabians, and Chinese; and

5. Preventive medicine including beverages, food, soil, clothing and habitation.

It is certainly to Dr. Flint's credit that from its early conception, first as Section of Materia Medica and thereafter as Division of Medicine, he planned for an all-embracing exhibition and reference collection of the medical sciences. Until the end of the 19th century and the early years of the 20th century, crude drugs as well as primitive and magic medicine held a more prominent place than medical instruments in the exhibits and collections. In 1905, Flint issued his last, known, literary contribution, "Directions for Collecting Information and Objects Ill.u.s.trating the History of Medicine," in Part S of _Bulletin of the U.S. National Museum_, no. 39. The emphasis he put upon this shows Dr. Flint's interest in collecting medical and pharmaceutical objects and equipment of historical value. Consequently, he arranged new exhibits including one on American Indian medicine. A medical historian, Fielding H. Garrison, inspected these about 1910 and, in his "An Introduction to the History of Medicine," wrote of their novelty and appeal. "In the interesting exhibit of folk medicine in the National Museum at Was.h.i.+ngton," he commented, "a buckeye or horse chestnut (_Aesculus flavus_), an Irish potato, a rabbit's foot, a leather strap previously worn by a horse, and a carbon from an arc light are shown as sovereign charms against rheumatism. Other amulets in the Was.h.i.+ngton exhibit," he added, "are the patella of a sheep and a ring made out of a coffin nail (dug out of a graveyard) for cramps and epilepsy, a peony root to be carried in the pocket against insanity, and rare and precious stones for all and sundry diseases." It had been Dr.

Flint's intention, besides presenting an educational display on the history of the medical arts, to warn the public against the perils of quackery and the faults of folk medicine, as well as to expose evils in drug adulteration. Today, we can see actual fulfillment of these intentions in the present exhibit at the medical gallery which has been executed recently on the basis of scientific, historical research.

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