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Electrosurgical in the Operating Room

September 12, 2014 - 8:37am by Andy Hickner

(Post authored by Terry Dagradi) Cushing operating at the Peter Bent Brigham Hospital Photo by Dr. Walter Willard Boyd 1928-32 On October 1, 1926 at Peter Bent Brigham Hospital in Boston, Massachusetts, Harvey Cushing performed an operation—removal of a mass from a patient’s head -- using the first commercial electrosurgical generator developed by to William T. Bovie [1], an engineer employed at Harvard University. The Bovie unit passed high frequency alternating current into the body, allowing the current to cut or coagulate. The device drastically reduced the complications of bleeding during intracranial operations, further reducing the mortality rates during brain surgery. After 88 years this basic device remains a fundamental tool in the practice of surgery. When Cushing began his surgical career in the early 1900s, brain tumors were considered to be inoperable. At that time the mortality rate for a surgical procedure involving the opening of the skull was around 90%. Cushing dramatically reduced the mortality rate for neurosurgery to less than 10%, and by the time of his retirement from the Peter Bent Brigham Hospital in 1932, he had successfully removed more than 2,000 tumors.[2] [1] Bovie, WT; Cushing, H (1928). "Electrosurgery as an aid to the removal of intracranial tumors with a preliminary note on a new surgical-current generator". Surg Gynecol Obstet 47: 751–84. [2] http://www.whonamedit.com/doctor.cfm/980.html https://www.mjhlifesciences.com/ http://www.uptodate.com/contents/overview-of-electrosurgery

Happy 145th Birthday Harvey Cushing!

April 8, 2014 - 1:07pm by Andy Hickner

Happy 145th Birthday Harvey Cushing!  Harvey Cushing, born on April 8th in Cleveland in 1869, was the last of ten children of Henry Kirke and Betsey Maria Cushing and descended from a long line of Cushing doctors. A brief list of his accomplishments include:  He considerably improved the survival of patients after difficult brain operations for intracranial tumors. In clinical medicine, he was an early advocate of x-ray and blood pressure determination. He developed techniques to control bleeding from the scalp and promoted decompression for relief of pain in cases of inoperative brain tumors. Cushing was an early adopter of electrosurgery, playing a role in the development of Bovie electrocautery tool with physicist W. T. Bovie. He was the world's leading teacher of neurosurgeons in the first decades of the 20th century. For Cushing’s 70th birthday in April of 1939, The Harvey Cushing Society, formed in 1932 by younger neurosurgeons in Cushing’s honor, met in New Haven Ct. for a celebration.     At the formal dinner Louise Eisenstadt, MD, colleague and collaborator of the Curator of the Brain Tumor Registry presented Cushing with the gift of Bibliography of the Writings of Harvey Cushing, prepared by the Harvey Cushing Society and published by Charles C Thomas. To learn more about Cushing’s life and accomplishments, visit the Cushing Center.

A Cure for What Ails You: Songs from the Medical Library’s Sheet Music Collection

January 26, 2014 - 3:51pm by Mark Gentry

Exhibit curated by Toby AppelJanuary 23rd-May 2nd, 2014Harvey Cushing/ John Hay Whitney Medical Library foyerJoin us for an exhibit tour on Thursday, February 13 at 11:30.  Meet at the entrance to the Medical Library.  The tour scheduled for the 13th is cancelled due to inclement weather and will be re-scheduled for a later date. Celebrating a new collection of recently donated medically themed sheet music, this exhibit highlights music on medical providers, purveyors of remedies, ailments both real and imagined, cures for all purposes (especially for lovesickness), health songs for children, and music advertising patent medicines. Most of the music was written for public entertainment, whether in London music halls, Parisian theaters, or American vaudeville and early musicals. Later songs in the collection were aired on the radio, featured in movies, recorded on record labels, or served as themes for TV shows on doctors and hospitals. Songs range from “The Cork Leg,” a traditional Irish song about a self-propelling prosthetic cork leg, to Loretta Lynn singing about the advantages of “The Pill.” The engraved and lithographed covers of the music provide striking images of medicine and popular culture.The collection with over 1,000 items was donated to the Medical Historical Library by William H. Helfand. Discover the entire collection through the finding aid: sheet music collection.

Secret Miracles of Nature

December 12, 2013 - 9:41pm by Melissa Grafe

We have a secret!  Blog post on an item in the Books of Secrets exhibit, by student curator Nell Meosky    Levinus Lemnius (1505-1568) was a Dutch physician who served the community of Manhuissatraat for nearly fourty years, traveled throughout Western Europe, and was highly regarded for his work during epidemics in 1529, 1532, and 1537.[1] Late in life and after his wife’s death, Lemnius went to seminary and became a priest, a transition which informs much of his most well-known book, De Occultis Naturae, which was first published in 1564. [2]Nearly a century after Lemnius’s death, De Occultis Naturae (literally, “The Hidden Nature”) was translated into English by an unknown translator, and given the title The Secret Miracles of Nature.[3]  Later, the work would be combined with a German manual on midwifery to produce Aristotle’s Masterpieces. Upon first glance, The Secret Miracles of Nature is an imposing book, much larger than other books of secrets of its day at approximately 11” by 7”. This is likely a sign that the printer was able to invest significantly in creating an impressive image for the book, supported by the robustness of the paper and binding that were used to construct it. Thanks to the reputation of Lemnius, who is described on the title page as “that great physician” and is acknowledged by scholars as well-respected, the printer was probably able to expect good sales of the book to higher class readers. The size of the book allows for more generous margins, which a reader could use to take notes on the recipes recorded within. The font of the text is somewhat larger than that of contemporary books of secrets, but not to scale with the size of the book, creating a formidable amount of reading to be done to reach the end of its 300-some pages. It does not appear, though, that the book was necessarily meant to be read from cover to cover in one setting, as it is made of up discrete recipes. The cover is worn and the edges of the pages, particularly at the very front and back of the book, appear almost charred, very brittle and dark. This suggests that the book was in fact used frequently, and the uneven staining of the pages hints that some of the sections may have been used more often than others. Although no readers’ names are recorded in the book, it seems to have been last owned by an individual around 1911, 250 years after its debut. Lemnius (or the translator) organized the volume into four discrete books: the soul and its immortality; plants and living creatures; diseases, their symptoms and cures; and other rarities. There is also a “bonus book” at the end, containing rules for how a man should lead his life. This book is particularly interesting because of Lemnius’s late-life career as a priest, and it begs the question of whether the four books were penned previously, with the fifth being added once Lemnius completed seminary. Within these books are many chapters, which are named quite descriptively and leave little room to imagine what is discussed on the pages indicated. This organization, and the abstract-like titles of chapters, makes it very easy to find the particular question that you are looking for an answer to – in fact, the titles could serve as something of an executive summary for those who do not wish to read the entire text. However, despite the clear organization of the books in their titles, their content overlaps. In book 1 (on the immortality of the soul), chapter V, Lemnius writes “of the strange longing of women with child, and their insatiable desire of things; And if they cannot get them they are in danger of life.” This chapter, while tangentially related to the soul because of the generation of a new soul through pregnancy, does not seem to quite fit the theme of the rest of the chapters of that book. However, after paging through the rest of the chapter, a logical flow begins to emerge: Lemnius begins with relationships between men and women, then to pregnancy and determination of gender (…the chapter on driving pests away from corn not withstanding). In content, The Secret Miracles of Nature is highly comprehensive, blending natural knowledge with philosophy.The language of the forward is difficult and arcane, but the language of the chapters is often easy to follow and engaging, and Lemnius addresses the book to “those that practice physic, and all others that desire to search into the hidden secrets of NATURE for the increase of Knowledge.” Lemnius often makes references to Hippocrates when explaining his medical decisions, and in book 2 includes disease knowledge from the rare and mystical to the most mundane: on physical phenomena, unnatural vs. natural death, the virulence of epidemics, and drunkenness. These medical portions are interesting in their blending of observation and experience with belief and religious texts; for example, on pg. 108 in Book II Chapter X: Every filthy smell is not hurtfull to Man, Lemnius observes of smells that “for some of these will difusse contagions, and resist corrupt diseases. By the way, whence came the Proverb, that horns are burnt there.” Lemnius was an author of great medical and spiritual prowess, and does not shy away from sharing his wisdom of both kinds in this, his greatest work. [1]PC Molhysen and PJ Block,New Netherland biographical dictionary. Part 8. AW Sijthoff, Leiden 1930. Accessed Oct 27, 2013 https://www.dbnl.org/tekst/molh003nieu08_01/molh003nieu08_01_1789.php 2 Charlotte F. Otten, Hamlet and the Secret Miracles of Nature. Notes and Queries (1994) 41 (1):38-41. https://academic.oup.com/nq/article-abstract/41/1/38/4593545 [3] Ibid.  

UpToDate Anywhere

October 13, 2013 - 11:15pm by Mark Gentry

The UpToDate Anywhere mobile app is available for Apple iOS, Android and Windows 8 phones and tablets.  Free individual access is available to all affiliates of Yale University and Yale-New Haven Hospital.  Initial registration must be done either on the network or from a remote connection to Yale or YNHH.  Individual login also allows accumulation of free CME/CE credits gained by reading UTD topics.  An Internet connection is required to use UpToDate Anywhere.  In order to keep your individual account active, logon to your account from a Yale or YNHH computer (or remote connection) at least once every 30 days. Consult the mobile device page for more information on UpToDate Anywhere app. UpToDate is linked from EPIC along with two other popular resources AccessMedicine and Micromedex.  By linking your individual account withUpToDate with your EPIC ID you can accumulate CME whenever you access UpToDate from within EPIC.  For details on UpToDate in Epic ...

Iconographie photographique de la Salpêtrière: The Physician and the Hysterical Women

September 27, 2013 - 8:39am by Lei Wang

The Iconographie photographique de la Salpêtrière (1876-80), a landmark publication in medical photography, is on view in the Rotunda of the Cushing/Whitney Medical Library through November 15th, 2013. This collection of texts and photographs represents the female patients of Dr. Jean-Martin Charcot at the Salpêtrière hospital and asylum during the years of his tenure as director. The patients, diagnosed primarily with hysteria or epilepsy, were treated at the asylum even as they acted as experimental subjects for Charcot’s development of the hysteria diagnosis. This collection represents a transformative moment in the history of the diagnosis, treatment, and representation of mental illness. The exhibit was organized by Courtney Thompson, doctoral student in the Program in the History of Medicine, and Susan Wheeler, Curator for Prints and Drawings at the Medical Library. 

A Vietnam War Surgeon Writes Home

June 17, 2013 - 11:41am by Melissa Grafe

The Kristaps J. Keggi Vietnam War service collection, recently donated to the Historical Medical Library, contains the complete correspondence between Dr. Kristaps J. Keggi and his wife, Julie, during his time as a surgeon in the Vietnam War. The materials were all donated by Dr. Keggi, the current Elihu Professor in Orthopedics at Yale School of Medicine. The scope of the collection—personal letters, photographs, teaching materials and war wound images- presents a unique and comprehensive look into the life of a war surgeon. Letters detail stories of MASH (Mobile Army Surgical Hospital), Montagnards plagued with leprosy, ceremonies with local tribes, a visit from a Playboy bunny and, of course, the extensive surgeries performed in a combat zone. A sample of photographs and letters are on display at the Historical Library.  

Unveiling Medicine’s Past: Medical Historical Collections Online

April 19, 2013 - 3:22pm by Melissa Grafe

The Medical Historical Library’s digital collection includes School of Medicine photographs, portraits of 16th Century anatomist Andreas Vesalius, Harvey Cushing, and others, medical and surgical instruments, prints, posters, and drawings, and much more!  Recently, thousands of medical works from the 19th and early 20th centuries have been added to the Medical Heritage Library, an online resource of free and open historical resources in medicine.  This exhibit, on view in the Medical Library Rotunda, Hallway, and Foyer, showcases a selection from the thousands of items currently available online, and describes the process of digitization, bringing medical history to users throughout the world with a few simple clicks.  On view April 11 to July 5, 2013

Over 2600 International Health and Safety posters at the Medical Historical Library

March 21, 2013 - 10:30am by Melissa Grafe

In January 2013, the Medical Historical Library acquired a collection of over 2600 international public health and safety posters from 56 countries.  Topics include maternal and child health, anti-drug and tobacco campaigns, breastfeeding, clean water, prevention of diseases such as malaria and polio, and accident prevention and safety.  Kenya, The Netherlands, Oman, France, and Germany are particularly well represented in the collection.  Posters issued by the World Health Organization (WHO), the Pan American Health Organization, and Doctors without Borders are also included.  Please contact Melissa Grafe, melissa.grafe@yale.edu, for more information and for access to the posters.

We've Still Got A Job To Do!

March 14, 2013 - 11:17am by Susan Wheeler

Howard Scott U.S.A. 1902-1983 We Still Have a Big Job to Do! 1943 U.S. Government Printing Office for the U.S. Navy, Industrial Incentive Division Purchased through the John F. Fulton Fund 2012 During World War II, the Industrial Incentive Division of the U.S. Navy sought to improve morale among workers in U.S. industrial plants by emphasizing the importance of the plant’s products in the overall war effort. The morale initiative, begun in May of 1943, employed audio interviews and other messages piped in through speaker systems in the workplace;  exhibited combat action photographs, specially commissioned posters and combat motion pictures in the workplace; and arranged for returned combat personnel to visit the plants engaged in war production. This recently acquired poster, created to boost the morale of defense industry workers during World War II, is on view through April 12, 2013  
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