Health Care Update: 1910

This week the news was filled with stories about the passage of the health care reform bill of 2010, and it occurred to me that it might be an opportune time to look back at what was happening in health care one hundred years ago. Here’s what a glance through the New York Times during 1910 reveals:

In 1910 there were no drugs as powerful as sulfa drugs or antibiotics, but the government and the medical profession were beginning to wrestle with regulation of the medicines that existed. The 1906 Pure Food and Drug Act outlawed the sale of poisonous patent medicines and pushed for the correct labeling of all medicines, but an article on February 2, 1910 discusses testimony of Dr. Henry Kraemer, a member of the Committee on Revision of the United States Pharmacopoeia, that reveals that administrators were still hard at work trying to identify, label, and deem acceptable the medicines that existed. Dr. Kraemer points out that seventy percent of the drugs being used were “vegetable drugs” (herbal drugs) and that there needed to be standards for them. “It is not reasonable to suppose or believe that a good fluid extract or tincture can be made from a poor drug any more than to suppose that a good malt can be prepared from a poor quality of barley grains or a good extract of beef from a poor quality of meat…”

The article speculates that the Committee on Revision of the United States Pharmacopoeia must be coming under pressure from “sinister influences,” based on the fact that Kraemer was finding it necessary to take the stance that he did. While we’ve come a long way on regulation of pharmaceuticals, today’s newspapers regularly feature stories about the regulation of medications, so in many ways, Dr. Kraemer’s committee would likely feel very much at home in the world of today.

The same cannot be said for those who undertook studies of mental health one hundred years ago. A story about criminal tendencies in children indicated they meant well but were still very ignorant about the workings of the body–and the brain. The story focused on the New York Society for the Prevention of Cruelty to Children, the first organization dedicated to safeguarding children (founded in 1875). By 1910 the Society had expanded its mission, and hoped to rid “feeble-minded children” of their criminal tendencies. Based on research provided by Dr. M.G Schlapp of Cornell University, they believed that many of the children who performed criminal acts were often normal children raised in an abnormal environment and the SPCC was undertaking programs to help these children. There were, however, some cases where “the child’s defect was traced to the absence of the thyroid gland,…the absence of this fluid [from the thyroid] eventually leads to dementia and often to crime.” They also were looking for ways to rectify this “absence of the thyroid.”

On a completely different note, medical personnel today would identify with an article that appeared on October 13, 1910. The article concerned the opening of a world-class medical facility on East 66th Street, the Rockefeller Institute for Medical Research. The plan for the Institute was to focus on only three health issues by admitting only those who suffered from poliomyelitis (infantile paralysis), heart disease, or pneumonia. By narrowing their field of study, those at the Rockefeller Institute felt they would be better able to develop effective treatments for each.

But one additional piece of information caught my eye. Today one of the hospital mandates has to do with improving hospital cleanliness, so it was particularly interesting to read this description of one of the modern elements of the new facility in 1910: “….the glass doors leading to the glass-enclosed rooms are opened and shut with the elbows instead of the hands, and the air from the room passing to the outlet in the roof is sterilized before it gets there. After examining his patient in the pavilion the doctor hurries to a small room where he washes his hands, and he turns the water on, not with his hands, but with his feet.” Perhaps today’s hospitals might pick up a pointer or two from the Rockefeller Institute of 1910.

As for health care today, the passage of the reform bill is a big step forward in offering preventive health care–the best type of medicine–to more Americans than ever before. All in all, it’s a good week for the United States.

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