"Knowledge Unbound: Literature of Medicine" Display Cases

DISPLAY CASES

The Edwin Smith Papyrus, translated by James Henry Breasted, University of Chicago Press, 1930.

Donated by John Herman, MD

One of the oldest of all known medical papyri, this surgical treatise encompasses cases rather than recipes, and is organized to begin with injuries of the head and proceed downward through the body, much like a modern treatise on anatomy.

James Henry Breasted, first academic Egyptologist in America and founder of the Oriental Institute in Chicago, translated, transcribed and published a facsimile edition of the Edwin Smith Papyrus in 1930.

University of Chicago Photographic Archive

The Edwin Smith Papyrus is a surgical text that contains 48 cases of trauma. Each case is presented with a description of the history and physical examination, a diagnosis of the medical condition and the prognosis for the patient. This papyrus provides written evidence of the beginnings of deductive scientific reasoning in Ancient Egypt.

The Edwin Smith Papyrus was purchased from a merchant in Luxor in 1862, and the current copy is thought to have been written around 1600 BCE. The original document was written about a thousand years earlier, between 3000 and 2500 BCE. The manuscript does not disclose the name of the author, though it is possible that a surgical treatise of this importance created during the Pyramid Age may have been written by Imhotep, a great physician who lived in the 30th century BCE. But this is purely conjecture.

The Badianus Manuscript, An Aztec Herbal of 1552, Martin de la Cruz, translation by Emily Walcott Emmart, Baltimore: Johns Hopkins Press, 1940.

William P. Didusch Center for Urologic History

The original title of the manuscript was: A Book of Indian Medical Herbs, composed by a certain Indian physician of the College of Santa Cruz, who is not theoretically learned but is taught only by experience. In the year of our Lord Savior 1552.

It is not surprising the book is today called The Badianus Manuscript.

For millennia, medical therapy consisted of herbal preparations and incantations; recipes for such medicines were transmitted through the American and European generations by word-of-mouth. In 1150 CE, Hildegard von Bingen, Abbess of a cloister at the Rhine in Germany, composed books on the healing powers of certain herbs.

In the Americas, it was much longer before anything was written. In 1552, an herbal was created at the first college in the New World, the College of Santa Cruz in Tlatelolco, by two Aztec Indians: Martinus de la Cruz, a native physician who composed the work, and Juan Badianus, who translated the text into Latin. The manuscript included beautiful colored images of 204 native herbs and trees, and described the plants, their properties, and preparation in 63 folios, written in Aztec and translated into Latin. An herbal, it deals with the pharmacological treatment of diseases and does not include any text on surgery. It is divided into 13 chapters, each grouping maladies by either similar type or similar location in the body, and includes multiple contributions on treating urinary problems, such as discoloration of urine or difficulty in passing urine.

The original Badianus was sent to King Charles V, but there is no record whether Charles V or his personal physician Andreas Vesalius ever read it. The manuscript eventually landed in the Vatican library, where it was found in 1929 by Professor Charles U. Clark of the Smithsonian Institute, who told of his discovery at a dinner club of Hopkins faculty. Everyone believed this book should be translated, as it was the first medical manuscript of the Americas. It was not until 1945 that Johns Hopkins biologist and faculty member Emily Walcott Emmart translated the Latin text of the book and included commentary on that text from her biological perspective.

EMILY WALCOTT EMMART Emily Walcott Emmart National Library of Medicine

Letter from Emily Walcott Emmart to her supporters Chesney Archives, John Hopkins

Publishing the manuscript entailed raising a great deal of money. Dr. Emmart wrote to one of her supporters that lithographing the colored plates of the facsimile would cost $9,744. The printing and binding of the book would cost another $2,000, bringing the total to $11,744. Though it was estimated that $7,500 would be collected as 1,000 books were sold at $7.50 each, there was still a shortage of $4,244 to be found. The American Pharmaceutical Association and the Smithsonian provided an initial $7,500 from their revolving publishing funds – to be repaid after the sale of the book. Through the support of numerous smaller associations, such as the Amateur Gardeners’ Club of Baltimore, the Herb Society of America and the Garden Club of America, Dr. Emmart obtained the necessary funding.

Born in Baltimore, Dr. Emmart attended Goucher College and later Hopkins, where she received both her Master’s degree and PhD. Dr. Emmart was engaged for over four years in the translation and editing of the manuscript. From the point of view of the history of botany in America, the original drawings in the manuscript represent the earliest illustration of American flora. The hand-colored copies of the originals were done by a Mme. Missonier, a niece of the Pro-Prefect of the Vatican Library and a graduate of the Academy of Fine Arts in Rome.

Emily Emmart checked her copies with the manuscript in the Vatican and declared them to be exact in every detail.

Speculum Hippocraticum, Notas et Praesagia Morborum Nec Non Varia Medendi Praecepta, Ex Magnii Hipocratis Coi Moumentis with Magni Hippocratis Coi Opuscula Aphoristica Semeiotico-Therapeutica VIII, published by Joh. Jacobi Episcopi, Basil in 1748.

William P. Didusch Center for Urologic History

The writings ascribed to Hippocrates are summarized as corpus hippocraticum and encompass a collection of nearly 60 texts compiled in the library of Alexandria in the middle of the 3rd century BCE; its nucleus was most likely the library of the medical school of Cos. The writings had a great number of authors and were written between 430-350 BCE, though a quarter of them stem from 1st/2nd century CE. It is not proven any of these texts were composed by Hippocrates himself. The collection contains texts of different literary forms, including elaborate teaching documents, speeches, notes, case histories and philosophical treatises about a variety of topics without obvious structure or system, reflecting the state of Greek medicine between 450 and 350 BCE. A common feature of the writings is their tendency to let the world and the human beings appear as rationally perceivable phenomena.

SIGNIFICANT PRINCIPLES OF HIPPOCRATIC WRITINGS: holistic view of the human organism theory of the humours as basis for the processes occurring in the healthy and ill organism: the four humours compose the nature of the human body rejection of supernatural influences and of magical therapies: disease is a process having its origin in natural causes that can be treated by natural means emphasis on prognostics: a correct prognosis assured the reputation of the physician healing power of nature: fostering of the self-regulating forces dietetics: regulation of the entire lifestyle little knowledge of pharmacology little anatomical knowledge (e.g., no differentiation between arteries and veins) fundamental importance of the qualities of the urine for the prognosis (uroscopy) The painting “Hippocrate Refusant Les Presents D’Artaxerces” by French painter Anne-Louis Girodet de Roussy-Trioson (1767-1824) shows Hippocrates turning down gifts for his services as a physician.

National Library of Medicine

range of surgical procedures: treatment of fractures, luxations, wounds, fistulas, hemorrhoids refusal of bloody surgical interventions in the “Hippocratic Oath”: the perilous cutting for the bladder stone was left to specialists

Portrait of Andreas Vesalius performing a dissection.

De Humani Corporis Fabrica (On the Fabric of the Human Body), Andreas Vesalius, Nieuwendijk, de Forel, 1975; facsimile of the 1555 Oporinus edition.

Edouard Hamman (1819-1888) National Library of Medicine

Donated by Rainer M. Engel, MD

In this book that changed medicine, Vesalius and his artist drew parts of the skeleton, the vascular and the nervous system from life.

ANDREAS VESALIUS (1514-1564) Andreas Vesalius was born in 1514 into a medical family; his father was apothecary to the Emperor Charles V of Brussels. After studying art in Louvain, Vesalius turned his mind to medicine; and in 1533 he went to Paris, where the leading medical school drew doctors and surgeons from all over France and beyond. Teaching took the form of lectures on texts in Latin (especially Hippocrates, Galen, Avicenna and Rhazes), showing the principles of medical theory and practice that they contained. Anatomy was primarily learned from a book, but when a dissection did take place, the body was cut up by a surgeon or an assistant while the teacher lectured. Though the Roman Empire (Catholic Church) had forbidden the dissection of the human body, Vesalius felt the best way to learn anatomy was to dissect human corpses himself. He managed to convince a judge to allow him to make comparative dissections of the bodies of executed criminals. After much practice, Vesalius became famous for his work with the knife.

TABULAE ANATOMICAE SEX In 1537 Vesalius graduated with his medical degree and was immediately appointed to a lectureship in surgery and anatomy. Within 18 months Vesalius had made his mark with his dissections and by exploiting the power of the printing press. In 1538 he published the Tabulae anatomicae sex, which included six anatomical plates drawn by the artist Jan van Calcar on the basis of Vesalius’ own drawings.

These six plates mark a major change in anatomical illustration. Earlier illustrations had been merely an aid to memory, with crudely drawn content and largely fanciful

anatomy. In contrast, Vesalius and his artist drew the skeleton, the vascular and the nervous system from life. Though based in Galenic medicine, in both text and illustration Vesalius modified or cast doubt on certain of Galen’s conclusions, which had been based on animal dissection. His choice of a competent artist and his aim to produce them at an affordable price for students attending his lectures were traits later seen in the Fabrica.

DE HUMANI CORPORIS FABRICA Vesalius began to write the Fabrica in 1540 and finished by 1542. It was based on his knowledge of Galenic anatomy and physiology, as well as the evidence he had gleaned from his many dissections.

By August 1542, the writing was finished, and the illustration blocks were traveling to the printer Johannes Oporinus at Basle; Vesalius arrived in Basle in January 1543 to supervise the printing. He continued to dissect while correcting proofs and making a few minor changes. He also prepared a digest of the Fabrica, the Epitome, for students.

The Epitome was six chapters long with nine illustrations, printed on poorer quality paper but of larger size to make their details clearer. The text was much simplified to fit the needs of a student audience.

Surgical Anatomy

by Joseph Maclise, Fellow of the Royal College of Surgeons, Henry C. Lea, 1866.

Donated by Herbert Schwartz, MD

Illustration from Surgical Anatomy Joseph Maclise Courtesy of Herbert Schwartz, MD

JOSEPH MACLISE (1815-1880) was an artist of morbid anatomy and a surgical artist, creating drawings of human anatomy from direct observation and his own dissections of human tissue. His work is kept in archives all over the world.

Dissections in the early 19th century were largely experimental, rare procedures; because of this, they were practices treasured by anatomists. Several important anatomists of that time made large, expensive texts to showcase their work and disseminate both the knowledge gleaned from the dissection and the experience of working on a cadaver at a time when obtaining cadavers was complicated and dissecting them was culturally abhorred.

Maclise’s figures of anatomical dissection seem lifelike; in many plates, the figure is shown as a torso, or a bust, or as a full- or half-length figure. The faces seem to be a gallery of portraits, perhaps of visitors to the 1851 Great Exhibition. They are mostly young men with fine hair – bearded, clean-shaven, or mustachioed; with or without sideburns – many appear god-like. This is indeed “high” art, only incidentally of an anatomical subject. As Elaine Challacombe pointed out in her exhibit Health through the Ages, “This artist gave his cadavers beautiful faces, nearly heroic, like something out of literature. Cadavers came from destitute and homeless populations. They almost certainly didn’t look like this.” His anatomy is beautifully hand drawn and every detail included.

Joseph Maclise was the second son of seven of Alexander Maclise (or McLise), a Scottish Highlander who worked as a tanner and shoemaker when his regiment was stationed in Cork, and Rebecca Buchanan, “daughter of Mrs. Buchanan, Almshouse.” Their eldest son Daniel (1806-1870) became the famous historical painter.

Joseph Maclise studied at University College, London, under Robert Liston and Samuel Cooper, to whom he dedicated his Surgical Anatomy. He continued his anatomical studies in Paris at the École Pratique, L’Hôpital le Pitié, and Museums, then settled in practice at 14 Russell Place, Fitzroy Square. In the intervals of a busy general practice, he found time to produce his fine anatomical publications, which are much like the style of his older brother Daniel. The brothers remained close, traveling in Italy together. Between 1861 and 1863, the brothers shared an address in Chelsea. Later, Joseph moved to 9 Great College Street, Westminster, and his name disappeared from the Medical Directory in 1880.

Campbell’s Urology (3 vols., First edition).

Meredith Campbell, W.B. Saunders Co., 1954 William P. Didusch Center for Urologic History

TRAINING IN UROLOGY involves accumulation of knowledge, as well as experience that includes both observation and participation. The surgical residency of reading and apprenticeship developed by Bernhard von Langenbeck in Berlin in the second half of the 19th century involved medical graduates remaining in the hospital to observe and supervise day-to-day care. His most famous house officers included Billroth and Kocher.

Osler and Halstead modeled their residency programs at John Hopkins University later that century on Langenbeck’s principles. There were multiple personal treatises to impart knowledge to urology residents — most involved specific areas of urology, such as stones (Thompson, Bigelow), testis (Cooper), bladder and prostate (Gross), and venereal disease (Hunter). In 1926, Young published his two-volume Practice of Urology, the first complete study of the specialty. Practical texts like McCrea’s Clinical Urology were also helpful to trainees as ‘how-I-do-it’ books. But it was not until 1954 when Campbell’s Urology was first published that residents had the most comprehensive text for their specialty.

Meredith Fairfax Campbell (1894-1969) was born and raised in Wisconsin. He received bachelor’s (1916) and master’s (1917) degrees at the University of Wisconsin. In 1919, he received his medical degree at Columbia College of Physicians and Surgeons and began his internship at Bellevue Hospital. Shortly thereafter, he contracted tuberculosis and was treated in a sanatorium for two years. Fully recovered, he completed his urology residency at Bellevue. He joined the faculty at the New York Post Graduate Medical School as instructor in urology in 1925, advancing to become Professor and Chair of the department from 1937-1949. He remained Professor Emeritus until he retired in 1964.

He held additional faculty appointments at Columbia University, New York Poly Clinic Medical School and the University of Miami, as well as Bellevue Hospital. A prolific writer, Campbell authored or co-authored more than 250 journal articles in addition to numerous textbooks.

CAMPBELL’S UROLOGY In 1954, Campbell published his comprehensive, three-volume textbook Urology. This ‘Bible of Urology’ was divided into 18 sections with 51 chapters, all heavily referenced.

Campbell, at this time Emeritus Professor of Urology at New York University, edited this text of more than 2,300 pages, with more than 1,100 illustrations. The list of 51 contributing authors was a veritable Who’s Who of urology. Campbell himself wrote three of the chapters. Campbell did not live to see the publication of the third edition in 1970. Dr. J. Hartwell Harrison, Professor of Urology at Harvard and Chief of Urology at Peter Bent Brigham Hospital in Boston, was the co-editor for this updated edition, which now included 74 contributing authors and more than 2,800 pages. There were now 70 chapters, including new chapters on radioisotope imaging, transplantation and reno-vascular surgery, urosepsis, vesicoureteral reflux and uropharmacology. When the fourth edition, now titled Campbell’s Urology, came out in 1978, there were five editors, including Dr. Harrison, Dr. Reuben Gittes (Professor of Urology at Harvard and Chief of Urology at Peter Bent Brigham Hospital), Dr. Alan Perlmutter (Chief of Pediatric Urology at the Children’s Hospital of Michigan and Professor of Urology at Wayne State), Dr. Thomas Stamey (Professor and Chair of Urology at Stanford) and Dr. Patrick Walsh (Professor and Chair of the Department of Urology at Johns Hopkins).

The list of contributing authors had now expanded to 105, of whom 87 were new contributors. The text was greatly revised and updated; the scientific and physiologic basis was extensively expanded. The sections on urologic cancer, trauma, infection, neuropathic bladder, urolithiasis and infertility were completely rewritten; and a new section of 17 chapters on pediatric urology was created or expanded. This updated volume had 88 chapters and more than 2,600 pages.

This preeminent urology text, now titled Campbell-Walsh Urology, is in its 10th edition and remains the primary source of education and knowledge in the field for both trainees and practitioners.

What began more than six decades ago as a proposal to Meredith Campbell from W.B. Saunders Company, the publisher of his Clinical Pediatric Urology, for a onevolume textbook of urology resulted in the three-volume text Urology in 1954. After 10 editions, Campbell’s Urology remains the ‘Bible of Urology.’

The Urology of Childhood Sir David Innes Williams, Buttersworth & Co., 1951 Courtesy of Peggy Duckett

SIR DAVID INNES WILLIAMS (1919-2013) Sir David Innes Williams Image Courtesy of Peggy Duckett

Born in London, Dr. Williams was appointed in 1952 as a senior genitourinary surgeon at the Great Ormond Street Hospital for Children, the first hospital in the United Kingdom to be devoted to the care of children, and worked there until 1978. Though there were surgeons in the UK and elsewhere who contributed enormously to the care of urological diseases of children as a part of their work, Dr. Williams was among a tiny group who made it their life’s work. Williams realized early on that there was little literature in the field of pediatric urology. Deciding that the field needed more study, he began collaboration for a book with Twistington Higgins, a general surgeon interested in urology. Williams, Higgins and D.F. Ellison Nash co-wrote The Urology of Childhood, which was published in 1951 and became a milestone in the development of child urology.

The Urology of Childhood started a productive phase in Williams’ writing life. Over the next few decades, Williams wrote and added to the existent literature, eventually writing four books on the specialty. He also enlarged and worked on the previous research, thereby strengthening the field. He wrote and published several papers based on his own surgical observations and often co-authored with inspired junior colleagues.

This copy of The Urology of Childhood was owned by pediatric urologist John Duckett, MD, and includes an inscription by author David Williams.

Courtesy of Peggy Duckett

At his death in June 2013, The Times of London wrote, “Sir David Innes Williams founded the surgical specialty of pediatric urology and was its acknowledged world leader for 25 years from 1953 to 1978. He was admired not just as a superbly deft operating surgeon but as a first-rate teacher and professional leader.” As a surgical trainee after World War II, Dr. Williams saw a clinical need and focused his practice on pediatric urology, ultimately teaching a number of colleagues through his experience and publications. Those trainees formed the first generation of pediatric urology.

Left: The Journal of Urology®, Volume 1, Number 1 Right: The Journal of Urology®, Volume 190, Number 6 William P. Didusch Center for Urologic History

THE JOURNAL OF UROLOGY® The six-issue, first volume of The Journal of Urology ®, which contained 32 articles and 579 pages, was published in February 1917 with Hugh Hampton Young as Editor and Drs. David M. Davis, Herman O. Mosenthal, and John T. Geraghty listed as the Executive Editorial Committee. In the Foreward to this issue, Dr. Young wrote The title of this publication, ‘The Journal of Urology, experimental, medical and surgical,’ expresses briefly the aims, hopes and ambitions of the editors. It is… evident that some common meeting place is extremely desirable—some medium in which all types of papers upon the field of common interest may appear—archives of Urology—historical, embryological, anatomical, biochemical, pharmacological, pathological, bacteriological, surgical and medical, experimental and clinical.

The American Urological Association (AUA) became the legal owner of The Journal in 1921.

THE JOURNAL OF UROLOGY® MATURES Numerous changes in submission procedures and format have taken place over the years. While the subject matter had become more diversified, the manuscripts submitted for publication and the process of their consideration became more formalized.

Grouping pediatric urology articles under an identifying subhead was instituted in 1970. By 1975, editorials on pertinent subjects and editorial comments by experts on select articles with rebuttals by authors, review articles and letters to the editor were published. Between 1975 and 1976, the pediatric subsection was joined by subsections for case reports and urodynamics.

In the 1980s, the manuscript review process was expanded, and the selective use of statistical consultants was instituted. In 1982, a major expansion of The Journal

reconfirmed its commitment to provide a broad spectrum of information pertinent to urology. The journals Urological Survey, edited by Hugh J. Jewett, and Investigative Urology, founded by William Wallace Scott and edited by Jay Y. Gillenwater, were incorporated as special sections in The Journal of Urology ®. The editors of these journals and their associates maintained control of the designated sections in The Journal resulting from these mergers. This “journal within a journal” format was expanded in 1994 when Pediatric Urology became the first subspecialty to have a designated section in The Journal.

Regular use of supplements with The Journal of Urology ® was initiated in 1986 with the yearly publication of manuscripts from papers presented at the annual meeting of the Section on Urology of the American Academy of Pediatrics. The Urologists at Work designation was also added the same year. In 1994, a quarterly Spanish edition was introduced. In 1995, single-page preview articles entitled “This Month in Clinical Urology” and “This Month in Investigative Urology” were added.

In addition to changes in content, the physical format of The Journal has evolved throughout the years. The 6 ½ x 9 ½-inch page size used since 1917 was changed to the 8½ x 11 inches in 1976, presumably to accommodate advertisers. Additionally, the cover has undergone a series of changes, and in 1956, the indicia “Founded by Hugh Hampton Young” was added. The description “Official Organ of the American Urological Association” of 1925 was changed to the “Official Journal of the American Urological Association” in 1972. The table of contents was replaced by the AUA logo in 1989 and a revised colored logo in 1998.

EDITORS OF THE JOURNAL OF UROLOGY® Hugh Hampton Young

1917 – 1945

J.A Campbell Colston

1945 – 1966

Hugh J. Jewett

1966 – 1977

William Wallace Scott

1977 – 1983

Herbert Brendler

1983 – 1985

John T. Grayhack

1985 – 1994

Jay Y. Gillenwater

1994 – 2004

Martin Resnick

2004 – 2007

William Steers

2007 – Present

The select works of Antoni van Leeuwenhoek: containing his microscopical discoveries in many of the works of nature G. Sidney, Black-Horse Court, Fleet-Street, 1800 Donated by the Medical and Chirurgical Faculty of Maryland

ANTONI VAN LEEUWENHOEK: FATHER OF MICROBIOLOGY Neither a doctor nor a professor, Antoni van Leeuwenhoek was born in the Netherlands in 1632 and made his living as a seller of dry goods as he ground hundreds of convex lenses for microscopes through which he peered to discover another world.

This part-time scientist kept a diary and sent over 580 scientific letters in Dutch – the only language he knew – to academic societies such as the Royal Society in London.

In rainwater he discovered little animals ten thousand times smaller than … the waterflea or water-louse, which you can see alive and moving in water with the bare eye and such attention led to his discovery of microscopic animals that were bacteria.

His report of thousands of animals in a drop of water led citizens and scientists to van Leeuwenhoek’s home in Delft to validate his findings. Even Robert Hooke, the Royal Society’s own microscopist, verified van Leeuwenhoek’s observations in 1678.

His contributions were herculean, including discovering the first single-cell organisms (Protists) in 1674, bacteria in 1676, spermatozoa in 1677 and the striations of muscle fibers in 1682. He was elected to membership in the Royal Society in 1680 and gave one of his microscopes to Peter the Great so that the emperor could view blood circulation any time he desired.

Though van Leeuwenhoek examined feces, semen, plaque and tongue scrapings to see the hundreds of animalcules within and saw the multiplication of these creatures in a decayed tooth and in scrapings from his tongue when he was ill, he never quite got the idea that the creatures could be responsible for the corruption in the first place. It was not until 39 years after van Leeuwenhoek’s death in 1723 that Austrian Marc von Plenciz (1795-1781) declared that contagious diseases were caused by these animalcules.

This chain of knowledge led eventually to Robert Koch’s landmark discoveries in infectious disease and the causes of tuberculosis and cholera.

Antoni van Leeuwenhoek Public Domain, Wikimedia

History of Urology, Prepared Under the Auspices of the American Urological Association Two-Volume Set, ©1933.

Editorial Committee: Edgar G. Ballenger, William A. Frontz, Homer G. Hamer, Bransford Lewis (Chairman) Donated by Brendan Fox, MD

The American Urological Association’s (AUA’s) two-volume History of Urology was the first comprehensive text chronicling the history of urology in the United States.

At the time it was published, the field of urology had begun to come into its own. In the preface, the writer describes how just a few years ago, urology was considered in many academic institutions as a minor department of general surgery and how those specializing in urology were considered to be “nothing but a respectable venerealist.”

Volume I of the work begins with a chapter by Bransford Lewis on the history and founding of the AUA — a chapter that should be read by all those interested in the history of the AUA. It would not be until 2002 that the complete history of the AUA would again be chronicled. It is followed by the early history of urology in Baltimore, Boston, Chicago, the Midwest, New York and Philadelphia, and on the West Coast; and it chronicles the careers of many prominent urologists during the time.

Volume II covers topics in urology, some of which include: lithiasis; neuroses and functional disease of the genitourinary tract; outstanding contributions to urology; prostatism and prostatic surgery; transurethral treatment of bladder neck obstructions; endoscopic prostatic resection; prostatic malignancy; roentgenology in urology; urology in childhood; and urological instruments. Chapter III in Volume II on “Outstanding Contributions to Urology” by John R. Caulk provides an excellent summary of the major advances in urology up to the early 1900s.

Bransford Lewis, editor of AUA’s History of Urology, 1933 William P. Didusch Center for Urologic History