Yet another news piece references our Dissection book. This most recent posting by reporter Kelly Heyboer, appeared in the online version of New Jersey’s Star Ledger on Friday March 26. Heyboer noted that “in recent months, medical schools around the nation have begun re-examining their ethics codes after a string of disturbing cases in which students photographed or videotaped cadavers and posted the images on Facebook and YouTube.” While acknowledging the troubling ethical impact of images conveyed by social networking tools, she also observed that “Taking photos with cadavers is nothing new. In the late 1800s and early 1900s, medical students regularly posed with cadavers. Some took darkly humorous shots with the dead bodies posed or dressed in costumes. Others took serious classroom photos mid-dissection.” To support this assertion, Heyboer featured an image from the Dittrick’s collection that appears in Dissection. We will have another opportunity to promote Dissection in early April, when John Warner and I will make a presentation at the Countway Library of Harvard Medical School. On April 7 we will be mounting an exhibition of dissection images there and talking about the book. Those in the Boston area are welcome to attend and may find event details here.
How did people learn about reproduction and birth control in early America? Traditional folk knowledge predominated, shared chiefly among women, passed by word of mouth. By 1700 a new source supplemented this oral tradition: a curious little book entitled Aristotle’s Master Piece, Displaying the Secrets of Nature in the Generation of Man. First published in English in 1684, copies of the book went on sale in Boston the following year. In time, Aristotle’s Masterpiece became the most widely circulated guide to childbirth and sexual matters before 1830. It said little on the subject of birth control, and instead presented knowledge of the body and childbirth. (Aristotle did not write this book, but the author thought using the name of the Greek philosopher would lend the work authority and prestige.)
Aristotle’s Masterpiece presented a mix of classical medical writings, 17th century midwifery treatises, and popular folklore. It described sexual anatomy and the essentials of reproduction, as then understood, without the stigma of guilt, sin, or shame. Informative and not intended to be lewd, Aristotle’s Masterpiece celebrated God’s gift of procreative power and the bliss of the matrimonial bedchamber. The tone of the writing at times waxed reverent; at others it bordered on the bawdy side. But throughout it conveyed a sense of discovery and wonder. Since Aristotle’s Masterpiece presented a subject (sex) rarely discussed in polite society, it remained a source seldom openly acknowledged. Medical men did not credit it as a legitimate body of knowledge, while common folk hid their well-thumbed copies under the mattress. Nevertheless, Aristotle’s Masterpiece became a clandestine classic. Some 27 editions appeared in North America; 11 in the 18th century, and 16 between 1801 and 1831.
Here is a flavor of the language found in Aristotle's Masterpiece:
And thus those nobler parts we see
For such the parts of generation be :
And they who carefully survey will find
Each part is fitted for the use design’d :
The purest blood we find if well we heed
Is in the testicles turn’d into seed :
Which by most proper channels is transmitted
Into the place by nature for it fitted :
With highest sense of pleasure to excite
In amorous combatants the more delight.
For in this work nature doth design
Profit and pleasure in one act to join.
The Works of Aristotle, the famous philosopher, in four parts…
New England, February 1813, pp. 8-9.
Stay tuned for a second post on Aristotle's Masterpiece, with references to historical writings by Mary Fissell that make more sense of the meanings this work conveys to us today.
Upon entering the exhibition Virtue, vice, and contraband: a history of contraception in America, you are greeted by imagery of storks, bearing infants, being beaten back or evaded by women who didn’t relish the prospect of motherhood.Such images are perhaps unexpected, but are indeed part and parcel of the iconography of both reproduction and contraception.
Storks atop a tower in Kayersberg, Haut Rhin (Alsace)
The stork, a symbol of fecundity, luck, and prosperity widely used across Europe, has for centuries been associated with childbirth.In Alsace (my favorite part of France) it is the symbol of that French region (more specifically the Haut Rhin département), and indeed storks perch atop spires and chimneys across the countryside.When confronted with the perennial question of where babies come from (awkward!!), a quick parental out is simply to say that “the stork brought them.”
This explanation found visual expression in postcards and announcements sent by prospective and new parents upon the occasion of childbirth.As the predominant icon of childbirth, the stork is closely followed by caggage-patch babies (how many of us recall the frantic parental search for “cabbage patch” dolls at Christmas in the 80s?).Both stork and cabbage patch images are found in abundance in a wonderful book entitled D'où viennent les bébés? by Laura Jaffe and Conce Codina.I came across this book at the Musée Flaubert in Rouen last September and bought a copy for the Dittrick.
Guest curator of Virtue, vice, and contraband Jimmy Meyer collected quite a few postcards with stork iconography, and added them to the Skuy collection last year. Along with the bouyant, cheerful stork images came some less cheery in character -- images of women (and their partners) frantically fending off or fleeing the stork. These postcards showed that not everyone desired a large family, and many eagerly sought some effective and safe way to achieve that goal.
For the next several posts, I am going to take you on a walk through the Dittrick’s interpretive exhibition, “Virtue, vice, and contraband: a history of contraception in America.” Along the way, we’ll linger to look closer at particular items -- rare books, images, and artifacts. It’s the largest and most comprehensive exhibit on this topic in North America, and show cases the Percy Skuy collection on the history of contraception that came to the Dittrick in late 2004.
I first saw the Skuy collection in Toronto, at the Janssen Ortho headquarters, and found it quirky, amusing, and informative. Never in my wildest imagination did I think that collection would come our way. Then, in the summer of 2003 Percy called and wanted to know if the Dittrick might wish to provide a home to his collection. It wasn’t a done deal; Percy was in conversation with at least two other museums. But I felt that we had much to offer and mounted a concerted pitch to set forth our cause. The happy outcome: the collection came to Cleveland.
Our next step? Work through the re-interpretation and installation of the Skuy collection in its own dedicated space. That finally came to pass last September when we opened “Virtue, vice, and contraband: a history of contraception in America.” In time, we will offer a virtual version of the exhibition on the Skuy collection website. For the moment, however, I will take you on a stroll through the display, highlighting the curious and the rare, as well as the banal and commonplace. It’s all grist for the mill in our museum, and I can guarantee you that you won’t see this stuff elsewhere. The Skuy collection is one of a kind.
The “Rythmeter” ranks as one of the most intriguing devices for calculating the time of ovulation and hence the fertile and “safe” periods of the menstrual cycle. Gilmore “Tilly” Tilbrook, a graduate of Carnegie Institute of Technology (1915), military aviator in World War I, and consulting engineer, took on the challenge of making such a calculator.
Tilbrook recalled its genesis years later:
While living in Europe, I had many opportunities to visit the best medical colleges and hospitals, with American doctor friends. It was in 1930, on such a visit at Graz, Austria, that Dr. Knaus explained his conclusions regarding the exact time of ovulation of a human female. [I was] convinced of the importance of this theory - - especially to those of the Catholic Faith. A doctor friend exclaimed: “Tilbrook, you are an engineer, and have devised aviation calculators to determine engine and plane performance, etc. - - Why can’t you work out a simple, foolproof calculator for the accurate application of the Rhythm?"
Tillbrook conferred with leading medical proponents of “Nature’s Rhythm Method,” including Leo J. Latz, Thurston S. Welton, C. G. Hartman, Robert Latou Dickinson, and many others in the field of reproductive health. Tilbrook ultimately patented two variants of the "rhythmeter," (mis-spelled to give it a catchy name suitable for snappy marketing, no doubt): US patent 2343592 March 7, 1944 and US patent 2418207 April 1, 1947, "Rythmeter for determining sterility and fertility." The “Rythmeter” comprised an ingenious calculator, but Tilbrook cautioned not to use his "Rythmeter" without a record of at least nine months past menstrual cycles.
Does this device look or seem user friendly? Decidedly not. But Gilmore nevertheless labored to sell it vigorously, even advertising it in his alma mater's literature in 1950:
I don't think the "Rythmeter" lasted much beyond its inventor's boosterism, however. It had the precision and complication only an engineer could love....
But I like to think that Gilmore developed the device out of altruistic sentiments, and hoped it would do good. In later life he shared the fruits of his successful engineering career by endowing the Gilmore and Charlotte Tilbrook fund for scolarships in engineering, science, or industrial management at his alma mater, today's Carnegie Mellon University. And on a yet more curious note, Gilmore's wife, Charlotte, was for a time personal secretary to aviation pioneer and reclusive entrepreneur Howard Hughes.
Jim Edmonson
I wish especially to thank Jennie Benford, University and Heinz Archivist, Carnegie Mellon University, for her help in finding material about Gilmore Tilbrook, and providing accompanying images.
Leo J. Latz, a Chicago doctor, first championed the Ogino-Knaus approach in the United States. He contended that the “findings of modern science disclose a rational, natural, and ethical means to space births and to regulate intelligently the number of children.” In 1932 Latz published The Rhythm of Sterility and Fertility in Women, which sold over 200,000 copies by 1942, and thus "rhythm" made its way into modern parlance. Latz also shared his approach with the medical community via an article in JAMA in 1935. Latz advised avoiding intercourse for eight days: for women with a regular menstrual cycle, this began five days before ovulation, with an extra three days tacked on for safety’s sake. As a devout Roman Catholic, Latz advanced this method of fertility control as more in line with Church teachings. He published pamphlets on rhythm for priests to distribute to couples, and parish bingo games gave out his book as a prize. Many shared Leo Latz’s faith in the science behind the Ogino-Knaus findings. But applying them to birth control proved not so simple, nor straightforward. Calculating the time of ovulation can still be tricky. It varies from woman to woman, and a woman can ovulate at a different time each month. Stress, illness, or interruptions in normal routine can also alter a woman’s cycle. Despite these uncertainties, the Ogino-Knaus method caught on, as evidenced by the proliferation of rhythm method calculators after 1930. Companies produced graphs, wheels, calendars, and slide rules, which cost from 10¢ to $5.
Despite Latz's enthusiasm, The Catholic Medical Guardian reported in 1935 that “the calculation of the ‘sterile period’ is never easy and in many cases appears to be impossible.” Interest yet remained, and in 1951 Pope Pius XII sanctioned the Rhythm Method as a “natural” method of regulating procreation. In 1955 over 65% of Catholic women surveyed said they used Rhythm.
Ironically, Leo Latz felt biting backlash for all his efforts to bring an acceptable form of contraception to Catholics. Some felt he went too far. When Latz published The Rhythm in 1932 he served on the medical faculty of Loyola University. According to Leslie Tentler, writing in Catholics and Contraception: An American History (2004), Latz "was abruptly fired from that position in August of 1934," and this action "was almost certainly a direct result of Latz's prominent association with the cause of rhythm." In 1935 Latz confessed to his friend Father Joseph Reiner, S.J., that no one "knew the anguish and dishonor I ...suffered, when people said: 'I heard you were thrown out of the University."
Last summer, when we were thick in the preparation of a new permanent gallery for the Percy Skuy collection, I learned about a later variant of rhythm calculator known as the “Gynodate.”Acquisition of this object was a matter of happenstance; one day, while shopping in the Coventry neighborhood of Cleveland Heights, I ran into Mitch Attenson, a local antiques dealer.Mitch said that he had something for the Dittrick that I would want to see: a calculator for determining fertile/infertile periods of a woman’s monthly cycle.He said that it came from the estate of a spinster teacher (but I didn’t pursue that…).Intrigued, I stopped by his shop, and sure enough, he had the real article.
Swiss clockmaker Jaquet introduced the “Gynodate” in 1958.It combined a regular alarm clock and a gauge to calculate the “safe period” as directed by Hermann Knaus.Jaquet claimed it “indispensable for every woman for natural birth control.”
Once back at the Dittrick, “gynodate” in hand, I did some preliminary google searching.Now if you put that word in google, the results are predictable: either porn, or something about making an appointment at the gynecologist’s office – equally uninformative for us, however.I did run across a true hit, mentioning the item in the New York Times in June, 1965.At that date, Hammacher Schlemmer, New York’s premier gift, gadget, and hardware store since 1848, offered the 'gynodate' for sale “to help married couples plan their families.”And the next day “one hundred ‘planned parenthood’ clocks were reported sold yesterday at Hammacher-Schlemmer…for $19.95.” Nothing more of substance, however.
As a last stab at finding out more about the "gynodate" I emailed colleagues at the Museum of contraception and abortionin Vienna, Austria.We’d been in touch before they opened and had hosted museum founder Christian Fiala and his associate Susanne Kresje in Cleveland in 2007. We stayed in touch and I’ve visited the museum in Vienna on two occasions.So I dropped an email to Susanne and Christian, inquiring if they had a "gynodate"clock.Paydirt, kinda.No, they didn’t have the item in question, but would love to get one should I happen to encounter another in my travels (slim chance of that). But they did have some associated ephemera that they freely shared and is posted here.
The thing that I like best about the "gynodate" is its stylish concealment of its function.Looks like a nice, if simple, alarm clock when the decorative bezel is closed.But lift the hinged cover and you reveal adjustable dials to set for the onset and end of the monthly period, and hence gauge the days of fertility. Reminds me of oral contraceptive dispensers in the form of lipstick containers or dialpak dispensers disguised as facial powder compacts.
Certainly not the first, nor the last, time that designers strived to camouflage the purpose of a medical device. Sometimes this was done to conceal an object's function from unwitting patients (as in the case of medical furniture in the 1880s), while at other times it was done to safeguard personal dignity, as in the concealment of contraceptive purpose of the object at hand, the "gynodate".
Advertisement for Thurston Scott Welton, The modern method of birth control. New York, W. J. Black [c1935]. Included "The calendar-wheel for finding fertile and sterile dates" in pocket on inside of front cover. Image courtesy of Paula Viterbo.
Learning through the artifact.
One of the great things about working with an important museum collection is that you’re always learning.And boy, with the Percy Skuy Collection on the history of contraception did we have a lot of learning to do!I’d like to share some of the fruits of that learning process by featuring a selection of objects, showcasing some of the more intriguing artifacts that are now on display in our thematic exhibition, Virtue, vice, and contraband: a history of contraception in America.
The Skuy collection is illustrative of several facets of medical artifact collections.First, most visitors are simply amazed at the variety of contraceptives, but this proves to be true of many medical technologies (viz: over 600 variants of OB forceps appeared from the 17th century through the 20th centuries).Contraceptives alsoprovide evidence of significant scientific inquiry and innovation involved in medical technologies, although much of this is a 20th century phenomenon.And lastly, our work with the Skuy collection brought a fuller appreciation of a growing body of scholarship in this domain.These points are well illustrated by a curious set of objects: rhythm method calculators.
Frankly, when we started work on reinterpreting the Skuy collection, I didn’t expect to focus on the rhythm method, and its associated calculating devices.Oh, I knew about rhythm, thanks to my Irish-American mother-in-law, who saw to it that my wife and I got a packet from the Catholic Social Services agency where she worked in Wilmington, Delaware.The packet didn’t get read closely, and in time the packet ended up in the Dittrick’s collection around 1981.
So, as we mapped out the Skuy collection gallery, I expected to give only a passing nod to rhythm.But as we sorted through the collection quite a number of calculators surfaced, chiefly from the 1930s-1960s.This surprised me, and I looked into why so many such items existed and what they tell us about contraceptive technologies.
Conception is central to the human experience, yet for centuries the process remained misunderstood. Doctors giving contraceptive advice in the 19th century often recommended having sex only during the "safe period," when a woman was not ovulating.But before 1930 (and even after), most physicians misidentified the time of ovulation. By studying animal behavior, they thought women were "safe" from pregnancy at the midpoint of the menstrual cycle. This is in fact when women are most likely to conceive.
This changed markedly in the 1920s when Kyusaku Ogino in Japan and Hermann Knaus in Austria studied ovulation carefully. They concluded that it normally occurs from 12 to 16 days before the onset of the menstrual period. They also asserted that an unfertilized ovum had a brief life, probably less than a day. At last, it seemed, the “safe period” could be more accurately determined. And this precipitate a spate of inventive activity, with many calculators being designed, patented, copyrighted, and produced in the ensuing decades.
These developments are the subject of an important dissertation by Paula Viterbo, an editor on the Thomas Jefferson papers.Viterbo’s work is entitled "The Promise of Rhythm: The Determination of the Woman's Time of Ovulation and Its Social Impact in the United States, 1920-1940," State University of New York at Stony Brook, 2000; I also commend her article “I got rhythm: Gershwin and birth control in the 1930s,” that appeared in Endeavor in 2004.She kindly helped us by reviewing our exhibit section on rhythm, and attended the opening of the Skuy gallery last September.
In a coming post I will present some specific examples of these calculators that now appear in the Skuy gallery.
We recently refurbished our Castele Gallery to accommodate small temporary exhibitions, particularly to accompany lectures and programs at the Dittrick. For the occasion of Natasha McEnroe’s presentation on safe sex in 18th century London (on March 18@6:00PM), we have mounted an exhibition, as mentioned in our post of Feb 26. We’ve entitled this exhibit The wages of sin: temptation, indulgence, and disease in 18th century London, as seen in the art of William Hogarth. It features prints from William Hogarth’s “novel” series including The Rake’s Progress, The Harlot’s Progress, and Marriage a la Mode.
Hogarth's series all tell a tale of innocents seduced, appetites indulged, honor compromised, and carnal pleasures leading to a bad end. Curator emerita Patsy Gerstner did the lion’s share of work on this exhibit, and we thank her heartily for that. For further reading on Hogarth and related topics, she recommends From Hogarth to Rowlandson: medicine in art in eighteenth-century Britain by Fiona Haslam. Just today (March 11) Hogarth’s print series has been wonderfully presented by Lucy Inglis in her award-winning blog, Georgian London. Hear her audio on Hogarth as social commentator in the Harlot’s Progress series.
Dittrick staff crafted a companion display of rare books entitled John Hunter : (mis)understanding venereal disease. Hunter believed gonorrhea (“the clap”) and syphilis (“the pox,” or lues venerea) to be different stages of the same disease, as presented in his A Treatise on the Venereal Disease (1786). According to Hunter, gonorrhea comprised the preliminary and local manifestation of the disease, affecting only the genital parts, while syphilis constituted a more generalized, or in Hunter’s parlance, “constitutional” mode of infection. Hunter felt compelled to prove these distinctions via experiment -- on himself. In 1767 he dipped his lancet into the gonorrheal sore of a patient, and jabbed the lancet into his own penis in two places (that’s heroic by anyone’s measure!). Unfortunately, for the success of this experiment, and for Hunter’s own health, he drew the infectious “poison” from someone suffering from both gonorrhea and syphilis. The symptoms progressed from one disease to the other, confirming in Hunter’s mind that he proved the unity of the two diseases. This view held sway until 1838, when Philippe Ricord set the record straight in his Traité pratique des maladies vénériennes.
Another somewhat out-of-the way Paris medical museum worth a visit is the Musée de l’Ecole vétérinaire de Maisons-Alfort.Established in 1766 as an adjunct to the royal veterinary school, it opened to the public in 1991, but was in a pretty sad state of repair.That has changed completely.Under the guidance of curator and professor of anatomy Christophe Deguerce, the museum underwent a complete facelift and re-opened to the public in November 2008.It is stunningly beautiful and showcases the collections to advantage, most notably the anatomical preparations of Honoré Fragonard.
Before we went, we contacted Dr. Deguerce and were lucky enough to spend some time discussing the museum and its renaissance.Ironically, he reported, a variant of the Body Worlds exhibit in Paris, Our Body: À Corps Ouvert, almost shut the doors of the museum. French human rights groups had filed a lawsuit complaining that the bodies were not displayed behind protective glass, and raised issues related to the problematic source of the cadavers.A judge ordered the Paris exhibition closed, ruling that it violated ethical and moral issues related to the provenance of the plastinated bodies.During this case, defenders of the show queried why it was ok for Fragonard’s flayed bodies to be publically seen at the Musée de l’Ecole vétérinaire, but that the modern plastinates were found to be offensive.Fortunately, the Fragonard collection is classed as a monument historique, and is thus valued as part of France’s national scientific and medical heritage.The museum happily remains open and welcomes an increasing tide of visitors
For what it’s worth, the Body Worlds originator Gunther von Hagens hastily distanced himself from that Paris show. I refer those interested in the murky issues surrounding Body Worlds and its clones to a superb article by Jim Connor, "Faux Reality" Show? The Body Worlds Phenomenon and Its Reinvention of Anatomical Spectacle, Bulletin of the History of Medicine (2007). Christophe Deguerce addresses these issues in an online interview (in French, alas, for non-francophone readers), comparing and contrasting the approaches and intent of Fragonard and von Hagens.
I guess the thing that impressed me most is that while Deguerce wants to present the collection to greatest advantage, he is more about scholarship than showmanship (a la von Hagens).He just published two fascinating articles in Clinical Anatomy analyzing 18th century specimen preparation and Fragonard’s injection methods.And Deguerce and conservator Laure Cadot have a book in the works entitled Honoré et ses écorchés; Fragonard, an anatomiste au siècle des lumières. Hopefully an English language version may be in the works, and its working title would be Honoré Fragonard and his «Ecorchés » An Anatomist at the Age of Enlightenment.I’ll keep you posted on any progess on that front.
Jim Edmonson
p.s. - Any reader having difficulty accessing either Jim Connor's article, or Christophe Deguerce's pieces, email me and I will send pdf copies. I may be reached at james.edmonson@case.edu or at 216-368-6391
