Friday, September 28, 2007

John Raaf Day 2007

It's that time of year again, and we've got neurosurgery on the brain: tomorrow is the 17th Annual John Raaf Day, sponsored by the Department of Neurological Surgery here at OHSU. This year's talks, on surgery of the spine, will be delivered by neurosurgeon Volker K.H. Sonntag of the University of Arizona at Tuscon.

When we blogged about last year's Raaf Day, we concentrated on the eponymous neurosurgeon; this year, with the recent opening of the Rosenbaum Library in the Department of Neurology and the subsequent arrival of 600 classic neurological texts from the Becker Library of Washington University in Saint Louis, it seems more fitting to concentrate on some of the nearly 150 early neurology books here in the History of Medicine Collection.

Our earliest (1672) is Thomas Willis' De anima brutorum, donated by surgeon, bibliophile, and OHSU alumnus William Garnjobst, M.D. Willis is widely considered the father of neuroanatomy, an area in which our medical school has been particularly strong over the course of its history. Olof Larsell, an early faculty member and author of The Doctor in Oregon, was internationally known for his work on the anatomy of the brain and nervous system.

Eighteenth-century developments in neurology are represented by two texts in our collection: George Cheyne's The English malady, or, A treatise of nervous diseases of all kinds (1733) and Alexander Monro's Observations on the structure and functions of the nervous system (1783). This Monro, number two in a three-generation series of medical Alexander Monros, was a noted Scottish anatomist, countryman to Cheyne. (Was it all the rain that affected British nerves? If so, I think we have the makings of a theory about why OHSU has been the site of so much neurological research.)

Our collection is well nigh replete with nineteenth-century neurological classics, from the Bells (John and Charles) to the other Cheyne (John) to Charcot, Cuvier, Flourens, and Andral, Brown-Sequard, Gowers, Retzius, a little Ramon y Cajal--and this last, "a little Ramon y Cajal," points to the literal limit of the History of Medicine Collection: the date restriction of 1901. Many classic works in the neurosciences remain in the general collections, simply because their authors (from Cushing to Larsell and beyond) lived and worked in the 20th century. If you add those books to our count, we have more than 4,000 core titles in the neurosciences. How many do you suppose Google Books has? If only they had the handy MeSH subject headings that our books have, I might be able to determine an answer...

Thursday, September 27, 2007

Book burning: a timely topic

As I mentioned yesterday, Danish physician Thomas Bartholin was not only a prolific writer but also a librarian, keeper of both a university collection and a private collection. In 1670, he suffered one of the greatest blows known to any librarian: the complete destruction of his personal library by fire.

In his essay, On the burning of his library, Thomas recounts the horrible events surrounding the loss. He begins with the lamentation: "It was disastrous to be so respectful." For it was during his absence from home, during a trip to the funeral of his revered teacher Poul Moth, that the conflagration occurred. Declaring that "while such unforeseen disasters have tried my spirit they did not prevail," Thomas nevertheless pours out his grief to his sons in this 42-page "dissertation."

No small amount of personal blame comes through in these pages:
I offered nourishment to the raging fire by consecrating my papers to eternity and testing their behavior in the purifying flame. Once risen to the sun they were examined for legitimacy. The foetuses of my talents and labor were also examined by the fire and found neither vital nor legitimate; because of their immaturity they were further matured by fire.
His epitaph for the departed:
You learned ashes, the greatest hope for my reputation, but as an immense and grievous ruin scarcely suitable as the conclusion of my labors, would that the pious care of my hand might move you.... You were announced before your birth and before you could be brought forth with the applause that all ages might have given to your birth. You have moved to immortality by this step, because you have come before the public without the affront of type and to fame without worms.
He finishes with an annotated list of the works which were lost, including a work on pagan anatomy, a popular medical tract aimed at Danish householders, an expanded edition of De unicornu, his treatise on shark teeth, commentaries on Celsus and Hippocrates, and many other studies.

The burning of the library provides Thomas with an occasion to reflect on historical book burnings, whether through accident or design. With the start of Banned Books Week just two days away, his comments seem fitting:
Here and there famous manuscripts have perished through pernicious zeal against libraries, or rather through hatred of their possessors .... Those have greater reason for the deed who sentence books to the pyre not through ill-will against the authors but through dislike of the subject, either impious or opposed to the decrees of princes.... The Roman senate, through Q. Petilius the praetor of the city, and in an assembly of the people, burned the Greek books of Numa which seemed in some degree to oppose the religion. In the judgment of Lactantius, De Falsa Religione, bk. 1, ch. 22, it was meaningless, for of what advantage was it that the books were burned since that for which they were burned, the fact that they denied the religion, had been handed on to memory. Everyone then in the senate was very stupid, for although the books could be destroyed yet the matter of them was recalled.
In honor of Banned Books Week and in memoriam for Thomas' loss, check out the list of books challenged in Oregon in 2007--and then literally check them out, at your local library. Because they may take our books, but they will never take our freedom.

Wednesday, September 26, 2007

Thomas Bartholin, a man for all seasons (or at least a few days' worth of blog posts

Thomas Bartholin has been much on my mind lately; in fact, I've been silently referring to him as "Thomas" (since he doesn't seem like a "Tom"--or a "Barty" for that matter). Sure, he was a Danish polymath who could discourse on medicine, mathematics, religion, philosophy, and the classics, but what did he do that was interesting? I have two words for you: De unicornu.

During a period of time before there were such harsh delineations between allopathy and homeopathy, Thomas wrote learned treatises on both shark teeth and the unicorn. On the unicorn is a rather scarce title, but sounds like it would be well worth the effort to find a copy to read (good thing I've been keeping up with my Latin). His thesis might be just the backing that modern purveyors of unicorn products are looking for to secure FDA approval.

Too prolific for for the monograph market alone, he also established the first Danish scientific journal, Acta medica et philosophica hafniensa (because unicorns are a big enough topic for book treatment, but what about gryphons?)

And, armed with this overwhelming profusion of books and journals of his own making, Thomas finally achieved the ultimate goal: he became rector and librarian of the University of Copenhagen in 1671. Coming in tomorrow's post: the sad history of Thomas' personal library...

Tuesday, September 25, 2007

Medicine in ancient Alexandria

The Danish physician Thomas Bartholin, late of yesterday's-post fame, encouraged both wide reading and wide travel as curatives for asinine syndrome. He notes in On medical travel that travel by physicians for the purpose of study is a time-honored tradition:
In Cyprus [Galen] investigated the mines, calamine, pompholyx and other things. Nor in passing by did he fail to greet the Alexandria of which, such was the fame of its school, that Ammianus Marcellinus, bk. 22 declares that whatever the experience of the physician, his authority was sufficiently recommended if he could say that he had been trained in Alexandria.
So, what was medical training like in Alexandria? Did the Great Library of Alexandria serve as an early medical library? Did the students come in to use the test prep books on reserve?

For some answers, let's turn to John Vallance's essay Doctors in the Library: the strange tale of Apollonius the Bookworm and other stories, which makes up chapter 5 in The Library of Alexandria: centre of learning in the Ancient World (2000). Vallance notes that while Alexandria "teemed with physicians," the method of medical education was largely one of apprenticeship with private practitioners--not the academic medical center model we know today. So what role might the Library collections have played in medical learning? There is apparently scant evidence that any physicians were affiliated with the Library or conducted research there, although Galen reported that medical texts were routinely seized by customs officials at the Alexandrian port (and, as Vallance notes, "originals were deposited in the Library, marked in the catalogue 'from the ships,' and their owners, if they were lucky, were supplied with copies." Now that's what I call library acquisitions!)

In fact, Vallance identifies two somewhat contradictory developments or trends in medical learning which may, or may not, be attributable to the influence of the Great Library on the city's medical men. One was the rise of critical commentary on the Hippocratic corpus, based on close reading of the original texts housed in the collection; the other was the rise of the Empiricist sect which, because it eschewed theory in favor of experience, oddly came to downplay the role of medical research (because as any postdoc knows, you can't really construct a good research study if you don't have a theory to test).

Did the Great Library benefit medicine? The jury still seems to be out on its direct relationship to practical advances in the medical arts, but one thing is clear from the extant literature: the Library's collections got everyone reading. As Vallance says:
By the middle of the third century BC, many doctors had broad interests in reading, and not merely in reading medical literature. ... The late third and second centuries BC saw the authority of the Hippocratic writings (not to say the importance of medical literature in general) continue to grow. The high status of enjoyed by the philological study of texts in Alexandria no doubt encouraged this; our earliest evidence for critical lexicographical work on Greek texts is focused on medical texts."
Thomas Bartholin would have been proud.

By the by, I could have used more details about Apollonius the Bookworm. Maybe Vallance has a monograph in the works...

Monday, September 24, 2007

Don't be an ass: on the value of continuing education (even if you don't remember a word of it)

Apologies to my more delicate readers for the crass post heading on this Monday morning, but sometimes ya gotta call 'em like ya see 'em. Take, for example, this advice from seventeenth-century physician Thomas Bartholin, dispensed to his sons on the occasion of their departure for travel abroad:
Possibly my own case may assist others. Avid to learn, I travelled for ten years enthusiastically undertaking not only very long trips to farthest Melita--not Thule--but also because of my wide interest I spent many hours designed for necessary studies to the Hebrew, Aramaic and Coptic languages, to lectures on law, to the delights of the poets, to the studies of the critics, to Platonic subtleties and to the curiosities of antiquity. I have forgotten a large part of all those things, but I do not regret that I undertook such a burden of no lucrative value. Whatever it may be, in addition to medical science, in which we seek pleasure in order to live happily, let us pursue it with diligence and care; and since a pure physician is commonly called a pure ass, one can devote those occasional hours which others spend in games, unseemly love-making, drinking parties, gambling and adornment to the pleasant studies of philology and antiquity by which the physician can render himself agreeable and cultivated.
(From Bartholin's essay On medical travel, 1674)
Sound advice! So go forth, dear readers, and read for fun! Browse the book stacks and pull some title advised only by the whims of serendipity! Drop in to your local archives and ask to see something you haven't looked at before! Don't worry, we'll still be here after poker night...