An Inside Look At Tonsils, Or A Medical Instrument From Hell

By Stephen J. Gertz

From: Leçons sur l'hypertrophie des amygdales et sur
une nouvelle méthode opératoire pour leur ablation
by Edouard Chassaignac.
Paris: Jean-Baptiste Baillière, 1854.
First (only) edition. Octavo. 120 pp.

Just the other day I received a letter from a medical student in Guatemala,   a chronically unemployed chimney sweep from Papua, New Guinea with higher ambitions and one of my protegés. Aware that I once practiced occupational therapy in hospitals and sub-acute facilities and that when I put on my white, crisply pressed lab coat I transmogrified onto a brilliant, sage physician possessing all the medical knowledge in the world, he asked me, "Doc Gertz,  do you have any lessons on the hypertrophy of tonsils and a new method for their ablation? I've a test coming up."

After performing my ablutions I should have told him to go look it up, I wasn't going to be around forever. I  am, after all, mortal and not the God-like medico I actually am but play-down, yet I couldn't resist the opp to, once again, have the ans immediately and inflate my vainglorious ego to its proper psi.

"Okay," I wrote back, "here's what you do. When those almond-shaped babies swell up like my vainglorious ego at its proper psi, yank 'em out. But not with the standard wire-cutter, apple-corer or strawberry-top remover. My old buddy, Edouard Chassaignac, has a new gizmo from 1857; he wrote a book about it. He took a couple of dinner forks, wrapped 'em around a couple of soap bubble-blowers. The bubble-blowers isolate the swollen tonsils, and the forks, when stuck into them, tell you they're done and ready to be served to the pathologist. It's also great for tumors, piles, and polypi, your basic weed-whacker for bad growths. Best part, no blood."

I couldn't resist spritzing one last factoid at him to push him over the top and into perpetual awe. "The procedure is called 'écrasement.' It means 'crushing.'"

Hell, Ed could've used a nutcracker to similar, albeit messier, effect but he's got the "M.D." after his name and I don't, like that should make any difference.

Need I add that Yauwii aced the exam? I'm feeling pumped.
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Image courtesy of Libraire Alain Brieux, currently offering this item, with our thanks.
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The Original Guide To Health and Wellness, From Iraq

By Stephen J. Gertz

In 1531, the first printed edition of what had originally been an eleventh century Arabic guide to good health was published.

Purification [enema].

The book, Tacuini Sanitatis (Tables of Health, i.e. Health Maintenance), in Latin, had been circulating in manuscript copies during the fourteenth and fifteenth centuries, providing encyclopedic counsel on health, hygiene, and well-being.

Constipation. Sexual Intercourse. Sperm.

Originally written by ibn Butlan, a Christian physician born in Baghdad (d. 1068) also known as Elluchasem Elimithar, the book lays out the six elements necessary for good health and avoiding stress: food and drink; air and climate; activity and rest; sleep and wakefulness, the secretion and excretion of humors; and states of mind, i.e. the emotions. Illness, according to ibn Butlan, was the result of an imbalance of these elements. A life lived in harmony with nature was the cure for what ailed you.

Health Building. Drunkenness.  Fires.

Sexual activity was considered an essential part of a well-balanced life, and ibn Butlan offers advice, i.e. eating the eyes of animals will increase sperm count (though nausea is noted as a potential side effect).

 

The healing properties of various plants are listed. Onions, for example, will soften the character, act as a diuretic, facilitate sexual intercourse, and sharpen vision. The abuse of lettuce, however, is harmful to sexual activity. Beyond over-consumption, however, it is not clear what constitutes abuse of lettuce,  though extreme foodies may consider anything more than a splash of balsamic vinegar to be a capital offense leading to depressed libido, if not appetite.

Drunkenness. Vomiting.

The book, known as Taqwim al-Sihha in Arabic, was first translated into Latin, 1258-1266, by order of Manfred, King of Sicily. Illustrated manuscript editions began to appear in the late fourteenth century. The first printed edition was published in Strasbourg in 1531 bearing woodcuts that, in many cases, are models of candor, matter-of-factly depicting the honest realities of our basic animal functions and activities.

Radish. Sleep. Conversation.

Tacuini Sanitatis was, until the seventeenth century brought rationalism to the study of science and medicine, the most popular guide to health and wellness among the European lay readership.

To speak in form. Vigilance.

Though fairly represented in library holdings worldwide the book is scarce in the marketplace, with only two copies coming to auction within the last thirty-seven years. The most recent, a complete copy in a modern binding by Sangorski & Sutcliffe, sold at Sotheby's May 7, 2009 for £11,000 ($17,710).

A defective copy, disbound and lacking the final two signatures, is being offered at Bloomsbury-London's Antiquarian Books: The Property of a Collector, Part I, sale Wednesday, April 4, 2012, lot 343. It is estimated to sell for £1000 - £1500 ($1600 - $2400). 

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ELIMITHAR (Elluchasem) aka Ibn Butlan, Abul Hasan al Muchtar ibn Botlan - Abu Ali Yahya ibn Isa ibn Guzlah al Baghdadi. Tacuini Sanitatis. Elluchasem Elimithar medici de Baldath, de sex rebus non naturalibus, earum naturis, operationibus, & rectificationibus, publico omnium usui, conseruandæ sanitatis, recens exarati. : Albengnefit De uirtutibus medicinarum, & ciborum. Iac. Alkindus De rerum gradibus. Argentorati (Strasbourg): Apud Ioannem Schottum Librarium, 1531.

Editio princeps. Folio. 163, [9] pp. Title page and text in red and black. Woodcut panel strips at foot of leaves.

Adams I11. Wellcome I, 1996. BL German Books, p. 365. Durling 2520 & 4774. Heirs to Hippocrates 69. Vicaire 323. Waller 2740.

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Images courtesy of Bloomsbury, with our thanks.
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Health And Disease In "The Floating World" On Show In San Francisco

By Nancy Mattoon

Ten Realms Within the Body.
Kuniteru Utagawa III, Artist, c. 1885
(All Images From UCSF Japanese Woodblock Print Collection.)

Four hundred rare images of the Japanese woodblock prints, commonly referred to as ukiyo-e, or "pictures of the floating world," have been digitized by the libraries of the University of California, San Francisco. The UCSF Japanese Woodblock Print Collection is the largest collection of such woodblock prints related to health in the United States. While the most common ukiyo-e prints contain images of famous Kabuki actors or geishas, this collection is unique in depicting the history of medicine in Japan in the mid-to-late nineteenth century. This time in history, known as the late Edo and Meiji periods, was one of great change, when Japan was opening to the West after almost two hundred and fifty years of self-imposed isolation.

Advertising For: "Three Drugs From Rakuzendō
For Low Energy, Heart-burn, and Constipation."
Eitaku, Artist, Late 19th Century.

The collection is defined by five broad subject areas. The topic of 80 of the prints is the treatment and prevention of three contagious diseases: smallpox, measles, and cholera. A closely related area shows the intervention of various deities, both Buddhist and Shinto, to bring about a cure for those deadly maladies. Foreigners were seen as carriers of disease, so the collection includes prints depicting their arrival by ship, and the confined Dutch settlement of Nagasaki. Women's health, and specifically, pregnancy, make up a fourth area, including images of the gestating fetus. Finally, the largest part of the collection is made up of advertisements for drugs, cosmetics, and other health products from the 19th century. There are also miscellaneous prints depicting medical and psychological problems from dizziness to nightmares, and prints about nutrition and bodily functions.

Treatment Method for "Baieki,"
Popularly Called "Korori" [cholera].
Isshō Hanabusa, Artist, Early 19th Century.

According to the library's online exhibition, "The woodblock prints in this collection offer a fascinating visual account of Japanese medical knowledge in the late Edo and Meiji periods. Collectively, they record a gradual shift, by the late nineteenth century, from the reliance on gods and charms for succor from disease, to the adoption of Western, scientific principles as the basis for medical knowledge. They show the introduction of imported drugs and vaccines and increased use of printed advertisements to promote new medicinal products."

Household Gods: Daikoku and Fukuroku.
(Daikoku on a ladder,
shaving the top of Fukuroku's head.)
Toyokuni Utagawa III, Artist, 1857.

The method of creating these prints is as interesting as their subject matter. As described in commentary to the show, "Ukiyo-e prints were products of a remarkable collaboration between print publishers, designers, master block carvers, and printers. The publisher was the impresario who brought together the other, highly specialized team members. Having obtained a detailed sketch from the artist, he supervised the carving of multiple cherrywood blocks: a finely detailed key block, rendering the outlines of the design, and as many as a dozen separate blocks for printing each of the colors. The printer then stepped in, applying color to the blocks and printing them in succession, carefully registering the edges, and rubbing the paper (placed facedown on the block) to evenly transfer the colors to the page."

Advertisement For: Iodide Iron Pill.
Sadanobu Hasegawa, Artist, No Date.

In spite of this labor-intensive process, the finished prints were not expensive. They were either sold directly by the publishers in runs of several hundred, or distributed cheaply, or for free, to traveling vendors, who in turn gave them to local merchants, artisans, and tradesmen. The prints, however, were never meant to last. Like today's health brochures and mass market advertising supplements, they were expected to be read and discarded. Their ephemeral nature makes it all the more impressive that such a fine collection of prints has been assembled and made available to 21st century viewers.

Advertisement For: "Medicine For Clear Vision."
Yoshitsuya Utagawa, Artist,
1862.

The UCSF woodblock print collection was begun in 1963 as part of the library's East Asian Collection. UCSF Provost and University Librarian, later Chancellor, John B. de C. Saunders, M.D., founded the collection, which was expanded over the next 30 years by Librarian/Curator Atsumi Minami. Ms. Minami's dedication to the collection is evident in its comprehensiveness and fine quality. According to the libraries website, she frequently "traveled to Japan and China and purchased items from various smaller, private collections, acquiring the woodblock prints as well as hundreds of rare Chinese and Japanese medical texts, manuscripts, and painted scrolls." The prints are housed in the Library's Archives and Special Collections, and are often featured in exhibits in the library's gallery. Luckily for online visitors, this fascinating virtual exhibit is always just a mouse-click away.

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The Rarest, Most Beautiful Atlas of Obstetrics

by Stephen J. Gertz

One of six plates from:
Uteri praegnantis & ad partum maturi demonstrationes
London:  1757.

A copy of the first edition of the scarcest obstetrical atlas yet produced, and certainly one of the most beautiful, featuring six magnificent life-size plates by Jan van Rymsdyk for Charles Nicholas Jenty, has come to market. There are no copies recorded in COPAC, and OCLC notes only one copy in North America, at University of Texas. 

"Superb life-size mezzotints " (Garrison & Morton) are what make Uteri praegnantis & ad partum maturi demonstrationes (1757) so attractive, in spite of their graphic nature.

"The six beautiful plates of pregnancy and parturation made by Riemsdijk for Charles Nicolas Jenty (1757), of London, are rare examples of mezzotint, which was seldom used in medical illustration" (Garrison).

The first plate was actually drawn by Thomas Burgess and the remainder by Rymsdyk. The mezzotint engraving was done by Thomas Burgess (2), Edward Fisher (1), and Richard Purcell (3). Jenty chose mezzotinting because "this method is softer, and capable of exhibiting a nearer imitation of Nature."

"Charles Nicholas Jenty was an elusive eighteenth century character about whom little is known apart from his writings, and even these are rare. They seldom come on the book market, and few medical libraries possess copies. Not fully appreciated because of their rarity, they are outstanding examples of the arts of the craftsmen, and have also ensured that Jenty's name has not been completely forgotten" (Thornton, Jan van Rymsdyk Medical Artist of the Eighteenth Century).

Another plate from:
Uteri praegnantis & ad partum maturi demonstrationes.
London:  1757.

Jan van Rymsdyk is generally known as the illustrator of obstetrician  William Smellie's Sett of Anatomical Tables (1754), and anatomist William Hunter's Anatomy of the Human Gravid Uterus (1774), all of which were drawn about the same time but in the case of Hunter not published until much later. 

So rare is Uteri praegnantis & ad partum maturi demonstrationes that, with few exceptions, this work remains unnoticed by websites discussing Rymsdyk; it seems to be completely unknown to all  except dedicated scholars.

In 1758 Jenty issued an octavo volume with sixteen pages of text to accompany this atlas, under the  title, The Demonstrations of a Pregnant Uterus of a Woman at her Full Term. Both the atlas and the text are extremely rare, and absent from almost all medical libraries.

A German edition was issued in 1761 at Nuremberg, with the plates re-engraved, under the title, Demonstratio vteri praegnantis mulieris cum foetu ad partum maturi.

The two plates from Uteri praegnantis & ad partum maturi demonstrationes that illustrate this post make their debut on the Internet via Booktryst. They will likely be the only digital reproductions  of any of the six mezzotints for some time to come; the atlas is that scarce.

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JENTY, Charles Nicholas. Uteri praegnantis & ad partum maturi demonstrationes.  London: [For the Author], 1757. Broadsheet (600 x 465 mm) comprised of six mezzotint engraved plates.

Garrison & Morton 6156.4. Russell 479. Waller 5152. Blocker, p. 211.
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Images courtesy of William Patrick Watson Antiquarian Books,  who is offering the book, with our thanks.
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A Doctor's Donations Make Medical History

TRAVERS, Benjamin. A synopsis of the diseases of the eye, and their treatment.

3rd ed. (London: Longman, Hurst, Rees, Orme & Brown, 1824).
(Dr. Richard Travers is a direct descendant of the author.)

An instructional manual for a 1901 version of Viagra and a pamphlet denouncing it as a fraud, a banned play about female sexuality and the published love letters of the playwright, and a volume on venereal disease by a surgeon who may have deliberately infected himself with gonorrhea. These are just a few of the intriguing items found in an enormous collection of rare books and ephemera on the history of medicine recently donated to Melbourne, Australia's Monash University.

The man who donated some 15,000 volumes to the school's Sir Louis Matheson Library, Dr. Richard Travers, has curated an exhibition comprised of 92 of his favorite acquisitions in over 40 years of collecting. The exhibit, A Doctor's Delights, will be on display in Melbourne through February 2010. Luckily for those of us outside of Oceania, a captivating virtual exhibition can be found on the Library's website. Dr. Travers had a tough time selecting the best items for the show, but says ultimately he has "chosen those titles [he] was most pleased to find." Brief descriptions of a few fascinating finds follow, but these are only the cream of a bumper crop.

McLAUGHLIN, M.A. Dr. McLaughlin's electric belt. ([Sydney : Dr. McLaughlin Co.], c1901)

Featured in a section of the show called "Scuttlebutt," the over-the-top artwork on this Pepto-Bismol pink pamphlet extols the (dubious) virtues of a (literally) shocking belt which today would be sold as a "Viagrabrator." Dr. McLaughlin's cure for all masculine ills, from impotence to alcoholism, was widely advertised at the turn of the 20th century as a fountain of youth. A typical testimonial, from a "Mr. A. Crawford of Pokegama" states: "I was an old man of 70 before I got your Belt. Now after wearing it for for 3 months I feel like a young man of thirty-five." One can only hope Mr. Crawford removed the device shortly after dashing off his endorsement: another three months of wear would logically return him to infancy.

WALLACE, R. "Pro bono publico." : Read this article. It will pay you well. Some points about the "Dr. McLaughlin electric belts." What they really cost ... [Sydney : Freeman & Wallace Electro-Medical and Surgical Institute?, 190-?]

Even circa 1900, there were skeptics who doubted that "Dr. McLaughlin's Electric Belt" could in "a few weeks of wear assure you health and happiness for the rest of your life." Hence the above item, by his fellow physicians Doctors Freeman and Wallace, denouncing the "iniquitous actions, deceptions, frauds, nefarious practices, and misleading advertisements" of their colleague. (And revealing that McLaughlin is selling the infernal device at a high-voltage 500% mark-up!) The printing of this scorching indictment on the same (shocking?) pink paper as the circular soft-soaping suckers into shelling out for the electrifying (electrocuting?) medical miracle is doubtless no coincidence.

STOPES, Marie Carmichael. A banned play and a preface on the censorship : Vectia
(Sydney : Hal & Lew Parks, [1932?])

The "Sex Education" section of the exhibit begins with two books by pioneering feminist sexologist Marie Stopes. The "Dr. Ruth" of the early 20th century, Stopes wrote Vectia, the story of a woman in a sexless marriage, for production on the London stage. It was banned by the Lord Chamberlain due to its scandalous call for an end to female sexual ignorance through reading. (Stopes was not above using the play to plug her own publications. When our heroine Vectia's prudish husband, William, discovers her scandalous books he rants: "What's the meaning of all this beastliness? Ellis's Sex Psychology! Stopes's Married Love! Stopes's Radiant Motherhood! Robie's Sex Ethics! Ellis's Sex Psychology, volume 2, volume 3, volume 4!") He might well have become apoplectic if Vectia had purchased Stopes's pseudonymous volume, Love Letters Of A Japanese.

Love letters of a Japanese, edited by G.N. Mortlake. 2nd ed. (London : S. Paul, [1911?])

(G.N. Mortlake is a pseudonym of Marie Stopes.)

Love Letters of a Japanese begins: "These letters are real. And like all real things they have a quality which no artificial counterpart can attain." Published under the editorship of "G. N. Mortlake," and documenting a love affair between "Mertyl Meredith" and "Kenrio Watanabe," the letters were actual artifacts from a disastrous love affair between Marie Stopes and Japanese botanist, Kenjiro Fujii. When a disenchanted Fujii decided to end the romance once and for all, he feigned an incurable and highly contagious case of leprosy. This wildly inventive exit strategy did the trick, but in an act of revenge Marie transcribed her illicit lover's letters word for word, and made them public under a veil thinner than see-through negligee. Marie’s biographer, Ruth Hall, wrote of the affair: "She never recovered from it, and all her subsequent endeavours can be seen as furious compensation claims for emotional injury."

In a bizarre coda to the story, Marie Stopes presented a copy of her hot off the press billets-doux to her first husband, Reginald Ruggles Gates, shortly after their marriage. Perhaps deliberately ignoring his new wife's indiscretion, Gates recalled: "My reaction to the 'Love Letters of a Japanese,' which I believe was the title, was one of mild shock, but I accepted it as one of the minor disabilities of being married to a literary woman."

HUNTER, John. A treatise on the venereal disease. 2nd ed. (London : G. Nicol; and Mr. J. Johnson, 1788)

Another section of the exhibit features books by the great Scottish surgeon, John Hunter. Quite a complicated character, Hunter has been variously described as "kindly and generous" and "rude and repelling." Bibliophiles will be happy to know that in addition to giving a break to the poor and clergymen, Dr. Hunter offered "professional authors and artists his services...without remuneration." He was among the first medical men to apply scientific research methods to the study of dentistry, gunshot wounds, digestion and child development. Another area of the physician's research was venereal disease, and it was here that he left an unfortunate legacy.

Hunter shared the belief of most physician's in the late 18th century that gonorrhea and syphilis were caused by a single pathogen, and he was determined to prove it. According to some sources, following a common but incredibly dangerous research method of the era, Hunter inoculated himself with gonorrhoeal discharge from a patient. Unfortunately, unbeknownst to him, either the patient he chose also suffered from syphilis, or the needle he used was contaminated with the bacterium that causes it. In either case, as the story goes, when Hunter contracted both gonorrhea and syphilis, he wrongly concluded the theory they were caused by the same bacterium was correct. Dr. Hunter included that incorrect information in the treatise pictured above, and five long years passed before another physician, Benjamin Bell, proved the two diseases had separate causes.

The treatise makes no mention of Hunter's rather bizarre self-experimentation, and some believe the entire tale is apocryphal. But the saga of a medical man with a reputation for both kindness and rudeness, and a willingness to be his own guinea pig, resonated with writer Robert Louis Stevenson. John Hunter was the inspiration for both mild-mannered Dr. Henry Jekyll and his alter-ego the villainous Edward Hyde. (Hunter's reputed "Hyde-side" may also have originated from his dealings with grave robbers. He frequently consorted with such criminals to obtain the corpses necessary for anatomical study.)

Cole's atlas of anatomy and physiology of the human body. (Melbourne : EW Cole Book Arcade, [191-?])

The richness of the rare books and ephemeral oddities donated by Dr. Richard Travers to Monash University merit an entire afternoon on the library's website, if not an excursion to the land down under. His tremendous generosity has allowed the entire collection to remain intact. It stands as a testament to the fine results of a lifetime of careful collecting in a single area of expertise. Dr. Travers is well aware of the dangers and delights in store for the passionate book buyer. In the introduction to his exhibition he paraphrases the famous words of John Dryden's play The Spanish Friar: "There is a pleasure sure in being mad which only madmen know." Here it becomes: "There is a pleasure in collecting books, which none but collectors know." Thanks for sharing the mad pleasures of a lifelong bibliophile with the world, Dr. Travers.