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By Theodora Burbank, April 13, 2020

On August 29, 1889, former dean of Harvard Medical School Oliver Wendell Holmes (1809-1894) turned 80 years old. Annie Fields (1834-1915) and Sarah Orne Jewett (1849-1909), along with nine other women, presented Holmes with this silver loving cup at his birthday celebration. The cup entered the Harvard Medical Library collection in 1940 when Mrs. Richard Rule—the great-granddaughter of Holmes’ sister—presented it to the Department of Anatomy. A renewed focus was recently placed on the cup as part of an inventory project for this collection.  

Oliver Wendell Holmes Friendship Cup. From the Harvard Medical Library in the Center for the History of Medicine, Francis A. Countway Library of Medicine (a001.098)

Holmes was the Dean of Harvard Medical School from 1847-1853 and was the Parkman Professor of Anatomy and Physiology until he retired in 1882. Holmes was a skilled physician who made great contributions to research in puerperal fever and was the first person to bring a microscope into an anatomy classroom in the United States. Along with his medical prowess, Holmes was also a prolific writer. He published both poetry and prose. He came up with the name for the magazine The Atlantic and contributed to it many times. These worlds often collided for Holmes: much of his writing revolved around the medical world, and he frequently gave recitations of his poetry at events for medical institutions. 

The 1889 loving cup—called the “Friendship Cup”—is engraved with a quote from Holmes’ poem “The Sentiment”. The engraving reads: 

The Pledge of Friendship 

Tis the heart’s current lends the cup its glow 

Whate’er the fountain whence the draught may flow 

The bottom of the loving cup

A loving cup is a shared drinking vessel and is usually used at weddings and other celebrations. In the 19th century, they were popular for trophies and commemorative gifts. Holmes was particularly enamored with the design of the cup. The names of the donors were on the bottom. In theory, the names could not be seen if the cup was full, so it would have to be emptied—and therefor shared—before they could be read. He highlighted this aspect of the cup in his poem, “To The Eleven Ladies Who Presented a Loving Cup to Me”, which begins: 

“Who gave this cup?” The secret thou wouldst steal 

 Its brimming flood forbids it to reveal: 

No mortal’s eye shall read it till he first 

Cool the red throat of thirst. 

 

If on the golden floor one draught remain, 

Trust me, thy careful search will be in vain; 

Not till the bowl is emptied shalt thou know 

The names enrolled below.

Originally, only twelve copies of this poem were printed: one for Holmes and one for each of the donors. He signed these copies by hand. Holmes later published the poem in his 1891 book Over the Teacups, a collection of poems and essays centered around fictional breakfast-table conversations. 

One of Twelve Original Copies of “To The Eleven Ladies”, signed by Oliver Wendell Holmes. From the Boston Medical Library in the Center for the History of Medicine, Francis A. Countway Library of Medicine.

Not much is known about the donors or why they presented Holmes with this gift, but there are a few notable names on the bottom of the cup. Annie Fields was a writer who published collections of poetry and essays as well as biographies of notable literary figures. Her husband, James Fields, was a publisher. Together they ran literally salons out of their home, many of which were attended by Holmes. Annie Fields was also the sister of Zabdiel Boylston Adams, Jr., who was a surgeon and attended Harvard Medical School while Holmes was Dean. Sarah Orne Jewett was a friend and later companion of Annie Fields. She was also a writer and was best known for her work describing rural New England Life. Her father, Theodore Herman Jewett, was a doctor. Her experience accompanying him on his rounds as a child inspired her book A Country Doctor. 

It is easy to see why Fields and Jewett would have been drawn to Holmes, and although not much is known about the other donors, the Friendship Cup is a clear sign of admiration from all eleven women. Holmes’ poem indicates that the admiration was reciprocal. This reciprocity is part of what makes the Friendship Cup stand out in the collection: it doesn’t just reveal information about Holmes himself, but about his friendship with the donors. Although this loving cup was donated to the Harvard Medical Library as an artifact relating to Oliver Wendell Holmes, it sheds some light on the lives of eleven others as well. 

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By Theodora Burbank, April 6, 2020

As I sorted through boxes of ear, nose, and throat instruments, I was excited to discover a clear collection forming. There were numerous instruments that had been carefully tagged with a description of the instrument and the name “Dr. J. W. Farlow”. This was particularly exciting because it wasn’t only a clear collection, but it all revolved around one particular subject. Before I knew anything about who J. W. Farlow was, I knew based on his collection that he was almost certainly a laryngologist.  

What was even more exciting was when I began looking at the names on the objects. Amongst objects with names like “Hajeck’s nasal punch” and “Roe’s septum forceps”, I found an object labeled “Farlow tonsil ecraseur”. J. W. Farlow wasn’t just a doctor, he was also an inventor.  

Farlow Tonsil Ecraseur. From the Warren Anatomical Museum in the Center for the History of Medicine, Francis A. Countway Library of Medicine (WAM 22220)

The instruments belonged to Dr. John Woodford Farlow (1853-1937), who was a laryngologist in Boston. At the time that Farlow was practicing, tonsillectomy—surgical removal of the tonsils—was a common procedure. In the early 20th century it was the most frequently practiced surgical procedure in the United States and would have made up a large portion of a laryngologist’s work. Because of this, there were many innovations in the tools used for these surgeries. Farlow made his mark with his tonsil forceps and the tonsil ecraseur (or tonsil snare) that is part of our collection.  

The tonsil ecraseur was an alternative to the tonsillotome or tonsil guillotine, allowing the physician to remove the tonsils in their entirety. It was often favored over other instruments because it removed the tonsils cleanly and because many believed—although it was disputed—that it reduced the chances of hemorrhage during surgery. Farlow’s ecraseur had a straight handle with a “cold wire”, meaning there was no heating element like some other devices. The wire was attached to a screw that could be rotated using the finger loops at the end of the handle. This allowed the physician using the device to carefully and gradually pull the wire, which gave Farlow’s design a distinct advantage over lever-based snares, which did not offer as much control. 

Farlow was associated with many hospitals in the Boston area throughout his career, including the Boston Dispensary, the Staniford Street Dispensary, the Free Dispensary for Diseases of Women, and the Boston City Hospital. He was on the Harvard Medical School faculty as a Clinical Instructor of Laryngology from 1892-1906. In 1902 he served as President of the American Laryngological Society. He was also very involved in the Boston Medical Library, which was the subject of most of his publications. Because of this, he is remembered more as a librarian than a laryngologist. His tonsil ecraseur and the rest of his collection are a reminder of his important contributions to his medical field.

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By Catherine Pate, April 2, 2020

Doctors at the Peter Bent Brigham Hospital in Boston, MA outfitted for handling the influenza epidemic of 1918.

In 1918, no hospital, including the Peter Bent Brigham Hospital, a parent institution of the Brigham and Women’s Hospital, was spared the responsibility of caring for those afflicted by the worldwide influenza epidemic. The records of their battle with the mysterious illness endure in the BWH Archives held in the Center for the History of Medicine, Countway Library.

I say mysterious, because there was very little known about viruses or routes of contagion in the early years of the twentieth century. It would be more than a decade before the viral nature of influenza was uncovered and another quarter-century before the development of a vaccine or the widespread use of antibiotics for secondary bacterial infections. At the time, hospitals such as the Brigham could offer influenza patients supportive care (fluids, oxygen delivery, attention to heart, bowels, etc.). Also considered therapeutic—a good dose of fresh air.

Ventilation

The current Brigham and Women’s Hospital complex evolved on the site of the original Peter Bent Brigham Hospital. The Peter was designed in 1912 in the pavilion style, a hospital building system for which Florence Nightingale had been a strong advocate in the late Victorian era. The idea was that disease was probably spread in the “miasmic” air around the sick. This meant that patient wards were built as physically separated buildings designed for maximum cross-ventilation, with extra space between patients, and access to the outside. The wards were connected to each other and the main hospital building by an outdoor walkway.

The patient wards of the Peter Bent Brigham Hospital in 1918. Note the outdoor beds for flu victims. (The ward pavilions were torn down in 1980.)

Flu patients in the Peter Bent Brigham Hospital recovering outdoors on the ward porch in 1918. Many archival photographs show patients recovering from illness outside in the early years of the hospital.

A New Warfront

When the influenza epidemic hit Boston, Dr. Henry A. Christian, the first Physician-in-Chief of the Peter Bent Brigham Hospital, was already dealing with a shortage of the experienced doctors and nurses who had taken leave to serve at military hospitals during the first World War—the armistice coming too late in the year to cause an appreciable change in staffing. Though filled to capacity and understaffed, the Brigham’s doctors, nurses, students, and volunteers worked selflessly to help the afflicted.

The best account of how the hospital managed the unexpected avalanche of influenza patients and the toll on his staff is from Dr. Christian’s own 1918 report:

The Influenza Epidemic

In the year 1918 no hospital event exceeded in importance and seriousness the epidemic of influenza, which burst upon Boston in September, and at the close of the year, was still prevalent, though to a lessened-degree. For a number of weeks practically the entire hospital was given over to the care of influenza cases. Every medical bed and half of the surgical beds were occupied by influenza cases. In the remaining beds were concentrated such surgical and medical cases as must needs remain in the hospital or be admitted as emergency cases. The Surgical Staff loaned to the Medical four of their house officers to care for influenza cases, and very generously the surgeons curtailed their work to a minimum. Without this help from the Surgical Staff we would have been unable to meet the needs of the situation.

The hospital cooperated with the Board of Health and took, in the main, cases selected by them, patients who could not be cared for at home, or those in almost dying condition that it was necessary to get out of their homes to ease the problem of home management of less seriously sick ones. Many died in a few hours after being brought to the hospital. The wards were filled with patients extremely ill with the pneumonia that accompanied influenza. More than half of our nursing and medical staffs themselves had influenza, but we managed to carry on without any outside help and without using probationers [newly admitted student nurses] or nurses’ aids in the immediate care of patients, feeling that for the less well trained the dangers of acquiring the disease from contact was greater.

From September 9 to December 31 we treated 557 cases of influenza. Of these about 60 per cent had clinically demonstrable pneumonia, a large percent being admitted to the hospital with pneumonia already developed. Of the influenza cases 153 died. A striking contrast to the general hospital cases were our nurses and doctors, who, put at once to bed and kept there, recovered with one exception. It seems certain that failure to go to bed and remain there was an important cause of the high mortality of the disease throughout the country. It had seemed wise to us to insist on a prolonged stay in bed after the temperature was normal. The very few relapses that we saw seemed amply to justify this course. No patients were hurried out of the hospital; all were urged to stay until we felt sure that their strength made the exertion of home life and getting there safe. In following up our patients since discharge we have found that results appear to show the wisdom of this course, for bad after-effects of the disease have been surprisingly few in our patients.

In handling influenza patients all who came in contact with them were gowned, capped, and masked, and care in washing hands was insisted on. Our present knowledge of influenza is too inadequate to make certain how far these precautions are necessary. At present they seem wise. Consideration of the infection among our nurses and doctors indicates that they acquired the disease not from patients in the wards but from contact with one another, or with maids, or with outside friends just developing the disease; in other words, the disease is most contagious during the incubation period. Only one non-influenza patient in the hospital acquired the disease in the hospital wards, and one patient acquired influenza in the operating room, probably from one of the doctors who assisted in operating on him as the doctor shortly thereafter developed influenza. Thus it would seem reasonably easy to maintain quarantine, even within an infected institution, when all visitors are excluded and other means of isolation are carried out. Such rigid quarantine probably is not possible in the community at large…

…Our nurses did most excellent work during the epidemic. The numerous cases of the disease among them made it necessary for the well ones to work with redoubled energy. Pupil nurses had to replace graduate head nurses as the latter fell ill, and so had thrust upon them much responsibility. Nurses could not but feel the grave danger they ran in handling a disease which evidently in some part of its course was extremely contagious and which was causing a high toll of deaths right under their eyes. There was no faltering; each did her duty and carried out her work efficiently. Particularly did the night nurses have a strenuous time, for in the silent hours of the night delirium was most active, and then it was that death claimed its largest numbers. The way our nurses met these demands upon them has caused the staff to feel great pride in them, and has been, I am sure, an occasion for much gratification to Miss Ivers and her associates who are immediately responsible for the training of the nurses. Personally it is a pleasure to me to voice here the feeling which all of the Medical Staff shares.

Leone N. Ivers, R.N., Acting Superintendent of Nurses, reported the situation for her nurses that same year:

On September 16, 1918, twelve nurses came down with influenza, and this epidemic was very serious during the balance of the year; the blackest day starting with forty-five nurses off duty. It was necessary for about one month to increase to a ten-hour day, with one afternoon off each week and four hours on Sunday. Enough cannot be said of the faithfulness and devotion of the nurses able to continue on duty during this period. It is with sincere regret that I am obliged to record the death of two of our pupil nurses. Marion Louise Winslow died from influenza at the New York Nursery and Child’s Hospital, New York City, October 12, 1918. She would have graduated January 26, 1919. Mabel Downton died from influenza at this hospital December 28, 1918. She was just starting on her senior year.

The full reports of all the administrators of the Peter Bent Brigham Hospital in 1918 can be read in the online version of the Peter Bent Brigham Hospital Annual Report for that year:
https://iiif.lib.harvard.edu/manifests/view/drs:427307276$1i