Today stethoscopes are a typical fixture around doctors’ necks. They are commonly used to listen to the sounds of the heart and lungs as well as the flow of blood during blood pressure readings.

The practice of percussion and immediate auscultation were popular in physical examinations by the early 1800s. In immediate auscultation, physicians placed their ear directly on the patient to observe internal sounds. A French physician named Rene Laennec (1781-1826) was a firm believer in this method of diagnosis. He worked to refine the auscultation procedure and link the sounds with specific physiological changes in the chest.

Immediate auscultation could be an awkward procedure, particularly for female patients.  In 1816, Laennec found himself in one of these situations. He rolled a few sheets of thick paper into a tube shape and applied the tube to the woman’s chest instead of his ear. Later, he made a more durable instrument out of wood and called it the stethoscope. It was a monaural model that consisted of one tube and was used on one ear.

The first practical bi-aural stethoscope was made in 1851. Flexible tubing is required to make a stethoscope that allowed physicians to use both ears. While many physicians readily adopted monaural stethoscopes, the bi-aural stethoscopes were met with some skepticism. Doctors worried about hearing imbalances caused by using both ears instead of one. For this reason, many doctors continued to use monaural stethoscopes into the early 1900s.

Camman's biaural stethoscope, c1890-1900

The stethoscopes used today are very similar to the ones used in the 1930s. New materials such as flexible rubber, stainless steel, and tygon make them lighter and easier to use. The bells (the end of the instrument applied to patient’s body) have also become flatter. The application of electronic amplifiers to the stethoscope provided the next major modification. These stethoscopes amplified the sound heard by the physician and were capable of filtering high pitched tones in order to make faint tones louder. Some electronic models could provide visual or audio recordings that could be used in training or consultation as well.

Maico Stethetron, c1948

The stethoscope is one of the medical instruments whose development has been dependent on the invention of new materials such as rubber and stainless steel. The sounds the stethoscope produces has been aided by the better understanding of the relationship between anatomy and the laws of physics. Not only did doctors need to understand how to efficiently transmit sound through tubes, they also need to understand how sound waves reacted in the various tissues of the body. These are some of the issues explored in our upcoming exhibit “Tools of the Trade: The history of medical instrumentation.”

The Rose Melnick Medical Museum has been featured on “Light The Wick,” a weekly video newsletter about people and events on Wick Avenue, Youngstown State University’s (YSU) arts corridor. The show typically includes profiles of students, staff, faculty, visiting artists, and administrators in the YSU arts scene as well as coverage of noteworthy events. The Museum was included in the episode that aired on November 13, 2009.

Click here to see the video.

While cleaning out a room in the museum, I found a shelf full of old photographs and negatives. Many of these photographs depicted local physicians and hospitals. I thought others might be interested in the images and decided that enlargements would be great decoration for the museum. I had 28 of the photographs scanned at a high resolution and then enlarged them to 11 x 14. They are now hanging in the library, conference room, and hallways of the museum. Here’s a sampling of what you’ll find:

An outing of local physicans, c1910

Nursing students at Youngstown Hospital, c1960

Women's Board of the Youngstown Hospital Association, 1930

Staff members of the Youngstown Hospital, c1912

Saturday, July 11th and Sunday, July 12th, 2009

Wick Aveune and the YSU campus will be packed with a variety of kids crafts, local art, and ethnic food!

This year, the Rose Melnick Medical Museum will be open. This is a great time to check us out! As always, admission to the Museum is free. In addition to tours of the exhibits, the Museum will have a craft activity for kids on the front lawn. The movies “Night at the Museum” and “Monsters Inc.” will be shown in the conference room.

Visit the Festival website to see what else is going on!

Last week, while leafing through a 1890s medical book from the museum’s library, I found a small slip of paper between the pages. It was a prescription recipe for the pharmacy of H. Waterman in Ravenna, OH.

As I looked over the neat handwriting, I realized that the drug names were written in Latin and the measurements were given using the symbols of the apothecaries’ system. It occurred to me that this prescription might be very useful to illustrate the pharmaceutical measurement system in the upcoming Tools of the Trade exhibit. The weights in this system are broken down like this:

One pound = 12 ounces
One ounce = 8 drams
One dram = 3 scruples
or
One dram = 60 grains

So I set out to translate the Latin and measurements. It was so exciting to slowly figure out the ingredients and their effects. Here is the transcription and translation:

“Potassii Acetatis [Potassium acetate]                      2 drams
Potassii Nitratis [Potassium nitrate]                       1 dram
Spiritus Juniperis [Spirit of Juniper]                   11 fluid ounces
Aqum mentha piperita [Peppermint water]        4 fluid ounces
mix
A teaspoonful twice a day together with an occasional aperient at night.”

According to digitized pharmaceutical books from this time period on ChestofBooks.com’s health and healing section-

Potassium acetate and potassium nitrate were commonly used in low doses as diuretics.

Spirit of Juniper is very similar to gin and can contain as much as 35% alcohol. Notice that it is the main ingredient.

Peppermint water is a treatment of acute indigestion.

The physician is instructing the patient to take this prescription twice a day in addition to an occasional aperient (laxative) at night. In the research I’ve done for the pharmaceutical section of the Tools exhibit, it seems that prescriptions like this were common in the 1700s and 1800s. Physicians often prescribed medicine that would purge the body in some fashion.  These medicines might have been combined with the practice of bloodletting, which was common in the United States until the mid-1800s.

Physicians and pharmacists continued to write prescriptions in Latin until the turn of the 20th century. I also found another prescription recipe in our collection from Kent, OH in 1914. The drug names are given in English and the amounts are shown using the apothecaries system symbols. “Lactopeptine” is a digestion aid. At the bottom, the physician has instructed the pharmacist to make four ounces and write a message on the bottle that one dram of the medicine is to be taken in water every three hours.

One of the blogs on the Melnick Medical Museum’s “blogroll” is Morbid Anatomy. The blog is written by Joanna Ebenstein. For more than two years she has used it to explore the intersection of anatomy and art.  As a photographer and graphic designer, Ebenstein has an eye for visually interesting images. She is interested in a wide range of formats including anatomical models and specimens, medical illustrations, and other visual media like post cards, slides, and broadsides. Her photographic exhibit called Anatomical Theatre took her around the world to capture stunning photographs from medical collections. Even though her project is complete, she continues to scour the Internet, blogs, and medical museums for historical and unique anatomical images.  Her blog is covered with clear, crisp, images of the things she has found. Through this art work, readers can learn new things about the history of medicine, disease, and cultures. Once you start looking, your curiosity gets the best of you and you can’t take your eyes away!

Ebenstein is also active in the art and medical museum communities. Her blog contains many, many links to medical museums, collections, and related online exhibits, blogs, artists, and sources. These lists can be overwhelming, but they are a great resource for those who have time to browse them. She also writes about events in the medical art and medical museum communities like conferences and exhibits. I am amazed at how much is going on!

On Monday, National Public Radio aired a story about Dr. Lauro Halstead, a doctor who published his research about what would come to be known as post-polio syndrome (PPS) 25 years ago this month. Halstead’s research described PPS as a condition that affects polio survivors decades after they were first struck by the disease and causes new weakening in muscles and joints, as well as general fatigue and exhaustion after minimal activity. For his work to educate the medical community about PPS, some polio survivors call him the “champion of the post-polio community.”

One of the reasons Halstead can speak with authority about the condition is that he survived polio and now experiences the symptoms of PPS himself. At 73 years old, he continues to work and the list of patients waiting to see him is growing. He uses a motorized scooter to get around, wears a leg brace, and takes naps in the afternoon to help his fatigue. When he talks with patients about ways to live with PPS, he often suggests some of the techniques that have helped him. Sometimes its a hard sell. Polio survivors have usually worked hard to regain a “normal” life and are proud of being independent people. Trying to convince them that they need to slow down and use canes, braces, or wheelchairs is difficult because they feel like they’re giving in to the disease.

National health and polio organizations estimate that there are between 440,000 and 775, 000 polio survivors alive today. PPS may effect 25-60% of them. At the same time, the number of doctors specializing in polio is falling as the disease is defeated. The number of people infected with polio was greatly reduced in the 1950s and 1960s as vaccines were created and there hasn’t been a new case of polio in the United States since 1979. Dr. Halstead is one of just a handful of doctors who specializes in polio but he’d like to retire. He’s hoping to find a young doctor that he can mentor to take over his practice first.

The NPR website for this story contains the original radio broadcast and a summary of the story. It also includes many postings from polio survivors suffering from PPS in which they talk about the ways they have learned to cope with the symptoms.

Today, May 7th, is the 162nd anniversary of the founding of the American Medical Association (AMA). The mission of the organization was to advance the science of medicine, to improve the standards for medical education, to develop a program of medical ethics, and to improve the health of the public. The AMA was organized in Philadelphia at the Academy of Natural Sciences by 250 delegates from 28 states. Dr. Nathan Smith Davis from New York was the main proponent of the formation of the AMA. Its first president was Dr. Nathaniel Chapman. Chapman was a well known physician in Philadelphia and was the chair of the department of Theory and Practice of Medicine at the University of Pennsylvania for 40 years. At the meeting the delegates adopted the first code of medical ethics and the first national standards for preliminary medical education and for the degree of MD. In 1883 the Journal of the American Medical Association (JAMA) begins publication and Nathan Davis is its first editor. Today JAMA has the largest circulation of any weekly medical journal in the world. To learn more about the history of the AMA, click here.

Common Threads exhibit by Jean Shin at the Smithsonian Museum of American Art:

This exhibit is made out of a collection of similar everyday objects. For example, “Chemical Balance III” makes lighted stalactite- and stalagmite-like sculptures out of empty prescriptions containers. According to the artist, this part of the exhibit speaks to a dependency on prescription medications.” Other installations include “Chance City” which is a cityscape made out of thousands of losing lottery tickets. “Everyday Moments” mimics the landscaping of the National Mall with old donated trophies. Find out more about the exhibit here. Look at behind the scenes photographs of this exhibit being installed at Jean Shin: Common Threads on Flickr.

“Balm of America” collection at the Smithsonian National Museum of American History:

This is an interesting and valuable database of patent medicines that has a wide range of audience and use. The product names and ingredients are amusing to almost anyone. For example, Dr. Strong’s Life Force Pills, Kickapoo Indian Sagwa Renovator, and Johnson’s Carbolic Salve. At the same time, this is a valuable tool for anyone researching over the counter medicine, drug use, or popular culture during the 19th century. Here’s the description from the Smithsonian website:

The Smithsonian Institution began to collect objects related to health and medicine in 1881. It first obtained examples of patent medicines in 1930, acquiring packages of Haarlem Oil (or Dutch Drops), Dr. John Hooper’s Female Pills, and Roche’s Herbal Embrocation.  Since then the Smithsonian’s collection of patent medicines has expanded to over 4,000 products, dating from the 19th century to the present day. The online exhibit “Balm of America” features examples from this collection, found in the Division of Medicine and Science at the National Museum of American History.  Each entry includes a photo of the object, the product’s name, maker’s name, place of manufacture, and a date range.  Ingredients and therapeutic claims are included when indicated on the product packaging.

Throughout medical history, the practice of dissection has been controversial. During some periods of history it was distasteful or even illegal. At other times it served as the cornerstone of anatomy classes. Public opinion and differences in religious beliefs often meant that some cultures accepted the practice while others did not. The Dittrick Medical History Center at Case Western Reserve University has just published a fascinating new book based their collection of dissection photographs. The book, Dissection: Photographs of a rite of passage in American medicine 1880-1930, discusses the role of dissection in medical school and a little bit about the history of the practice. These images are not for those with weak stomachs! Dissection in the late 1800s was a messy and unsanitary process. You can see the on-line exhibit here. In addition, the blog Morbid Anatomy has a recent post that includes photographs from the book and a press release.