Monday, May 17, 2010

Celebrating the Pill: two offerings from across the spectrum of interest.

With all the hoopla commemorating the 50th anniversary of the Pill, I’ve seen and read a lot of compelling commentaries. But for my money, the two best offerings come distant poles of competence and interest. One comes from a distinguished senior scientist in family planning residing in California, and the other is from a high school sophomore (!) in greater Cleveland.

The most compelling and well-reasoned celebration of the Pill that I’ve read so far comes from Malcolm Potts, the Bixby Professor of Population and Family Planning at the School of Public Health, University of California, Berkeley. Dr. Potts is a Cambridge educated obstetrician who has devoted his career to women’s health and reproduction science, and for ten years he served as Medical Director of the International Planned Parenthood Federation. On Mother’s day he published an op-ed piece in the LA Times, and I commend it heartily to you: The pill — a modern philosopher's stone.

Another celebration of the Pill comes to us from Shaker High School sophomore Luken Zhang. For her
National History Day project, Ms. Zhang decided to focus on the Pill, its social and culture origins and impact. To present her perspective she fashioned a super website entitled The Pill: Birth of a New Woman. The site is loaded with pictures, video clips, and archival sources, making the story of the Pill really come alive.

Ms. Zhang stopped by the Dittrick to capture some i
mages in our gallery featuring the Percy Skuy Collection on the History of Contraception. She also interviewed me on the topic, after her website had made it to the regional finals of History Day. In our conversation, I asked her what she had learned in the process of studying the Pill. She said that she never appreciated how much one thing, one innovation, could influence our lives so profoundly. Seems like a pretty good lesson to have learned while still yet a high school sophomore! Ms. Zhang is off to the National History Day national finals in Washington, DC in June, and we’ll be rooting for her and wishing her much well-deserved success!

Jim Edmonson

p.s. -- by the way, National History Day originated at Case Western Reserve University in 1974, as the brainchild of history professor David van Tassel. Read about it in a
remembrance of van Tassel by Cathy Gorn, director of National History Day.

Thursday, May 13, 2010

Picturing the physician–patient encounter.

L. M. Lawson, M.D., "Lectures on the Pathology, Diagnosis and Treatment of Diseases of the Chest; … Mode of Auscultation -- Stethoscopes," The Western Lancet Vol XI, No.3 (March, 1850): fig 24 (opp p 137).

This summer at the Dittrick we are busy revamping our balcony display of diagnostic instruments first installed way back in 1976. As previously discussed in the Newsletter of the Cleveland Medical Library Associaton, this renovation has been precipitated by donations by Don Blaufox of drawings of stethoscopes (Fall 2008) and his extensive collection of historic stethoscopes and sphygmomanometers (Spring 2009).

A.B. Norton, M.D Ophthalmic Diseases and Therapeutics. 1898. p 30, fig 6

It’s an exciting and challenging prospect to make these instruments come alive, to show how they enhanced the process of diagnosis and altered the physician-patient encounter in the physical examination. We’re hot on the trail of images depicting doctors and their patients, using a variety of diagnostic instruments. Great help is to be found in the Cleveland Medical Library collection in the Allen, the first core library established in 1893. Museum volunteer Jim Vendeland, a retired ophthalmologist, is plowing his way through the monograph collection to ferret out such images. As Jim tracks them down, museum student assistant Gillian Seaman (history major at Case) is scanning the images and carefully documenting them. The result? A growing fund of images seldom seen before, as most are buried deeply in medical literature of the late nineteenth and early twentieth centuries.

H. C. Burnett, System of Diseases of the Ear, Nose, and Throat. 1893. p 116, fig 16.

In addition to providing a pool of images useful for the diagnostic instrument gallery, we are generating a visual library of arresting and fresh (though technically “old”) depictions of doctors examining patients. All too often, illustrated works on the history of medicine use hackneyed, clich├ęd images. We’re happy to break from that pattern, and will be sharing our finds as this project proceeds.

Bon courage.

Jim Edmonson

Thursday, May 6, 2010

When a pill became The Pill, a half century ago

This Sunday, Mother's Day, marks the fiftieth anniversary of FDA approval of oral contraception. The occasion is being observed in many news stories about the Pill, its advent and its social, cultural, and demographic impact. It's no small matter as over 100 milliion women use oral contraceptives in America today.

The Dittrick’s Skuy Gallery features a display devoted to the Pill, highlighting those responsible for its development, and how this new form of contraception was received by the medical community, and across the political spectrum from the Catholic church to proponents of the “sexual revolution”.

The forms of packaging used for the marketing and dosage comprise a particularly interesting aspect of the Skuy Gallery display. Early pill bottles, for Enovid distributed by G. D. Searle, & Co. resemble those customarily used for any form of oral medication. Soon, however, contraceptive makers introduced a range of packaging concealing the identity and function of oral contraceptives.

By placing them in containers that resembled cosmetic compacts or lipstick holders, pharmaceutical manufacturers promoted social discretion of those taking the Pill. In some states, contraceptives remained ostensibly illegal in 1960, so concealment was the order of the day.

To encourage compliance and ensure appropriate dosage, one concerned husband, an engineer named David Wagner, redesigned the oral contraceptive container, giving us the iconic dialpak dispenser (patented July 27, 1962). He first presented it to G. D. Searle, but they seemed preoccupied with other marketing issues. In the fall of 1962 Wagner showed it to Ortho Pharmaceutical, but they, too, showed little apparent interest. Six months later, in February 1963, Ortho introduced the Dialpak, which curiously resembled Wagner's design in every way! Long story short, Wagner defended his patent and the two parties settled. Wagner's dialpak design was here to stay. And there's no mistaking it for anything else!

The dialpak story is compellingly told by Pat Gossell in her essay, “Packaging the Pill,” which appeared in the collection of essays entitled Manifesting Medicine: Bodies and Machines (1999) edited by Robert Bud, Bernard Finn, Helmuth Trischler.

With all that is being written and posted online, I took a look around and can recommend these articles for further reading:

The Pill at 50: Sex, Freedom and Paradox. Time by Nancy Gibb, Apr. 22, 2010

It Started More Than One Revolution. NYT by Gardiner Harris May 3, 2010

The Pill at 50: Taking stock. Huffington Post by Christiane Northrup, MD April 22, 2010.

Why I hate the pill. The birth control revolution brought freedom to countless women. It brought misery to me. by Geraldine Sealey May 3, 201

What Every Girl Should Know. NYT by Gail Collins May 8, 2010

50 Years of a sometimes bitter pill. BBC News by Claire Murphy May 7, 2010