First Look at the Burns Collection of Early Medical Photographs

By |May 19th, 2011

CBS News has posted a gripping set of images, mostly of cancer patients, dating to the 1880s. The photos from the Burns Archive are graphic, as much as they’re telling, instructive and rare.

 

This photograph, taken in New York City in 1886, is one of the earliest ever taken of breast surgery. Surgeons had begun to adopt infection-control measures in the operating room, but at this point they hadn’t yet adopted the use of surgical masks and hats and their surgical gowns were simply put on over their street clothes. The anesthesiologist whose hands are visible holding the patient’s arm on the left side of the frame is wearing street clothes. Anesthesiologists were the last doctors to don surgical clothing in the operating room.

Credit: Dr. Stanley B. Burns, via CBS News

According to its website, the Burns Archive houses the nation’s largest and most comprehensive collection of early medical photography (1840-1920). It turns out the collection is based on East 38th Street. It’s nearby, and I should explore it for real.

Meanwhile, I recommend that my non-squeamish readers take a look at the CBS-published images. If nothing else, these digitized relics display how far improved are surgical methods – and cancer treatments – since the late 19th Century.

Related Posts:

A Play About the Life and Work of Dr. Rosalind Franklin

By |November 11th, 2010

Last weekend I snagged a last-minute ticket to see Photograph 51, a new play about the work and life of Rosalind Franklin. Her data, possibly stolen, enabled Francis Crick and James Watson to decipher and model the double-helix structure of DNA.

The intimate production, enacted by the small Ensemble Studio Theatre on the second floor of a nondescript building on West 52nd Street, affords a fresh look, albeit partly fictionalized, into important moments in the history of science. Most of the scenes take place in a research lab in post-War London, at King’s College, where Franklin took on a faculty appointment.

Franklin’s story starts like this: She was born in 1920 to a Jewish family in London. She excelled in math and science. She studied physical chemistry at Cambridge, where she received her undergraduate degree in 1941. After performing research in photochemistry in the following year on scholarship, she joined the British Coal Utilisation Research Association (BCURA) and carried out basic investigations on the micro-structure of coal and carbon compounds, and so earned a Ph.D. from Cambridge University. She was a polyglot, and next found herself in Paris at the Laboratoire Central des Services Chimique de l’Etat, where she picked up some fine skills in x-ray crystallography.

You get the picture: she was smart, well-educated and totally immersed in physical chemistry before, during and after WWII. Single-minded and focused, you might say –

Franklin in Photograph 51 wears a simple brown dress with large black buttons straight down the middle of her lithe frame. Her lipstick and haircut seem right, but her three inch heels, even after a few years of experiencing the joie de vivre in Paris, or just being holed up in a research institute there, seem a tad too high for such a pragmatic soul. The lab set is perfect with its double-distilling glassware, wooden pegs on racks, tall metal stools with small, flat circular seats, light microscopes, heavy metal desks with file drawers and a contentious cast of characters.

As this narrative goes, Franklin spurns socializing with most of her colleagues. They find her difficult. She spends nearly all of her time and late hours using x-rays to generate crystallographic images of DNA and making detailed notes and related calculations. Eventually a lab assistant gives her key data, Photograph 51, to her colleague, Maurice Wilkins, who is inexpert in crystallography and cannot independently interpret the structure. While Franklin continues working at a measured pace, refusing to rush into publishing a model until she’s sure of her findings and the implications, Wilkins shares the image with Watson and Crick. They move quickly, publish first in Nature and, later, win the Nobel Prize for the discovery. Meanwhile Franklin leaves Wilkins’ lab and starts a new project on the structure of tobacco mosaic virus. She dies at the age of 37 of ovarian cancer, likely caused or effectuated by the radiation to which she exposed herself at work.

It’s a sad story, but instructive, engaging and very well-done, so much that it’s haunted me for days. Hard to know what’s real –

According to a program note from Anna Ziegler, the playwright: “this play is a work of fiction, though it is based on the story of the race to the double helix in England in the years between 1951 and 1953.” Ziegler refers to several books from which she drew material: The Dark Lady of DNA (by Brenda Maddox), The Double Helix (by James Watson) and The Third Man of the Double Helix (by Maurice Wilkins).

My favorite part is Franklin’s statement at the beginning: “We made the visible, visible.”


For a (depressing) counterpoint to this play’s version of events, you can take a look at Nobel Laureate James Watson’s 2007 TED lecture on YouTube. “She was a crystallographer,” he says of Franklin, and other things, before delving into his late-life happiness and current ventures in cancer genetics and autism studies.


ADVERTISEMENTS:

Related Posts:

Notes on Cholera, Old and New

By |October 25th, 2010

Cholera was a far-away kind of affliction, almost an abstraction, when I first studied microbiology in 1984. The legendary, infectious scourge still affected people in places like Bangladesh or Indonesia, but was a treatable condition that, surely, would be eradicated within a decade or so through progress, if you could call it that, like basic plumbing and sanitation.

The tiny comma-shaped bacteria, Vibrio cholerae, tend to thrive in brackish water, the kind that’s just a bit salty from a mix of ocean and fresh sources. These sometimes stagnant watery places crop up in river deltas, like the Ganges, and coastal estuaries such as those along the U.S. Gulf Coast. We learned that you might, very rarely, pick up a case of cholera by eating contaminated shellfish like crabs or oysters.

The most common symptom of cholera is diarrhea, so rapid and voluminous that a person can die, quickly if without remedy, by straightforward dehydration. The diagnosis of cholera can be tricky, as many people are afflicted with severe gastrointestinal diseases worldwide, but most don’t have this particular, potent toxic germ. Cholera spreads by contamination of infected human feces in the water supply. The disease can afflict people who drink tainted water, who touch it and then put unclean fingers into their mouths, as children do, and who eat food prepared by those with affected hands.

illustration by Robert Seymour (1831), image from the National Library of Medicine, image A021786

Choleraphoby, illustration by Robert Seymour (1831), lithograph from the National Library of Medicine, Image #A021786

Dr. John Snow, an anesthesiologist and founder of public health, recognized the means of cholera’s spread more than 150 years ago in London, where he became famous for mandating the closure of the Broad Street Pump. Snow died at the age of 45, of what was said to be apoplexy, old jargon for a stroke.

In 2009, there were 221,226 cholera cases reported and 4,946 cholera deaths in 45 countries, according to the CDC. Based on information put together by the World Health Organization, the case-fatality rate is 2.24%. A trend in recent years is that the overwhelming majority of cases, roughly 99 percent, are reported in Africa.

According to the 17th edition of Harrison’s Principles of Internal Medicine, there have been seven global cholera pandemics since 1817. The current rage, attributed primarily to the El Tor biotype, started in Indonesia around 1961. That strain spread, eventually, as far as coastal Peru in the early 1990s. There have been no cholera epidemics in North America since the middle of the 19th Century.

What’s happening in Haiti now is the real deal, says the CDC. Thousands are infected, mainly in towns along the Artibonite River, which squiggles on the map and in real terrain through the western section of Hispaniola, north of Haiti’s capital, Port-Au-Prince. Among other concerns are the vast numbers of people living without toilets in tent cities and slums outside of the capital, especially since an earthquake devastated the region last January.

The CDC offers some very practical tips for people who live or travel in areas where cholera is endemic. Most people who are exposed to cholera and survive become immune, although infectious strains vary and immunity may not be long-lasting. In the U.S. there is no available vaccine for cholera, according to the CDC. Treatment consists primarily of giving electrolyte solutions, for rehydration, and antibiotics in some cases.

Now, the mortality rate from cholera in Haiti is running just under 10 percent, according to today’s news. Hopefully, doctors from MSF and other agencies working in the region will get this epidemic under control. But already it’s clear that hundreds of lives have been lost to an illness that it seems should have been eradicated long ago.

Related Posts:

Classic Saturday Night Live on Bloodletting, and Barbarism

By |October 20th, 2010

New Year’s Update:  The video to which this post refers is no longer available through legal, open-access sources. You can still read a bit on phlebotomy, near the post’s end. – ES, Jan 2014

***

A student clued me in on an old take on therapeutic phlebotomy: the classic 1978 SNL skit, Theodoric of York (Season 3, episode 18), stars Steve Martin (as the barber, Theodoric of York.). It also features Dan Aykroyd (as William), Gilda Radner (as Broom Gilda), Jane Curtin (as Joan), John Belushi (as a hunchback) and a youthful Bill Murray (as a drunkard).

Theodoric of York

It’s a very funny skit when it’s not too gory, with some insight into the history of medicine.

But it’s also a sad reminder about the early deaths of Belushi, a promising actor who died at 33 years from heroin and cocaine toxicity, and of Radner, a wonderful comedian who died at 42 years from ovarian cancer.

As for modern, therapeutic phlebotomy -

In the U.S. and most other places, trained physicians, nurses and other providers perform this procedure routinely using sterile techniques and other precautions. (Checklist, anyone?) Typically a pint or so of blood is carefully drawn from the body so as to reduce iron overload in people with hemochromatosis, or to lessen the number of circulating red blood cells in patients with other, rarer blood conditions.

For the record, we don’t use leeches any more, although a New Yorker piece from several years ago delves nicely into those slimy creatures’ comeback in research and other possible applications.

One thing I learned today is there’s surprisingly little open-access information on modern therapeutic phlebotomy, which might serve as a useful counterpoint to the SNL skit. The NIH (including National Heart, Lung and Blood Institute) and MedlinePlus offer little specific information on this procedure, and in a multi-hour search I can’t find any non-commercial sites that do.

—–

Related Posts:

newsletter software
Get Adobe Flash player