Topics in the News
The American Medical Association Reorganizes
In 1846 and 1847 physicians held meetings in New York City and Philadelphia to discuss the creation of a national medical association. The new organization, the American Medical Association (AMA), held its first meeting on 2 May 1848 in Baltimore. Yet despite more than fifty years of existence the AMA remained a weak organization in 1900, reflecting the medical profession's lack of institutional control over itself. The AMA's strength lay in the East and Midwest, but its complicated method of granting membership based on attendance at annual meetings severely limited the organization's base and its prospects for expansion. Only a small percentage of eligible physicians bothered to attend meetings and thus join the AMA. The group did publish a prominent weekly journal, but not even all AMA members subscribed. Internal problems kept the AMA from effectively addressing important professional issues raised by poor medical education, competing health philosophies, and increasing specialization among physicians.
At the June 1900 annual meeting in Atlantic City the AMA initiated its self-reform movement. A committee that became the Committee on Organization was formed and included a prominent member from each state. At this same meeting the group also created the Special Committee on...
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Diversity in the Medical Profession: African American Physicians
The first black physician in the United States is generally considered to be James Derham, who was born a slave in Philadelphia in 1762. Derham learned medicine under his owner, prominent physician Dr. James Kearsley Jr. At the close of the Revolutionary War Derham was sold to Dr. Robert Dove of New Orleans and continued his apprenticeship. Derham apparently developed a lucrative practice in that city. In 1837 James Smith became the first black American physician to obtain a medical degree, which he received from the University of Glasgow in Scotland. Ten years later David Smith became the first black U.S. medical school graduate when he finished at Rush Medical College in Chicago. Until the end of the Civil War most blacks in the United States were slaves. However, several hundred thousand, mostly in the northeastern states, were free and could obtain an education. Thus, several black males obtained medical degrees in the United States before the war. In 1864 Rebecca Lee became the first black female to receive such a degree when she graduated from the New England Female Medical College (now Boston University School of Medicine).
After 1865 several for-profit and religious medical schools were opened to serve the former slaves from the South. The earliest of these institutions was Howard...
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Diversity in the Medical Profession: Women Physicians
In 1900 more than seven thousand female physicians were practicing in the United States. More than one hundred of these doctors were African Americans. These women comprised about 5 percent of all doctors, and that percentage remained steady until increases began in the 1960s. Elizabeth Blackwell, the first woman in the United States to receive a medical degree, began her studies at Geneva Medical College in upstate New York in October 1847. Her admission had been a fluke. The college faculty opposed the idea and put it to a vote of the students on the assumption they would agree. The students considered the matter a joke, and all voted for her. Two years later Blackwell graduated at the top of her class. Blackwell's younger sister Emily was not so lucky: she had to apply to eleven schools before Rush Medical College in Chicago admitted her in 1852. In the meantime, the Woman's Medical College of Pennsylvania had opened in Philadelphia in October 1850 and graduated its first class of eight women in December 1851, even though male medical students in the city attempted to disrupt the ceremony. Before the end of the century nineteen medical colleges for women were founded.
Social Context.In the mid nineteenth century most male physicians were opposed to the medical education of females. Women were considered temperamentally and...
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Hookworm in the South
The Southern Disease.
Hookworm is an aggressive intestinal parasite that causes physical and mental under-development and other symptoms such as dry hair, ulcered shins and feet, protruding shoulder blades and stomachs, and a general lack of energy. The hookworm contaminates soil through unsanitary privies or out-houses; primarily, victims become infected by walking through larvae-rich soil in bare feet. The disease was common in the rural American South after the Civil War. This "germ of laziness" or "ground itch" created a southern stereotype: poor, barefoot, lazy, deformed, and mentally deficient.
First Known American Cases.
The parasite was first identified in Europe in the mid 1800s. A few American physicians suspected its presence in the United States as well, but the first confirmed case was not reported until Philadelphia physician Abe Blickhalm published an account in 1893. Other cases from Richmond and New Orleans soon appeared, and in 1901 Dr. Allen J. Smith diagnosed a sailor in Galveston, Texas. Smith believed this hookworm was a different species from the European parasite.
One man, Dr. Charles Wardell Stiles, was primarily responsible for identifying the American hookworm and alerting the nation to its devastating effects. Born in North Carolina, Stiles...
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Human Subjects in Medical Research
A Growing Debate.
Humans had served as experimental subjects in medical research long before 1900. In 1799 and 1800 more than forty volunteers participated in extensive trials on the effects of inhaling nitrous oxide gas. In 1803 Englishman Thomas Percival wrote a classic text on medical ethics in which he discussed experimentation on patients. Contributing to the increase in this type of research was the acceptance in the United States, beginning in the 1880s, of the germ theory of disease causation, which required more research with both animals and humans. Basic research of all kinds was also beginning in American medical schools. In the closing decades of the nineteenth century many examples of research on hospital patients in the United States and Europe were publicized, and opposition to such work developed among both medical professionals and laymen. Many antivivisectionists who were critical of experimentation on animals soon joined this debate.
The word vivisection means to cut open a living human or animal. Around the turn of the century the term human vivisection came to mean any experimental procedure that did not offer direct benefit to a patient's health. Organizations such as the American Society for the Prevention of Cruelty to Animals and the American Humane Society, founded just after...
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Medical Education Reform
Medical schools proliferated in America during the nineteenth century; between 1810 and 1875 at least seventy-three such institutions opened for business. Most of these schools were proprietary, meaning they were owned by one or more physicians who operated them in order to make a profit. Both entrance and graduation requirements were low. Classes consisted solely of lectures by professors. Clinical, laboratory, and library resources were either inadequate or, most often, nonexistent. Those who could not afford even these rudimentary medical schools could ap-prentice themselves to established physicians and then call themselves doctors.
Early Reform Efforts.
Throughout the nineteenth century many doctors condemned the quality of medical education in the United States. At an 1846 meeting in New York City, where more than one hundred physicians had gathered to form a national association, a committee was appointed to study and recommend changes in medical education. Although sweeping reforms were suggested, just two schools adopted them and then only until their enrollment began to decline. By 1900 more than 150 medical schools were operating in the country, but the vast majority put student fees ahead of educational standards. Yet change was slowly coming. In 1870 the president of Harvard University, Charles...
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Pellagra in the South
Pellagra is a disease caused by a diet deficiency of nicotinamide, a B vitamin, and results in dermatitis (inflammation of the skin), diarrhea, dementia, and often death. Today the disease is rare even in undeveloped countries. First identified in Spain in 1735 by Don Pedro Casal, physician to King Philip V, pellagra was for many years thought to be nonexistent in America. Yet from about 1900 until the 1940s an epidemic swept through the country that accounted for more than three million cases and one hundred thousand deaths.
In 1902 Dr. H. F. Harris reported a single case of pellagra in a Georgia farmer at the state's annual medical association meeting. Alabama physician George H. Searcy published in 1907 a description of eighty-eight cases at the state's insane asylum. The following year Dr. James Babcock identified cases among the insane in South Carolina. Later in 1908 the first National Conference on Pellagra was held in Columbia, South Carolina, with more than seventy physicians in attendance. The next year more than four hundred doctors attended, and Babcock was elected first president of the National Association for the Study of Pellagra. By 1924 pellagra was being reported in thirty-six states and the District of Columbia, with 90 percent of the cases in nine southern states. Four southern...
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Plague in San Francisco
Bubonic plague is a disease caused by the Yersinia pestis bacillus and is most often transmitted from rats to humans by infected fleas; symptoms include virulent fever and swollen lymph nodes. Known since biblical times, bubonic plague has swept through various regions of the world during the last fifteen hundred years. At least four widespread outbreaks—pandemics—have occurred as well as many local outbreaks, or epidemics. In the first decade of this century, the disease struck San Francisco twice. The second of these two epidemics suggested how effective a coordinated public health campaign could be, but the first showed how political meddling could lead to deadly results.
Death in Chinatown.
On 6 March 1900 the body of a Chinese worker was discovered in the Globe Hotel basement. The dead man was one of more than eighteen thousand Chinese and almost two thousand Japanese who lived in a fourteen-block area of San Francisco. At this time the city was California's major city, and the area known as Chinatown was among its important tourist attractions. When the assistant city physician, Dr. Frank P. Wilson, performed an autopsy, he discovered symptoms that suggested plague. He notified the city health officer, Dr. A. P. O'Brien, and bacteriologist Dr. Wilfred H. Kellogg. These men confirmed the discovery and...
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The Tuberculosis Movement
Tuberculosis is a bacterial infection contracted by humans either through inhaling the bacteria or by eating meat from infected animals. Common symptoms are coughing, fatigue, and weight loss. Aging, poor nutrition, or other stresses on the body can free the bacteria, and clinical, or "open," tuberculosis results. Most frequently attacked are the lungs. As the victim coughs, the tubercles (nodules that the body forms around the bacteria as a defense mechanism) burst and particles are exhaled or released in sputum. Open cases can carry and spread the disease for months or years. Tuberculosis was long thought to be hereditary, but around 1880 the German Robert Koch discovered its bacterial cause. Today the disease can be controlled with drugs.
Tuberculosis in the 1900s.
An ancient disease, tuberculosis was long known as "consumption," since victims appeared to be consumed by their sickness. In 1900 the standard treatment was fresh air, proper nutrition, and rest—a therapy only the wealthy could afford. Since the disease spread slowly, tuberculosis did not create as much fear as yellow fever, cholera, or typhoid. Yet tuberculosis was the cause for more than 10 percent of U.S. disease mortality in 1908. The public health effort against tuberculosis had begun in New York City in 1889 when that city's board of health issued a...
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Yellow Fever in the United States.
Before the twentieth century the acute viral disease yellow fever was one of the most feared diseases in the United States, especially in the Southeast. Victims suffered high body temperatures, headaches, liver damage and resulting jaundice, and internal bleeding that caused discharge from the nose and mouth, bloody stool, and black vomit. Death could follow in one day or two weeks, and reported mortality rates often reached 50 percent of known cases. Between the mid 1600s and 1905 yellow fever epidemics ravaged many cities along the coastal and lower Mississippi Valley regions of North America. During those years more than 230 major epidemics were recorded. The country's earliest outbreaks appeared in Spanish Florida and the Northeast; as populations grew in the lower Atlantic and Gulf Coast states, yellow fever followed. Transmitted by the bite of the female Aedes aegypti mosquito, the disease typically developed in the summer and early fall and spread rapidly. By November or December yellow fever would disappear. By the mid 1820s quarantine measures and improvements in sewerage and water drainage effectively eliminated yellow fever from the cooler northern states. Warmer cities from South Carolina to Louisiana continued to endure epidemics until 1905, when the final outbreak in the United States hit New Orleans.
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Abel, John J. 1857-1938
Descended from German immigrants John Jacob Abel was born near Cleveland on 19 May 1857, the son of farmer George M. Abel and his wife Mary. At age nineteen he entered the University of Michigan, where he received his Ph.D. in 1883. Abel spent the following year conducting graduate research in biology at Johns Hopkins University in Baltimore. In 1884, at the age of twenty-seven, Abel embarked on a study trip to Europe that lasted seven years. During his time abroad Abel trained under the biggest names in pharmacology of that era, including the Germans Bernhard Naunyn, Felix Hoppe-Seyler, and Oswald Schmiedeberg. While on the Continent he received an M.D. from the University of Strasbourg in 1888.
Return to the United States.
When he returned to his native country, Abel was offered a faculty position at the University of Michigan. Before Abel could establish a department of pharmacology as he was hired to do, Dr. William Osier asked him to accept the chair of pharmacology at Johns Hopkins. Abel arrived in Baltimore in the fall of 1893. In the late nineteenth century pharmacology was just beginning to develop as a specialty. The rise of chemistry in the first half of the century had demonstrated that organic compounds could be synthesized in the laboratory. Experimentation by...
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Gorgas, William Crawford 1845-1920
ARMY SURGEON AND SANITATION EXPERT
William Craw-ford Gorgas was born on 3 October 1845 in Mobile, Alabama. His father, Josiah, served as chief of ordnance for the Confederate army during the Civil War and later as a college president. His mother, Amelia, was a member of a prominent Mobile family. Gorgas received a bachelor's degree from the University of the South in 1875 and four years later finished his M.D. at Bellevue Hospital Medical College in New York. After a year as an intern at Bellevue, Gorgas entered the military as a first lieutenant at a salary of $1,500 per year. He remained in the U.S. Army Medical Corps until the year before his death.
During the next two decades Gorgas rotated through remote military posts in the United States, including forts in Texas, North Dakota, and Florida. Gorgas had his first contact with yellow fever in 1883 while stationed at Fort Brown, Texas, located on the Rio Grande River. Some twenty-three hundred sufferers from the disease were quarantined at the fort, and Gorgas was under orders not to have contact...
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Macfadden, Bernarr Adolphus 1868-1955
ADVOCATE OF "PHYSICAL CULTURE" AND PUBLISHER
Born 16 August 1868 in Mill Spring, Missouri, Bernarr Macfadden was the son of farmer William McFadden and his wife, Mary. Bernard (who later changed the spelling of his first and last names) received only a grade-school education. By the time he was eleven, his parents had divorced and then died—his father from alcoholism and his mother from tuberculosis. After a brief period spent with farmer relatives, Macfadden left home and worked a series of odd jobs that included farm laborer, delivery boy, printer's assistant, bookkeeper, and bill collector. Years later he would observe about this period that he "had no chance to indulge in those exercises so necessary to the health of boys ofthat age.… At the age of sixteen I was a complete wreck. I had the hacking cough of a consumptive; my muscular system had so wasted that I resembled a skeleton; my digestive organs were in a deplorable condition." He consulted various doctors but found little help and quickly developed a hatred of the medical profession and its reliance on prescription drugs.
Macfadden bought a pair of dumbbells and began a daily schedule of exercise that he maintained for the rest of his life. By the age of eighteen he was calling himself a "professor of kinesitherapy" and...
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Reed, Walter 1851-1902
ARMY SURGEON AND PATHOLOGIST
Born in Belroi, Virginia, on 13 September 1851, Walter Reed was the son of Methodist minister Lemuel S. Reed and his wife, Pharaba. Reed received his first medical degree from the University of Virginia in 1869 and a second degree from Bellevue Hospital Medical College in New York City the following year. After a two-year internship in Brooklyn, he served in two public health posts in New York City until 1875. In that year he joined the U.S. Army Medical Corps and rotated through various U.S. posts—including Fort Apache, Arizona—until being named to the just-opened Army Medical School's faculty in 1893. Prior to this assignment, Reed spent two years studying pathology under the famed Dr. William Welch at Johns Hopkins University in Baltimore. Much of this work involved laboratory research on hog cholera and typhoid fever. His studies of microscopic bacteriology under Welch were useful in his academic post in Washington, D.C.
Reed spent much of the final decade of his life doing original laboratory and clinical work related...
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People in the News
In 1900 Dr. John Auer begins a decade of work with Dr. Samuel J. Meltzer on the use of artificial ventilation and anesthesia during surgical operations in which the chest is open.
In 1908 Dr. Sara Josephine Baker becomes head of the Division of Child Hygiene within the New York City Health Department. She remains in the post for fifteen years.
Orthopedic surgeon Edward Hickling Bradford convinces state authorities to open the Massachusetts Hospital School for Crippled Children in Canton in 1904.
Dr. Will Henry Chase helps establish Alaska's first medical society in 1906 and the future state's first hospital two years later.
In August 1909 Dr. Alfred Einstein Cohn, a specialist in cardiovascular diseases, brings the first electrocardiograph to the Western Hemisphere at Mount Sinai Hospital in New York City.
In 1906 Dr. Arthur Joseph Cramp organizes the American Medical Association's Bureau of Investigation to research fraud and quackery in medicine.
Ohio surgeon George Washington Crile develops bloodtransfusion methods and pioneers their use in surgery beginning in 1905.
Famed Johns Hopkins University surgeon William Stewart Halsted publishes one of the most famous of his many works, an article...
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Dr. Edmund Andrews, 80, surgeon who developed many instruments and pioneered the use of nitrous oxide/oxygen mixture and blood transfusion, 22 January 1904.
Wilbur Olin Atwater, 63, agricultural chemist who researched heat-energy potential and caloric values of foods, 22 September 1907.
Dr. Frederick Jones Bancroft, 69, pioneer Colorado physician who organized a medical department at the University of Denver, 16 January 1903.
Dr. Roberts Bartholow, 73, physician who made an early study of electrical stimulation of the brain, 10 May 1904.
Dr. John Janvier Black, 72, prominent physician in the treatment of tuberculosis in Delaware, 27 September 1909.
Dr. Nathan Bozeman, 80, physician responsible for many advances in gynecology and obstetrics, 16 December 1905.
Dr. John Hill Brinton, 75, surgeon who was active in the Civil War, first curator of the Army Medical Museum, and organizer of a major medical history of the war, 18 March 1907.
Dr. Charlotte Amanda Blake Brown, 58, strong supporter of public health measures and women in medicine, 19 April 1904.
Dr. Samuel Clagett Busey, 73, pioneer in pediatric medicine in the District of Columbia, 12 February 1901.
Dr. James Carroll, 53, physician who worked under Dr....
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Albert Abrams, Diseases of the Heart (Chicago: Engelhard, 1900);
Samuel Hopkins Adams, The Great American Fraud (New York: Collier, 1905);
James M. Anders, A Text-book of the Practice of Medicine (Philadelphia & New York: W. B. Saunders, 1903);
Frank Billings, General Medicine (Chicago: Year Book, 1901);
John Janvier Black, Forty Years in the Medical Profession, 1858-1898 (Philadelphia: Lippincott, 1900);
Eugene Wilson Caldwell and William Posey, The Practical Application of the Roentgen Rays in Therapeutics and Diagnosis (New York: Saunders, 1903);
J. M. G. Carter, Lectures on Diseases of the Stomach (Saint Louis: Fortnightly, 1902);
Charles Value Chapin, Municipal Sanitation in the United States (Providence, R.I.: Snow & Farnham, 1901);
Eugene Fauntleroy Cordell, The Medical Annals of Mary-land, 1799-1899 (Baltimore: Press of Williams & Wilkins, 1903);
Thomas Stephen Cullen, Cancer of the Uterus (New York: Appleton, 1900);
Ronald G. Curtin, A Study of Ancient and Modern Secret Medical Fraternities (Philadelphia, 1907?);
Nathan Smith Davis, History of Medicine...
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Important Events in Medicine and Health, 1900–1909
- Dr. Ludvig Hektoen creates one of the earliest experimental disease models, for cirrhosis of the liver.
- Dr. Ernest Amory Codman begins his work on diseases and injuries of the shoulder.
- On January 1, more than 7,000 women physicians practice medicine in the U.S.
- In February, Dr. George Blumer demonstrates that trichinosis, a disease caused by a worm infecting undercooked pork, is more widespread in the United States than previously believed.
- In February, Sen. Jacob H. Gallinger introduces a bill to regulate medical research on humans in the District of Columbia. Congress does not enact the bill.
- On March 6, the body of a Chinese laborer is discovered in the Globe Hotel's basement in the Chinese district of San Francisco. Local officials find that he died of bubonic plague. The outbreak of the disease will last for four years and kill more than one hundred people.
- On March 16, Wyoming physician C. Dana Carter performs the first caesarean section.
- In May, Dr. Eugene Lindsay Opie discovers the relationship between degeneration of the islets of Langerhans (the special cells of the pancreas that secrete insulin) and diabetes.
- On May 2, Colonel Theodore Roosevelt of the Rough Riders makes headlines by testifying...
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