Links to Pass The Time

Since I've been away from the blog for a while, I thought I'd dive back in with the most routine of blog posts: links, links and more links.

• Street Anatomy had word of a 4-d human atlas.  Want one.
  
• Wired's Danger Room blog points to a story about emergency blood protocols.
  
• Bioephemera visited our Neuroanatomical Collection and took some great photos.
  
• Civil War Women introduced us to nurse Isabella Fogg of Maine.
  

Former museum staffer now shepherds hurricane's PR

Our former public affairs officer Stephen Solomon sent in an article too.

From body parts to Rodin sculpture

Here's an article that features our former exhibits guy, J. Carey Crane, and shows him getting to move a Rodin sculpture.

We're famous! Sorta.

Today we received an email from matador.org that two of our photos that we posted on our Flickr accounts have been picked up under the Creative Commons license for use on their website. I posted one that they used and looking at it now, I wonder what I thought was so great about it. But if it brings us traffic to our Flickr pages, I guess it's all right.

Engravings du jour

This one's largely for Joanna of Morbid Anatomy. We had a researcher looking at the 19th Century Army Medical Museum this week so I pulled down a book I enjoy using - Mary Clemmer Ames, Ten Years in Washington: Life and Scenes in the National Capital as a Woman Sees Them (Hartford, CT: A.D. Worthington & Co, 1874). This is from when a guidebook had opinions and was proud of them. Here's five plates that we've scanned from the book, because they relate to medicine or the Civil War.



"All that remains above ground of John Wilkes Booth..." - now that's a guidebook!



"The City of the Slain"! Talk about accurate!

We are not alone

The Medical Museion in Copenhagen has a blogpost about their storage problem, which amazingly enough, appears worse than ours! Something to feel good about!

More microscope catalogue scans

Here's some more microscope catalogues scanned and uploaded to the Internet Archive.

Graf-Apsco 1938

Graf-Apsco 1943

Graf-Apsco 1946

A new motto for the archives

I saw Brian of anatomical collections this morning as we swapped some folders of Civil War soldiers files that a researcher had asked to see. He popped back into archives about an hour later, surprising me as I hadn't expected to see him again on a day when he had visitors coming in and I had a long Institutional Review Board meeting (21 straight hours! No lie!) assigned to me. I queried him on his reappearance in the Archives and he said "There's too many secrets hidden here". That's our new motto.

A collector's estate

Working in a medical museum means that you meet people with... different... ideas of collecting and hobbies. I never met John Lattimer, the focus of this article, but my late friend Gretchen Worden, curator of the Mutter Museum in Philadelphia worked with him. For more on Lattimer, see "In a Father's Clutter, Historic Oddities," By KASSIE BRACKEN and ERIK OLSEN, New York Times August 21, 2008.

A new (tiny) collection in the archives

We recently acquired the Welling Collection – a set of photographs and a PowerPoint presentation – from Col. David Welling, M.D. (retired). Dr. Welling was part of the Critical Care Air Transport Team (CCATT) that was deployed to Yemen to treat and evacuate US sailors injured in the terrorist bombing of the USS Cole. The team was awarded the McKay Trophy, an annual award that the National Aeronautic Association gives to the Air Force person, crew, or organization that makes the most meritorious flight of the year. Dr. Welling said, “The mission was the highlight of my 30-year career.”

The photo above is from Dr. Welling. It shows patients and medical staff inside one of the planes that evacuated the wounded from Yemen to Germany.

Now, a behind-the-scenes peek at the decision about how to handle this collection. We could fold it into the MIS (Medical Illustration Service) collection or make it a collection all its own. The MIS collection is a kind of generic bunch of stuff (which is not to say there’s nothing interesting there – there is plenty interesting) but it’s also 4000 boxes. Bankers’ boxes. It would be easy to “lose” something in there. Plus, the Welling collection was born digital. The only hard copy of anything we had was the disc he sent to us and the emails about it that we printed out.

The other way to treat it – as a collection of its own – would be a consideration even though it’s a one-folder collection. Kind of small for a whole collection, but that’s how we decided to treat it. This is important to us because we have very little contemporary material and we really want to be able to put our hands on it when we need it. By making it a collection we automatically make it a line item on our shelf list (the inventory of our collections) and so it remains higher in visibility of the materials we maintain. We copied the disc Dr. Welling sent us onto a gold archival disc and printed out the photos and the PowerPoint, and all of it will go into a box that holds other small collections right here in the archives.

NIH wants your great-grandparent

Here's an interesting idea - The LONG LIFE Family Study. If you've made it past 79 years old and you've got older living relatives, NIH might want you. They called my grandmother who's ticking away at 94 last week, and my sister signed her up. I think this is a good idea.

More 1918 influenza research leads to pneumonia

Actually, this isn't much of a surprise - the Army's WW1 medical history that we've scanned and uploaded said as much in the 1920s. Here's the NIH press release with Jeff Taubenberger who used to work at AFIP on this subject. The samples of influenza tissues referred to were collected by the Army Medical Museum and are in the AFIP's repository now. (And thanks to Jeff Reznick for passing this one along).

Bacterial Pneumonia Caused Most Deaths in 1918 Influenza Pandemic
Implications for Future Pandemic Planning

The majority of deaths during the influenza pandemic of 1918-1919 were not caused by the influenza virus acting alone, report researchers from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. Instead, most victims succumbed to bacterial pneumonia following influenza virus infection. The pneumonia was caused when bacteria that normally inhabit the nose and throat invaded the lungs along a pathway created when the virus destroyed the cells that line the bronchial tubes and lungs.

A future influenza pandemic may unfold in a similar manner, say the NIAID authors, whose paper in the Oct. 1 issue of The Journal of Infectious Diseases is now available online. Therefore, the authors conclude, comprehensive pandemic preparations should include not only efforts to produce new or improved influenza vaccines and antiviral drugs but also provisions to stockpile antibiotics and bacterial vaccines as well.

The work presents complementary lines of evidence from the fields of pathology and history of medicine to support this conclusion. "The weight of evidence we examined from both historical and modern analyses of the 1918 influenza pandemic favors a scenario in which viral damage followed by bacterial pneumonia led to the vast majority of deaths," says co-author NIAID Director Anthony S. Fauci, M.D. "In essence, the virus landed the first blow while bacteria delivered the knockout punch."

NIAID co-author and pathologist Jeffery Taubenberger, M.D., Ph.D., examined lung tissue samples from 58 soldiers who died of influenza at various U. S. military bases in 1918 and 1919. The samples, preserved in paraffin blocks, were re-cut and stained to allow microscopic evaluation. Examination revealed a spectrum of tissue damage "ranging from changes characteristic of the primary viral pneumonia and evidence of tissue repair to evidence of severe, acute, secondary bacterial pneumonia," says Dr. Taubenberger. In most cases, he adds, the predominant disease at the time of death appeared to have been bacterial pneumonia. There also was evidence that the virus destroyed the cells lining the bronchial tubes, including cells with protective hair-like projections, or cilia. This loss made other kinds of cells throughout the entire respiratory tract — including cells deep in the lungs — vulnerable to attack by bacteria that migrated down the newly created pathway from the nose and throat.

In a quest to obtain all scientific publications reporting on the pathology and bacteriology of the 1918-1919 influenza pandemic, Dr. Taubenberger and NIAID co-author David Morens, M.D., searched bibliography sources for papers in any language. They also reviewed scientific and medical journals published in English, French and German, and located all papers reporting on autopsies conducted on influenza victims. From a pool of more than 2,000 publications that appeared between 1919 and 1929, the researchers identified 118 key autopsy series reports. In total, the autopsy series they reviewed represented 8,398 individual autopsies conducted in 15 countries.

The published reports "clearly and consistently implicated secondary bacterial pneumonia caused by common upper respiratory flora in most influenza fatalities," says Dr. Morens. Pathologists of the time, he adds, were nearly unanimous in the conviction that deaths were not caused directly by the then-unidentified influenza virus, but rather resulted from severe secondary pneumonia caused by various bacteria. Absent the secondary bacterial infections, many patients might have survived, experts at the time believed. Indeed, the availability of antibiotics during the other influenza pandemics of the 20th century, specifically those of 1957 and 1968, was probably a key factor in the lower number of worldwide deaths during those outbreaks, notes Dr. Morens.

The cause and timing of the next influenza pandemic cannot be predicted with certainty, the authors acknowledge, nor can the virulence of the pandemic influenza virus strain. However, it is possible that — as in 1918 — a similar pattern of viral damage followed by bacterial invasion could unfold, say the authors. Preparations for diagnosing, treating and preventing bacterial pneumonia should be among highest priorities in influenza pandemic planning, they write. "We are encouraged by the fact that pandemic planners are already considering and implementing some of these actions," says Dr. Fauci.

Visit http://www.PandemicFlu.gov for one-stop access to U.S. Government information on avian and pandemic flu.
NIAID conducts and supports research — at NIH, throughout the United States, and worldwide — to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.Reference: DM Morens et al. Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: Implications for pandemic influenza preparedness. The Journal of Infectious Diseases DOI: 10.1086/591708 (2008).

Save the Date: Stigma of Leprosy Discussion, Wed., 8/27, 2pm in the Museum

Save the Date: Stigma of Leprosy Discussion, Wed., 8/27, 2pm in the Museum

Afternoon Coffee Talk at the National Museum of Health and Medicine

"Carville: The Landscape of Stigma" with guest speaker Elizabeth Schexnyder, Curator, The National Hansen's Disease Museum.

Join a discussion on how the fear of leprosy led to displays of stigma associated with the disease. Learn how "othering" human beings diagnosed with leprosy shaped the unique social and physical landscape of the National Leprosarium at Carville, Louisiana. After the talk, visit the temporary exhibition 'Triumph at Carville: A Tale of Leprosy in America.'

When: Wednesday, August 27, 2:00-3:00 p.m.

Where: Russell Auditorium (in the Museum, Bldg. 54)

Cost: FREE!! Coffee!!

A day in the life...

Today began with nothing much on the calendar, but Bruce from the Department of Veterinary Pathology (VetPath) stopped by to say that Dr. John King was arriving with his donation of 35mm slides for the museum. Dr. King and Cornell University had been digitizing the collection as Dr. John M. King's Necropsy Show & Tell and posting them online. They got about 1/2 done, but Dr. King donated all the slides to us and we're going to finish the scanning job.

Dr. King was in his early 80s, and lively and full of interesting stories about veterinary pathology and how there are some controversies in the field like the bursting aortas of racehorses (which I'd never heard of - the competing theories are high blood pressure v. King's compressing the chest when collapsing or mating). He's also a collector of veterinary instruments and brought down some for us.

When I mentioned this collection coming in, I didn't tell you readers that it's 48,000 35mm slides in 108 notebooks, arranged by animal and pathology (ie herpes, heart disease, liver failure). Cool, huh?

Midday was a tour for Lauren the intern's mom. It's always fun to take people that are interested on a tour. Lauren's done a great job for us this summer, working most recently on updating the Vorwald Collection finding aid and adding more material into the trade literature collection (ie advertising), General Medical Products Information Collection.

Later on in the day, we got a call from people doing renovations in the area the AFIP director works in and so we removed paintings of the former directors for safe storage while the work goes on.

Trigeminal neuralgia

Tomorrow's Washington Post magazine, which gets delivered to my house on Saturday, runs an article about a man with trigeminal neuralgia, "an affliction so intolerable it's known as the 'suicide disease,'" because the pain is said to be the worst a person can experience. It's a sudden, electrical pain that can be triggered by as little as water from the shower cascading over the face, by shaving, by applying makeup. This sounded so familiar because my dad had this kind of pain and I heard it described in exactly the same way. It took me a while to remember what he called it, and a quick Google search told me that his tic douloureux and trigeminal neuralgia were the same thing. Today there are a few treatment options but he had to live with it for many years. I don't know how he did it.

AFIP medical examiners mentioned in Post and Times

Human remains from a long lost plane crash have been found and identified by the Armed Forces Institute of Pathology's medical examiners. The story is "9 Years Later, a Fatal Mystery Solved; Experts Trace Body Part From 1948 Plane Crash to Roanoke Seaman," By Michael E. Ruane, Washington Post Staff Writer, Saturday, August 16, 2008. A similar case is reported on in "Missing pilot to be brought home; Recovered remains to receive Arlington burial," by Jennifer Harper, Washington Times Thursday, August 14, 2008.

The AFIP isn't mentioned by name in either article which is typical. The Armed Forces DNA Identification Laboratory (AFDIL) is, but they are a component of the Office of the Armed Forces Medical Examiner, which in turn falls under the AFIP. And the medical examiners would have done the fingerprint work mentioned in the Post article, not the DNA technicians.



Remember, the museum has on display Resolved, an exhibit on forensic identification of military dead that's just opened.

Ford's Theatre renovation and reopening

A museum in Ford's Theatre is mentioned in passing in this article "The History Will Linger At Remade Ford's Theatre," By Michael E. Ruane, Washington Post Staff Writer, Friday, August 15, 2008; Page A01.

Ruane wrote, "The government bought the theater from Ford and used it over the years as a museum and as an office and storage building."

Well, that was the Army Medical Museum which was there for almost two decades, before it moved to a new bulding on the Mall (which was knocked down in 1968 for the Hirschorn). I wrote about the Museum there in Washington History (available from the Washington Historical Society) last year. Here's some relevant paragraphs edited down somewhat:

After President Lincoln's assassination in 1865, the federal government purchased and renovated the notorious Ford's Theatre to house the museum, the Surgeon General's Library, and the more than 16,000 bound volumes of the Records and Pension Division of the Surgeon General's Office. The move to Ford's Theatre in December 1866 permitted the museum to expand its collecting to include Native American weapons and “specimens of comparative anatomy.” Now the museum, with its larger exhibit space and broader scope, would become a well-known Washington-area landmark.

The museum had no difficulty attracting the public. Medical specimens, including many anomalies and curiosities, fascinated both lay and professional visitors alike. No doubt part of the fascination lay in the innate morbid curiosity of seeing human remains usually available in circus side-shows, but the Civil War had just ended, and the displays of specimens from maimed soldiers of both sides led visitors to see the museum as an unintentional national memorial. The glass cases of specimens were flanked by flags and standards of ambulances corps as well as Union and Confederate swords and sabers. While the displays were systematic, rather than artistic, they were nonetheless alluring, especially for thrill-seekers. A reporter for the popular Appleton’s Journal captured the atmosphere:

It is, indeed, not such a collection as the timid would care to visit at midnight, and alone. Fancy the pale moonlight lighting up with a bluish tinge, the blanched skeletons and grinning skulls — the same moon that saw, in many a case, the death-blow given, or the bullet pierce. The thought is not a comforting one, and those fancies would not be calculated, at such a time, to inspire courage. But in broad daylight, with the sun shining outside, and brightening up, with its tinge of life and activity, the tessellated floor, with the noise and traffic of the street outside, and the hum and murmur of numerous clerks and attendants inside, even those of timid proclivities do not then hesitate to inspect closely and with curiosity the objects which, twelve hours later, when the building is dark and deserted, they would scarce care to approach.

Opened to the public on April 16, 1867, the museum drew around 6,000 visitors by the end of the year. “It cannot fail to be one of the most absorbing spots on earth to the student of surgery or medicine,” opined guidebook author Mary Clemmer Ames in 1874, “but to the unscientific mind, especially to one still aching with the memories of war, it must remain a museum of horrors. . . . No! the Museum is a very interesting, but can never be a popular place to visit." In spite, or because, of Ames's concerns, by 1874, the number of visitors sometimes reached more than 2,600 per month, even the museum was only open from 10 am to 3 pm on weekdays, and on Saturday from 10 am to 2 pm. As early as 1866, the museum was well-known enough to be mentioned in Atlantic Monthly. In Dr. S. Weir Mitchell's fictional story, "The Case of George Dedlow," the hero, who lost both legs due to the war, was contacted by spirits during a séance. The spirits proved to be his amputated limbs, preserved in the Medical Museum: "A strange sense of wonder filled [Dedlow], and, to the amazement of every one, I arose, and, staggering a little, walked across the room on limbs invisible to them or me. It was no wonder I staggered, for, as I briefly reflected, my legs had been nine months in the strongest alcohol." Undoubtedly, readers of the story would have wished to visit the museum to look for the imaginary Dedlow's limbs.


As early as 1880, the Ford's Theatre building was proving inadequate for the expanding museum and library. In fact one exterior wall as falling away, and eventually the interior floors collapsed after the museum had moved out. In 1881 the museum attracted 40,000 visitors, while in 1888, the library had 5,000 readers. In his annual message to Congress, President Rutherford Hayes asked for an appropriation to replace the building. “The collection of books, specimens, and records constituting the Army Medical Museum and Library are of national importance. . . ,” Hayes wrote. “Their destruction would be an irreparable loss not only to the United States but to the world.”

Some congressmen opposed the idea of a new building, suggesting instead that the Army's medical records merge with the Pension Bureau's in their new building (now the National Building Museum), or amalgam the library with the Library of Congress and the museum with the Smithsonian Institution. Representative Clarkson Potter of New York objected on emotional grounds and opposed funding the museum and “preserving the relics and bones or wounds caused by the war at any place in our capital,” wishing instead that "they were all buried and covered all over with green grass and hidden from sight forever." On the other side, the more forward-thinking Representative Theodore Lyman of Massachusetts envisioned an institution something like today’s National Institutes of Health and "discern[ed] a hope that , , , germs may be used for inoculation and may protect us from . . . diseases, just as vaccination protects against smallpox.” Lyman deemed the museum’s studies “essential to the welfare of our people,” and the library “now the first in the world, and whose not less admirable collection of military pathology, are placed at the disposal of all investigators.”

The full article, "The Rise and Fall of the Army Medical Museum," has much more information in it of course.

To show that nothing really changes, we're currently scheduled to move off of Walter Reed Army Medical Center's DC campus due to the BRAC closure of the base, but no new home has been designated for us.

Ruane also wrote, "On the morning of June 9, 1893, the building was packed with 500 government clerks, occupying several floors of jury-rigged office space, when the interior collapsed, according to a Washington Post account the next day. Scores were killed and injured, and the theater's already altered interior was destroyed."

The space wasn't jury-rigged - actually it was built of cast iron, fireproof construction, but the space wasn't strong enough for all the tons of pension records that were being stored there.

Unknown

I was at Arlington National Cemetery Sunday morning when it opened so I could photograph the grave markers of the parents of a friend of mine from San Diego. She was able to come back for her dad's funeral in March but can't swing another trip to visit their grave. While I was there I wandered around and found the memorial that marks the graves of sailors and Marines who went down on the United States Battleship Maine in Havana Harbor in 1898.
The ship exploded and all hands, 229 of them, were lost. Seventeen years later their bodies were repatriated and buried in section 24 of Arlington, near the mast of the Maine. Their names are engraved on the foundation of the memorial.

A sad story in and of itself, but the most poignant part is when you walk among the tombstones and see this. Our Resolved exhibit shows how far we've come and made this kind of memorial obsolete.

Another view of our Resolved exhibit

I think this is my favorite view of the exhibit. That's a transfer case draped with a flag and a backdrop from the Joint POW/MIA Accounting Command Forensic Anthropology Lab at Hickam AFB in Hawaii, showing the process of reconstructing human skeletons with the aim of identification. I always assumed it was a casket that brought our soldiers home, but it's not. The same grim purpose, a more utilitarian box.

Military medicine training article

Speaking of moulages and training, here's an article that talks about their current use. "Trial by (Simulated) Fire: Military Doctors Learn to Practice Wartime Medicine on Mock Battlefield," By Philip Rucker, Washington Post Staff Writer, Friday, August 8, 2008; B01. I met the doctor who's quoted at the end, Capt. Trueman Sharp, last year when the museum got a collection of Vietnam-era medical data from his department for scanning - the Wound Data Munitions Effectiveness Team (WDMET) records include wounding information, x-rays, 35mm slides and sometimes fragments. We've got the material being scanned now, but it's going to take a while to finish.