Publisher’s Corner: May 2019

Publisher’s Corner: May 2019

Inside the Doctor’s Bag
By Maxine Carter Lome
For those of us old enough to remember when doctors made house calls, nothing is more iconic than the leather Doctor’s Bag, which contained all the basic tools for evaluating, diagnosing, and attending to a patient’s ailment or illness from their bedside. Typically those tools included a stethoscope, reflex hammer, blood pressure cuff, mercury thermometer, syringes, tongue suppressors, bandages, alcohol, penlights, and the other implements of the trade needed to treat a wide range of routine and emergency medical issues.
Although home visits are now associated more with “concierge” doctors than with the general practitioners of old, the doctor’s bag is still an important and practical accessory for the traveling medical professional. It’s what is inside the bag, however, that has changed over time, leaving in the wake of progress a range of items that define the market for medical collectibles today, from medical textbooks to surgical instruments, medicine jars, and doctors bags.
The road to modern medicine has been a long one, and doctors have come up with a variety of tools along the way, many improvised in the moment to address the medical issue at hand. Nowhere was that more the case than on the battlefield, where crude implements and methods have been used to address the needs of the wounded for centuries.
During the Revolutionary War, battle injuries were addressed with such tools as grooved forceps, amputation saws, scalpels, and lancets. Since doctors could not receive medicines from England during this time of war and anesthetics had not yet been invented, they had to improvise and use painkillers such as some mercury compounds, lavender spirits, and cream of tartar. In preparation for surgery, officers were given rum or brandy to help reduce the pain. Soldiers, on the other hand, were given a wooden stick to bite down on.
During the Civil War, amputation kits and surgical tools included saws, forceps, trephines (hole saws used to remove circles of tissue or bone), knives, tweezers, and tourniquets. There was little to no attempt to keep surgery sterile, as this, too, was an era before antiseptics, or anesthesia for that matter. Instead of treating infections brought on by battle wounds, surgeons would simply remove the artillery or amputate the affected area. You can learn more about Civil War surgical tools in Melody Amsel-Arieli’s article.
From a medical standpoint, World War I was a miserable and bloody affair. In less than a year the American armed forces suffered more than 318,000 casualties, of which 120,000 were deaths; however, medical care on the battlefield was more organized than in previous wars with the establishment of a medical corps and mobilized transport. Although wound care was much better than during previous wars (mortality following amputation dropped from 25 percent during the Civil War to 5 percent during WWI), medical practitioners were now faced with new battlefield threats such as shell shock, lice and diseases contracted in the trenches, and the effects of nerve gas.
Today, collections of medical and surgical tools, field kits, medicines, prosthetic devices, textbooks, surgical catalogs, medical and pharmaceutical memorabilia, and other related artifacts tell a compelling story of one of the oldest continuing professions, and how our understanding of the human body, and advancements in science and medicine, save lives every day.
Many medical practitioners of particularly the 19th and 20th century were also great collectors of their profession’s history, seeing historic value in outdated and discarded instruments and texts, and donating their collections to museums, libraries, and universities for future generations to study and learn from. One public and unique example is the Mütter Museum in Philadelphia, PA.
The Mütter Museum is arguably one of America’s finest museums dedicated to medical history. Its beautifully preserved collections of anatomical specimens, models, and medical instruments of primarily the mid-19th century to the early 20th century, are displayed in a 19th-century “cabinet museum” setting. The Museum’s collection was seeded by American surgeon Thomas Dent Mütter, MD (1811-1859), who was determined to improve and reform medical education. Dr. Mütter donated his 1,700 objects and $30,000 to The College of Physicians of Philadelphia, with the stipulation that they hire a curator, maintain and expand the collection, fund annual lectures, and erect a fireproof building to house the collection. Since Dr. Mütter’s donation, the Museum collection has grown to include more than 25,000 objects. A notable recent acquisition includes sections of Albert Einstein’s brain.
Medical practitioners have long worked hand-in-hand with apothecaries in the use of herbs, plants, spices, and wine to create remedies for the ailments and illnesses they treated. The precursor to modern day pharmacies, the shelves of an apothecary shop were lined with glass jars and bottles storing everything from drugs and perfumes to spices and poisons. Most of the bottles were made by glass companies in Pittsburgh, West Virginia, and Ohio, where coal—an important glass ingredient—was abundant. The plain, cylindrical jars generally had paper labels and heavy covers that were set into the mouth, like stoppers. Today, a well-preserved apothecary jar can be worth over $500 because they’re rarely found in good condition. These bottles were utilitarian things, they were knocked around, and they took a beating.
In this issue, Judy Gonyeau looks at the world of Medical Art, Douglas Arbittier, MD, MBA provides a fascinating look at Bloodletting Instruments and Methods, and I interview Dr. Natan Schleider, a purveyor, restorer, and collector of fine medical antiques who has used his collection to recreate an early-20th century doctor’s office for the enjoyment of his patients. It’s a pure throwback to a time that was for an appreciation of how far we’ve come!

Publisher’s Corner: May 2019