...., ,I ___, I \ I 1/ r • I -- ) ... ..... 1 ~ rt-Ila-: • I J \ - . ••c l ,I ,... t l "'~ ~, ,! I I .{ ~ I 'I t· I t ,. ... - l..' .... .,....,. , . •. ,.... 'lf->1--••<P> ~. T I • r ~J'_._ e t , ! - \ I ' II ,. • ..,. I - .. I I ,., I J. • ,. XIXU! CENTlTI~Y M\t1UCA The exhibit on display from May 6 through May 31 covers some prominent figures in American medicine during the nineteenth century -- Ephraim MACDOWELL, who performed the first successful ovariotomy (1809), William BEAUMONT , who carried out investigations on the gastric juice (1833), Daniel DRAKE, an important figure in the history of medical education and author of Principal Diseases of the Interior Talley of North America (1850) , and Walter REED (d. 1902) , conqueror of yellow fever. Walter REED (1851 - 1902) (1851 - 1902) The University of Virginia in 1869 awarded the degree of Doctor of Medicine to Walter Reed, at the age of 17 the youngest man to graduate from the medical school. Reed continued his training at Bellevue Hospital in New York and at King's County Hospital in Brooklyn. He was commissioned First Lieutenant, Medical Corps, u. s. Army, in 1875, and served initially as sole physician at a frontier post in Arizona. In 1890 Reed was ordered to Baltimore for work in bacteriology and pathology in the laboratories of William H. WELCH. In 1893 he was ordered to duty at the Surgeon General's Office in Washington. At the outbreak of the Spanish-American War, he served as Chairman of a Committee to study the modes of propagation of typhoid fever. Reed's last and most significant Army assignment was his investigation of the mode of transmission of yellow fever. His yellow fever commission arrived in Cuba in the summer of 1900. Reed's associates were Dr James Carroll, bacteriologist, Dr Jesse WLazear, entomologist, and Dr Aristides Agramonte, pathologist. Bacteriologic observations on the mortally stricken were studied first. The findings were discouragingly negative; the attendants of the yellow fever victims who came in contact with fomites did not contract the disease. Second, following the hunch of Dr Carlos FINLAY who had postulated mos~uito transmission of the disease, Reed carried out animal experiments to establish the facts, but this preliminary study was likewise fruitless and abandoned in due time. Finally, Governor General (and Doctor) Leonard WOOD granted permission for carrying out human studies. Carroll exposed himself to the bite of an infected mosquito, contracted the disease, but recovered. Lazear was accidentally bitten, and not long after died of yellow fever, before the series of planned experiments was begun in the late fall. Two mosquito-proof buildings were constructed, a group of Army volunteers came forward, and mosquitoes (Aedes aegypti, then named Stegomya) were bred from eggs provided by Finlay. The control group lived in filth, but were not exposed to mosquitoes, and did not contract the disease; the other group, exposed to mosquitoes, came down with yellow fever. Not only was Finlay's hypothesis confirmed, but the critical chronology --- feeding the mosquito within the first 3 to 5 days of the disease, and a minimum incubation period of 12 days in the mosquito -- was established. It was further shown that yellow fever developed following the subcutaneous injection of blood taken from patients in the first few days of their illness; Carroll further showed that the inoculum could be passed through a Berkefeld filter and still remain potently pathogenic. William BEAUMONT (1785 - 1853) Beaumont, born in Connecticut, tried farming for awhile, taught school, and "read" medicine; in 1810 he became apprenticed for two years to a physician in St Albans, Vermont. In 1812 Beaumont was licensed by the Third Medical Society of the State of Yermont to practice physic and surgery. He then joined the U. s. Army, and participated in the campaigns of the second war against Great Britain. lie wrote in his diary (27 Oct 1812): A most distressing scene ensues in the hospital -- nothing but the groans of the wounded and agonies of the Dying are to be heard. The Surgeons wading in blood, cutting off arms, legs, and trepanning heads to rescue their fellow creatures from untimely deaths•••I cut and slashed for 48 hours without food or sleep. My God! Who can think of the shocking scene when his fellow-creatures lie mashed and mangled in every part•••without having his very heart pained with the acutest sensibility and his blood chill in his veins. Then who can behold it without agonizing sympathy••• In 1822 Beaumont, then post surgeon (and the only physician) at Fort Mackinac, Michigan Territory, was called to see a young voyageur and fur-trapper named Alexis St Martin, who had been wounded with a shotgun blast in a drunken brawl. The muzzle was less than a yard away from St Martin; the full charge of buckshot entered posteriorly on the left lateral flank, shot away a portion of the abdominal wall, and fractured and splintered the 5~ and 6~ ribs, exposing the lower portion of the left lung and the diaphragm, and leaving a perforation in the anterior wall of the stomach. During the first days after the accident, firm dressings were necessary to keep the contents of the stomach from spewing through the perforation. By the fourth week, St Martin's appetite returned, and digestion was regular. After eighteen months, a fold had formed near the external orifice of the gastric fistula, acting as a natural valve in retaining food and drink in the hollow viscus. Beaumont assumed financial and professional responsibility for his patient, who sometimes willingly, sometimes only after firm persuasion, participated in experimental studies for board, room, and a very modest honorarium. Over a period of 10 years , at Mackinac, Prairie du Chien, and Plattsburgh, Beaumont pursued his physiological investigations, primarily using eyes, nose, taste buds, hands, a magnifying lens, and a Fahrenheit thermometer. Gastric juice could be recovered from the fistula with ease; when siphoned from the fasting stomach, it was essentially clear, almost odorless, and slightly acid to taste. Vegetables are generally slower of digestion than meat and farinaceous substances, though they sometimes pass out of the stomach before them, in an undigested state. On laying him horizontally on his back, pressing the hand upon the hepatic region, agitating a little, and at the same time turning him to the left side, bright yellow bile appears to flow freely through the pylorus, and passes out through the tube. Another circumstance or two may also have contributed to interrupt the process of digestion, such as anger and impatience, which were manifested by the subject during the experiment. Beaumont's great monograph, Experiments and Observations on the gastric Juice and the Physiology of Digestion, was published in Plattsburgh in 1833. It constituted the basis for the later studies of Muller, bernard, Pavlov, Cannon, and Carlson. -- Talbott Daniel DRAKE (1785 - 1852) When Drake was three years old, his father loaded up the family and its meager possessions, crossed the Alleghanies, transferred to a flatboat on the Ohio River, and floated with the current to Maysville, Kentucky, where they settled in a log cabin without windows, on 38 acres of land. Drake attended school when he could be spared from farm chores, and read the Bible, Aesop's Fables, Pilgrim's Progress, and Franklin's Autobiography. At the age of 15, Drake was apprenticed to Dr William Goforth of Cincinnati, then a booming frontier town of 750 settlers. (Drake's father paid Goforth $400 for the privilege.) The pupil was vaccinated by the teacher (this was 2 years after Jenner's publication.) In 1805 Goforth inscribed in longhand a diploma. for Drake; this was the first medical "degree" issued west of the Alleghanies. Drake sought further training at the University of Pennsylvania. His fee to Benjamin RUSH was $20, for a five month's course. He returned to Cincinnati to take over Goforth's practice, and opened a drugstore as a sideline . D. Drake t Co., Drugs and Medicines, featured a soda fountain and dispensed hardware and groceries as well as Dover's powder, Glauber's salts, and Peruvian bark. Drake practiced for a decade with no more authority than the certificate issued by Goforth. He rece~jd a degree from the University of Pennsylvania in 1815. Drake constantly moved from place to place -- Cincinnati, Transylvania, Louisville in aid of the cause of medical education, apparently dissatisfied with every condition he met. He changed his locality as a teacher no less than seven times during his life, and founded two important medical faculties, the Medical College of Ohio (1821) and the Medical Department of Cincinnati Colleg~ (1835) , the present sole survivor of the 20 medical schools established in Cincinnati between 1819 and 1893. In the latter venture he had as associates some of the best American teachers of his day, including Samuel D. GROSS and Willard PARKER. Drake's celebrated essays on medical education, reprinted in 1832, are{J..~~ and away "the most important contributions ever made to the subject in this country. They are written in a style which, for clarity and beauty, is even today a perfect model of what such writing should be . " (Garrison) Two of Drake's early pamphlets are among the rarest of medical Americana: The Climate and Disease:;of Cincinnati (1810), and A Narrative of the Rise and Fall of the Medical College of Ohio (1822), one of the choicest pieces of medical humor in existence -- he was dismissed from the faculty by a two-thirds vote, the other two professors voting against him. Drake wrote on epidemic cholera as it appeared in Cincinnati in 1832, on the "trembles" or milk sickness (1841), mesmerism (1844), moral defects in medical students (1847), and an entertaining posthumously published work entitled Pioneer Life in Kentucky (1870).