Historical Medical Library

It’s National Influenza Vaccination Week, and we’re taking a look back to 1918, the time of the “Spanish” influenza pandemic. When the illness emerged, several useful vaccines had already been developed: smallpox, typhoid fever, and rabies, for example. Scientists and physicians tried many different approaches to develop influenza vaccines during the pandemic even though the cause of influenza was not clear. We look at several of them below.

No other epidemic has claimed as many lives as the Spanish influenza epidemic in 1918-1919. Worldwide, at least 40 million people died as this virulent illness swept through city after city (some estimates put total deaths closer to 70 million). Newspaper reports described people dying within hours of first feeling ill. The mortality rate was highest among adults under age 50, who were, for unknown reasons, particularly vulnerable to serious disease resulting from this strain of influenza.

The first reported cases of an unusual influenza appeared in U.S. Army camps in Kansas in early spring 1918. Later that spring, officials reported large numbers of cases from Europe, though this flu did not seem particularly dangerous. However, influenza became more deadly in late summer. Soon waves of infection moved through towns, nations, and continents, overwhelming hospitals and medical personnel. Because of wartime censorship, reports of influenza were not widely distributed, but news from Spain continued to flow. The name Spanish influenza came from the devastating effects of the flu in Spain in autumn 1918. More

Robert D. Hicks, PhD, Director, Mütter Museum/Historical Medical Library, The College of Physicians of Philadelphia, contributes today’s blog post. In preparation for an exhibit on Civil War medicine at the Mütter Museum in 2012, Dr. Hicks has been researching, among other topics, the occurrence of spurious vaccination in the Civil War. Spurious vaccination was smallpox vaccination that either did not produce immunity in the recipient or that resulted in a transfer of a communicable disease such as syphilis. While physicians in the United States frequently used humanized smallpox vaccine during the Civil War, French physicians at the time were popularizing a mode of smallpox vaccination that relied solely on serial propagation of vaccine in cows. Human transmission of smallpox vaccine disappeared by the turn of the century.

According to Joseph Jones, MD, Professor of Physiology and Pathology, University of Nashville, vital medical research was “brought to a sudden and unexpected close, by the disastrous termination of the civil war.” Writing in 1866, in a radically changed and changing South in the aftermath of the Civil War which ended the previous year, Jones expressed frustration that a Confederate medical investigation on smallpox vaccinations “was destroyed during the evacuation of Richmond.” Confederate medical records in Richmond, Virginia, disappeared after the victorious Union Army torched the city. Vexed by these circumstances, Jones surveyed physicians throughout the South who served in the Confederate Army to elicit data about “spurious vaccinations” and resurrect the destroyed report. Spurious cases were smallpox vaccinations of soldiers deemed “accidents” because they conferred no subsequent immunity to the disease or, compounding misery, introduced other diseases incident to vaccination, particularly syphilis. Jones paints a dire portrait of a Confederate Army that experienced far too many deaths and disabilities due to spurious vaccinations. More

Research for new articles about typhoid fever and cholera have kept us busy in The College's Historical Medical Library over the past week, and as usual, we stumbled across some great holdings. One that we particularly wanted to share was this map showing deaths from typhoid fever and malaria in Washington, D.C., from 1888-1892.

Click on the image or click here to be taken to its page in the Gallery, where you can zoom in on the map to see how the diseases affected the city's districts. With red dots representing deaths from typhoid, and blue representing deaths from malaria, the map documents 626 typhoid deaths and 363 from malaria over the five-year period. More

If you've been following our blog over the past few months, you'll notice that our look has changed. Our website, historyofvaccines.org, is now in previews after several years of planning and about a year of development.

The site provides a historical and scientific context for the development of immunizations. It features not only holdings of the Historical Medical Library and Mütter Museum of The College of Physicians of Philadelphia, but also images, text, and video from a variety of public and private sources.

We invite you to explore the site -- the media-rich timelines on yellow fever, polio, smallpox, measles, diphtheria, and other diseases; the educational activities on how vaccines work, how vaccines are made, and how the scientific method is employed; the variety of articles on social and medical issues surrounding vaccination; and the gallery, which houses over 400 images and videos.

The History of Vaccines will officially launch on November 3, 2010, with an event here in Philadelphia: Stanley A. Plotkin, MD, developer of the rubella vaccine in current worldwide use, and emeritus professor of The Wistar Institute and The University of Pennsylvania, will give the Samuel X Radbill lecture entitled "Four Centuries of Vaccinology." Register HERE for the free event.

If you'd like to be notified about future History of Vaccines events and content releases, join our email list. More

In anticipation of the launch of the full History of Vaccines website on September 29, we offer here an excerpt from our collection of smallpox information.

Dover's Title Page Dover's Title Page, The College of Physicians of Philadelphia Thomas Sydenham (1624-1689), a noted English doctor, had observed that the rich seemed to have a higher mortality rate from smallpox than the poor. This led him to conclude that contemporary medical treatments, largely inaccessible to the poor, might be more harmful than helpful in mild smallpox cases. And yet, the care he provided his own patients was quite elaborate. Thomas Dover, a patient of Sydenham and a future doctor, documented his treatment at Sydenham’s hands for a serious case of smallpox. Below is Dover’s description; it is likely that the year is 1684. More

Darin Hayton, PhD, recently wrote a post for The Philadelphia Area Center for the History of Science blog about Marie Curie’s 1923 visit to The College of Physicians of Philadelphia. While here, Curie presented the College with her piezo-electric apparatus (which later needed to be decontaminated). At this event, Robert Abbe, about whom we have written, donated to the College his collection of Louis Pasteur memorabilia.

Please take a look: History of Science in Philadelphia: Curie’s Early Piezo-Electric Apparatus

Many of the items from the Curie and Pasteur collections are on display in the lobby of the College, and others are held in the Historical Medical Library. More

Early in our vaccine research at The Historical Medical Library of The College of Physicians of Philadelphia, we came across an interesting reprint from a 1911 medical journal. In honor of the anniversary of the birth of the article’s subject, we’ll share some of the images here.

Sir Almroth Edward Wright, born August 10, 1861, died 1947, was a British bacteriologist who co-developed an inactivated typhoid vaccine (1896) and pneumococcal vaccine (1911). He promoted the use of autogenous vaccines for bacterial infections—that is, removing bacteria from a patient’s own infection and inactivating it, and then treating the patient with the material. This type of therapy became largely obsolete with the development of antimicrobials.

As one book reviewer states, Wright had “a deep aversion to statistics,” and some of Wright’s own claims for efficacy of his vaccines were difficult or impossible to evaluate. (Wright was colorful in other ways: he opposed women’s suffrage to such a degree that he wrote a 1913 treatise titled The Unexpurgated Case Against Woman Suffrage, from which we will avoid quoting here–as this post is, remember, in honor of his birthday. You are, however, invited to read it at http://www.gutenberg.org/etext/5183.) Wright’s typhoid vaccine, however, was shown to be effective in a large trial by the British War Board, and it protected thousands of soldiers in the British Army during World War I. More

In honor of National Immunization Awareness Month, we look at one of the diseases that immunization has nearly eliminated in the United States…

One of the fascinating things about the history of vaccinology is how quickly late 19th century researchers moved from identifying microbes as the cause of certain diseases to developing ways to treat and immunize people.

Diphtheria is a case in point. Edwin Klebs (1834-1913), a Swiss-German pathologist, identified and described the bacterium that causes diphtheria in 1883. (Just to point out the devastation that diphtheria caused, in 1883, the diphtheria death rate was 125 per 100,000 people in New York City.) A year later, German bacteriologist Friedrich Loeffler (1852-1915) became the first to cultivate Corynebacterium diphtheriae, and he then showed that C. diphtheriae produces a toxin. More

Guest post by Robert D. Hicks, Ph.D.Director, Mütter Museum & Historical Medical LibraryWilliam Maul Measey Chair for the History of Medicine

As the recipient of a research grant, I recently had the opportunity to travel to Minneapolis to spend a week at The Bakken Museum. Founded in 1975 by electrical engineer Earl Bakken, a pioneer in medical devices including the first wearable, externally-worn, battery-powered pacemaker, the Bakken’s collection of artifacts and texts have promoted the study of electricity in medicine. The mission has expanded to embrace electricity in American life. The object collection features about 3000 artifacts dating to the 18th century, including electrostatic generators, batteries, various devices for physiological application, and other medical stimulators. The library’s collection of 11,000 books, journals, and manuscripts illuminates “the history of electricity and magnetism with a focus on their roles in the life sciences and medicine,” to quote the Bakken. Among its treasures is a primary source collection of trade ephemera including advertisements, catalogs, pamphlets, postcards, and circulars. “Ephemera” is libraryspeak for literature never intended for permanent use or retention. Last year’s catalogs usually end up in the trash bin. Historians are grateful for all of those people who do not toss out such stuff. My own research involved electro-medical devices during the Civil War, which I will apply to designing a future exhibit on Civil War medicine at the Mütter Museum. More

Guest post by Annie Brogran, Librarian, Historical Medical Library

I feel very fortunate that I have the privilege of getting to dig around the treasure trove that is the Historical Medical Library of The College of Physicians of Philadelphia for a living. The volumes and manuscript material in the library certainly provide an extensive lesson on the history of medicine, from Galen to Gross and beyond. Every so often, though, I come across an item, be it a letter or a note, which highlights an aspect of medicine that is not always apparent in the telling of the great moments of medical breakthroughs or reading through the minutes of a committee meeting. I refer, of course, to the human aspect, where disease and medicine may not be the main focus of a document, but we see how they affect people’s lives. More