A Daily History of Holes, Dots, Lines, Science, History, Math, the Unintentional Absurd & Nothing |1.6 million words, 7500 images, 4 million hits| Press & appearances in The Times, Le Figaro, MENSA, The Economist, The Guardian, Discovery News, Slate, Le Monde, Sci American Blogs, Le Point, and many other places... 4,200+ total posts
When you think of expense and medical care, why on Earth should any of it cost so much? Well, that question would make more sense if asked in the year 1819, because--according to the make-believe history of Medical Billing Capacity-- the need for compensation for knowledge or spent stores or supplies or whatever was not very great, at all.
E(ward) Cutbush, a very capable naval surgeon (and noted as the father of modern American naval medicine) attests to this, and did so in this report on the status and expense of the hospitals and medical care facilities available to the U.S. Navy (and which was published in 1819). He didn't of course know necessarily that health care wasn't very expensive at all--especially if relation to the price of wine--Cutbush just reported the numbers.
And the numbers are interesting: in 1814, for the U.S. Naval Hospital in Washington, D.C., for the 116 inpatients and 86 outpatients seen during the year, a total of $344.74 was spent on "medicines, instruments and dressings", $1,166.30 on "support of patients, nurses and attendants" (which really meant food and sundries), and another $180.00 in wages for "nurses and attendants". By comparison, $79.70 was spent on soap and candles, $334.52 on replacement furniture, and $368.40 on fuel. $50.56 was spent of fruits and vegetables.
And somewhere in there, we are shown that about $30 was spent on "clothing of an insane pensioner", which I guess must mean that some old Seamen were judged to be "insane", and needed clothing, before they were sent off and away from the hospital.
[This image is clear once enlarged.]
A little bit further on, Cutbsuh tells of the more exact expenses on food/"support" for the folks at the D.C. hospital in 1814. By far the leading expense (in the total of $1,166.30 3/4) was meat, meaty fresh meat, which accounted for nearly half of the total outlay ($439.88). Bread was next ($179) followed by Madeira wine ($108). Actually all of the alcoholic beverages--which included Madeira, brandy, sherry, port and whiskey) added up to $153.00, almost as much as bread. Meat, bread and booze then accounted for $726, or 62% of the food budget (less the minimal cost of fresh veggies). Milk, tea and coffee weighed in at $92, which means the drinking-goods totaled $245, or 21% of the food outlay. Barley, rice, oat meal corn meal and "biscuit" came in at $24; vinegar, molasses and brown sugar surpassed those staples at $97.
We don't get any information on the surgeon's pay, unless we look at the stats for the naval hospital at Baltimore. There, for 1814, we see that $352.00 was spent on medicine, $80 on surgeon's instruments, $231 on fuel, $1645 on provisions, $18 for nurses, $18 for cooks, and $1282 on surgeon pay. Unfortunately, I cannot find how many surgeons were called to receive this compensation, but we can see that their pay consumed 26% of the hospital expenses while caring for a total of 244 sailors over the run of one year. It is not impossible that there was one surgeon on hand, and one nurse. So, each sailor getting care from Baltimore received about $1.44 worth of medicine for their stay; the nurse and cook each got about 7 cents for each of the patients receiving care there, and the doctor picked up about $5.25 per sailor.
Of course there wasn't much in the way of surgical tools when compared with even the late 19th century to spend money on--ditto medicine. Stand-alone hospital machinery was virtually non-existent in 1814, and so the major factor upon which all hopes were laid was the surgeon, a sort of walking hospital--a job of superior messiness and long and lonely responsibility.
These numbers were for the late period of the War of 1812, when more than 2,650 servicemen were killed and 4,500 wounded.I could not in a cursory effort find the number of surgeons serving or employed during 1814, nor an overall figure on total medical care cost for seamen. But it does seem likely that more was spent on milk, bread and booze than on medicine and surgical instruments. And certainly the doctor cost far more than any other single unit int he medical care scheme--and, given that the greatest part of all care necessary resided with the physician, it was probably worth every penny (or fourth thereof.)
1. Cutbush at this time was given the direction of the "Marine and Navy Hospital establishment and of the medical and hospital Stores, which may from time to time be required for the use of the hospitals, or for the vessels of the United States equipped at this place."--Dudley, William S.. The Naval War of 1812, a documentary history, Volume 3.. Naval Historical Center, 1985.
This image was a cringeworthy expedition--the thought of being filled with metal shards and splinters and slivers in 1915 and needing them to be removed filled me with a Johnny-Got-His-Gun-Trumboian dread. If you didn't read the caption or know what this machine was intended to do, you might think it a humorous image--it isn't.
I found this very arresting image on the wonderful Whewell's Ghost history of science/medicine/tech roundup (https://whewellsghost.wordpress.com), edited by Thony Christie (of the excellent The Renaissance Mathematicus blog, https://thonyc.wordpress.com/ and twitter account @rmathematicus). This cure-all was being sold by Radium Limited U.S.A. (25 West 45th St, NYC1) around 1900, which means that like many quake devices it hit the shelves for public consumption not long after a scientific discovery it sought to exploit--in this case the discovery of radium by Marie and Pierre Curie in 1898. The toxicity factors of radium at this stage was not yet known, though the new-remarkableness of radium led some to establish a for-profit belief that the stuff in all of its glorious newness should be taken internally for the treatment of whatever quack-inspired ideas came to mind. One shriveling aspect in the text is that when used in therapy the radium-infused radioluminescent elixir was the only one of its kind to be visible in the dark. Modern knowledge aside, it is probably a good thing to abide the anonymous non-soliphisms of (1) never drinking anything that you can't lift with one hand, and (2) never drink anything that glows.
The full pamphlet is reproduced by the College of Physicians of Philadelphia http://www.cppdigitallibrary.org/exhibits/show/radium/item/4351
The pamphlet has a hand-changed address of 22 W. 45th St, the original building now evidently gone, replaced by the Berkeley Building in 1917. Post-appropriately right across the street is the Cock and Bull Pub.)
[Source: College of Physicians of Philadelphia http://www.cppdigitallibrary.org/exhibits/show/radium/item/4351]
Riding the last waves of wear into the public conscience and pocketbook come these two ads, published in a very large full-page format in the Illustrated London News in August 1918, just a few months before the end of WWI. Yes, no doubt there was a public "nervousness" about the affairs of the self/state/world in general, and yes there was a problem at this point with the beginning of flu season (which would soon develop into a world-wide pandemic that killed millions), and I guess the makers of Sanatogen and Oxo thought that they could make a positive impact on these things. Considering that Sanatogen was a tonic and both a relaxing and a vitalizing agent, and made of 95% milk protein, probably would not make much of an impact in anyone's nervous system. Same deal too to Oxo--apart from water the major ingredients were flour, beef fat, and dried beef bone, and probably whatever beefy thin might have fallen to the floor at the slaughterhouse. Certainly there was no good to come of treating a deadly influenza with beef fat--except of course that the manufacturer would do well distributing dietary supplement made of the stuff that has almost no value of any sort.
So, I guess I'll need to check out Oxo for the winter of 1918/19 and see how often this ad appears--it wouldn't be until the fall of 1918 that the pandemic would begin, killing about as many people who were killed in the just-ended war. Combating infectious disease with left-over stuff from a beef killing floor was probably not a hope-filled thing.
In this pamphlet1 Dr. Gerrish writes with kindness and compassion, and conviction, on the perils of the moral/ethical/medical life of a prostitute. He believed that prostitutes should be given as great a care as any and even more so to prevent the spread of communicable disease; and that understanding and empathy be extended to them from the medical profession as a way of building their self-esteem and perhaps on this strength be able to leave the profession. He was pissed that brothel owners, Johns, and prostitutes were arraigned differently and (usually) separately, and that they should all be arraigned together, as it wasn't just the fault of the prostitute that the law was broken. He made the case that prostitution was a fixable societal problem, and it must be addressed, in spite of what he saw was its massiveness. He claimed that slavery wasn't abolished --it simply went by the name of "prostitution" ("... that slavery has disappeared from European civilization. This is an error. It exists always ; but it weighs only on woman, and is called prostitution").
Read it in full at Hathi Trust: https://babel.hathitrust.org/cgi/pt?id=mdp.39015011655837;view=thumb;seq=6
1. Frederic Henry Gerrish, The duties of the medical profession concerning prostitution and its allied vices : being the oration before the Maine Medical Association of its annual meeting, 12th of June 1878. Portland (Maine), Loring, Short & Harmon, 1878. First edition (a second edition appeared in 1879 with the same pagination, and a third of 39pp appeared in 1886). 23x15 cm WorldCat/OCLC--surprisingly, only three print copies of the first edition are found.
It happens now and then that I unearth interesting bits from the pamphlet collection here that instantly create their own categorization--this in spite of already having a hundred sculpted categories. Works like this demand a deeper inspection to sustain their uncommon non-bond with other similar but not-so works. On the face of it, Fairchild's Nature's Laws... looks like just another quack medical remedy/cure/belief system (or suspension thereof), except that on closer inspection there is more text regarding the product on the pamphlet's covers than in the work itself. The thing does wind up being 36pp long, but it is most testimonial and promise--after all, you can't say all that much abut secret ingredients for the "liver patch" that you were supposed to wear, and you couldn't say much about the medical inventiveness and foundation behind it because there wasn't any. So I guess you fill space with words that aren't necessarily connected to anything and that collectively had no value, much like a year's worth of Trumpian nothingness. Anyway, there's a lot going on on teh covers of this pamphlet, and much like what is going on inside of it, it all adds up to chicken scratches.
D.W. Fairchild. Nature's Laws; New Ideas Concerning Them. A Medical Lecture Delivered in Wesleyan Hall, Boston, on Friday Evening, March 30, 1877...Illustrating the Principles of Absorption, as Developed in the Holman Liver Pad...copied from the Boston Daily Globe of Saturday, March 31st, 1877. 22x14.5cm, 36pp. Printed by the Holman Liver Pad Company, 1877. WorldCat/OCLC locates only two print copies and many others in microform.
At the end of the 19th century it was recognized that international data collected on mental illness would be highly useful. Unfortunately there was no real possibility of applying a series of great common denominators to the vast majority of mental illnesses--the classification of mental diseases lacked general consensus and clarity for not understanding the pathology of the disease, therefore having to fall back on classification according to symptology, which is open to interpretation, and individual experience, and occasional faith, with the apparent mental conditions judged by exterior behavior and appearance. This pamphlet below is the sum of the efforts of international institutions to come up with a plan for this classification that might make disparate data more refined and so more useful to communities around the world. It seems as though this was done with a simplicity that was also useful, as there was a common language to describe those conditions that are marked for classification.
Full text can be viewed of Yale's copy, here:https://archive.org/details/39002086346195.med.yale.edu
Clark Bell. Report on Classification of Mental Diseases as a basis of international statistics of the insane, made to the Belgian Society of Mental Medicine. 23x15cm, 14pp. Wrappers. Provenance: Library of Congress Smithsonian Deposit (received in 1886) from Dr. Bell (with a tiny 1.5cm embossed stamp bearing his name and address at top-center front page). I suspect that this is a separate printing of this article that appeared the Medico-Legal Journal, volume 4, 1886, as it has the same exact appearance--Bell was also the editor of that journal.
And the classifications, which appeared on the last two pages of the document:
Dr. Edward Jarvis (1803-1884) conducted a study1 in 1866 to determine how much a factor distance from an "insane hospital" was in regards to people using the facility. It sounds like an obvious-enough question with a probably-obvious answer, but these things are really never so until someone actually looks at the data and extracts an answer. And so Dr. Jarvis performed this function, answering the question once and for all that yes, indeed, the further away you are from a facility the less likely you are going to be to use it, and thus we have Jarvis' Law.
"Mental health researchers have long considered the importance of distance on psychiatric service use. Systemic analyses regarding the relationship between distance and the use of mental health care can be traced back to the mid nineteenth century, when Edward Jarvis identified inverse associations between home-to-hospital distance and the rates of admission to Oneida County Hospital of New York and the Kentucky Lunatic Asylum in Fayette County. He claimed that people living near psychiatric hospitals send more patients there for admission than do those living far away (Jarvis’s law).The study also revealed urban–rural differences in the prevalence of insanity, and high admission rates to psychiatric hospitals among people residing near the city center. Jarvis’s law has been identified in numerous studies since the mid-twentieth century."--Kuon-Chiao Tseng, et al, "Travel Distance and the Use of Inpatient Care among Patients with Schizophrenia", Adm Policy Ment Health. 2008 Sep; 35(5): 346–356, published online 2008 May 30
1. Edward Jarvis, M.D. "Influence of Distance from and Nearness to an Insane Hospital on its Use by the People." Published by Separately printed from the American Journal of Insanity, XXII, January 1866, pp 361-406. This publication paginated 1-46. (1866).
This is a striking image of a bright and reaching idea--the use of dogs to find, identify, and alert the presence of a wounded soldier on the battlefield. The dog would be sent out onto the battlefield, where it would find wounded soldiers, after which the dog would retrieve a possession of the soldier's and return to the trenches, and then lead a squad to retrieve the wounded man. That, or the dog would stay and stand guard, barking to alert stretcher bearers the location of the soldier. The dog houses are of a massive construction, like fortified dugouts--I suspect that the camp was far enough front to be subject to bombardment. I'm not sure of the breeds there, but perhaps these are Bouvier des Flandres, or Briard? I can't tell.
A Picture-Book about the Costs of Medical Care was composed by the Julius Rosenwald Fund in 1932. One of the major data visualizations in the short pamphlet was the distribution of medical care according to income--and it comes as no surprise that during the Depression that the wealthiest people are enjoying more medical care than the other classes. The stats are mostly not displayed in this pamphlet so there's not much that I think I can say about them--except that it seems that the class distinctions/percentage in this chart are similar to the William Thompson & Joseph Hickey (2005) class model.
So from the Rosenwald Fund the numbers are described like so (with the addition of the bureau of Labor Statistic's calculated figures for teh purchasing power of the 1932 dollar in 2016):
<$1,299, 15% of the population, ($20,957 in 2016 dollars)
$1,200-$2,000, 35% of the pop, ($34,938 in 2016 dollars)
$2,000-$3,000, 25% of the population ($52,392 in 2016 dollars)
$3,000-$5,000, 15% of the population, ($87,321 in 2016 dollars)
$5,000-$10,000, 7% of the population, ($174,643 in 2016 dollars)
$10,000+, $2.9% population, (greater than $174,643 in 2016 dollars)
The Thompson/Hickey model
Upper middle class 15%
Lower Middle Class 32%
Working class 32%
Lower classes (including the working poor 20%
The bottom two classes in the Rosenwald could constitute the poor and the working poor, making 50% which is what is most in-line with the Thompson/Hickey model. It is a little more difficult to work the numbers and try to distinguish the super rich, rich, upper middle class, and middle class in other models against the Rosenwald graphic. However when you look at two other models the poor and the working poor add up to about the same as above; the Dennis Gilbert model (2002) finds 55% in this category and the Leonard Beeghley (2005) finds 57%. This is real smashmouth statistical surfing, I know, but it does seem as though there is a good correlation between the Rosenwald working class/working poor/poor numbers from 1932 and more recent models.
JF Ptak Science Books Quick Post (Revisiting an earlier post with an added GIF)
These images are brought to us by the Irish-born Quain brothers: Jones Quain (1796-1865), an anatomist and professor of Anatomy and Physiology at the University of London; and Richard Quain (1800-1887), professor of anatomy in 1832 at the University of London, then surgeon at North London Hospital, and president of the Royal College of Surgeons. The illustrations are from a later (ca. 1850's) and smaller printing of their beautiful 1844 work The Anatomy of the Arteries of the Human Body, with its Applications to Pathology and Operative Surgery, in Lithographic Drawings with Practical Commentaries.
[This bedside nurse's aid appeared in the July 17, 1869 issue of the Scientific American.]
According to the article, "The inventor of this nursing table has endeavored to afford greater comfort to the sick by providing them with the means of supplying in a measure their own wants during the absence of an attendant. In large hospitals the want of something of this kind has been long felt and in many cases its use in private houses would be a great convenience..." Mostly it was a drinking-and-spit-bucket apparatus--still it would no doubt come in handy and loosen the duties of the nurse somewhat.
J.G. Heck wrote and compiled a fascinating and complex work entitled The Iconographic Encyclopedia of Science, Literature and Art, and was published in America for the first time in 1851 following Spencer Baird’s translation from its original German.
The key to his work is the amount of data displayed on each of the 500 engraved plates illustrating this work and the way in which it is arranged. The design and layout of the 30,000 items on these 500 plates was a work of genius, and for my money it is easily the best-presented complex means of the display of data and objects that was published in the 19th century.
The image above is from one engraved plate featuring 43 aspects of the human eye--beautifully arranged, and somehow fitting perfectly on the 9x11" sheet of paper. It is a work of real design engineering.
This is a large, full front page advertisement for ultraviolet therapy, and appears in the Illustrirte Zeitung (Leipzig) for September 21, 1922. Therapy using UV lamps of various origins was of relatively recent origin (ultraviolet radiation being discovered by Johann Ritter in 1801) as stated in the text here, which gives a pretty lengthy appreciation of the history of the use of crystal lamps, and noting (in paragraph four) that the principle in the invention of such material was Richard Kuch. (Kuch was a physicist and chemist who created the first mercury vapor quartz glass lamp in 1905 and the first mercury vapor high pressure lamp in 1906.) UV treatment does have its proper place in the history of medicine, but it certainly came to occupy a lofty perch in quack medical treatments for home use in curing everything from cancer to gout to dandruff via the "purple light rays". I really don't know all that much about this subject and was reporting on the design aspect of the ad--the treatment of the subject though certainly seems academic, complete with a priced guide to related literature.