I work in a museum that is devoted to the history of healthcare (yes, healthcare, a word deliberately chosen over medicine). As the curator, much of my work is behind the scenes, but I spend a significant chunk of my time interacting with the public and giving tours. It’s a part of the job I (mostly) enjoy, not least because every tour demonstrates anew the power of objects to create a connection with medical history.
As the tour starts even people who are deeply engaged and interested see the history at a distance. They want to know dates, sigh over how lucky they are to live in the 21st century. But as we walk through, the questions change. How did student nurses keep their uniforms clean? How did people in an iron lung go the bathroom? Faceless demographics turn into human beings. Lists of statistics turn into experiences. Visitors see themselves in the history.
Objects have the power to illuminate the past for the historian as well. Medical humanities have grappled with the concept of social histories of medicine and patient-centred narratives since the 1960s and ‘70s. “Traditional” medical history has been criticised as elitist for its tendency to focus on the doctors and researchers and for writing “hero” narratives.
Consequently, the patient experience is not always easy to find in the text. Even some of the patients whose names made it into written records left little evidence of their own thoughts. James Phipps, the very first person immunized against smallpox, was the eight-year-old son of a labourer. Mary Mallon, better known as Typhoid Mary, was a domestic servant and an immigrant. That’s almost all we know about them.
Even in cases where a concerted effort has been made to recognize the contributions of the patients, the doctor still tends to be the most memorialized. Pioneering gynecologist James Marion Sims is an excellent example; his legacy is being revisited, his victims/patients are being named and acknowledged (as much as we can – Anarcha, Betsey, and Lucy are the only patients for whom we have records) and his statue in Central Park, New York has been taken down. But a quick glance at a medical catalogue shows that his name lives on in the title of multiple tools. Anarcha, Betsey, and Lucy were slaves. We can only know them from a distance.
Or can we?
It is a simple truth that medical care involves things. What those things are changes over time, with new medical theories and advances in technologies. But whether it is a cupping set on the wall of an Egyptian temple or a tube of paper that will become the first stethoscope, the presence of things themselves is a near constant.
Things exist. They have materiality. They tell a story. There is a power in their physical presence to evoke emotion and connection.
It’s a power that has been used in the annals of medical history before. Consider the protests against the Contagious Diseases Act in Britain, the requirement passed in 1864 for women suspected of sex work to be regularly inspected for sexually transmitted illnesses. There are plenty of reasons to find the laws distressing, but many protests focused on the objects that would be used during the inspections. It was the cruelty of the speculum that became the lynchpin of many arguments – not only that its use was dehumanizing, but that the physicality of it was cruel: it was too big, too painful, too unhygienic. This rhetoric must have been effective, because the Acts were repealed in 1886.
For the medical historian, then, what can the object say? The object can be interacted with. It can be seen, smelled, touched, spun around, experienced with multiple senses. Its form, its material composition, even the wear on its surface is dependent on its function. These qualities can be understood physically. An object speaks through its weight, its colour, the texture of its surface. We can, in some ways, experience the object in the same way that the person who used it did and through that, illuminate something about how they navigated their own experience as a patient.
Sarah Chaney’s article on the straitjacket shows the power of focusing on the materiality of objects to reveal insights about their everyday usage. As a symbol, the straitjacket represents danger, oppression, institutional violence. As an object, the story becomes more complex. Chaney investigated several straitjackets and found evidence of the ways that each was individually adapted to the person or people using it. Padding was sewn in by hand around the neck, illustrative of some attendant or friend trying to make the experience of wearing the jacket more comfortable. There were even nods to contemporary fashion on straitjackets for women – frills, decorative patterns of stitches, even the shaping of the bodice. These inbuilt design elements showed a recognition of the wearer not merely as a patient who needed to be controlled, but as a person wearing a garment.
My own work has recently focused on the sputum flask. Designed for consumptive patients, it was an early form of disease prevention. By the time of its introduction in the late 1800s, Mycobacterium tuberculosis had been identified and tuberculosis was understood as something contagious, rather than the romantic disease of the previous century. The sputum flask or cup was meant to be expectorated into by a diagnosed tuberculous patient in order to contain their germs.
While recommended by medical professionals, usage of the flasks marked the user as infected and therefore dangerous. Contemporary records reveal the tension between public health and public scorn. Writers of the time complain that users are treated like lepers; in response medical professionals provide tips and tricks for concealing the flasks. These seemingly simple objects provide surprising insights about the lived experiences of turn of the century tuberculosis patients.
But beyond the written records, there is a physicality to the flasks. Holding one in your hand, it is simple to test how easily it can be slipped into a pocket or hidden in a handkerchief (a simple trick suggested in the contemporary records and yet it is a fumbling movement in person, the flask and cloth together bulky and unwieldy). It is natural, suddenly, to picture actually using it, to understand it in a way that is hard to even consider from a picture. You are aware of the subtle way your fingers stretch to grasp it, just a breath too far to be completely comfortable (this wasn’t made for me, you think, aware that the original designer was male and that you are a woman and your hands are smaller). You imagine spitting into it, calculating how close you’d have to bring it your face to ensure that you hit your target. People at the time complained that the flasks did no good, because they still had spit caught in their beards or had to wipe their mouths on their handkerchiefs. When you’re reading such accounts, it feels like an excuse but with the flask in your hand, it’s suddenly plausible.
That is the power of the thing, of the object. It makes the intangible real. It makes history touchable and therefore, understandable.
Works Cited
Chaney, Sarah. “Psychiatry’s Material Culture: The Symbolic Power of the Straitjacket.” InSources in the History of Psychiatry, from 1800 to the Present. Taylor & Francis, 2022.
Cronin, Monica. “Anarcha, Betsey, Lucy, and the women whose names were not recorded: The legacy of J Marion Sims.”Anaesthesia and Intensive Care48, no. 3_suppl (2020): 6-13.
Ellis, Harold. “James Phipps, first to be vaccinated against smallpox by Edward Jenner.”Journal of Perioperative Practice31, no. 1-2 (2021): 51-52.
Feudtner, John Christopher.Bittersweet: diabetes, insulin, and the transformation of illness. Univ of North Carolina Press, 2003.
Hasian, Marouf A. “Power, medical knowledge, and the rhetorical invention of “Typhoid Mary”.”Journal of Medical Humanities21, no. 3 (2000): 123-139.
Herzog, Basel H. “History of tuberculosis.” Respiration 65, no. 1 (1998): 5-15.
Jones, Edith P. “The Disposal of Sputa,” The American Journal of Nursing, 7, 2 (1906)
King, Dougall Macdougall,The Battle with Tuberculosis and how to Win it: A Book for the Patient and His Friends, (Philadelphia: Lippincott, 1917)
“Reports And Analyses And Descriptions Of New Inventions, In Medicine, Surgeiry, Dietetics, And The Allied Sciences. Dr. Dettweiler’s Pocket Flask For The Disposal Of The Sputa In Phthisis,” The British Medical Journal, (1889)
Sealey, Jessica. “Monstrous Instruments: The vagin*l Speculum and the Contagious Diseases Acts Repeal Movement.” Museum of Health Care at Kingston, Margaret Angus Research Fellowship., (2023).
Warner, John Harley. “The humanising power of medical history: responses to biomedicine in the 20th century United States.”Medical Humanities37, no. 2 (2011): 91-96.
