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  • May 28, 2022 10:43 AM | Anonymous member (Administrator)

    by Guest Blogger, Heidi Bitsoli from Sunshine Behavioral Health

    Although addiction treatment has garnered media attention and public interest over the past few decades, humans have been dealing with substance use since as early as 12,000 B.C. Historians believe that these early civilizations discovered that certain plants would produce a pleasant smell and interesting effects if ground into a powder.

    We’ve been picking up mind-altering substances ever since, but the treatment of addiction is a relatively new concept.

    The earliest American addiction treatment efforts date around the 18th and 19th centuries. As they say, the rest is history.

    Humble Beginnings of Addiction Treatment

    Since the colonists first came to America, alcohol was an integral part of their culture. In the 1800s, distilleries abundantly furnished the early settlers with alcoholic beverages. Still, the colonists frowned upon public drunkenness. Much like today, alcohol was commonly available and easy to access, but overindulging earned the judgment of those who could control their drinking. Since alcohol was the first common drug in this land, it was also the first form of addiction early practitioners attempted to treat.

    Between the 18th century and the 19th century, institutions and similar facilities began making space for alcoholics. Although the public held drunks in contempt, they housed them in designated spaces – including incarcerating alcoholics in jails. It doesn’t seem like reform or recovery happened very often in these cases because alcohol was served in jails at the time.

    Almshouses (facilities that housed the destitute), hospitals, and asylums sometimes took in alcoholics. But even these places had limited space, which left many alcoholics to die of their disease socially stigmatized and ill.

    Prohibition

    While many people think of the “Roaring Twenties” of the 20th century as a raucous, decade-long party, it was during this time – 1920-1933 – that alcohol was also banned.

    Prohibition was a nationwide effort to curb alcohol usage by outlawing it. Unfortunately, these laws seemed to have the opposite effect. Although the thinking at the time considered alcohol usage to be a moral failing, it is an illness and a maladaptive coping skill. Since prohibition only banned drinking, it did not address the root issues that cause excessive drinking.

    When alcohol became illegal, it became even more popular as groups and individuals began going “underground” to purchase and drink alcohol. This failed experiment in ending alcohol use was not entirely fruitless. It showed later generations that banning a substance alone will not treat it. We have since discovered that making a substance legal and widely available can decrease usage while banning it can do the opposite, and lead to abuse.

    Alcoholics Anonymous

    What started as a meeting between two men (one who was having his last drink as they spoke) has become the gold standard for peer-facilitated group therapy in addiction recovery. When Bill W. and Dr. Bob S. met in 1935, it’s hard to say whether they envisioned the scope of people that their program Alcoholics Anonymous and subsequent 12-step programs would help.

    Bill W. published the Alcoholics Anonymous Big Book in 1939.Since then, the principles and steps have remained largely the same. Individuals gather, work the steps, support each other in recovery, and welcome back those who have relapsed, so they can start recovering again.

    Over time, a handful of meetings offered to workmen turned into countless meetings across the country that help people of all backgrounds.

    National Committee for Education on Alcoholism (and Drug Dependence)

    Right around the time when Alcoholics Anonymous meetings were spreading through the nation, another forerunner in addiction treatment history emerged. Marty Mann founded the National Committee for Education on Alcoholism(currently called the National Council on Alcoholism and Drug Dependence).

    Mann based this committee on several key propositions. First, he defined alcohol as a disease. He then dubbed the alcoholic a “sick person.” Because of this, we could assume the alcoholic can be helped and is worth helping. At the time, he argued that alcoholism was the fourth most prevalent public health problem and it was the responsibility of the public to resolve it.

    For local NCEA affiliates, Mann wanted to implement a five-point approach to tackle the problem. He believed in launching local public education campaigns about alcoholism, pushing local hospitals to hospitalize alcoholics for acute detox, creating alcohol information centers, establishing clinics for diagnostic and treatment purposes, and building what he called “rest centers” to house and care for alcoholics in the long-term.

    Mann’s treatment model resembles some of the avenues of treating and preventing addiction that professionals in the field still use in this century.

    Addiction Treatment Today

    From simply storing alcoholics away from the rest of society in asylums and alcohol-serving jail cells to ineffectively banning alcohol to the beginnings of 12-step meetings, a lot has changed in the past few centuries for addiction treatment.

    Today, addiction treatment consists of a variety of psychological and medical interventions in different outpatient and inpatient settings. For someone who is experiencing withdrawal symptoms, “medically managed withdrawal” can ease the process for those detoxing from opioids, benzodiazepines, alcohol, nicotine, barbiturates, and other sedatives.

    Once an individual safely comes to the other side of the detoxification process, therapeutic programs such as intensive outpatient or long-term residential treatment can help him or her deal with the underlying issues and behaviors that contributed to the substance use.

    Nowadays, we have a great deal of information about addiction as a disease, and researchers are continuing to increase their understanding of this complex illness.

    The Future of Addiction Treatment

    As our society gains a better understanding of how addiction affects the brain, body, and culture, we will be able to develop even more effective means of treating this disease. Like the early colonists who couldn’t imagine things like the AA meetings and medically assisted withdrawals of today, we can’t even begin to picture what addiction treatment could look like decades from now.

    Some experts suggest that those suffering from addiction today can expect decreased stigma around addiction, redefined success for treatment outcomes, increased recognition of co-occurring disorders such as anxiety and other mental health concerns, and evolving treatment strategies.

     

    Sources

    sunshinebehavioralhealth.com- Finding Drug Rehab Centers in Indiana

    sciencetimes.com - The History of Addiction Treatment

    researchgate.net - History of Substance Use Treatment

    williamwhitepapers.com - Significant Events in the History of Addiction Treatment and

    Recovery in America

    nida.nih.gov - Types of Treatment Programs

     


  • May 13, 2022 8:47 AM | Anonymous member (Administrator)

    by Allison Reardon, IMHM Public History Graduate Intern from the Indiana Medical History Museum

    From TV shows like Monk to movies like As Good As It Gets, we commonly see obsessive-compulsive disorder (OCD) portrayed in pop culture. However, it is not always portrayed accurately, and this can cause real harm to people living with the disorder. For some people, media representations may be the first way they learn about OCD and the people affected by it. If these portrayals are inaccurate and promote stereotypes, they can contribute to the stigma around mental illness that often stops people from seeking help or talking about their struggles [1]. Therefore, it is important to assess OCD in media and the ways in which people’s perceptions of the disorder may be influenced.

    OCD has not always been portrayed in the same way throughout history. In his article “What’s So Funny about Obsessive-Compulsive Disorder?,” Paul Cefalu explains that more recent characters suffering from OCD are “typically cast [...] as the protagonists in comedies,” but earlier depictions “often showed up in melodramas, tragedies, and gothic literature” [2]. As discussed in part two of this blog post series and mentioned by Cefalu, these earlier depictions were not clearly labeled as OCD and were, instead, viewed as diagnoses like monomania and scrupulosity [2]. Because of these differing diagnoses, it is sometimes difficult to clearly identify the characters as people dealing with OCD. However, obsessions and compulsions are common symptoms in many of these gothic stories.

    Many of Edgar Allan Poe’s stories involve monomania. However, several modern diagnoses would have fallen into the category of monomania, with one article describing paranoid schizophrenia in “The Tell-Tale Heart” and phobias in “The Premature Burial” [3]. OCD would have also fallen into this broad category. Although the characters in these monomania stories are often associated with different modern diagnoses, it is useful to discuss them in the context of OCD because they would have been perceived similarly at the time. [Photo: 1935 illustration by Arthur Rackman for Poe’s short story “The Imp of the Perverse.”]

    One thing that stands out in these gothic stories is the violence often carried out by characters with monomania. For example, one story by Poe that is often cited as an example of intrusive thoughts, which play a significant role in OCD, is “The Imp of the Perverse” [4]. In this story, the narrator’s intrusive thoughts lead him to kill another person. Violent representations like this example contribute to stigma and prejudice surrounding mental illness [1]. Also, it is an inaccurate representation of obsessive-compulsive disorder because according to OCD-UK, “people living with OCD are the least likely people to actually act on such thoughts” [5].

    In more recent times, media representations of OCD have moved away from these violent depictions to more comedic portrayals. However, these can still be harmful. As described by Paul Cefalu, “mainstream depictions tend to make us forget that, according to the DSM IV, OCD is fundamentally an anxiety disorder, hardly a laughing matter to most of its long-term victims” [2].

    A 2018 study delved into one particular comedic portrayal of the disorder: Monk. The title character, Adrian Monk, suffers from OCD, and the show has received a lot of praise and acclaim for this representation. However, this particular study, which focused on reception of the show from people dealing with OCD and other anxiety disorders, demonstrated that there were some negative reactions to it. For example, one person responded to the show by saying that it “minimizes the suffering of a person with severe OCD experiences [because it] tends to feed the stereotype that OCD is merely about fear of dirt and germs.” Another person responded by explaining that although “the humor on the show lightens up the topic of mental illness,” it also “makes light of being mentally ill in a society that already thinks we are dangerous/completely crazy/the butt end of all jokes and useless to society” [6]. [Photo: Monk Season 1 DVD cover, which describes the title character with the words “Obsessive. Compulsive. Detective.”]

    Although many pieces of media depict OCD in a comedic way that contributes to stigma and stereotyping, not all recent portrayals are harmful. In fact, one more accurate representation is found in a book that conveniently has a strong Indiana connection: Turtles All the Way Down by John Green. The main character of this Indianapolis-based book, Aza Holmes, suffers from OCD, and this portrayal is largely informed by Green’s own experiences with the disorder. Because of this basis in reality, the book gets a lot right about the disorder, those struggling with it, and people trying to support loved ones with OCD. In the article “How ‘Turtles All the Way Down’ Perfectly Explained My OCD,” Maia Kinney-Petrucha explains her connection to the story through this statement: “It felt like I experienced something more than empathy” [7]. Another article discusses the book’s portrayal of mental illness and ultimately praises it and recommends that it “be used in secondary English classrooms to create mental health allies” and to provide accurate representations for young adults struggling with OCD [8]. [Photo: Book cover for Turtles All the Way Down by John Green.]

    Overall, media representations of OCD have rarely been completely accurate. As one article explains, it is important to be aware of the impact of these portrayals, especially in “depictions of stigmatized groups that are tinged with humor, where there is a fine line between what can seem true and what can seem trivializing” [6]. Although there are positives associated with the depiction of OCD in pop culture, we still have a long way to go to accurately depict the disorder and reduce stigma around it. As mentioned by Rachel May in an article discussing OCD in Encanto, “[a]t a time when anxiety disorders (of which OCD is a part) and depression are skyrocketing among both children and adults due to the pandemic, it would be helpful to see OCD accurately represented, and to use a mentally ill character for something other than the punchline” [9]. The next part of this series will focus on COVID-19 and some of the unique challenges of OCD in the pandemic, demonstrating the need for more accurate media portrayals.

     

    References

    [1] “Stigma, Prejudice and Discrimination Against People with Mental Illness.” American Psychiatric Association. Accessed March 4, 2022. https://www.psychiatry.org/patients-families/stigma-and-discrimination.

    [2] Cefalu, Paul. “What’s So Funny about Obsessive-Compulsive Disorder?” PMLA 124, no. 1 (2009): 44-58. https://www.jstor.org/stable/25614247.

    [3] Zimmerman, Brett. “Poe as Amateur Psychologist: Flooding, Phobias, Psychosomatics, and ‘The Premature Burial.’” Edgar Allan Poe Review 10, no. 1 (2009): 7-19. https://www.jstor.org/stable/41507855.

    [4] Mahoney, Donna M., and Deborah L. Wilke. “The Self Psychological View of Obsessive-Compulsive Disorder: Treating the Tormented Self.” Annals of Psychotherapy & Integrative Health (Spring 2012): 26-34.

    [5] “What are obsessions?” OCD-UK. Accessed January 29, 2022. https://www.ocduk.org/ocd/obsessions/.

    [6] Hoffner, Cynthia A., and Elizabeth L. Cohen. “A Comedic Entertainment Portrayal of Obsessive-Compulsive Disorder: Responses by Individuals With Anxiety Disorders.” Stigma and Health 3, no. 2 (2018): 159-169. http://dx.doi.org.proxy.ulib.uits.iu.edu/10.1037/sah0000083.

    [7] Kinney-Petrucha, Maia. “How ‘Turtles All the Way Down’ Perfectly Explained My OCD.” The Mighty, November 26, 2017, https://themighty.com/2017/11/turtles-all-the-way-down-john-green-explain-obsessive-compulsive-disorder-ocd/.

    [8] Hall, Michael. “Bibliotherapy and OCD: The Case of Turtles All the Way Down by John Green (2017).” New Horizons in English Studies 5, no. 1 (2020): 74-87. doi: 10.17951/nh.2020.5.74-87.

    [9] May, Rachel. “Let’s Talk About Bruno: In Encanto’s OCD Allegory, the Weird Brother Deserves Better.” Literary Hub, January 26, 2022, https://lithub.com/lets-talk-about-bruno-in-encantos-ocd-allegory-the-weird-brother-deserves-better/#top.

     

    Image Credits

    Image 1: Rackman, Arthur. Illustration for “The Imp of the Perverse.” In Poe’s Tales of Mystery and Imagination. 1935. Wikimedia Commons. https://commons.wikimedia.org/wiki/File:09_rackham_poe_impoftheperverse.jpg.

    Image 2: “Monk Season One DVD.” Wikimedia Commons. https://en.wikipedia.org/wiki/File:Monk_Season_One_DVD.jpg.

    Image 3: “John Green Turtles All the Way Down Book Cover.” Wikimedia Commons. https://en.wikipedia.


  • May 06, 2022 9:46 AM | Anonymous member (Administrator)

    by Allison Reardon, Public History Graduate Student at the Indiana Medical History Museum

    The history of obsessive-compulsive disorder (OCD) is extensive. In fact, it can be traced back to at least the Middle Ages [1]. Early descriptions of OCD-like symptoms are often connected to the idea of “scruples” [2]. According to Joanna Bourke in her article about religious scruples, people who suffered from it were in “a serious state of existence that included fanatical performance of religious devotion combined with an overwhelming burden of spiritual doubt” [3]. Several mentions of religious scruples can be found in sources from the 17th century, including a 1691 sermon from John Moore in which he labels scruples as “religious melancholy” [2]. This quote from Moore’s sermon is a perfect example:

    “Because it is not in the power of those disconsolate Christians, whom these bad Thoughts so vex and torment, with all their endeavors to stifle and suppress them. Nay often the more they struggle with them, the more they encrease [sic]” [4].

    Along with these more general examples, there is evidence suggesting that some early religious figures suffered from scruples. One major figure, Martin Luther, who lived in the late 15th and early 16th centuries, is often cited as one of these “famous sufferers” [3]. An example of this scrupulous behavior is cited in a 2004 biography: “And yet my conscience would not give me any certainty, but I always doubted and said, ‘You didn’t do that right. You weren’t contrite enough. You left that out of your confession’” [5]. Although these religious obsessions would now be viewed as OCD-like symptoms, they were not always discussed in a psychiatric context. The shift to more psychiatric discussions occurred in the 20th century [3]. [Photo: Drawing based on a photograph of a person suffering from religious melancholy, printed in 1858.]

    Moving past the narrow descriptions of scruples, the concept of OCD changed several times before eventually reaching our current definition of obsessions and compulsions. Even within the 19th century, psychiatrists differed in their definitions and understandings of the disorder. As mentioned on the Stanford Medicine website, “psychiatrists [mainly from France and Germany] disagreed about whether the source of OCD lay in disorders of the will, the emotions or the intellect” [2]. In the early 19th century, some psychiatrists, especially the French psychiatrist Esquirol, categorized the disorder under monomania, but by the end of the century, it was largely accepted as part of the broad category of neurasthenia [2]. (For more information about this diagnosis, check out this other blog post.)

    According to Stanford Medicine, OCD was more clearly distinguished from neurasthenia at the beginning of the 20th century by both Pierre Janel and Sigmund Freud [2]. In his 1920 book, A General Introduction to Psychoanalysis, Freud discusses “obsessional neurosis,” and he additionally credits both Janet and Josef Breuer with the discovery of “[t]he meaning of neurotic symptoms,” although he does express some disagreement with many of Janet’s views [6]. Janet proposed the isolation of “psychasthenia” from neurasthenia in Les Obsessions et la Psychasthenie (1903) [2]. Some other doctors of the time questioned his argument because they felt there was no reason to separate it from the already accepted diagnoses of neurasthenia and hysteria [7]. Despite this resistance, the term “psychasthenia” was used by some in early 20th century medical journals. [Photo: Part of a 1922 newspaper article describing symptoms of psychasthenia that are similar to possible symptoms of OCD]

    Psychasthenia was also an accepted diagnosis at Central State Hospital. The first mention of this specific diagnosis for a patient at Central State seems to have been in 1927, and between 1927 and 1946, 21 people were diagnosed with psychasthenia at their first admission to the hospital. Some of the diagnoses were listed as “psychasthenia or compulsive states,” which seems more closely related to the current name of the disorder [8]. It is difficult to tell how many people admitted to the hospital may have suffered with OCD before the name psychasthenia was used, but there are some broader diagnoses into which the disorder may have fallen. For example, “monomania,” “neurasthenia,” and general “psychoneuroses” were diagnoses that were used at the hospital before 1927 [9]. Although it is possible that people who received these diagnoses suffered with OCD, it is not possible to say that with certainty. Also, “religious excitement” is often listed as a cause for mental illness (as opposed to a form), even at the opening of the hospital, and it is possible that there is a connection to the idea of religious scruples [10]. Again, however, there is no way to prove this connection.

    Eventually, people adopted the name “obsessive-compulsive disorder.” This label can be traced back to the German psychiatrist Westphal and the term “Zwangvorstellung” [2]. This term was translated into English in two different ways: “obsession” was used in Great Britain and “compulsion” in the United States [2]. A footnote in a 1952 printing of Freud’s A General Introduction to Psychoanalysis notes this difference. In this book, Freud describes “obsessional neurosis,” and the footnote explains that “Zwangneurose [is] sometimes called in English compulsion-neurosis” [6].

    Although the name “obsessive-compulsive disorder” did not appear until well into the 20th century, the history makes it clear that it is not a new disorder. Examples of OCD-like symptoms have been present since at least the 17th century, and some are even cited before that time [2]. This history also illuminates the fact that there is always more to learn. In fact, part one of this series discussed the ongoing conversation among researchers about differences between OCPD and OCD [11]. Some recent research has also focused on the effects of trauma in OCD [12] (Interestingly, an article written during World War I discussed connections between psychasthenia and shell shock [13]). Overall, the history of OCD has been long and winding, and it is still a subject of learning and debate. The next part will focus on another aspect of this history: media representations.

    References

    [1] Baldridge, Iona C., and Nancy A. Piotrowski. “Obsessive-Compulsive Disorder.” In Magill’s Medical Guide, edited by Bryan C. Auday, Michael A. Buratovich, Geraldine F. Marrocco, and Paul Moglia, 1631-1634. 7th ed. 5 vols. Ipswich, MA: Salem Press, 2014.

    [2] “History.” Stanford Medicine. Accessed February 23, 2022. https://med.stanford.edu/ocd/treatment/history.html.

    [3] Bourke, Joanna. “Divine Madness: The Dilemma of Religious Scruples in Twentieth-Century America and Britain.” Journal of Social History 42, no. 3 (2009): 581-603. https://www.jstor.org/stable/27696480.

    [4] Moore, John. Of religious melancholy a sermon preach’d before the Queen at White-Hall March the 6th, 1691/2 / by the Right Reverend Father in God John, Lord Bishop of Norwich. London: Printed for William Rogers, 1692; Ann Arbor: Text Creation Partnership. http://name.umdl.umich.edu/A51223.0001.001.

    [5] Mullett, Michael A. Martin Luther. London: Routledge, 2004.

    [6] Freud, Sigmund. A General Introduction to Psychoanalysis. Garden City, NY: Garden City Books, 1952.

    [7] Schwab, Sidney I. “Psychasthenia: Its Clinical Entity Illustrated by a Case.” Journal of Nervous & Mental Disease 32, no. 11 (1905): 721-728, https://oce-ovid-com.proxy.ulib.uits.iu.edu/article/00005053-190511000-00003/HTML.

    [8] Central State Hospital. (1927-1946). Annual Report of the Board of Trustees and Superintendent of the Central State Hospital at Indianapolis, Indiana.

    [9] Indiana Hospital for the Insane. (1888). Annual Report of the Trustees and Superintendent of the Indiana Hospital for the Insane. https://babel.hathitrust.org/cgi/pt?id=nyp.33433004139758&view=1up&seq=9&skin=2021.

    Central Indiana Hospital for the Insane. (1904). Annual Report of the Board of Trustees and Superintendent of the Central Indiana Hospital for Insane. https://babel.hathitrust.org/cgi/pt?id=nyp.33433004139766&view=1up&seq=9&skin=2021.

    Central Indiana Hospital for the Insane. (1924). Annual Report for the Board of Trustees and Superintendent of Central Indiana Hospital for the Insane at Indianapolis, Indiana.

    [10] Indiana Hospital for the Insane. (1849). Annual Report of the Commissioners and Medical Superintendent of the Hospital for the Insane, to the General Assembly, of the State of Indiana.

    [11] Thamby, Abel, and Sumant Khanna. “The role of personality disorders in obsessive-compulsive disorder.” Indian Journal of Psychiatry 61, Suppl 1 (2019): S114-S118. doi: 10.4103/psychiatry.IndianJPsychiatry_526_18.

    [12] Dykshoorn, Kristy L. “Trauma-related obsessive-compulsive disorder: a review.” Health Psychology and Behavioral Medicine 2, no. 1 (2014): 517-528. https://doi.org/10.1080/21642850.2014.905207.

    [13] Williamson, R. T. “Remarks on the Treatment of Neurasthenia and Psychasthenia Following Shell Shock.” British Medical Journal 2, no. 2970 (1917): 713-715. https://www.jstor.org/stable/20308835.

    Image Credits

    Image 1: Bagg, W. ‘Religious melancholy’ after a photograph by H. W. Diamond. Drawing. Wellcome Collection. January 2, 1858. https://wellcomecollection.org/works/hu8xh2qs.

    Image 2: “Peculiar Moods.” South Bend News-Times (South Bend, IN) 39, no. 194, July 13, 1922. https://newspapers.library.in.gov/?a=d&d=SBNT19220713.1.6&srpos=1&e=-------en-20--1---txIN-------.


  • April 29, 2022 12:52 PM | Anonymous member (Administrator)

    by Allison Reardon, Public History Graduate Student at the Indiana Medical History Museum

    “I’m a bit OCD.” This is a common phrase that you have likely heard at some point in your life. People often use it as a joke to explain their desire to keep their spaces tidy or their projects organized, and it can go unquestioned because it is so common. However, the ubiquitous nature of the phrase can obscure the real diagnosis of obsessive-compulsive disorder (OCD) behind a layer of jokes and misunderstandings. Advocates for those suffering with OCD often fight against these misunderstandings. For example, the charity OCD-UK shared facts to bust OCD myths in 2019. Some of these myths included “People with OCD love to clean” and the familiar “Everybody has a bit of OCD” [1]. [Photo: OCD myth, busted by OCD-UK, that “Everybody has a bit of OCD.”]

    The first step in the process of busting the myths of OCD is learning about the disorder, which, according to Magill’s Medical Guide, “affects 1 to 2 percent of the population” [2]. There are two main concepts to understand, and they are conveniently listed in the name: obsessions and compulsions.

    Obsessions are defined as “persistent and uncontrollable thoughts, […] images, impulses, worries, fears or doubts [that] interfere with the sufferers [sic] ability to function on a day-to-day basis” [3]. These obsessions can vary widely from person to person. OCD-UK lists several common obsessions, such as “Worrying that you or something/someone/somewhere is contaminated,” “Worrying that everything must look and feel arranged at a specific position,” “Unwanted and unpleasant sexual thoughts,” “Fear of something bad happening unless checked,” and “Worrying that you have caused an accident whilst driving” [3]. Not everyone who struggles with OCD suffers from all of these obsessions, and this list is by no means exhaustive.

    OCD-UK defines compulsions, the other part of OCD, “as repetitious, purposeful physical or mental actions that the individual feels compelled to engage in according to their own strict rules or in a stereotyped manner” [4]. Compulsions, like obsessions, can vary widely from person to person. Examples include more visible acts like “Excessive washing of one’s hands or body,” “Hoarding,” and “Checking that items are arranged ‘just right’” as well as mental acts like seeking the “reassurance of trying to remember a particular incident or event” and “Avoiding particular places, people or situations to avoid an OCD thought” [4]. Compulsions occur as a response to obsessions [1]. [Photo: OCD myth, busted by OCD-UK, that “All OCD compulsions are visible.”]

    One of the easiest obsession/compulsion combinations to describe is related to germs and contamination because this idea is what many people associate with OCD. For someone with obsessions related to germs, one obsessive thought may be a fear that touching a doorknob will contaminate it and harm other people who touch it later. This thought could then lead to a compulsion of washing their hands. Although this compulsion may decrease anxiety, it will not suppress it permanently. In one article, Rachel May explains that although people who suffer from OCD are aware that their thoughts are irrational, they cannot “take the risk” of not carrying out compulsions in response because the disorder is like a series of “What ifs” [5]. It is also important to mention that, as explained by OCD-UK, these obsessive thoughts are involuntary, and in regards to more upsetting thoughts people experience, “people living with OCD are the least likely people to actually act on such thoughts” [3].

                Many aspects of OCD can be found in people without the disorder. However, they are not seen to the same extent. People often experience intrusive thoughts, but it is not always an indication that they have OCD [3]. The disorder is associated with more intense and disruptive thoughts, and it is known as a disorder because it “critically impacts on a person’s ability to function” [2,1]. OCD can also be confused with a similar but separate disorder: obsessive-compulsive personality disorder (OCPD). This disorder is associated with “a maladaptive pattern of excessive preoccupation with detail and orderliness, excessive perfectionism, and need for control over one’s environment” [6]. Although there has been less research conducted into OCPD, there is evidence that it is a separate diagnosis to OCD, and some studies estimate that it affects around 7% of the population [6].

                Learning the definitions behind obsessive-compulsive disorder is the first step in breaking the misunderstandings that can harm those struggling with it. Saying “I’m a bit OCD,” in some ways, disregards the diagnosis as a “personality quirk” [7]. However, it is a real disorder that can be debilitating. In some cases, it can have drastic impacts on a person’s quality of life [7]. Although it is not always severe and is manageable, it is important to recognize the devastating effect it can have on those affected. This post is the first in a series on the blog that will seek to build an understanding of OCD. The series will explore the history of the diagnosis, the ways in which it is portrayed in media, and the unique challenges that arise with life in a pandemic.

     

    References

    [1] “OCD Awareness Handouts.” OCD-UK. Accessed January 29, 2022. https://www.ocduk.org/category/ocdhandouts/.

    [2] Baldridge, Iona C., and Nancy A. Piotrowski. “Obsessive-Compulsive Disorder.” In Magill’s Medical Guide, edited by Bryan C. Auday, Michael A. Buratovich, Geraldine F. Marrocco, and Paul Moglia, 1631-1634. 7th ed. 5 vols. Ipswich, MA: Salem Press, 2014.

    [3] “What are obsessions?” OCD-UK. Accessed January 29, 2022. https://www.ocduk.org/ocd/obsessions/.

    [4] “What are compulsions?” OCD-UK. Accessed January 29, 2022. https://www.ocduk.org/ocd/compulsions/.

    [5] May, Rachel. “Let’s Talk About Bruno: In Encanto’s OCD Allegory, the Weird Brother Deserves Better.” Literary Hub, January 26, 2022, https://lithub.com/lets-talk-about-bruno-in-encantos-ocd-allegory-the-weird-brother-deserves-better/.

     [6] Thamby, Abel, and Sumant Khanna. “The role of personality disorders in obsessive-compulsive disorder.” Indian Journal of Psychiatry 61, Suppl 1 (2019): S114-S118. doi: 10.4103/psychiatry.IndianJPsychiatry_526_18.

    [7] “The Impact of OCD.” OCD-UK. Accessed February 2, 2022. https://www.ocduk.org/ocd/impact-of-ocd.

    Image Credits

    “OCD Awareness Handouts.” OCD-UK. Accessed January 29, 2022. https://www.ocduk.org/category/ocdhandouts/.


  • March 27, 2022 4:38 PM | Anonymous member (Administrator)

    by Norma Erickson

    Henry Watson Furniss’s life could have been one more example of a brilliant Black physician who could not reach his full potential because of the barriers imposed by 19th and 20th century racial segregation. His story can be summed up not as career opportunities denied, but rather his was marked with achievements driven by ability, ambition, and being in the right place at the right time.

    Furniss was born in Brooklyn, New York, in 1868 to a highly educated African American couple, whose ancestors also included relatives of European origin.*  Not long after his birth, his father William Henry Furniss was appointed the Assistant Secretary of State of Mississippi. He moved his wife, Caroline Williams Furniss, and young Henry to the capital city of Jackson, where little brother Sumner was born in 1874. In just a few years, Reconstruction would end in 1877 and the Federal troops that provided protection for Blacks trying to advance politically and economically in the South were withdrawn.  The family remained in Mississippi until around 1880, then settled in Indianapolis, where the Furniss men thrived in the community. The boys attended high school at Indianapolis High School, and ultimately both went on to study medicine in local medical colleges. Their father scored the highest grade on the postal clerk exam and was placed in charge of a post office department. Their mother also had a teaching career, and the entire family became part of the elite of the African American community of Indianapolis. 

    Rather than immediately establishing a medical practice in Indianapolis after graduation, Henry went east for further study at Howard Medical School, the Harvard Medical School master’s program, the New York Post Graduate School, and the PhD in Pharmacology program at NYU. His medical experience began with a surgical internship at Freedman’s Hospital in Washington, DC, in 1895. When he returned to Indianapolis in 1896, he was likely one of the most highly-trained physicians in the city at that time—Black or White. 


    Besides his academic medical achievements, he also returned to Indianapolis with connections made in Washington that would lead to a career in diplomatic service for the US. In 1897, he was appointed by President William McKinley to be Consul to the Brazilian state of Bahia, one of the few diplomatic positions open to Blacks at the time. His mission there was to provide information to the US State Department and American companies who might have an interest in establishing businesses in Brazil. He learned Portuguese, traveled the countryside widely, and wrote detailed reports back to the States. His experience as a physician resulted in extensive information about public health issues in the locale being sent back to the States.

    Late in 1905, Furniss was appointed US Minister to Haiti by President Theodore Roosevelt, a post traditionally given to Blacks since 1862. Connections with Roosevelt’s Vice President, Hoosier Charles M. Fairbanks, might also have pushed his appointment forward.  He left Bahia with years of valuable diplomatic experience that would carry him through the service ahead of him. He also landed in Haiti with a white German-born wife.  Both would impose barriers and produce advantages, depending on the time and place. His diplomatic service ended in 1913. 

    Henry wed Anna Wichmann in London, England, in October of 1903. She was the daughter of a wealthy German businessman and maintained ties with family in Hamburg. The Furnisses had three children in Haiti, but their firstborn died of tropical dysentery shortly after his first birthday.  His term in Haiti ended in 1913, but the family remained there until about 1917. Henry did not return to Indianapolis to practice medicine with his brother as he did in 1896. On one hand, Indiana had strict miscegenation laws; putting down roots with a white wife and two mulatto children in tow would be difficult. The situation promised no improvement, as Indiana was beginning to enter its active Ku Klux Klan decade. On the other, the Black community was not especially pleased that one of their most successful sons had married outside of its circle.

    The family returned to the US, settling in the West Hartford, Connecticut area, where Dr. Furness set up a urology practice. The barriers he might encounter because of his Blackness held less importance in his life there.  In some respects, a more liberal northeastern community may have made the family’s acceptance better. Also around this time, he was received differently for one very important reason—he ultimately began to identify as white. His son, William, who was listed as Black when he attended Tufts University Medical School, also assumed a different life—passing as a white man when enlisting in the army and serving as a flight surgeon in WWII.

    Fluent in English, German, and Portuguese, Furniss was a 33rd degree Mason, a member of the American Society of International Law, the American Microscopical Society, and the American Medical Association. Furniss passed away in 1955, aged 87. His death certificate identified him as White.

     (Furniss's parents were sometimes described with the ethnic designation commonly used at the time--mulatto. This is considered a derogatory term today and rightly so because of its origin in slavery culture).

    Sources:

    Happy, Richard and Diane Furniss Happy, Under the Radar: The Little Known Story of Dr. Henry Watson Furniss, An African-American Pioneer. (Middletown, DE, 2020)

    Transactions of the Indiana State Medical Association, Issue 48, p. 291

    Who’s Who of the Colored Race, Vol.1, 1915

    Indiana Medical Journal: A Monthly Journal of Medicine and Surgery, Vol.14, p.453

    Fredrick Douglass and American Empire in Haiti, https://reparationscomm.org/reparations-news/editors-choice/frederick-douglass-and-american-empire-in-haiti/#:~:text=At%20the%20age%20of%20seventy,reward%20for%20the%20elderly%20abolitionist, accessed 2/14/2022

    Photos:

    1) Henry  W. Furniss, MD (Photo from cover of Under the Radar: The Little Known Story of Dr. Henry Watson Furniss, An African-American Pioneer)

    2)Caption: Furniss was the first Black physician to deliver a paper at an Indiana State Medical Association annual meeting.    (Transactions of The Indiana State Medical Association, Issue 48, p. 291,Forty-eighth Annual Session, 1897, Terre Haute, Indiana.)

    3) Henry W. Furniss, Envoy to Haiti, courtesy of the New York 


  • January 28, 2022 2:07 PM | Anonymous member (Administrator)

    by Allison Reardon

    The collections of a museum often stretch much further than what could ever be displayed to the public, and even the artifacts that are exhibited can fall by the wayside due to the time restraints of a guided tour. Although these artifacts are sometimes overlooked in favor of other interesting objects on the tour, that doesn’t mean that they don’t also have important and interesting stories of their own. One such example is found in the clinical laboratory at the Indiana Medical History Museum. On the lab bench, surrounded by various other pieces of equipment, lies a small box with a velvet lining holding several small pieces of a medical device. (The lining of the device currently on display has faded to a tan color; a look at another version in the museum’s collection shows the beautiful original green velvet.) The box itself reveals the device’s identity: “The Dare Hemoglobinometer.” [Photo: Dare Hemoglobinometer on display at IMHM]

    The Dare hemoglobinometer is a device that was patented in 1922, and 100 years later, hemoglobinometers are still in use. Although modern examples would be unrecognizable compared to this artifact, they serve the same purpose: to determine the amount of hemoglobin (Hb), a protein that carries oxygen, in a patient’s blood. To operate the Dare hemoglobinometer, a physician would place a pipet with a patient’s blood sample in a portion of the device that lined up with a color scale; they would then compare the blood to this scale, indicating the percentage of Hb in the blood [1]. Many methods are available today for the same test, but similar examples are often digital. Digital hemoglobinometers are similar to the Dare hemoglobinometer because they are able to be used outside of a laboratory and read quickly, but these digital devices have many advantages, such as the fact that there is “no or minimal subjectivity in the estimation of Hb” [2]. Digital hemoglobinometers like TrueHb Hemometer and HemoCue® work through photometry rather than estimation by a physician looking through a lens [2]. [Photo: Another Dare Hemoglobinometer in the IMHM collection]

    [Photo: Advertisement for the Dare Hemoglobinometer showing the device set-up]

    Although these disparate technologies are separated by a century, they serve similar purposes in the realm of healthcare. They are both examples of point-of-care tests, which are medical tests that do not need to be performed in a hospital laboratory. The unique qualities of point-of-care tests – including their small footprint and their speed of providing results – make them great candidates for use in low-income countries, and according to UNICEF, they “offer an unprecedented opportunity to reduce inequalities in health” [3]. Hemoglobinometers, including the artifact on display at the IMHM, can be held up as examples of point-of-care testing, and they are an essential part of solving the worldwide health issue of anemia. This medical condition, which occurs due to a low level of hemoglobin in the blood, affects “42% of children less than 5 years of age and 40% of pregnant women worldwide” and is most prevalent in low-income countries [4].

    Anemia is not the only serious global health issue that can benefit from point-of-care testing. A more recent issue that has been put at the forefront of scientific research and discussion is the COVID-19 pandemic. At the beginning of the pandemic, people brought point-of-care testing into the conversation because it can allow for faster testing, which in turn helps to slow the transmission of the disease [5]. A September 2021 New York Times article explained that the U.S. was falling behind other countries in regards to this type of testing, and this “shortage of testing in the U.S. may be contributing to the virus’s spread” [6]. Of course, there are disadvantages to point-of-care and at-home testing for COVID-19. However, this Times article argues that the advantages may outweigh the disadvantages. Rapid tests do not have the same level of sensitivity as PCR tests (most often used in the U.S.), but some experts explain that they “do not need to be so sensitive to be effective” [6]. Like with anemia, researchers have also thought of these tests as a way to reduce health inequalities. COVID-19 has “disproportionately impacted people of color and under-resourced regions,” and point-of-care testing is a viable option for making testing faster and more accessible [5]. [Photo: NHS rapid COVID-19 test]

    Point-of-care testing is an essential part of health care today that is actively discussed and improved in response to global health concerns – from anemia to COVID-19. As researchers look into point-of-care technology, a look back at some earlier examples of these tests can give us a more complete appreciation of their use and convenience. So, although the Dare hemoglobinometer in the clinical laboratory at the Indiana Medical History Museum may seem like a small, insignificant object in a room full of equipment, a closer look reveals that this point-of-care device foreshadows current healthcare solutions.

               

    References

    [1] “The Dare Hemoglobinometer.” Smithsonian’s National Zoo & Conservation Biology Institute. Accessed September 8, 2021. https://nationalzoo.si.edu/object/nmah_735248.

    [2] Yadav, Kapil, Shashi Kant, Gomathi Ramaswamy, Farhad Ahamed, and Kashish Vohra. “Digital Hemoglobinometers as Point-of-Care Testing Devices for Hemoglobin Estimation: A Validation Study from India.” Indian Journal of Community Medicine 45, no. 4 (2020): 506-510. doi: 10.4103/ijcm.IJCM_558_19.

    [3] Kirby, Rebecca, and Kara Palamountain. Target Product Profile: Hemoglobinometer – Point-of-Care Diagnostics. UNICEF, 2020. Accessed September 8, 2021. https://www.unicef.org/supply/media/2911/file/Hemoglobinometer-TPP-v1.pdf.

    [4] “Anaemia.” World Health Organization. Accessed September 9, 2021. https://www.who.int/health-topics/anaemia#tab=tab_1.

    [5] Valera, Enrique, Aaron Jankelow, Jongwon Lim, Victoria Kindratenko, Anurup Ganguli, Karen White, James Kumar, and Rashid Bashir. “COVID-19 Point-of-Care Diagnostics: Present and Future.” ACS Nano 15, no. 5 (2021): 7899-7906. https://doi.org/10.1021/acsnano.1c02981.

    [6] Leonhardt, David. “Where Are the Tests?” The New York Times. September 21, 2021. https://www.nytimes.com/2021/09/21/briefing/rapid-testing-covid-us.html.

    Image Credits

    Image 1: Dare hemoglobinometer found in IMHM clinical laboratory, photo provided by author.

    Image 2: Another version of Dare hemoglobinometer in IMHM collection, photo provided by author.

    Image 3: Hemoglobinometer – Originated and Perfected by Dr Arthur Dare. Wikimedia Commons. 1920, https://commons.wikimedia.org/wiki/File:Hemoglobinometer_-_Originated_and_Perfected_by_Dr_Arthur_Dare.jpg.

    Image 4: Jwslubbock. NHS Covid test pack and contents 2. Photograph. Wikimedia Commons.August 18, 2021, https://commons.wikimedia.org/wiki/File:NHS_Covid_test_pack_and_contents_2.jpg. (To view the license for this image, visit https://creativecommons.org/licenses/by-sa/4.0/deed.en)


  • January 06, 2022 10:19 AM | Anonymous member (Administrator)

    by guest blogger, David Zauner

    Sir Arthur Conan Doyle is most famous for his accounts of the cases of that great consulting detective, Sherlock Holmes of 221B, Baker Street, London, perhaps the best-known literary character in the world.  However, Conan Doyle was also a trained physician and well versed in both detective fiction and real-life criminal cases.  This background gave him a body of knowledge and experience that not only informed his writing and shaped Holmes as a detective quite different than his fictional predecessors, but also made him an advocate for improvements in investigative procedures and led him to conduct his own inquiries into a number of cases, including several in which he saw gross miscarriages of justice.  On this 6th of January – recognized by many in the Sherlockian world as the birthday of Holmes – we delve deeper into Conan Doyle’s own story and how he not only changed detective fiction, but likely also had a significant impact on the development of modern investigative methods.

    (Image: Sidney Paget illustration of Sherlock Holmes engaged in a chemical experiment in Arthur Conan Doyle's short story "The Adventure of the Naval Treaty.")

    Edinburgh University, where Conan Doyle studied medicine from 1876 to 1881, had several notable figures in medical jurisprudence, as forensic medicine was then known, on the faculty or teaching in extramural schools loosely associated with the University.  Sir Robert Christison taught materia medica and therapeutics during Conan Doyle’s time at the University, and had authored several standard texts on medical jurisprudence.  His successor and former research assistant, Professor Thomas Fraser, taught one of Conan Doyle’s classes.  Dr. Henry Littlejohn had a forensic medicine practice and was a popular extramural lecturer; one of his former students, Dr. Joseph Bell, had an uncanny ability to diagnose medical conditions simply by observing patients.  Conan Doyle worked closely with Dr. Bell as outpatient clerk in the Royal Infirmary, and Dr. Bell is widely credited as the inspiration for Sherlock Holmes’ powers of observation.

    Besides being a student of medicine, Conan Doyle was also a student of crime, reading the Newgate Calendars – accounts of notable crimes and trials from the 1770s – and the memoirs of Eugène Vidocq of the Paris Sûreté, plus the fictional tales of Edgar Allan Poe and Èmile Gaboriau.  He corresponded with Francis Galton, one of the pioneers of fingerprint identification; knew about Alphonse Bertillon’s method of identification through the use of body measurements, known as anthropometry; and visited the London Metropolitan Police “Black Museum” to research police procedures.  Conan Doyle was acquainted with Bernard Spilsbury, who became perhaps the most renowned forensic pathologist in Great Britain.  Through his reading and contacts, Conan Doyle gained practical information on the methods and procedures of criminal investigation.

    Although Conan Doyle started writing as a student, it was his Sherlock Holmes stories that made his literary mark.  By creating a detective who used information gleaned from close observation and scientific analysis of minute clues to make deductions to solve his cases, Conan Doyle not only found the niche that gave him a lasting place on the list of great authors, he also seized the opportunity to use his writing ability to advocate for a systematic and scientific approach to criminal investigation, along the lines of that taken in the realm of medical diagnosis and jurisprudence with which he was so familiar.  The cases of Sherlock Holmes, following his axiom that “detection is, or ought to be, an exact science and should be treated in the same cold and unemotional manner,” introduced the reading public to these possibilities as well, and started a fascination with crime detection and forensic science that continues to this day.  Conan Doyle’s stories had an impact on professionals as well:  Edmond Locard, a pioneer in forensic science who established the world’s first police laboratory in Lyon, France, in 1912 and wrote an encyclopedia of criminalistics still referenced today, acknowledged Holmes as one of his inspirations, and even referenced him in the introduction to one of his books.  The official police were finally starting to catch up to the methods of Holmes.

    As Sherlock Holmes grew in popularity, Conan Doyle became well known around the world, and with that fame came an increasing number of letters.  Some were simply “fan mail”, but a number of others – addressed either to Holmes or to Conan Doyle himself – were pleas to look into cases that the authorities were unable to solve.  At first, he simply dismissed these, but later he did look into several matters, applying the same methods of reason and rational deduction used by the character he created.  Two of his inquiries stand out in particular; in both, Conan Doyle was able to exonerate individuals unjustly accused of serious crimes and convicted on flimsy evidence.  George Edalji was convicted of horse-maiming in Staffordshire in 1903, and was suspected in a number of other animal mutilation cases, mainly due to a vicious campaign of anonymous letters against him and his family.  Conan Doyle’s investigation revealed that the police case against Edalji was based on flawed – and perhaps fabricated – evidence, as well as rampant racial prejudice in the rural district; Edalji was the son of an Indian father and British mother.  Conan Doyle’s work on Edalji’s behalf resulted in him being granted a full pardon.  Oscar Slater was convicted of murdering a woman in Glasgow in 1908 and sentenced to life imprisonment, but Conan Doyle found inconsistencies in witness statements, unexplored leads, and evidence of judicial misconduct in the case. Slater was pardoned in 1927 and compensated by the British government for his unjust conviction and imprisonment.  Conan Doyle took on a number of other cases in his lifetime; not all ended as successfully as these two, but he approached each in the manner of his Great Detective.

    Arthur Conan Doyle, through his literary offspring Sherlock Holmes, offered a new approach to crime detection, one that used observation, science, and reason to solve cases and bring miscreants to justice.  He sparked a lasting public interest in police procedures and forensic science, and served as an inspiration to some who were working to incorporate these principles into real-life police investigations.  Conan Doyle himself embodied many of the same qualities and abilities he ascribed to Holmes, and deserves recognition for his exploits as a “consulting detective” as well as for his masterful storytelling.

    Many biographies of Sir Arthur Conan Doyle have been written, but two of the better ones (in this author’s humble opinion) are Andrew Lycett’s 2007 work, Conan Doyle: The Man Who Created Sherlock Holmes; and Peter Costello’s 2006 account, Conan Doyle, Detective: True Crimes Investigated by the Creator of Sherlock Holmes.


    David Zauner, the author of this “trifling monograph”, serves as a docent, collections assistant, and member of the board of the Indiana Medical History Museum.  He is a retired forensic scientist, and a member of The Illustrious Clients of Indianapolis, a Sherlock Holmes literary society.


  • November 03, 2021 7:00 PM | Anonymous member (Administrator)

    by Marissa Hamm, IMHM Intern

    [a] One of the many popular “medicines” for neurasthenia. Indianapolis Times April 15, 1927.In Charlotte Perkins Gilman's The Yellow Wallpaper, readers follow the downward spiral of the female protagonist as she suffers from “temporary nervous depression.” To cure her issues of fatigue and irritability, her physician husband, John, whisks her away to a house in the country where she is confined to an attic room and ordered to stay in bed. John provides his wife with “cod liver oil, tonics, ale, wine, and rare meat” and prevents her from having any “excitement” that would further drain her nervous energy. By the end of the story, the protagonist’s condition has worsened and she  imagines that she is now part of the yellow wallpaper that lines the attic room.[1]

    This short story often lives on in the minds of those who read it in their high school literature classes. However, many do not know about the real condition underlying the protagonist’s troubles: Neurasthenia. In 1869, George Beard coined the term neurasthenia. Beard posited that the human body was a machine powered by nervous energy -- a compelling metaphor for Americans embroiled in the industrial revolution. When people expended too much nervous energy, they became fatigued and sick with neurasthenia.[2]

    Symptoms of neurasthenia included depression, irritability, insomnia, lethargy, indigestion, a lack of ambition, an inability to concentrate, anxiety, headaches, muscle and joint pain, weight loss, impotence, amenorrhea, and mental and physical collapse. As this laundry list of symptoms shows, neurasthenia was a catch-all diagnosis for many issues. So what exactly caused this illness? 

    Physicians like Beard believed that modernity and society’s progress took a toll on one’s nervous energy and led to neurasthenia. It was thought that modern conventions such as steam power, the periodical press, telegraphs, overpopulated cities, and “the mental activity of women” placed demands on citizens that were sometimes too much to handle.[2] Neurasthenia quickly became known by a secondary name, “Americanitis,” and those with the condition were said to be an “active mind, a competitive character, a lover of liberty -- in short, the quintessential American.”[2,3] Some patients begged their physicians to diagnosis them with neurasthenia because of the condition’s positive perception, and many doctors were eager to make the diagnosis. [b] Some drugs used the colloquial name “Americanitis” in their advertisements. Greencastle Harold May 11, 1911

    An important distinction to keep in mind is that neurasthenia was an illness of the privileged, particularly white, Northern, and Protestant Americans. In order to get the diagnosis, one had to be able to afford to see a physician and then pay for the recommended treatments. Further, the illness became a tool of oppression used against Catholics, Southern whites, Native Americans, immigrants, and African Americans. Beard theorized that these groups of people were immune to neurasthenia because they lived in various states of “ignorance” therefore their brains were not at risk of being overworked.[2]

    The primary treatments for neurasthenia were total rest for women, as seen in “The Yellow Wallpaper”, or an “escape” to the Western U.S. for men so that they could participate in “manly” work – an actual treatment prescribed to Theodore Roosevelt before his presidency.[3] In Indianapolis, wealthy citizens could check into a facility such as “Norways”, Dr. Albert E. Sterne’s sanatorium for nervous diseases. In 1912, Norways cost patients $35 to $90 a week and promised a luxurious experience (as one would expect for that price tag!).[4] Yet Central State Hospital also cared for neurasthenic patients, although on a much smaller scale. Between 1889 to 1916, Central State admitted four cases of neurasthenia, 75% of which were female.[5] 

    The Hospital also admitted patients for “nervous prostration” and “overwork.” There were only two cases of nervous prostration (a type of nervous exhaustion), one male and one female, between 1889 and 1896. Significantly more popular was the diagnosis overwork. Between 1889 and 1916, 36 males and 25 females were admitted to the Hospital for overwork.[5,6] Overwork was very similar to neurasthenia. As Horatio C. Wood explained it in his 1885 book Brain-Work and Overwork, when people are engaged in “emotional excitement” for extended periods of time, such as stockbrokers, they forget to check in with their body and rest, which leads to nervous exhaustion known as overwork.[7] 


    [c] Advertisement for “Norways,” the sanatorium for the wealthy. Indianapolis Medical Journal, January 1912

    Despite its earlier popularity, neurasthenia eventually fell out of favor as the psychology field grew. By 1920, neurasthenia was largely out of use and in 1980, the DSM III officially removed the diagnosis. However the legacy of neurasthenia lingers. Not only do scholars agree that conditions such as chronic fatigue syndrome, fibromyalgia, anxiety, and depression are modern day equivalents of neurasthenia, the illness also transformed the way that Western nations view health. There is a societal belief that happiness, comfort, and emotional wellbeing lead to good physical health.[2]

    In many ways, people around the world still struggle with neurasthenia today, but instead we call it things like “stress” or “burnout.” We long to take relaxing vacations, spend time in nature, and discover our “inner peace” as ways to manage the daily stressors of modern life. We may have more ways to discuss and understand how our mental and physical health are connected, but at the end of the day, we are still trying to achieve the ideal “happiness” that promises long-term health, just like the neurasthenics did over a century prior. 


    Sources:

    [1] Gilman, Charlotte Perkins. The Yellow Wallpaper. Auckland: The Floating Press, 2009. 

    [2] Schuster, David G. Neurasthenic Nation: America’s Search for Health, Happiness, and Comfort, 1869-1920. New Brunswick: Rutgers University Press, 2011. 

    [3] Beck, Julie. “‘Americanitis’: The Disease of Living Too Fast.” The Atlantic. March 11, 2016. https://www.theatlantic.com/health/archive/2016/03/the-history-of-neurasthenia-or-americanitis-health-happiness-and-culture/473253/ 

    [4] Hostetler, Joan. “Then and Now: Clifford Place and Norways Sanatorium.” Historic Indianapolis. May 12, 2011. https://historicindianapolis.com/then-and-now-clifford-place-and-norways-sanatorium/

    [5] Annual Report of the Central Indiana Hospital for the Insane, Volumes 40-49. http://hdl.handle.net/2027/nyp.33433004139758

    [6] Annual Report of the Board of Trustees and Superintendent of the Central Indiana Hospital for Insane, Issues 54-67. http://hdl.handle.net/2027/mdp.39015069712100

    [7] Wood, H.C., M.D. Brain-Work and Overwork. Philadelphia: P. Blakiston, Son & Co., 1885. https://hdl.handle.net/2027/umn.31951000955961b


    Images: 

    [a] “Dr. Miles Nervine Advertisement.” Indianapolis Times (Indianapolis, IN), April 15, 1927. https://newspapers.library.in.gov/?a=d&d=IPT19270415.1.9&srpos=92&e=-------en-20--81--txt-txIN------- 

    [b] “Americanitis Elixir Advertisement.” Greencastle Harold (Greencastle, IN), May 11, 1911. https://newspapers.library.in.gov/?a=d&d=GH19110511-01.1.4&srpos=2&e=-------en-20--1--txt-txIN------- 

    [c] “‘Norways’ Sanatorium Inc. – for Nervous Diseases Advertisement.” Indianapolis Medical Journal 15, no. 1 (1912): 18a. 

  • June 01, 2021 2:12 PM | Anonymous member (Administrator)

    by Sarah Halter

    July 6, 2021 Update: If you missed our May 23, 2021 virtual program on “Medical Education and Body Snatching in Indiana,” never fear! The recording is now available here. One famous incident I mentioned during the program has sometimes been referred to as The Harrison Horror. The story was too long to tell in full, but as promised, here are the fascinating details. [Image: print of body snatchers at work, Library of Congress]

    In the early spring of 1878, General Benjamin Harrison visited his father at his home in Point Farm, Ohio, a suburb of Cincinnati. (He was still General Harrison, because he hadn't become the President of the United States yet. That didn't happen until 1889. Learn more about President Harrison from the Benjamin Harrison Presidential Site here.)

    During that visit, John Scott Harrison was in pretty good health, so when he died on May 26th, it was a bit of a  shock despite his age. Just the week before, in fact, General Harrison received a letter that his father had ridden 12 miles on horseback to attend the funeral service and burial of a distant nephew, a young man named Augustus Devin, who had died unexpectedly at just 23 years old. But on that Sunday morning, May 26, 1878, when General Harrison and his family came back home from church a waiting telegram informed him that his father had passed away in the night. Right away General Harrison and his wife, Caroline, got on a train and headed down to be with his family and lay his father to rest. [Image: photo of President Benjamin Harrison, 1896, Library of Congress]

    The old family mansion was suddenly a bustling place. Hundreds of people came to offer condolences to the Harrison family. They began making plans to bury John Scott Harrison at Congress Green Cemetery, near where Augustus Devin had been buried just the previous week. While visiting the cemetery before the funeral, family members noticed that there was something odd about Augustus' grave. It looked like it had been disturbed. When they got a closer look, to everyone's shock and horror, it was clear that the grave had been robbed… Augustus' body had been stolen.

    If someone stole Augustus' body right out of his grave, might someone do the same to John Scott Harrison's body? This was the beloved patriarch of the family and the last son of William Henry Harrison, the US President who famously died a month into his presidency. His body and his grave had to be protected at any cost, and the Harrison family could afford to pay for it.

    ---

    On May 29th, the vast funeral procession proceeded to Congress Green Cemetery. General Harrison himself supervised the lowering of the sturdy and secure metal casket that contained John Scott Harrison's body into the freshly dug grave. The grave was eight feet deep, and at the bottom was a brick vault into which the casket was placed. The walls of the vault were thick, and the bottom was lined with a stone floor. Workmen placed three massive stones on top of the vault, two at the foot end of the casket and one extra large stone at the head of the casket, where body snatchers usually struck. But they didn't stop there. Next the stones were cemented together, and then several men stood watch at the open grave for several hours while the cement dried. Then finally, the rest of the hole on top of the stones was filled in with dirt. General Harrison, fearful that the body snatchers would return, paid a watchman $30 to stand guard over the grave for 30 nights until the body decomposed enough to make it useless for dissection.

    ---

    General Harrison and his wife returned to Indianapolis after the funeral feeling pretty confident, I imagine, that his father's body was safe. He went on about his business as one of the City's most well-known lawyers. His brother John stayed in Cincinnati the night of the funeral, so that bright and early the next morning, he could begin the search for the missing body of Augustus Devin. 

    John Harrison and a constable named Lacey set out to search all of the medical schools in the area. They got a tip that a wagon was seen pulling up in the alley behind the Ohio Medical College building at 3am the previous night. A large object was removed from the wagon and carried into the college building, and then the wagon drove on. It was a promising lead. And so, they began the search there. [Image: Ohio Medical College, 1835, The Ohio History Connection]

    When they arrived, the irritated janitor reluctantly showed them around the building, taking them from room to room, so that they could see for themselves that there were no illegal bodies at the Ohio Medical College.

    After John and the constable had carefully searched the whole building without finding anything suspicious, they were about to leave when Constable Lacey noticed an odd thing. He saw a oddly placed air vent with a windlass. The windlass had a rope tied to it that hung down into the air shaft. And the rope looked tight, like something heavy might be hanging from it. They ordered the janitor to pull it up. And as the rope was pulled up, slowly a figure began to emerge. It was a body with a rope tied around its neck. But was it Augustus Devin? Was their search over already in the first place they tried?

    It was not.

    The head and shoulders were covered with a cloth, but John Harrison could tell by looking at the rest of the naked body that it was a much older man than Augustus Devin was. But whether it was Augustus or not, it was still a human body, one that was likely acquired illegally by the medical school. So the constable used his stick to remove the cloth and uncover the man's face.

    ---

    It was John Scott Harrison, whom the family had just buried the day before. General Harrison probably shouldn't have paid the watchman in advance to guard the grave for 30 days.

    John Harrison found a local undertaker to take custody of the body until he could figure out what to do, and he sent a telegram to General Harrison in Indianapolis, to let him know what had happened.

    But by the time he received word from John, he had already heard the shocking news elsewhere. Three of his relatives who went to the cemetery to visit John Scott Harrison's grave earlier that morning were horrified to discover that the grave had been dug up, and the two smaller stones at the foot end of the casket had been lifted on end. There was a hole in the top of the vault, and the sealed casket had been pried open. After all the trouble General Harrison went through to ensure his father's eternal rest, his body had still be stolen.

    Was one of the body snatchers present in the crowd at the burial? Had someone staked out the funeral to know what precautions were taken? This was a common practice for body snatchers, but removing the body through the foot end of the casket was not. Whoever stole the body obviously knew what they were dealing with ahead of time. 

    General Harrison immediately made arrangements to return to Cincinnati, thinking that he now had two bodies to locate. Right away, he met with the police, but he also hired the Pinkerton Detective Agency to find the culprits and track down the bodies. He wasn't messing around now, and he wasn't going to leave the whole case in the hands of the Cincinnati Police Department, who so far had not been very helpful. [Image: photograph of Pinkerton Detective Agency report on the Harrison body snatching, Benjamin Harrison Presidential Site]

    But with General Harrison back in town, the police now seemed more inclined to take action. They even made an arrest. Mr. Marshall, the janitor in the Ohio Medical College who had shown the constable and John Harrison around the building, was arrested and charged with "receiving, concealing, and secreting" John Scott Harrison's body which had been "unlawfully and maliciously removed from its grave."

    This did not please the medical school staff, who all rallied around Mr. Marshall and posted his $5,000 bail.

    This action by the medical school faculty did not please the good citizens of Cincinnati, who were a little creeped out by the medical school anyway and who were outraged by the body snatching that had been going on to supply it with bodies. It was shocking that the body of someone like John Scott Harrison might be treated so outrageously. And if it could happen to him, it could happen to anyone.

    The medical school faculty, realizing that they were now even more firmly planted on the wrong side of public opinion, issued a statement expressing their "…deep regret that the grave of Honorable J. Scott Harrison had been violated" which is a pretty poor apology, I think. It's not really an apology at all. 

    One journalist reporting on the angry public reaction to this whole mess wrote of the medical school, "...it would have been better for it to say nothing at all... And heroic doses of the Ohio Penitentiary are the best medical treatment the people of Cincinnati can prescribe for it."

    The Harrisons reburied their father and continued the search for Augustus Devin. Ohio Medical College faculty and staff were questioned again, this time before a grand jury. But they didn't have much to say, even under oath. A local journalist got a tip that a well-known and prolific body snatcher from Toledo, Ohio named Charles Morton and his gang of ghouls were responsible for both thefts. But no one could find him. He used several aliases, sometimes going by Gabriel Morton, or Dr. Christian, or Dr. Gordon.

    Finally Ohio Medical College professors admitted to the grand jury what everyone already knew...that like most other medical schools in the country, theirs had entered into a contract with unnamed body snatchers to receive a regular supply of cadavers each year so that they had the "material" they needed to properly educate their students. These professors insisted, though, that they were as shocked as anyone else that none other than John Scott Harrison had turned up in their dissecting room. They were under the impression that private burials were not to be disturbed. Bodies were supposed to be coming from public burying grounds, or places where paupers or unclaimed bodies from hospitals and prisons, were buried…people they seemed to think mattered less.

    These doctors who taught in these schools agreed that body snatching was a problem, but they also saw that it was a necessary evil. They felt sorry for the families and understood their anger, but they also supported the physicians who were driven to such means as purchasing bodies from body snatchers. It's tricky, isn't it? There were no imaging technologies, and the only way to better understand, and therefore better heal, the body was to look inside it and study it firsthand.

    ---

    The janitor of another medical school in Cincinnati came forward confirming that they too purchased bodies from Morton. And he said that while school was not in session, Morton paid him to use the medical building as a workspace for preparing and shipping these bodies all over. Some of the bodies had gone to Ann Arbor, Michigan, disguised with labels that read "Quimby & Co.," so a detective set off right away to Ann Arbor. The barrels were easy to track, it turned out, and he quickly located a barrel labeled "Quimby & Co." Sure enough, inside that barrel of pickled bodies was....finally...poor Augustus Devin.

    When the Harrisons in Cincinnati heard the news, they were quite relieved. Devin was laid to rest for the second time...for real this time. And though the whole business wasn't over...there was still an upcoming trial after all against Charles Morton and the janitor Mr. Marshall. And the Harrisons filed civil suits for the costs of the investigation and the pain and suffering caused by the whole terrible ordeal....But General Harrison could finally go home knowing that his father and Augustus were finally "home."

  • March 16, 2021 9:12 AM | Anonymous member (Administrator)

    by Haley Brinker

    Snake oil. Those two words illicit an immediate response of fraudulent hucksters, traveling salesmen with dubious morals, and a host of other suspicious characters, hawking questionable wares across the United States in the late nineteenth and early twentieth centuries. In modern times, calling someone a snake oil salesman is the equivalent of calling them a liar, a charlatan, peddling too-good-to-be-true products or ideas to make a quick buck. However, the history of snake oil itself is a little more interesting. Snake oil is and was a real product, and some scientists today acknowledge that it might actually work to cure bodily ills.

    So, what is snake oil exactly? During the 1800s, over 100,000 Chinese immigrants came to the United States in order to find work building the Transcontinental Railroad. They brought with them their families, their culture, and, most important to this story, their medicines. One medicine, perhaps corked into a small, glass bottle, was snake oil. This was no ordinary snake oil, either. It came from the Chinese water snake, and this snake was rich [1]. No, not that kind of rich. The oil from Chinese water snakes is chock full of omega-3 acids. These have been known to help with things like arthritis and other muscle and joint pain [2]. The Chinese immigrants working on the railroad (all the live-long day) would have been exhausted and probably incredibly sore. The perfect cure? Snake oil! They might have even shared some with their fellow workers, building the miracle-cure aura of this product and spreading the news far and wide.

    “But wait,” you say, “then why do people call snake oil fake?” That part comes next. Seizing on the newfound popularity of this miracle product, but lacking the ability to rustle up a Chinese water snake, the salesmen made do. Cue Clark Stanley, a Texan with panache and a scheme to get rich. Stanley called himself the “Rattlesnake King” and traveled across the United States, dressed as a cowboy, and put on shows [3]. In front of crowds, Stanley would slice open a live rattlesnake, throw it into boiling water, and bottle up the oil that rose to the top [1]. He claimed that this was what was in each bottle of “Stanley’s Snake Oil” and people lined up for a chance to buy it [3].

    Unfortunately, shockingly, some cowboys just can’t be trusted, and Clark Stanley was a prime example of this. When the United States government decided to analyze the oil in 1917, they found that the Rattlesnake King’s oil was actually just a combination of mineral and fatty oils with a few additives, none of which derived from snakes [1]. They found him guilty of misrepresentation of his product and he was fined twenty dollars [2]. It’s worth noting that, even if Clark Stanley’s snake oil really did have genuine rattlesnake oil in it, it probably wouldn’t have been very effective. Modern studies have shown that the original snake oil from China, made from Chinese water snakes, contains around “20 percent eicosapentaenoic acid,” which is a type of omega-3. Rattlesnakes, on the other hand, only have a little over eight percent of the acid. It’s also worth noting that salmon, which is far easier to procure and much less dangerous to handle, have about eighteen percent [4]. Admittedly, though, Salmon King just doesn’t have the same ring to it.

    After the Rattlesnake King’s treachery became public, it was only a matter of time before the term “snake oil salesman” became synonymous with fakes, frauds, and falsifiers. It was popularized when snake oil salesmen began popping up in American Westerns. It’s mentioned by the poet, Stephen Vincent Benet in John Brown’s Body and again in The Iceman Cometh by Eugene O’Neill [1]. These products of popular culture further propelled the terminology into the public lexicon. While snake oil itself (the good stuff from Chinese water snakes) is a great remedy in traditional Chinese culture, its benefits have been lost from sight in western culture, sinking beneath the surface of the slippery sea of slimy salesmen.

    [1] Gandhi, L. (2013, August 26). A History Of 'Snake Oil Salesmen'. Retrieved September 24,   2020, from https://www.npr.org/sections/codeswitch/2013/08/26/215761377/a-history-of-snake-oil-salesmen

    [2] Haynes, A. (2015, January 23). The history of snake oil. Retrieved September 24, 2020, from https://www.pharmaceutical-journal.com/opinion/blogs/the-history-of-snake-oil/20067691.blog?firstPass=false

    [3] Clark Stanley: The Original Snake Oil Salesman. (n.d.). Retrieved September 25, 2020, from https://ancientoriginsmagazine.com/clark-stanley

    [4] Graber, C. (2007, November 01). Snake Oil Salesmen Were on to Something. Retrieved September 25, 2020, from https://www.scientificamerican.com/article/snake-oil-salesmen-knew-something/

    Photo Credit: https://www.nlm.nih.gov/exhibition/ephemera/medshow.html, attributed to: Clark Stanley's Snake Oil Liniment, True Life in the Far West, 200 page pamphlet, illus., Worcester, Massachusetts, c. 1905


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