William Bradley Coley MD – Pioneer of Immunotherapy

William Bradley Coley (center)

 

William Bradley Coley (1862 – 1936) was an American bone surgeon and cancer researcher and the pioneer of cancer immunotherapy. He developed a treatment based on provoking an immune response to bacteria. In 1968 a protein related to his work was identified and called tumor necrosis factor-alpha.

 

William Coley was born to a very old Connecticut family, on January 12, 1862 in Westfield, to Horace Bradley Coley and Clarina B. Wakeman. He went to college at Yale and graduated from Harvard Medical School in 1888. He then joined the staff of the New York Hospital as an intern on the surgical service, following which he began his career as a bone surgeon at New York Cancer Hospital (which later became part of the Memorial Sloan-Kettering Cancer Center). Coley became more interested in cancer treatment when one of his early patients, Elizabeth Dashiell, died from bone cancer. While going through hospital records, Coley found a sarcoma case study of one patient named Fred Stein, whose tumor disappeared following a high fever from erysipelas infection, now known as Streptococcus pyogenes. This sparked Coley’s interest and drove him to find what few examples of similar cancer treatment had been previously recorded. He discovered that other medical pioneers including Robert Koch, Louis Pasteur, and Emil von Behring, had recorded observations of erysipelas infection coinciding with cancer regression.

 

From 1925 to 1933, Coley served as Surgeon-in-Chief of the Hospital for Special Surgery in New York City, where he developed the theory that post-surgical infections had helped patients to recover better from their cancer by provoking an immune response. In 1891 he began to experiment by deliberately causing this phenomenon, injecting streptococcus bacteria directly into people being treated; later because this had the adverse effect of causing infection, he switched to using dead bacteria. Coley published the results of his work as a case series, making it difficult to interpret them with confidence. According to the American Cancer Society, “More research would be needed to determine what benefit, if any, this therapy might have for people with cancer“. Cancer Research UK say that “available scientific evidence does not currently support claims that Coley’s toxins can treat or prevent cancer“. People with cancer who take Coley’s toxins alongside conventional cancer treatments, or who use it as a substitute for those treatments, risk seriously harming their health. By 1901, the development of x-rays as a cancer treatment showed great promise. In particular, the therapy resulted in immediate tumor destruction and pain relief. Although Coley claimed successful treatment of hundreds of patients, the absence of proven benefit or reproducibility led to broader emphasis on surgery and on the newly developing field of radiation therapy. This decision was borne out by the eventual successful treatment of millions of people worldwide with radiation therapy. Coley arranged for a wealthy friend to provide funds to purchase two x-ray machines for his use. However, after several years of experience, Coley came to the conclusion that the effect of that primitive x-ray therapy in the untrained hands of experimenters was localized, temporary and not curative. The scientific majority disagreed, most notably his contemporary James Ewing. His contemporary critics cited the dangerous and unpredictable effects, predominantly the fever caused by the bacteria, that the vaccine had upon individuals weakened by cancer. Furthermore, the vaccine had to be made to a patient’s exact needs, making it more labor-intensive, time-consuming and expensive.

 

In 2009, Coley’s theory that immune systems in humans functioned in a cycle was demonstrated by a research team led by Associate Professor Brendon Coventry, which could have significant ramifications for cancer treatment. In 2005, drug makers including Pfizer and Sanofi-Aventis had a renewed interest in modern versions of Coley’s Toxins. Pfizer has acquired the Coley Pharmaceutical Group, set up in 1997. The historical results of Coley vaccine therapy are difficult to compare with modern results. Coley’s studies were not well controlled and factors such as length of treatment and fever level were not adequately documented. Many of his patients had also received radiation and sometimes surgery. According to the analyses of Coley Nauts and Starnes, treatment success correlated with length of therapy and the fevers induced by the toxins. Coley’s daughter, Helen Coley Nauts, established the nonprofit Cancer Research Institute in 1953 to study her father’s work. The organization has since become a leader in funding research in immunology and tumor immunology at universities and hospitals worldwide.

 

Today immunotherapy (plus personalized medicine) is cutting-edge cancer treatment. But more than 100 years ago, it was extremely difficult to get other physicians to agree with William Coley MD. Here is a more detailed account of the cases contributing to Dr. Coley’s ideas:

 

In the late summer of 1890 young Coley was getting ready to examine a new patient at his practice in New York City. What he didn’t know was that the young woman waiting to see him would change his life and the future of cancer research. Her name was Elizabeth Dashiell, also known as Bessie. Bessie was 17 and showed up complaining of a problem with her hand. It seemed like a minor injury, just a small bump where she’d hurt it, but it wasn’t getting better, and she was in a lot of pain. She’d seen other doctors but nobody could diagnose the problem. At first Coley thought Bessie must have an infection. But when he took a biopsy, it turned out to be a malignant, very advanced cancer called a sarcoma. In those days there wasn’t very much anyone could do for Bessie. This was before radiation and chemotherapy, so Coley did the only thing he could – he amputated Bessie’s right arm just below the elbow in an attempt to stop the disease from spreading. Sadly, it didn’t work, and within a month, according to David Levine, the cancer had spread “to her lungs, to her liver and all over her body.“ Bessie’s final days were wrenching and painful. Coley was with her when she died on Jan. 23, 1891. Bessie’s death made a huge impression on the young surgeon. “It really shocked him,“ says Stephen Hall, who wrote about Coley in his book A Commotion in the Blood: Life, Death and the Immune System. Bessie’s death also spurred Coley into action. There wasn’t a lot known about cancer at the time, so Coley started digging through dozens upon dozens of old records at New York Hospital. He was looking for something that would help him understand this cruel and aggressive disease. As a student, Coley had read Charles Darwin, and one of the lessons he took away from Darwin, Hall says, was to always pay attention when there’s a biological exception to the rule. “To ask yourself: Why this has happened?“ Coley discovered one of these biological exceptions. It was the case of a German immigrant named Fred Stein. Stein had been a patient in New York Hospital eight years earlier. He had a tumor on his neck that doctors tried to remove several times. Unfortunately for Stein, the tumor kept coming back and doctors expected him to die from the disease. Then Stein contracted a serious infection of the skin caused by the strep bacteria. “It looked like Stein’s days were numbered,“ Levine says. But Stein didn’t die. In fact, his tumor disappeared, and he was discharged. Coley wondered if all these years later, Stein could still be alive. So in the winter of 1891, William Coley the surgeon became William Coley the detective. He headed for the tenements of the Lower East Side of Manhattan where the German immigrant community lived. He knocked on door after door asking for a man named Fred Stein who had a distinctive scar across his neck. After several weeks of searching, Coley found him alive and cancer-free. So why did Stein’s cancer go away and stay away after he got a bacterial infection? Coley speculated that the strep infection had reversed the cancer. and wondered what would happen if he tried to reproduce the effect by deliberately injecting cancer patients with bacteria. He decided to test his idea on people who were the most seriously ill. His first subject was an Italian immigrant named Zola who, just like Bessie Dashiell, was suffering from sarcoma. Zola had tumors riddling his throat. He was so sick he could barely eat or speak or even breathe. For months Coley would try to make Zola sick from infection by creating little cuts and rubbing the strep bacteria into them, Hall says. There would be “a slight response but not too much.“ Then Coley got his hands on a much stronger strain of the bacteria. This time, Zola became violently ill with an infection that could easily have killed him. But within 24 hours, Zola’s orange-sized tumor began to liquefy and disintegrate. “This was a phenomenon that occurred rarely, but when you saw it you were utterly astonished,“ Hall says. Zola completely recovered. Coley knew he was on to something. He kept experimenting and refining his use of bacteria. Eventually, he named the treatment Coley’s toxins.

 

It was an exciting time. Coley was having tremendous success and his efforts were celebrated in America and abroad. But Bradley Coley Jr., William Coley’s grandson, says the American medical establishment at the time was skeptical. Nobody knew how Coley’s toxins worked, or why they worked sometimes and not others. Not even Coley could explain it. That’s largely because the immune system was still a mystery and would remain so for decades to come. When radiation therapy came along in the early 1900s, interest in Coley’s toxins was completely overshadowed by this new therapy. When his grandfather died, Bradley Coley says, “All interest in [Coley’s toxins] stopped.“ And quite possibly, that’s where Coley’s legacy would have ended except for this: After Coley’s death in 1936, his daughter, Helen Coley Nauts, started looking through her father’s papers while doing research for his biography. She found about 1,000 files of patients her father had treated with Coley’s toxins. She spent years carefully analyzing these cases and could see that he had extraordinary rates of success in regressing some cancerous tumors. She couldn’t get anyone interested in studying her father’s work, so she decided to do it herself. With a small grant, in 1953 Helen Coley Nauts started the Cancer Research Institute, dedicated to understanding the immune system and its relationship to cancer. In the more than 60 years since, researchers have expanded their understanding of the immune system dramatically and today, that understanding is paying off. Treatments that harness the power of the immune system are now available for a range of cancers such as stomach, lung, leukemia, melanoma and kidney. Jedd Wolchok, chief of the melanoma and immunotherapeutics service at Memorial Sloan Kettering Cancer Center, says any treatment currently in use that exploits the power of the immune system to fight cancer has to “tip its hat“ to the work William Coley began more than 100 years ago. William Coley’s intuitions were correct: Stimulating the immune system may be effective in treating cancer. He was a model of the clinician-scientist, treating patients and using his practice to initiate research and build theories. But he was a man before his time, and he met with severe criticism. Despite this criticism, however, Coley stuck with his ideas, and today we are recognizing their potential value.

Sources: NIH.gov; The University of Iowa; npr.org; Wikipedia

Thrilling Rescue Revealed, of U.S. Medics & Nurses, During WW 2 in Albania

U.S. Medics at work during WW2;  Source: Public Domain, Wikipedia Commons

 

Harold Hayes was a member of a band of airborne American medics and nurses who crash-landed in Nazi-occupied Albania in 1943 and trekked 600 miles to their rescue. All of these brave heroes were military trained army lieutenants. Harold Hayes, was the last surviving member of a band of airborne American medics and nurses who crashed-landed in Nazi-occupied Albania in 1943 and survived German attacks, blizzards and horrific privations on a 600-mile trek to their rescue on the Adriatic coast. He died last Sunday in Medford, Ore. He was 94. His death, at a hospital, followed an operation to remove a blood clot from his leg, his daughter Margaret Bleakley said.

 

The survival of the 30 noncombatants was a long-held secret of World War II: the story of 13 female nurses, 13 male medics and the four-man crew of a medical evacuation plane who were stranded behind enemy lines for nine weeks, hiding in villages and caves in wintry mountains, afflicted with lice and dysentery, often near starvation and hunted by German patrols. Their odyssey was classified during the war and for years afterward to protect partisan fighters, Allied agents and villagers who gave them food, shelter and guidance. Some were shot by the Germans for their acts of kindness, and after the war, as rumors became death sentences, those even suspected of helping the Americans were executed by Albania’s Communist dictator, Enver Hoxha, whose rule ended with his death in 1985.

 

“For many years, I didn’t say anything about what happened in Albania,“ Mr. Hayes said in a 2015 telephone interview with The New York Times from his assisted-living home in Medford. “After the war was over, Hoxha was ruthless. If he discovered the names of anyone who had helped us, he had them and their families executed.“ Mr. Hayes had no special role in the group’s survival, but by outliving all his wartime comrades, he became a last conduit for their story, which was related in a 1999 memoir by one of the nurses, and more recently in several books, notably “The Secret Rescue“ (2013), by Cate Lineberry, whose account relied heavily on Mr. Hayes’s recollections.

 

Harold Hayes and the other medics and nurses were part of a Medical Air Evacuation Transport Squadron. The United States medical air evacuation program was an innovative new medical military program within the Army Air Forces that transported wounded and sick from hospitals near the frontlines to better-equipped facilities for additional care. It was started in 1942, and during the war transported more than one million troops, with only forty-six dying in flight. In 1945, General of the Army Dwight Eisenhower deemed air evacuation as important as other WWII medical innovations, including penicillin and sulfa drugs. At the time the air evacuation program was developed in 1942, most Americans had never been on an airplane before. In fact, on January 14, 1943, FDR became the first U.S. president to fly on official business while on his way to the Casablanca Conference. The perilous adventure began two months after Italy surrendered and Allied forces invaded Italy to begin pushing the Germans back across Europe. On Nov. 8, 1943, the nurses, medics and fliers of the Army Air Force’s 807th Medical Air Evacuation Transport Squadron took off from Catania, Sicily, bound for Bari, on Italy’s east coast, where hundreds of wounded troops awaited air evacuation. Their twin-engine cargo plane carried no weapons, but the pilot, First Lt. Charles Thrasher, 22, anticipated no fighting. With him were a co-pilot, radio operator and crew chief. The nurses, all second lieutenants, were 22 to 32 years old. The medics, including Mr. Hayes, 21, from Indianola, Iowa, were all equivalent to staff sergeants and ranged in age from 21 to 36.

 

There wasn’t a cloud in the sky when we left the airfield, but the closer we got to Bari, the more clouds appeared. We were soon caught in a violent storm and lost all communication with the station at Bari. The plane’s compass and communications failed. In addition, the plane was low on gas. The pilots ascended above the clouds, but when the plane got up to about 8,000 feet, the wings started icing up, so we had to dive down through the clouds. Blown 100 miles off course, our plane crossed over into Albania. We could see a coastline; the pilots thought we might have flown across Italy and were near Italy’s western coast. They didn’t realize we’d crossed the Adriatic. The pilots tried to land on what looked like an abandoned airfield, and that’s when someone started shooting at us. The pilots immediately headed for the clouds. That was probably the scariest part?flying through a valley where the tops of the mountains were higher than the clouds. When we emerged from the clouds, our plane was very close to a German fighter plane and then to another, which attacked with antiaircraft guns. The pilots continued trying to dodge the enemy planes and eventually found a place near a lake where we crash-landed, 25 miles inland. When they started landing, medic, Harold Hayes thought the pilots wouldn’t be able to stop in time and that they would end up in the water. The pilots braked hard, and the landing gear sank in the mud. Just before the plane would have hit the water, it came to a violent stop. The force embedded the plane’s nose in the marshy ground, and the fuselage hovered upright for a few seconds before falling to the ground in a belly flop. The crew chief in the back of the plane was the only one not strapped in, and he went flying forward. Willis Shumway, 23, the crew chief, was the only casualty, with a knee injury that left him unable to walk. The disoriented Americans had no idea where they were. Fearing a fuel explosion, they scrambled out of the plane and encountered their first bit of luck. Striding out of a woods was a band of rugged-looking men with rifles and daggers. One spoke a little English. He was Hasan Gina, an anti-German partisan leader. He told the Americans they were in Albania. Two resistance groups were essentially fighting to see who would control Albania after the war ended. The partisans who met the Americans were one group, and the Balli Kombetar, or BK, was the second group. The BK was a right-wing nationalist group, opposed to the communist-led National Liberation Movement. The two groups had formed when the Italians occupied Albania. Italy had surrendered to the Allies in September 1943, two months before the Germans took control of the country. When the partisans led the Americans through the countryside they had to avoid not only the Germans but also the BK. Later, they would learn that they were 150 miles east of Bari, on the wrong side of the Adriatic, surrounded by German forces that had occupied Albania for months, and were caught in a civil war between rival partisan groups. With only a general plan to reach the west coast and somehow cross the Adriatic to Italy, the group began walking in the wrong direction.

 

After five days, they rested at a partisan-controlled town called Berat, but their respite was brief. German forces entered the town and three nurses were separated. They hid in Berat for four months while the group continued.

Over the ensuing weeks, they trekked through mountains and valleys, battling starvation, parasites and diarrhea. Sometimes they had to cut back or travel in circles to avoid German patrols. Lt. Gavan Duffy, a British secret agent, found the group in eastern Albania and began leading them westward, intending to reach the coast. At Gjirokaster, German troops blocked the way, and the Americans were too sick and exhausted to go on. He radioed for an American air rescue. Two C-47 cargo planes flew in with fighter escorts. But the Germans disrupted the landing. On Jan. 9, after a 63-day ordeal, they finally boarded a British launch and crossed to Italy.

 

The Americans knew almost nothing of Albania, a small, mostly Muslim country that had changed little in centuries. The mountainous terrain was dotted with impoverished villages. There were no railroads and few roads. Mules and horses were the main transportation. There was little running water or electricity. Winters were brutal, food was scarce, and blood feuds were common among the ferociously proud peoples. With only a general plan to reach the west coast and somehow cross the Adriatic to Italy, the Americans began walking in the wrong direction. Over the ensuing weeks, guided by the partisans, they trekked through mountains and valleys, sometimes cutting back or traveling in circles to avoid German patrols, living in the open or sheltering in villages and sharing cornbread with peasants. The Americans were soon listed as missing in action, and War Department telegrams, beginning “regret to inform you,“ were sent to their families back home.

 

The survivors, meantime, carried Sergeant Shumway on a stretcher made of seats from the plane; they later found pack animals for him. After five days, they rested at a partisan-controlled town called Berat, where they were cheered, mistaken for the vanguard of an Allied invasion to liberate Albania. They also met other partisan leaders, and learned of a British agent who had recently parachuted into the country. Their respite lasted only a few days. Then, they awoke to gunfire and the explosion of artillery shells as German forces entered the town. In the ensuing confusion, German planes strafed a truck carrying some of the escaping Americans. Three nurses were separated from the main group and left behind in Berat; they took refuge in a farmhouse, and remained in hiding in the area for four months. The main group of Americans climbed on foot to a mountain village and were caught in a crossfire between partisan groups. “It was the first time the Americans had heard of the rival group, and they were beginning to realize they were in as much danger from the country’s internal battle as they were from the Germans,“ Ms. Lineberry wrote in “The Secret Rescue.“ They encountered other perils. “Some of the blankets offered to them to ward off the cold night air were infested with fleas and lice,“ the author wrote. “Since they’d crashed, most of them had been unable to bathe, aside from splashing some water on their faces and arms from mountain streams or an occasional basin, and they were all filthy and now battling fleas, lice and the GIs,“ Army slang for diarrhea. The Americans were often unable to find food. Facing starvation, they made tea by boiling straw and ate berries that worsened their diarrhea. Sharing with peasants was sometimes a culture shock. Mr. Hayes and another medic saw a sheep’s head roasted over coals, then split in half with an ax. “The Americans watched wide-eyed as two women each took one-half of the head and ate everything, including the eyeballs,“ Ms. Lineberry wrote. “Nothing was wasted.“

 

As autumn waned, blizzards enveloped the Americans. Their clothing was too thin. Their shoes were worn out. “Though all their feet soon felt like blocks of ice and their bodies shivered, they knew they had to keep going,“ Ms. Lineberry wrote. “The snow was coming down so fast they could barely see the person in front of them, but they had to stay together to avoid losing one another in the blinding white storm.“ On Nov. 27, British intelligence in Albania learned from partisans that the American plane had crashed and that the nurses, medics and crew were alive, trying to reach the coast. Gen. Dwight D. Eisenhower, the Allied commander in Europe, and President Franklin D. Roosevelt and the families of the missing were told. In December, an American rescue plan was developed, led by an Army captain, Lloyd G. Smith, 24, who was assigned to the Office of Strategic Services, precursor of the Central Intelligence Agency. Under cover of darkness, he slipped onto the heavily guarded Albanian coast by boat and set up a base camp in a cave in the cliffs overlooking the Adriatic. Others joined him, and they moved inland to find the Americans. The British, meantime, organized a second rescue effort under Lt. Gavan Duffy, a secret agent who with a small team had reached Albania months earlier by parachute and on foot. Through partisan contacts, he found the Americans in eastern Albania and began leading them westward, intending to reach the coast. But halfway there, at Gjirokaster, German troops blocked the way, and the Americans were too sick and exhausted to go on. He radioed for an American air rescue. Two C-47 cargo planes flew in with fighter escorts. But the Germans disrupted the landing, and Lieutenant Duffy called it off. The Americans, after the euphoria of nearly being rescued, were crushed. But they resumed their journey, and with American and British help reached the coast. On Jan. 9, after a 63-day ordeal, 27 Americans – 10 nurses and 17 medics and fliers – boarded a British launch and crossed to Italy.  Three nurses remained behind in German-occupied Berat. Captain Lloyd Smith brought them to safety in March 1944. They rode pack mules most of the way to the coast and were met by a torpedo boat, which took them across the Adriatic.

 

Kostaq Stefa was the main Albanian partisan leader, who led the Americans for several weeks. Sadly, when Kostaq returned from helping the Americans, he was tortured for several days by the BK. After the war, communist dictator Enver Hoxha had Stefa executed in 1948. He left behind a widow and five children.

 

After the war, Mr. Hayes returned to civilian life, attended Iowa State College and became an aeronautical engineer for North American Aviation, designing military planes and conducting studies for the Air Force and the National Aeronautics and Space Administration until he retired in 1984. He married the former Betty Allen in 1944. She and their daughter survive him, as does another daughter, Victoria Sprott; two brothers, Karl and James; a sister, Virginia McCall; two grandsons; and a great-granddaughter. Harold Lyle Hayes was born in Pekin, Iowa, on April 11, 1922, to Ralph and Jenella Van Gorp Hayes. He graduated from high school in Indianola in 1940. After Japan attacked Pearl Harbor on Dec. 7, 1941, he was drafted, volunteered as a medic and by 1943 was in Sicily, flying evacuation missions. “When he first returned to Allied lines, he had nightmares of being chased,“ Ms. Lineberry wrote of Mr. Hayes. “Those faded with time, but as was true of many in the group, he rarely talked about his ordeal over the years.“ Source: The New York Times, by Robert D. McFadden

 

Ancient Methods of Birth Control

Ancient silver coin from Cyrene depicting a stalk of silphium

Sources: Wikipedia Commons

 

The Egyptian Ebers Papyrus from 1550 BCE and the Kahun Papyrus from 1850 BCE have within them some of the earliest documented descriptions of birth control: the use of honey, acacia leaves and lint to be placed in the vagina to block sperm. It is believed that in Ancient Greece silphium was used as birth control which, due to its effectiveness and thus desirability, was harvested into extinction. In medieval Europe, any effort to halt pregnancy was deemed immoral by the Catholic Church, although it is believed that women of the time still used a number of birth control measures, such as coitus interruptus and inserting lily root and rue into the vagina. Women in the Middle Ages were also encouraged to tie weasel testicles around their thighs during sex to prevent pregnancy. The oldest condoms discovered to date were recovered in the ruins of Dudley Castle in England, and are dated back to 1640. They were made of animal gut, and were most likely used to prevent the spread of sexually transmitted diseases during the English Civil War. Casanova, living in 18th century Italy, described the use of a lambskin covering to prevent pregnancy; however, condoms only became widely available in the 20th century.

 

A CycleBeads, used for estimating fertility based on days since last menstruation. Credit: By Dellex – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=5608730

 

 

Birth Control Movement

 

And the villain still pursues her“, a satirical Victorian era postcard. Source: Wikipedia Commons

 

 

The birth control movement developed during the 19th and early 20th centuries. The Malthusian League, based on the ideas of Thomas Malthus, was established in 1877 in the United Kingdom to educate the public about the importance of family planning and to advocate for getting rid of penalties for promoting birth control. It was founded during the “Knowlton trial“ of Annie Besant and Charles Bradlaugh, who were prosecuted for publishing on various methods of birth control. In the United States, Margaret Sanger and Otto Bobsein popularized the phrase “birth control“ in 1914. Sanger was mainly active in the United States but had gained an international reputation by the 1930s. At the time, under the Comstock Law, distribution of birth control information was illegal. She jumped bail in 1914 after her arrest for distributing birth control information and left the United States for the United Kingdom to return in 1915. Sanger established a short-lived birth-control clinic based in the Brownville section of Brooklyn, New York in 1916, which was shut down after eleven days and resulted in her arrest. The publicity surrounding the arrest, trial, and appeal sparked birth control activism across the United States.

 

The first permanent birth-control clinic was established in Britain in 1921 by Marie Stopes working with the Malthusian League. The clinic, run by midwives and supported by visiting doctors, offered women’s birth-control advice and taught them the use of a cervical cap. Her clinic made contraception acceptable during the 1920s by presenting it in scientific terms. In 1921, Sanger founded the American Birth Control League, which later became the Planned Parenthood Federation of America. In 1924 the Society for the Provision of Birth Control Clinics was founded to campaign for municipal clinics; this led to the opening of a second clinic in Greengate, Salford in 1926. Throughout the 1920s, Stopes and other feminist pioneers, including Dora Russell and Stella Browne, played a major role in breaking down taboos. In April 1930 the Birth Control Conference assembled 700 delegates and was successful in bringing birth control and abortion into the political sphere. Three months later, the Ministry of Health, in the United Kingdom, allowed local authorities to give birth-control advice in welfare centers. In 1936 the U.S. court ruled in U.S. v. One Package that medically prescribing contraception to save a person’s life or well-being was not illegal under the Comstock Law. Following this decision, the American Medical Association Committee on Contraception revoked its 1936 statement condemning birth control. A national survey in 1937 showed 71% of the adult population supported the use of contraception. By 1938 347 birth control clinics were running in the United States despite their advertisement still being illegal. First Lady Eleanor Roosevelt publicly supported birth control and family planning. In 1966, President Lyndon B. Johnson started endorsing public funding for family planning services, and the Federal Government began subsidizing birth control services for low-income families. The Affordable Care Act, passed into law on March 23, 2010 under President Barack Obama, requires all plans in the Health Insurance Marketplace to cover contraceptive methods. These include barrier methods, hormonal methods, implanted devices, emergency contraceptives, and sterilization procedures.

 

In 1909, Richard Richter developed the first intrauterine device made from silkworm gut, which was further developed and marketed in Germany by Ernst Grafenberg in the late 1920s. In 1951, a chemist, named Carl Djerassi from Mexico City made the hormones in progesterone pill using Mexican yams. Djerassi had chemically created the pill but was not equipped to distribute them to patients. Meanwhile, Gregory Pincus and John Rock, with help from the Planned Parenthood Federation of America, developed the first birth control pills in the 1950s, such as mestranol/noretynodrel, which became publicly available in the 1960s in the US under the name Enovid. Medical abortion became an alternative to surgical abortion with the availability of prostaglandin analogs in the 1970s and mifepristone in the 1980s.

 

2017 marks the 57th anniversary of the birth control pill, which many considered to have empowered women and sparked the sexual revolution. However, for centuries, women have had some control over reproduction, although perhaps, not as effective as what’s available today.

 

Records exist of women in ancient Rome and Greece relying on dances and amulets to prevent pregnancy, and we can assume that those practices probably didn’t work.

 

Citric Acid

 

Credit: Wikipedia

 

 

Citric acid is said to have spermicidal properties, and women used to soak sponges in lemon juice before inserting them vaginally. Mentioned in the Talmud, this was a preferred method of birth control in ancient Jewish communities. The sponge itself would act as a pessary, a physical barrier between the sperm and the cervix. The great womanizer Casanova was said to have inserted the rind of half a lemon into his lovers as a primitive cervical cap or diaphragm, the residual lemon juice serving to annihilate the sperm. Lemon- and lime-juice douches following coitus were also recommended as a form of birth control, but this method was likely less effective, since sperm can enter the cervix – and hence out of reach of any douching – within minutes of ejaculation. Incidentally, some alternative medicine practitioners today suggest that megadoses of vitamin C (6 to 10 g a day) could induce an abortion in women under 4 weeks of pregnancy, but there’s no evidence that citrus fruits were used in this way in ancient times.

 

Queen Anne’s Lace

 

Queen Anne’s Lace (most beautiful wild flower). Credit: Wikipedia

 

 

Queen Anne’s Lace is also known as wild carrot, and its seeds have long been used as a contraceptive. Hippocrates described this use over two millennia ago. The seeds block progesterone synthesis, disrupting implantation and are most effective as emergency contraception within eight hours of exposure to sperm, a sort of “morning after“ form of birth control. Taking Queen Anne’s Lace led to no or mild side effects (like a bit of constipation), and women who stopped taking it could conceive and rear a healthy child. The only danger, it seemed, was confusing the plant with similar-looking but potentially deadly poison hemlock and water hemlock.

 

Pennyroyal

 

Pennyroyal Credit: Wikipedia Commons

 

Pennyroyal is a plant in the mint genus and has a fragrance similar to that of spearmint. The ancient Greeks and Romans used it as a cooking herb and a flavoring ingredient in wine. They also drank pennyroyal tea to induce menstruation and abortion. 1st-century physician Dioscorides records this use of pennyroyal in his massive five-volume encyclopedia on herbal medicine. Too much of the tea could be highly toxic, however, leading to multiple organ failure.

 

Blue Cohosh

 

Blue cohosh found on the grounds of the University of Michigan.

Credit: Wikipedia Commons

 

Blue cohosh, traditionally used for birth control by Native Americans. It contains at least two abortifacient substances: one mimics oxytocin, a hormone produced during childbirth that stimulates the uterus to contract, and a substance unique to blue cohosh, caulosaponin, also results in uterine contractions. Midwives today may use blue cohosh in the last month of pregnancy to tone the uterus in preparation for labor. The completely unrelated but similarly named black cohosh also has estrogenic and abortifacient properties and was often combined with blue cohosh to terminate a pregnancy.

 

Dong Quai or Chinese Angelica

 

Dong quai, also known as Chinese angelica, has long been known for its powerful effects on a woman’s cycle. Women drank a tonic brewed with dong quai roots to help regulate irregular menstruation, alleviate menstrual cramps and help the body regenerate after menstruation. Taken during early pregnancy, however, dong quai had the effect of causing uterine contractions and inducing abortion. European and American species of angelica have similar properties but were not as widely used.

 

Common Rue

 

The Tacuinum Sanitatis, a medieval handbook on wellness, lists the following 5 properties of rue:

  • Nature: Warm and dry in the third degree.
  • Optimum: That which is grown near a fig tree.
  • Usefulness: It sharpens the eyesight and dissipates flatulence.
  • Dangers: It augments the sperm and dampens the desire for coitus.
  • Neutralization of the Dangers: With foods that multiply the sperm.

 

The refined oil of rue is an emmenagogue and was cited by the Roman historian Pliny the Elder and the gynecologist Soranus as a potent abortifacient (inducing abortion). Rue, a blue-green herb with feathery leaves, is also grown as an ornamental plant and is favored by gardeners for its hardiness. It is rather bitter but can be used in small amounts as a flavoring ingredient in cooking. Soranus, a gynecologist from 2nd-century Greece, described its use as a potent abortifacient, and women in Latin America have traditionally eaten rue in salads as a contraceptive and drunk rue tea as emergency contraception or to induce abortion. Ingested regularly, rue decreases blood flow to the endometrium, essentially making the lining of the uterus non-nutritive to a fertilized egg.

 

Cotton

 

Cotton Shrub; Credit: Wikipedia Commons

 

The earliest evidence of cotton use has been found at sites where cotton threads were preserved in copper beads; these finds have been dated to Neolithic (between 6000 and 5000 BCE). Cotton cultivation in the region is dated to the Indus Valley Civilization.In the ancient medical manuscript the Ebers Papyrus (1550 BCE), women were advised to grind dates, acacia tree bark, and honey together into a paste, apply this mixture to seed wool, and insert the seed wool vaginally for use as a pessary. Granted, it was what was in the cotton rather than the cotton itself that promoted its effectiveness as birth control – acacia ferments into lactic acid, a well-known spermicide – but the seed wool did serve as a physical barrier between ejaculate and cervix. Interestingly, though, women during the times of American slavery would chew on the bark of cotton root to prevent pregnancy. Cotton root bark contains substances that interfere with the corpus luteum, which is the hole left in the ovary when ovulation occurs. The corpus luteum secretes progesterone to prepare the uterus for implantation of a fertilized egg. By impeding the corpus luteum’s actions, cotton root bark halts progesterone production, without which a pregnancy can’t continue.

 

 

Papaya

 

Papaya tree and fruit, from Koehler’s Medicinal-Plants (1887). Source: Wikipedia Commons

 

 

In South Asia and Southeast Asia, unripe papaya was used to prevent or terminate pregnancy. Once papaya is ripe, though, it loses the phytochemicals that interfere with progesterone and thus its contraceptive and abortifacient properties. The seeds of the papaya could actually serve as an effective male contraceptive. Papaya seeds, taken daily, could cut a man’s sperm count to zero and was safe for long-term use. Best of all, the sterility was reversible: if the man stopped taking the seeds, his sperm count would return to normal.

 

Silphium

 

Silphium on ancient Banner. Source: Italian Wikipedia, Wikipedia Commons

 

 

Silphium was a member of the fennel family that grew on the shores of Cyrenaica (in present-day Libya). It was so important to the Cyrenean economy that it graced that ancient city’s coins. Silphium had a host of uses in cooking and in medicine, and Pliny the Elder recorded the herb’s use as a contraceptive. It was reportedly effective for contraception when taken once a month as a tincture. It could also be used as emergency birth control, either orally or vaginally, as an abortifacient. By the second century CE, the plant had gone extinct, likely because of over harvesting.

 

Mercury

 

Credit: Wikipedia Commons

 

Civilizations the world over, from the ancient Assyrians and Egyptians to the Greeks, were fascinated by mercury and were convinced that it had medicinal value and special curative properties, using it to treat everything from skin rashes to syphilis. In ancient China, women were advised to drink hot mercury to prevent pregnancy. It was effective at convincing a woman’s body that she wasn’t fit to carry a child, leading to miscarriage, so, it did work as a contraceptive. However, mercury is enormously toxic, causing kidney and lung failure, as well as brain damage and death. Sources: Iva Cheung; Wikipedia

 

100 Years Later, Death Theories of Healer, Grigori Rasputin Remain a Mystery

Grigori Rasputin 1869-1916: Photo source: Public Domain, Wikipedia Commons

 

 

Grigori Yefimovich Rasputin was a Russian peasant, an experienced traveler, a mystical faith healer, and trusted friend of the family of Nicholas II, the last Tsar of the Russian Empire. He became an influential figure in Saint Petersburg, especially after August 1915 when Nicholas took command of the army fighting in World War I. Advising his wife, Alexandra Feodorovna, in countless spiritual and political issues, Rasputin became an easy scapegoat for Russian nationalists, liberals and aristocrats. There is uncertainty over much of Rasputin’s life and the degree of influence that he exerted over the extremely shy Tsar and the strong-willed Tsarina. Accounts are often based on dubious memoirs, hearsay, and legend. While his influence and position may have been exaggerated by society gossip and his own drunken boasting his presence played a significant role in the increasing unpopularity of the Imperial couple. It is believed that Rasputin was murdered by monarchists who hoped to save Tsarism by ending his sway over the royal family. The end of December 2016, marked the 100th anniversary of the death of Rasputin, the “mad monk of Russia“, or “lover of the Russian queen.“

 

Grigori Yefimovich Rasputin, a mystic and spiritual healer born in Pokrovskoe in Siberia, wielded huge influence over the Russian royal family, particularly Alexandra, the Tsarina, who looked to the spiritual healer to cure her hemophiliac son, heir, Tsesarevich Alexei.

 

On 13 October 1906, Rasputin paid a visit to the Imperial family and presented an icon. On request of the Tsar, he then visited the next prime minister, Pyotr Stolypin. A few weeks before, 29 people had been killed on Aptekarsky Island in a bomb attack by the Maximalists and two of Stolypin’s children were wounded. Rasputin was invited to pray. On 6 April 1907, Rasputin was invited to Alexander Palace in Tsarskoe Selo, this time to see Tsesarevich Alexei, the heir. The boy had suffered an injury which caused him painful bleeding. By then, it was not known that Alexei had a rare form of hemophilia. The doctors could not supply a cure, and the desperate Tsarina invited Rasputin. He was able to calm the parents and their son, standing at the foot of the bed and praying. From that moment, Alexandra believed Rasputin was Alexei’s savior. Pierre Gilliard, the French historian Helene Carrere d’Encausse, and journalist Diarmuid Jeffreys speculated that Rasputin’s healing practice included halting the administration of aspirin, a pain-relieving analgesic available since 1899. Aspirin is an anticoagulant and has blood-thinning properties; the mechanism of action of aspirin is that it prevents clotting and promotes bleeding, which could have caused the hemarthrosis at the root of Alexei’s joints swelling and pain. On September 1912, the Romanovs were visiting their hunting retreat in the Bialowieza Forest; on 5 September, the careless Tsesarevich jumped into a rowboat and hit one of the oarlocks. A large bruise appeared within minutes. Within a week the hematoma reduced in size. In mid-September, the family moved to Spala (then in Russian Poland). On 2 October, after a drive in the woods, the “juddering of the carriage had caused still healing hematoma in his upper thigh to rupture and start bleeding again.“ Alexei had to be carried out in an almost unconscious state. His temperature rose and his heartbeat dropped, caused by a swelling in the left groin; Alexandra barely left his bedside. A constant record was kept of the boy’s temperature. On 10 October, a medical bulletin appeared in the newspapers, and Alexei received the last sacrament. His condition then improved at once, according to the Tsar. The positive trend continued throughout the next day. According to Nelipa, Robert K. Massie was correct to recommend that psychological factors do play a part.

 

It is not exactly clear on which day, either 9, 10, or 11 October, the Tsarina turned to her lady-in-waiting and best friend, Anna Vyrubova, to secure the help of the peasant healer, who at that time was out of favor. According to his daughter, Rasputin received the telegram on 12 October. If Maria Rasputin was right about the day, the telegram was sent “the longstanding claim that Rasputin had somehow alleviated Alexei’s condition is simply fictitious“, according to Nelipa. The next day he seems to have responded, with a short telegram, including the prophecy: “The little one will not die. Do not allow the doctors [c.q. Eugene Botkin and Vladimir Derevenko] to bother him too much.“ On 19 October, Alexei’s condition was considerably better and the hematoma disappeared, but he had to undergo orthopedic therapy to straighten his left leg. The court physician, Botkin, believed that Rasputin was a charlatan and his apparent healing powers arose from his use of hypnosis, but Rasputin was not interested in this practice before 1913 and his teacher Gerasim Papnadato was expelled from St. Petersburg in 1914. Felix Yusupov, one of Rasputin’s enemies, suggested that he secretly drugged Alexei with Tibetan herbs which he had obtained from a “quack doctor“. For Fuhrmann, these ideas on hypnosis and drugs flourished because the imperial family lived such isolated lives. For Moynahan, “There is no evidence that Rasputin ever summoned up spirits, or felt the need to; he won his admirers through force of personality, not by tricks.“ For Maria Rasputin and Vladimir Sukhomlinov, it was magnetism. For Shelley, the secret of his power lay in the sense of calm, gentle strength, and shining warmth of conviction.

 

What is known about the death of Rasputin, December, 1916, one hundred years ago, is that one evening Rasputin went to the Yusupov Palace in St Petersburg at the invitation of Prince Felix Yusupov. Rasputin’s dead body was recovered from the frozen Neva River days later. No one is completely sure what happened in between these two events. The most well-known account of the events comes from Prince Yusupov himself in his memoirs Lost Splendour. This autobiography reads more like a boy’s own adventure story than a reliable historical document and many doubt the authenticity of what he wrote. According to Yusupov, when Rasputin arrived at the palace he was taken down to the cellar where he was given cake and madeira wine. Upstairs, a gramophone played Yankee Doodle Dandy to fool the monk in to believing there was a party in full swing. Yusupov and his accomplices had planned things carefully. The cakes offered to Rasputin had been laced with enough potassium cyanide to slay a monastery full of monks. But Rasputin just kept eating them. Incredulous at the monk’s survival, Prince Yusupov poured madeira into a cyanide-laced wine glass and handed it to Rasputin. Instead of collapsing into unconsciousness within seconds, as would be expected from a massive dose of cyanide, Rasputin continued to sip the wine like a connoisseur. A second lethal glass disappeared into the monk’s mouth with little apparent effect other than some difficulty swallowing. Asked if he was feeling unwell he replied “Yes, my head is heavy and I’ve a burning sensation in my stomach.“ A third glass of tainted wine only seemed to revive him. Having ingested their whole stock of cyanide, the group of assassins were somewhat at a loss as to what to do next. So they shot him. The bullet appeared to have entered the body near the heart – certain death, or so they thought. But, soon after, Rasputin’s eyes opened and, clearly upset at the turn of events, he attacked Yusupov. There was a ferocious struggle before the prince could free himself and run away up the stairs. Rasputin followed. The group finally emerged into a courtyard, where four more shots were fired into Rasputin’s body before he slumped to the ground. To make sure they wouldn’t be troubled again, the assassins wrapped and tied the body with a piece of heavy linen, bundled it into a car and drove to Petrovski Island, where it was dropped from a bridge into the frozen river below.

 

The whole account sounds fanciful from start to finish, but remarkable things do happen. Human beings have achieved incredible physical feats in spite of horrible injuries. Maybe Rasputin really was still alive after the first shot and capable of a fight. But what about the poison? Surely no one could eat so much cyanide with so little effect? The theories as to why the cyanide didn’t kill Rasputin are almost as numerous as the theories of how he really died. What is surprising is that the theories are scientifically credible. The first theory is that the poisoners were not the supposed strength. Either they didn’t use enough, or the cyanide they had was old stock that had decayed into something far less toxic. Though plausible, a century after the events it is impossible to tell if this is true. The second theory is that Rasputin, aware that someone might be trying to kill him (he had survived at least one assassination attempt already), had decided to protect himself against poison. Perhaps he was inspired by Mithridates, king of Pontus in the first century BCE, who, fearful of poisoners, concocted an antidote or preventative. By ingesting sub-lethal amounts of every known poison he developed an immunity. When Mithridates was under threat from the local populace he tried to kill himself with poison, but the attempt failed and he had to request that a guard kill him with a sword. It is true that the body can develop a natural immunity or tolerance to some very toxic substances by administering very small doses over a period of time. Some of these toxic compounds include snake venom, ricin and opiates, to name but a few. Unfortunately, cyanide isn’t one of those substances. You simply cannot build up a natural tolerance to cyanide by using this method. The third theory is that Rasputin had alcoholic gastritis, which can lead to having less stomach acid. Without acid in the stomach, the potassium cyanide can’t be converted into hydrogen cyanide, and is therefore considerably less toxic. It’s another plausible explanation, but no one really knows if Rasputin suffered from this complaint or not. The fourth theory is that his poisoners unintentionally gave him the antidote along with the poison. Studies have shown that rats fed sugar with cyanide fare a lot better than those fed cyanide without it. The theory, though not proven, is that the sugar binds to the cyanide in a way that allows its excretion before it can be fully absorbed into the body. The assassins therefore may have chosen poorly when they elected to deliver the cyanide in sugary cakes and wine. The final theory is that Yusupov made the whole thing up, and Rasputin was simply shot shortly after he arrived at the palace by a person or persons unknown. This is probably much nearer the truth – but it isn’t nearly as interesting as stories of an “unkillable“ monk.

 

Rasputin was an extraordinary but minor figure. He contributed little to the tragedy that engulfed Russia in the first two decades of the 20th century. Far more important were a grossly incompetent monarch in the shape of Nicholas II, a ruthless revolutionary in the form of Lenin, and a world war that the Russian government was no more able to avert than any other. All combined to bring down a nation that, if left to itself, might perhaps have become what so many Russians have hoped for, a “normal“ and prosperous country. Sources: The Guardian (Kathryn Harkup); Wikipedia

 

Homosexuality

Burning of two homosexuals at the stake outside Z?rich, 1482 (Spiezer Schilling).

Source: Public Domain, Wikipedia Commons

 

 

Classical period: Europe

 

The earliest Western documents (in the form of literary works, art objects, and mythographic materials) concerning same-gender relationships are derived from ancient Greece. With regard to male homosexuality such documents depict a world in which relationships with women and relationships with youths were the essential foundation of a normal man’s love life. Same-gender relationships were a social institution variously constructed over time and from one city to another. The formal practice, an erotic yet often restrained relationship between a free adult male and a free adolescent, was valued for its pedagogic benefits and as a means of population control, though occasionally blamed for causing disorder. Plato praised its benefits in his early writings but in his late works proposed its prohibition. Aristotle, in the Politics, dismissed Plato’s ideas about abolishing homosexuality; he explains that barbarians like the Celts accorded it a special honor, while the Cretans used it to regulate the population.

 

Little is known of female homosexuality in antiquity. Sappho, born on the island of Lesbos, was included by later Greeks in the canonical list of nine lyric poets. The adjectives deriving from her name and place of birth (Sapphic and Lesbian) came to be applied to female homosexuality beginning in the 19th century. Sappho’s poetry centers on passion and love for various personages and both genders. The narrators of many of her poems speak of infatuations and love (sometimes requited, sometimes not) for various females, but descriptions of physical acts between women are few and subject to debate.

 

Sappho reading to her companions on an Attic vase of c. 435 BCE.

Source: Public Domain, Wikipedia Commons

 

 

In Ancient Rome the young male body remained a focus, but relationships were between older free men and slaves or freed youths who took the receptive role. The Hellenophile emperor Hadrian is renowned for his relationship with Antinous, but the Christian emperor Theodosius I decreed a law on 6 August 390, condemning passive males to be burned at the stake. Justinian, towards the end of his reign, expanded the proscription to the active partner as well (in 558), warning that such conduct can lead to the destruction of cities through the “wrath of God“. Notwithstanding these regulations, taxes on brothels of boys available for homosexual relationships continued to be collected until the end of the reign of Anastasius I in 518.

 

Renaissance

 

During the Renaissance, wealthy cities in northern Italy – Florence and Venice in particular – were renowned for their widespread practice of same-gender love, engaged in by a considerable part of the male population and constructed along the classical pattern of Greece and Rome. But even as many of the male population were engaging in same-gender relationships, the authorities, under the aegis of the Officers of the Night court, were prosecuting, fining, and imprisoning a good portion of that population. From the second half of the 13th century, death was the punishment for male homosexuality in most of Europe. The relationships of socially prominent figures, such as King James I and the Duke of Buckingham, served to highlight the issue, including in anonymously authored street pamphlets: “The world is chang’d I know not how, For men Kiss Men, not Women now;.Of J. the First and Buckingham: He, true it is, his Wives Embraces fled, To slabber his lov’d Ganimede“ (Mundus Foppensis, or The Fop Display’d, 1691).

 

18th and 19th Centuries

 

Love Letters Between a Certain Late Nobleman and the Famous Mr. Wilson was published in 1723 in England and was presumed by some modern scholars to be a novel. The 1749 edition of John Cleland’s popular novel Fanny Hill includes a homosexual scene, but this was removed in its 1750 edition. Also in 1749, the earliest extended and serious defense of homosexuality in English, Ancient and Modern Pederasty Investigated and Exemplified, written by Thomas Cannon, was published, but was suppressed almost immediately. It includes the passage, “Unnatural Desire is a Contradiction in Terms; downright Nonsense. Desire is an amatory Impulse of the inmost human Parts.“ Around 1785 Jeremy Bentham wrote another defense, but this was not published until 1978. Executions for certain activities continued in the Netherlands until 1803, and in England until 1835. Between 1864 and 1880 Karl Heinrich Ulrichs published a series of twelve tracts, which he collectively titled Research on the Riddle of Man-Manly Love. In 1867, he became the first self-proclaimed gay person to speak out publicly in defense of gayness when he pleaded at the Congress of German Jurists in Munich for a resolution urging the repeal of discriminatory laws. A book by Havelock Ellis, published in 1896, challenged theories that homosexuality was abnormal, as well as stereotypes, and insisted on the ubiquity of homosexuality and its association with intellectual and artistic achievement. Although medical texts like these (written partly in Latin to obscure the graphic details) were not widely read by the general public, they did lead to the rise of Magnus Hirschfeld’s Scientific-Humanitarian Committee, which campaigned from 1897 to 1933 against discriminatory laws in Germany, as well as a much more informal, unpublicized movement among British intellectuals and writers, led by such figures as Edward Carpenter and John Addington Symonds. Beginning in 1894 with Homogenic Love, Socialist activist and poet Edward Carpenter wrote a string of pro-gay articles and pamphlets, and “came out“ in 1916 in his book My Days and Dreams. In 1900, Elisar von Kupffer published an anthology of homosexual literature from antiquity to his own time, Lieblingminne und Freundesliebe in der Weltliteratur.

 

Dementia

Credit: Garrondo, National Institute on Aging; Public Domain, Wikipedia Commons

 

Credit: National Institutes of Health nlm.nih.gov/medline; Public Domain, Wikipedia Commons

 

 

The history of dementia is probably as old as mankind itself. In recent years, considerable advances have been made in our understanding of the epidemiology, the pathogenesis and the diagnosis of Alzheimer’s disease (AD) and related disorders, and the nosology of these disorders is under scrutiny. Furthermore, we are witnessing the emergence of therapeutic agents specifically designed to enhance memory and cognition in AD patients. Despite the limited efficacy of the agents currently available, their introduction has shed an entirely new light on the field. We therefore feel that this is a good time to look at the past to understand the present and perhaps gain insight into the future. Until the end of the 19th century, dementia was a much broader clinical concept. It included mental illness and any type of psychosocial incapacity, including conditions that could be reversed. Dementia at this time simply referred to anyone who had lost the ability to reason, and was applied equally to psychosis of mental illness, “organic“ diseases like syphilis that destroy the brain, and to the dementia associated with old age, which was attributed to “hardening of the arteries.“

 

Dementia has been referred to in medical texts since antiquity. One of the earliest known accounts was written by the 7th century BCE Greek physician and mathematician Pythagoras, who divided the human lifespan into six distinct phases, which were 0-6 (infancy), 7-21 (adolescence), 22-49 (young adulthood), 50-62 (middle age), 63-79 (old age), and 80- (advanced age). The last two he described as the “senium“, a period of mental and physical decay, and of the final phase being where “the scene of mortal existence closes after a great length of time that very fortunately, few of the human species arrive at, where the mind is reduced to the imbecility of the first epoch of infancy“. In 550 BCE, the Greek Athenian statesman and poet Solon argued that the terms of a man’s will might be invalidated if he exhibited loss of judgement due to advanced age. Chinese medical texts made allusions to the condition as well, and the characters for “dementia“ translate literally to “foolish old person“.

 

Aristotle and Plato from Ancient Greece spoke of the mental decay of advanced age, but apparently simply viewed it as an inevitable process that affected all old men, and which nothing could prevent. The latter stated that the elderly were unsuited for any position of responsibility because, “There is not much acumen of the mind that once carried them in their youth, those characteristics one would call judgement, imagination, power of reasoning, and memory. They see them gradually blunted by deterioration and can hardly fulfill their function.“ For comparison, the Roman statesman Cicero held a view much more in line with modern-day medical wisdom that loss of mental function was not inevitable in the elderly and “affected only those old men who were weak-willed.“ He spoke of how those who remained mentally active and eager to learn new things could stave off dementia. However, Cicero’s views on aging, although progressive, were largely ignored in a world that would be dominated by Aristotle’s medical writings for centuries. Subsequent physicians during the time of Roman Empire such as Galen and Celsus simply repeated the beliefs of Aristotle while adding few new contributions to medical knowledge.

 

Byzantine physicians sometimes wrote of dementia, and it is recorded that at least seven emperors whose lifespans exceeded the age of 70 displayed signs of cognitive decline. In Constantinople, there existed special hospitals to house those diagnosed with dementia or insanity, but these naturally did not apply to the emperors who were above the law and whose health conditions could not be publicly acknowledged. Otherwise, little is recorded about senile dementia in Western medical texts for nearly 1700 years. One of the few references to it was the 13th-century friar Roger Bacon, who viewed old age as divine punishment for original sin. Although he repeated existing Aristotelian beliefs that dementia was inevitable after a long enough lifespan, he did make the extremely progressive assertion that the brain was the center of memory and thought rather than the heart. Poets, playwrights, and other writers however made frequent allusions to the loss of mental function in old age. Shakespeare notably mentions it in some of his plays including Hamlet and King Lear.

 

Dementia in the elderly was called senile dementia or senility, and viewed as a normal and somewhat inevitable aspect of growing old, rather than as being caused by any specific diseases. At the same time, in 1907, a specific organic dementing process of early onset, called Alzheimer’s disease, had been described. This was associated with particular microscopic changes in the brain, but was seen as a rare disease of middle age because the first patient diagnosed with it was a 50-year-old woman. During the 19th century, doctors generally came to believe that dementia in the elderly was the result of cerebral atherosclerosis, although opinions fluctuated between the idea that it was due to blockage of the major arteries supplying the brain or small strokes within the vessels of the cerebral cortex. This viewpoint remained conventional medical wisdom through the first half of the 20th century, but by the 1960s was increasingly challenged as the link between neurodegenerative diseases and age-related cognitive decline was established. By the 1970s, the medical community maintained that vascular dementia was rarer than previously thought and Alzheimer’s disease caused the vast majority of mental impairments in old age. More recently however, it is believed that dementia is often a mixture of both conditions.

 

Much like other diseases associated with aging, dementia was comparatively rare before the 20th century, due to the fact that it is most common in people over 80, and such lifespans were uncommon in preindustrial times. Conversely, syphilitic dementia was widespread in the developed world until largely being eradicated by the use of penicillin after WWII. With significant increases in life expectancy following WWII, the number of people in developed countries over 65 started rapidly climbing. While elderly persons constituted an average of 3-5% of the population prior to 1945, by 2010 it was common in many countries to have 10-14% of people over 65 and in Germany and Japan, this figure exceeded 20%. Public awareness of Alzheimer’s Disease was greatly increased in 1994 when former US president Ronald Reagan announced that he had been diagnoses with the condition. By the period of 1913-20, schizophrenia had been well-defined in a way similar to today, and also the term dementia praecox had been used to suggest the development of senile-type dementia at a younger age. Eventually the two terms fused, so that until 1952 physicians used the terms dementia praecox (precocious dementia) and schizophrenia interchangeably. The term precocious dementia for a mental illness suggested that a type of mental illness like schizophrenia (including paranoia and decreased cognitive capacity) could be expected to arrive normally in all persons with greater age (see paraphrenia). After about 1920, the beginning use of dementia for what we now understand as schizophrenia and senile dementia helped limit the word’s meaning to “permanent, irreversible mental deterioration“. This began the change to the more recognizable use of the term today.

 

In 1976, neurologist Robert Katzmann suggested a link between senile dementia and Alzheimer’s disease. Katzmann suggested that much of the senile dementia occurring (by definition) after the age of 65, was pathologically identical with Alzheimer’s disease occurring before age 65 and therefore should not be treated differently. He noted that the fact that “senile dementia“ was not considered a disease, but rather part of aging, was keeping millions of aged patients experiencing what otherwise was identical with Alzheimer’s disease from being diagnosed as having a disease process, rather than simply considered as aging normally. Katzmann thus suggested that Alzheimer’s disease, if taken to occur over age 65, is actually common, not rare, and was the 4th or 5th leading cause of death, even though rarely reported on death certificates in 1976. This suggestion opened the view that dementia is never normal, and must always be the result of a particular disease process, and is not part of the normal healthy aging process, per se. The ensuing debate led for a time to the proposed disease diagnosis of “senile dementia of the Alzheimer’s type“ (SDAT) in persons over the age of 65, with “Alzheimer’s disease“ diagnosed in persons younger than 65 who had the same pathology. Eventually, however, it was agreed that the age limit was artificial, and that Alzheimer’s disease was the appropriate term for persons with the particular brain pathology seen in this disorder, regardless of the age of the person with the diagnosis. A helpful finding was that although the incidence of Alzheimer’s disease increased with age (from 5-10% of 75-year-olds to as many as 40-50% of 90-year-olds), there was no age at which all persons developed it, so it was not an inevitable consequence of aging, no matter how great an age a person attained. Evidence of this is shown by numerous documented supercentenarians (people living to 110+) that experienced no serious cognitive impairment. There is some evidence that dementia is most likely to develop between the ages of 80-84 and individuals who pass that point without being affected have a lower chance of developing it. Women account for a larger percentage of dementia cases than men, although this can be attributed to their longer overall lifespan and greater odds of attaining an age where the condition is likely to occur. Also, after 1952, mental illnesses like schizophrenia were removed from the category of organic brain syndromes, and thus (by definition) removed from possible causes of “dementing illnesses“ (dementias). At the same, however, the traditional cause of senile dementia – “hardening of the arteries“ – now returned as a set of dementias of vascular cause (small strokes). These were now termed multi-infarct dementias or vascular dementias.

 

In the 21st century, a number of other types of dementia have been differentiated from Alzheimer’s disease and vascular dementias (these two being the most common types). This differentiation is on the basis of pathological examination of brain tissues, symptomatology, and by different patterns of brain metabolic activity in nuclear medical imaging tests such as SPECT and PETscans of the brain. The various forms of dementia have differing prognoses (expected outcome of illness), and also differing sets of epidemologic risk factors. The causal etiology of many of them, including Alzheimer’s disease, remains unclear, although many theories exist such as accumulation of protein plaques as part of normal aging, inflammation (either from bacterial pathogens or exposure to toxic chemicals), inadequate blood sugar, and traumatic brain injury. Sources: nih.gov; Wikipedia

 

Carl Tanzler (1877-1952): Who Knew Bacteriologists Were So Interesting!

Tanzler in 1940

 

 

Carl Tanzler, or sometimes called, Count Carl von Cosel (February 8, 1877 July 3, 1952), was a German-born bacteriologist at the United States Marine Hospital in Key West, Florida. He developed an obsession for a young Cuban-American tuberculosis patient, Elena “Helen“ Milagro de Hoyos (July 31, 1909 – October 25, 1931), that carried on well after the disease had caused her death. In 1933, almost two years after her death, Tanzler removed Hoyos’s body from its tomb, and lived with the corpse at his home for seven years until its discovery by Hoyos’s relatives and authorities in 1940.

 

Tanzler went by many names; he was listed as Georg Karl Tanzler on his German marriage certificate. He was listed as Carl Tanzler von Cosel on his United States citizenship papers, and he was listed as Carl Tanzler on his Florida death certificate. Some of his hospital records were signed Count Carl Tanzler von Cosel. He was born as Karl Tanzler or Georg Karl Tanzler on February 8, 1877 in Dresden, Germany. Around 1920 he married Doris Anna Shafer (1889-1977) and he was listed as “Georg Karl T?nzler“ on the marriage certificate. Together they had two children: Ayesha Tanzler (1922-1998), and Crystal Tanzler (1924-1934), who died of diphtheria. Tanzler grew up in Germany. The following “Editorial Note“ accompanying the autobiographical account “The Trial Bay Organ: A Product of Wit and Ingenuity“ by “Carl von Cosel“ in the Rosicrucian Digest of March and April 1939, gives details about his stay in Australia before and during World War I and his return to Germany after the war:

 

Many years ago, Carl von Cosel travelled from India to Australia with the intention of proceeding to the South Seas Islands. He paused in Australia to collect equipment and suitable boats, and to become acquainted with prevailing weather and sea conditions. However, he became interested in engineering and electrical work there, bought property, boats, an organ, an island in the Pacific?so that he was still in Australia at the end of ten years. He had just begun to build a trans-ocean flyer when the war broke out and the British military authorities placed him in a concentration camp for ‘safe-keeping’ along with many officers India and China who were prisoners of war. Later he was removed to Trial Bay to a castle-like prison on the cliffs, and there the work in this narrative was accomplished. At the end of the war no prisoner was permitted to return to his former residence, but all were shipped to the prisoner’s exchange in Holland. When Carl von Cosel was released he set out to find his mother from whom he had not heard since the beginning of the war. Finding her safe, he remained with her for three years, witnessing the chaos that followed in the wake of the war. Finally, she suggested that her son return to his sister in the United States.

 

Tanzler’s account of Trial Bay Gaol, his secret building of a sailing boat, etc., is confirmed by Nyanatiloka Thera, who mentions that he planned to escape from the Gaol with “Count Carl von Cosel“ in a sailing boat, and provides other information about the interment of Germans in Australia during WWI. Tanzler emigrated to the United States in 1926, sailing from Rotterdam on February 6, 1926 to Havana, Cuba. From Cuba he settled in Zephyrhills, Florida, to where his sister had already emigrated, and was later joined by his wife and two daughters. Leaving his family behind in Zephyrhills in 1927, he took a job as a radiologic technologist at the U.S. Marine Hospital in Key West, Florida under the name Carl von Cosel.

 

During his childhood in Germany, and later while traveling briefly in Genoa, Italy, Tanzler claimed to have been visited by visions of a dead ancestor, Countess Anna Constantia von Cosel, who revealed the face of his true love, an exotic dark-haired woman, to him.

 

On April 22, 1930, while working at the Marine Hospital in Key West, Tanzler met Maria Elena “Helen“ Milagro de Hoyos (1909-1931), a local Cuban-American woman who had been brought to the hospital by her mother for an examination. Tanzler immediately recognized her as the beautiful dark-haired woman that had been revealed to him in his earlier “visions.“ By all accounts, Hoyos was viewed as a local beauty in Key West. Elena was the daughter of local cigar maker Francisco “Pancho“ Hoyos (1883-1934) and Aurora Milagro (1881-1940). She had two sisters, Florinda “Nana“ Milagro Hoyos (1906-1944), who married Mario Medina (c.1905-1944) and also succumbed to tuberculosis; and Celia Milagro Hoyos (1913-?). Medina, Nana’s husband, was electrocuted trying to rescue a coworker who hit a powerline with his crane at a construction site. On February 18, 1926, Hoyos married Luis Mesa (1908-?), the son of Caridad and Isaac Mesa. Luis left Hoyos shortly after Hoyos miscarried the couple’s child, and moved to Miami. Hoyos was legally married to Mesa at the time of her death. Hoyos was eventually diagnosed with tuberculosis, a typically fatal disease at the time, that eventually claimed the lives of almost all of her entire immediate family. Tanzler, with his self-professed medical knowledge, attempted to treat and cure Hoyos with a variety of medicines, as well as x-ray and electrical equipment, that were brought to the Hoyoses’ home. Tanzler showered Hoyos with gifts of jewelry and clothing, and allegedly professed his love to her, but no evidence has surfaced to show that any of his affection was reciprocated by Hoyos.

 

The corpse of Maria Elena Milagro de Hoyos (1910-1931) encased in wax and plaster circa 1940. Source: Wikipedia Commons

 

 

Despite Tanzler’s best efforts, Hoyos died of terminal tuberculosis at her parents’ home in Key West on October 25, 1931.Tanzler paid for her funeral, and with the permission of her family he then commissioned the construction of an above ground mausoleum in the Key West Cemetery, which he visited almost every night. One evening in April, 1933, Tanzler crept through the cemetery where Hoyos was buried and removed her body from the mausoleum, carting it through the cemetery after dark on a toy wagon, and transporting it to his home. He reportedly said that Elena’s spirit would come to him when he would sit by her grave and serenade her corpse with a favorite Spanish song. He also said that she would often tell him to take her from the grave. Tanzler attached the corpse’s bones together with wire and coat hangers, and fitted the face with glass eyes. As the skin of the corpse decomposed, Tanzler replaced it with silk cloth soaked in wax and plaster of Paris. As the hair fell out of the decomposing scalp, Tanzler fashioned a wig from Hoyos’s hair that had been collected by her mother and given to Tanzler not long after her burial in 1931. Tanzler filled the corpse’s abdominal and chest cavity with rags to keep the original form, dressed Hoyos’s remains in stockings, jewelry, and gloves, and kept the body in his bed. Tanzler also used copious amounts of perfume, disinfectants, and preserving agents, to mask the odor and forestall the effects of the corpse’s decomposition.

 

In October, 1940, Elena’s sister Florinda heard rumors of Tanzler sleeping with the disinterred body of her sister, and confronted Tanzler at his home, where Hoyos’s body was eventually discovered. Florinda notified the authorities, and Tanzler was arrested and detained. Tanzler was psychiatrically examined, and found mentally competent to stand trial on the charge of “wantonly and maliciously destroying a grave and removing a body without authorization.“ After a preliminary hearing on October 9, 1940 at the Monroe County Courthouse in Key West, Tanzler was held to answer on the charge, but the case was eventually dropped and he was released, as the statute of limitations for the crime had expired. Shortly after the corpse’s discovery by authorities, Hoyos’s body was examined by physicians and pathologists, and put on public display at the Dean-Lopez Funeral Home, where it was viewed by as many as 6,800 people. Hoyos’s body was eventually returned to the Key West Cemetery where the remains were buried in an unmarked grave, in a secret location, to prevent further tampering. The facts underlying the case and the preliminary hearing drew much interest from the media at the time (most notably, from the Key West Citizen and Miami Herald), and created a sensation among the public, both regionally and nationwide. The public mood was generally sympathetic to Tanzler, whom many viewed as an eccentric “romantic“.

 

Though not reported contemporaneously, research (most notably by authors Harrison and Swicegood) has revealed evidence of Tanzler’s necrophilia with Hoyos’s corpse. Two physicians (Dr. DePoo and Dr. Foraker) who attended the 1940 autopsy of Hoyos’s remains recalled in 1972 that a paper tube had been inserted in the vaginal area of the corpse that allowed for intercourse. Others contend that since no evidence of necrophilia was presented at the 1940 preliminary hearing, and because the physicians’ “proof“ surfaced in 1972, over 30 years after the case had been dismissed, the necrophilia allegation is questionable. While no existing contemporary photographs of the autopsy or photographs taken at the public display show a tube, the necrophilia claim was repeated by the HBO Autopsy program in 2005.

 

In 1944, Tanzler moved to Pasco County, Florida close to Zephyrhills, Florida, where he wrote an autobiography that appeared in the Pulp publication, Fantastic Adventures, in 1947. His home was near his wife Doris, who apparently helped to support Tanzler in his later years. Tanzler received United States citizenship in 1950 in Tampa. Separated from his obsession, Tanzler used a death mask to create a life-sized effigy of Hoyos, and lived with it until his death on July 3, 1952. His body was discovered on the floor of his home three weeks after his death. He died under the name “Carl Tanzler“. It has been recounted that Tanzler was found in the arms of the Hoyos effigy upon discovery of his corpse, but his obituary reported that he died on the floor behind one of his organs. The obituary recounted: “a metal cylinder on a shelf above a table, in it wrapped in silken cloth and a robe was a waxen image“. It has been written (most notably by Swicegood) that Tanzler had the bodies switched (or that Hoyos’s remains were secretly returned to him), and that he died with the real body of Elena.

 

Simon Baruch MD (1840 – 1921)

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Public baths and public comfort stations by the Mayor’s committee of New York City (1897). Sources: Flickr‘s The Commons, no known copyright restrictions exist. Wikipedia Commons

 

 

Simon Baruch MD was a Jewish physician, scholar, and the foremost advocate of the urban public bathhouse to benefit public health in the United States. Simon Baruch, the son of Bernard and Theresa (Green), was born July 29, 1840 in Schwersenz, Poland (formerly Posen). He attended the Royal Gymnasium in Posen-West Prussia. In 1855, when Simon was15-years-old, his family emigrated to South Carolina to live with the Manus Baum family. Baruch worked for Manus Baum as a bookkeeper before beginning to study medicine in 1859. Baruch attended lectures at the Medical College of the State of South Carolina, and enrolled at the Medical College of Virginia (MCV), (now Virginia Commonwealth University) in Richmond, Virginia, where he received a medical degree in 1862.

 

Baruch began his career as a surgeon in the Confederate Army; reportedly entering the service “without even having lanced a boil.“ He initially accepted a commission as Assistant Surgeon of the 3rd South Carolina Battalion on April 4, 1864, and in August of that same year, he transferred to the 13th Mississippi Infantry Regiment, in the position of Surgeon. During the Civil War, Baruch gained considerable surgical experience. After the Confederate surrender at Gettysburg in July 1863, he stayed on to treat the wounded for six weeks. Afterwards, he was imprisoned at Fort McHenry in Baltimore, Maryland, and he returned to his unit in December 1863. Following a period of ill health, he returned to the 13th Mississippi Regiment 6-months later, and he served until the end of the war.

 

After the war, Baruch remained in the South during the Reconstruction Era, where he practiced medicine and authored a widely read pamphlet on “Bayonet Wounds.“ In 1865, Baruch went to New York City where he worked for one year in a post-graduate position as an attending physician to the Medical Polyclinic of the North-Eastern Dispensary in the Hell’s Kitchen, Manhattan district of Manhattan – a bastion of poor and working-class people. There, Baruch tended to patients who were suffering from communicable infection, most of whom lacked access to clean bath water, fresh air, and sunshine. A year later, Dr. Baruch returned to Camden, South Carolina, in 1867.

 

For 16-years Baruch practiced medicine in South Carolina. He also advocated for the smallpox vaccination for the children of the state, and he helped to reactivate the South Carolina State Medical Association, serving as president. He held a position on the faculty of the South Carolina State Medical College, and he was chairman of the Board of Health, later renamed South Carolina Department of Health and Environmental Control. However, Baruch grew increasingly dissatisfied with the indiscriminate use of unproven medical remedies. He studied the healing philosophies of Austrian physician Vincent Priessnitz (1799-1852), and in particular, the success of a therapeutic spa in the Silesian Foothills. The remedies where largely predicated upon frequent bathing and irrigation of the gastrointestinal tract; an alternative form of medicine called hydrotherapy. Patients recuperated in a restful, calm environment, ate a prudent diet, eliminated alcohol and tobacco, and engaged in physical activity. Later, Baruch also credited Wilhelm Winternitz for his pioneering work in hydrotherpy. Baruch would go on to introduce medicinal spring therapies, known as balneology, and hydrotherapy to the United States of America.

 

In 1881, Baruch took up residence in New York City with his wife Belle, and their four sons, Hartwig (“Harty“) Nathaniel (1868-1953), Bernard Mannes (1870-1965), Herman Benjamin (1872-1953), and Sailing Wolfe (1874-1963). He became known as an active public health advocate and medical writer. He also gained professional credibility for diagnosing the first case of perforating appendicitis successfully operated on, and in the widely publicized “child cruelty“ case involving the musical prodigy Josef Hofmann, Baruch was the consulting physician. After examining Hofmann, Baruch recommended the boy musician rest and resume the lifestyle of a child. In 1892, Baruch became a fellow of the New York Academy of Medicine. As a physician and scholar, Baruch’s enduring interest in hydrotherpy guided many of his professional and civic pursuits. He published the standard texts, “The Uses of Water in Modern Medicine“ (1892), “Therapeutic reflections: a plea for physiological remedies“ (1893), and “The Principles and Practice of Hydrotherapy“(1898).

 

From 1903 to 1913, he taught a course in hydro-therapeutics, or methods of using water to treat various diseases, at New York Post Graduate Medical School and Hospital of the University of the State of New York. He resigned when hydrotherapy was made an elective subject of study. In 1910, Baruch wrote “Lessons of half a century in medicine.“ In 1920, he authored “Epitome of hydrotherapy for physicians, architects and nurses.“ Notably, Baruch’s interest in hydrotherapy led to his role as the country’s foremost municipal bath advocate. Ever since his trip in the 1880s to study the public bath system of Germany, Baruch was a tireless advocate for free public baths in New York City, during a period of immigration in American history when newcomers flooded cities. After he studied hydrotherapy, and understood the utility of fresh water to the prevention of infection. Baruch worked tirelessly to educate public officials and the medical community about the importance of water to public health. For many years, the general public and civic leaders were skeptical about the debilitating effects of poor sanitation on physical health; pessimistic Mayor Hugh J. Grant (1852-1910) declared, “The people won’t bathe.“ Despite decades of opposition, Baruch managed to convince three successive Mayors of the utility of water, and in particular, the importance of a public bath system to the population health of the urban working class and poor. He wrote numerous journal and newspaper articles on the medical utility of water, including first article published in America on public baths for the Philadelphia Medical Times and Register on August 24, 1889. He reported on the structure, functioning, and health benefits of a public bath systems to the New York’s Committee on Hygiene, in his role as Chairman. Baruch also delivered addresses on the topic to medical and scientific societies. Moreover, Baruch was medical editor at the New York Sun, from 1912 to 1918, and he covered all the major health concerns of the period, and wrote articles on a variety of topics, from the common cold to malarial fevers.

 

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Free Public Baths 538 East 11th Street; Wikipedia Commons

 

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Asser Levy Recreation Center; Wikipedia Commons

 

 

Although Baruch met with continual resistance, by 1895, he successfully persuaded the State Legislature to pass a law to obligate cities exceeding a population of 50,000 to establish and maintain free bathhouse facilities, and an order from the local Board of Alderman to construct a public bath in the City of New York. In 1897, 9 Centre Market Place People’s Baths, located between Center and Mulberry Streets, served as a prototype public bathhouse. Financed by private contributions from the Association for Improving the Condition of the Poor (AICP), and built on land owned by the City Mission and the Tract Society, the facility provided more than 100,000 people a year with a bath, soap, and a towel for five cents. In 1901, Baruch and his colleagues, Deputy Commissioner of Health of the City of New York Fowler and Dr. Van Santvoord, presided over the opening of the first free public bathhouse, Rivington Street municipal bath, located at 326 Rivington, on the Lower East Side of Manhattan. The bathhouse facility featured indoor and outdoor bathing pools, 45 showers and five soaking tubs for men, and 22 showers for women. Other public baths of the period, credited to the advocacy of Baruch, include the Clarkson Street Bathhouse, located at 83 Carmine Street in Greenwich Village, which provided showers, tubs, and a gymnasium complex on two floors, as well as an open-air classroom on the rooftop for children in poor health. The facility has since become part of the Tony Dapolito Recreation Center. In 1904, several more free public baths opened in Manhattan, including the Milbank Memorial Bath, located on 325-327 East 38th Street, a gift to the City of New York by a Borden (company) heiress, which had the capacity to hold 3,000 people. That same year, the City opened West 60th Street Bathhouse, now Gertrude Elderle Recreation Center, providing 49 showers for men and 20 for women. In 1905, The Public Baths, designed by prominent architect Arnold W. Brunner, opened at 538 East 11th Street, between Avenues A and B, in the Alphabet City area of the East Village neighborhood of Manhattan; the building is also on the List of New York City Designated Landmarks in Manhattan below 14th Street. Asser Levy Public Baths opened in 1906, at the corner of Asser Levy Place and East 23rd Street, in the Kips Bay area. Also designed by architect Arnold W. Brunner and Martin Aiken, the facility has since become part of the Asser Levy Recreation Center, and the building is a designated historic landmark.

 

In 1912, Dr. Baruch was appointed the founding president of the American Association for Promoting Hygiene and Public Baths, a position he held until his death. Baruch said he had “done more to save life and prevent the spread of disease in my work for public baths than in all my work as a physician.“

 

In 1867, Simon Baruch married Isabelle (“Belle“) Wolfe (1850-1921), daughter of cotton farmer Sailing Wolfe of Winnsboro, South Carolina. Their son Bernard M. Baruch went on to a successful career on Wall Street and a financial advisor to U.S. Presidents from Woodrow Wilson to Harry S. Truman; his substantial fortune afforded him the opportunity to endow university chairs, medical school facilities, and public buildings in his father’s name. Herman B. Baruch followed his father’s footsteps to become a physician, and then a Diplomat, and president of the Simon Baruch Foundation. Hartwig Baruch was an actor, and Sailing Baruch was a banker and stockbroker.

 

Simon Baruch is the namesake of civil monuments, educational entities, and academic departments in New York City, and throughout the country, many of which were established by his son Bernard M. Baruch, including Simon Baruch Houses, a public housing complex in Manhattan, as well as buildings, halls, and academic chairs at Columbia University, Clemson University, New York University College of Medicine, and the Medical College of Virginia/ VCU. New York City Department of Education’s Middle School 104 is named Simon Baruch Middle School, along with an adjacent Simon Baruch Playground and Garden, under the auspices of the New York City Department of Parks. In 1933, the Simon Baruch Research Institute of Baleneology at Saratoga Springs Spa, Saratoga Springs, New York was established. In 1940, Bernard M. Baruch endowed in honor of Simon Baruch, the Simon Baruch Auditorium building on the campus of the Medical University of South Carolina, Charleston, South Carolina, the Department of Physical Medicine and Rehabilitation at Virginia Commonwealth University as well as the university’s Egyptian Building, designed by architect Thomas Somerville Stewart, now a National Historic Landmark. Biannually, the Richmond, Virginia chapter of the United Daughters of the Confederacy grants the Mrs. Simon Baruch University Award to a work of scholarly research on Southern history.

 

Francis Schlatter (1856-1896), Healer with Copper Rod

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Francis Schlatter Credit: Unknown – This image is available from the United States Library of Congress’s Prints and Photographs Division; Public Domain, Wikipedia Commons

 

Francis Schlatter (1856-1896) was an Alsatian cobbler who, because of miraculous cures attributed to him, became known as the Healer. Schlatter was born in the village of Ebersheim, Bas-Rhin, near Selestat, in Alsace on April 29, 1856. In 1884 he emigrated to the United States, where he worked at his trade in various cities, arriving in Denver, Colorado, in 1892. There, a few months later, he experienced a vision at his cobbler’s bench in which he heard the voice of the Father commanding him to sell his business, give the money to the poor, and devote his life to healing the sick. He then undertook a two-year, 3,000-mile walking pilgrimage around the American West which took him across eastern Colorado, Kansas, and Oklahoma, and then to Hot Springs, Arkansas, where he was arrested and jailed for vagrancy. In early 1894 he escaped and headed west, walking across Texas, New Mexico, and Arizona and into southern California, where he began his first efforts at healing with the Indians of the San Jacinto Valley. After two months, he again took up his pilgrimage and traveled east across the Mohave Desert, living on nothing but flour and water.

 

In July 1895 he emerged as a Christ-like healer in the Rio Grande villages south of Albuquerque. There, while treating hundreds of sick, suffering, and disabled people who flocked to Albuquerque’s Old Town, he became famous. Crowds gathered about him daily, hoping to be cured of their diseases simply by clasping his hands. The following month he returned to Denver, but did not resume his healings until mid-September. During the next few weeks, his ministry drew tens of thousands of pilgrims to a small home in North Denver. Schlatter is said to have refused all rewards for his services. His manner of living was of the simplest, and he taught no new doctrine. He said only that he obeyed a power which he called Father, and from this power he received his healing virtue.

 

On the night of November 13, 1895, he suddenly disappeared, leaving behind him a note in which he said that his mission was ended. Then, in 1897 news came out of Mexico that the healer’s bones and possessions had been found on a mountainside in the Sierra Madre. At the same time, a New Mexico woman named Ada Morley published a book called The Life of the Harp in the Hand of the Harper which told of the healer’s three-month retreat on her ranch in Datil, New Mexico, after his disappearance from Denver. The book, which carried the title the healer gave it, also contained a first-person description of his two-year pilgrimage, which he believed held the same significance for mankind as Christ’s forty days in the wilderness. On departing the Morley ranch, Schlatter told Morley that God intended to establish New Jerusalem in the Datil Mountains, and the healer promised to return at that time. In the wake of the healer’s death, several men claiming to be Francis Schlatter made headlines around the country in 1909, 1916, and 1922.

 

In August Strindberg?s autobiographical novel Inferno, Francis Schlatter is mentioned as a doppelganger of another man Strindberg met in Paris in 1896, the year after Schlatter disappeared. He was afraid of Schlatter. The “double“ turned out to be Paul Herrmann, a German-American painter.

 

The Healer’s Copper Rod

 

In 1906 Edgar Lee Hewett, who became a noted archaeologist and museum director, was conducting research near Casas Grandes, Chihuahua, Mexico, when his Mexican guide pointed out an unmarked grave. Ten years before, the guide said, he had come across the body of a dead man following a blizzard. From the guide’s description, Hewett surmised that the dead man the guide had come across was Francis Schlatter, whom Hewett had met and whose healing sessions he observed in 1895. Hewett asked if any of the man’s possessions had survived. The guide led him to the home of the jefe of Casas Grandes, and there Hewett saw Schlatter’s Bible, saddle, and copper rod – which had become a mysterious hallmark of the healer from the time of his disappearance. Years later, in 1922, Hewett returned to Mexico and examined the copper rod again. By now, Edgar Lee Hewett had become the director of the School of American Research (now the School for Advanced Research) and the Museum of New Mexico Hewett showed interest in the rod and made a donation to the village of Casas Grandes to hire a teacher. Back in Santa Fe, a few weeks later, he received a heavy, burlap-wrapped package, and inside was Francis Schlatter’s copper rod. He placed the rod in the collections of the two institutions he directed, which shared space in the Palace of the Governors in Santa Fe, N.M. Today the rod lies in the collections of the New Mexico History Museum in the Palace of the Governors. Almost immediately after reports came out of Mexico announcing the healer’s death, skepticism arose. Ada Morley, who had visited at length with Schlatter during his three-month stay at her ranch in New Mexico in early 1896, had her doubts. “The men who found the skeleton declared to have been [Schlatter’s],“ she said, “say it was resting as though it had never been disturbed. I know the coyotes would never have left it, if it had ever lain there bearing flesh.“ The New York Times expressed doubts as well. “It does not appear that the human remains were actually identified as Schlatter’s,“ the newspaper stated on June 19, 1897, “or that any identification was possible.“ However, the presence of the healer’s possessions at the scene, especially his copper rod, convinced most people otherwise. Over the next twenty-five years, several men arose claiming to be Francis Schlatter. One, a Presbyterian minister named Charles McLean, died in Hastings, Nebraska, in 1909, creating a controversy between skeptics and believers. Two others, August Schrader and Jacob Kunze, who formed a healing team that operated between 1908 and 1917, were arrested and jailed in 1916 for mail fraud. A final so-called imposter died in St. Louis, Missouri, in October 1922.

 

During the second half of the twentieth century, a renewed interest in Schlatter brought with it speculation about the claim of the healer who had died in St. Louis. Most recently, The Vanishing Messiah: The Life and Resurrections of Francis Schlatter (2016), argues that the healer conspired to stage his death in the mountains of Mexico and returned to the United States to continue healing in the eastern and southern parts of the country until his death in St. Louis in 1922. The Vanishing Messiah claim rests in part on the discovery of a largely forgotten autobiography in the Library of Congress entitled Modern Miracles of Healing: A True Account of the Life, Works and Wanderings of Francis Schlatter, the Healer, attributed to “Francis Schlatter, The Alsacian,“ and published in 1903.

 

Veterans Day – Honoring Those Who Served: The Race to Bring Penicillin to the Troops in WWII

 

The following was excerpted from the FDA Blog and authored by John P. Swann, Ph.D., an FDA Historian

 

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Chemical structure of Penicillin G. The sulfur and nitrogen of the five-membered thiazolidine ring are shown in yellow and blue respectively. The image shows that the thiazolidine ring and fused four-membered beta-lactam are not in the same plane. Credit: Public Domain, Wikipedia Commons

 

 

On Veterans Day this year (11 November 2016), we remembered that nearly 75 years ago dozens of American academic, commercial, nonprofit, and governmental institutions – including FDA – joined together in a race to provide penicillin, a promising but complex and unstable medicine to troops fighting in World War II. Knowing that infection is the major killer in wars, not battle injuries, the goal was to help turn a British discovery into a crucial wartime medical contribution and what would become an indispensable therapeutic agent long after that conflict ended.

 

Many people are familiar with the story of Alexander Fleming’s 1928 discovery of a Penicillium mold that had contaminated – and surprisingly destroyed – his cultures of pathogenic organisms. Though Fleming and several others in the next decade studied the mold filtrate, known as penicillin, it was Howard Florey and his colleagues at Oxford who uncovered the drug’s chemotherapeutic potential. Their work began with studies in mice in May 1940 and transitioned to a handful of clinical cases nine months later. However, the drug was difficult to purify. Also, it presented an immense challenge to produce in sufficient quantities for study, and with Britain under siege firms there were too involved in other aspects of the war effort to offer much assistance. So Florey and a colleague came to the U. S. in the summer of 1941 for help.

 

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FDA Voice: A meeting of NRRL staff in the 1940s (courtesy of the American Institute

of the History of Pharmacy).

 

 

Among the first sites they visited was the Department of Agriculture’s Northern Regional Research Laboratory (NRRL) in Illinois, which had extensive experience in fermentation work, and from there they contacted several drug and chemical companies to drum up support. Americans quickly combined forces to tackle the challenge. The federal Office of Scientific Research and Development (OSRD), the federal entity that organized and facilitated investigations to support the war effort, arranged to act as a clearing-house for the latest research on chemical and other studies of penicillin, exchanging data with dozens of organizations in the U.S. and Britain. NRRL developed several production modifications that increased the yield of penicillin by 100 fold.

 

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FDA Voice: An FDA analyst in the 1950s carries out part of the procedure

in testing penicillin for moisture content.

 

 

FDA’s first experience with the potential wonder drug was around September 1942, when the NRRL Director approached FDA about testing the antibacterial effectiveness of a small quantity of penicillin. A year later, enough of the drug had been produced to confirm in 200 patients what the early results at Oxford had suggested, and penicillin was ready to enter the war. First, however, OSRD asked that FDA certify every lot produced by the half-dozen or so manufacturers, a task the agency also performed for insulin under statutory authority that began in 1941. Six FDA technicians certified samples for potency, absence of fever-producing contaminants, toxicity, sterility, and optimum moisture, which can affect the drug’s stability. So scarce was penicillin that companies always reconditioned the occasional rejected lot rather than destroying it.

 

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FDA Voice: The strain of Penicillium notatum that Fleming discovered at St. Mary’s Hospital in London.

 

 

By the end of the war, some of the participating firms had increased purity of the drug from the Oxford group’s one percent to about 85%. Penicillin was not only more potent, it was also more abundant, its production having increased by a factor of 500 from 1943 to 1945. In fact, by 1945 the output of penicillin, formerly under severe restriction outside of military and scientific use, was now available for most civilian needs as well. In a few years the cost of producing penicillin had decreased so much that the glass used to store ampules of the drug cost more than the drug itself. FDA’s wartime work was codified in the Penicillin Amendment of 1945, which mandated FDA’s certification of penicillin and, through subsequent laws, most other antibiotics – a responsibility that continued for nearly four decades, when the need for government testing no longer existed based on industry’s record of production. But it all started with an international effort to provide a lifesaving drug to the armed forces, bringing together all sorts of scientific and medical institutions, including FDA. Like so many others participating in this collaboration on a scale unseen up to that point, FDA played a small but critical role to support our troops at this time of global crisis.

 

This entry was posted in Drugs, Other Topics and tagged Northern Regional Research Laboratory (NRRL), Office of Scientific Research and Development (OSRD), penicillin, Veterans Day, World War II by FDA Voice.

 

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