We marvel at modern medicine's ability to heal life-threatening injuries, prolong lives, and cure diseases. And yet, as any physician will tell you, medicine is an imprecise science. A cell undergoes permutation or an organ fails, and no number of pills or procedures can help. A full understanding of the intricacies of the human body—the fragile sack of liquids, organs, nerves, and bones that propels us through our brief, mortal existence—remains elusive.
On the ground floor of the Duke University Medical Center Library, a stone's throw from labs in which researchers conduct experimental drug protocols and doctors perform groundbreaking surgical procedures, the History of Medicine Collections offer glimpses into how our knowledge about the human condition has evolved It's a stunning assortment of rare medical texts and manuscripts, instruments, artifacts, and artwork. On display are doctors' bags, home medicine chests, early-sixteenth-century Italian apothecary jars, portable syringe kits, dauntingly large amputation saws, a box of blue-iris glass eyes, a late-eighteenth-century horseshoe tourniquet, and an exquisite array of ivory anatomical manikins from Western Europe.
The most valuable item in the collections, says curator Suzanne Porter, is a first edition of British physician William Harvey's Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, a landmark text published in 1628 in which he accurately detailed the circulation of blood. Kept with other precious volumes in a walk-in safe, the Harvey book contains meticulously recorded handwritten notations by previous owners and collectors documenting its provenance.
Porter explains that the core of the collections was assembled by Josiah Charles Trent, the founding chief of the division of thoracic surgery at Duke. For Christmas in 1938, the young intern received a rare copy of William Beaumont's Experiments and Observations on the Gastric Juice and the Physiology of Digestion. The gift "carried the deadly virus of bibliomania," Trent wrote. For the next ten years, until his premature death in 1948 at the age of thirty-four, he amassed, with assistance from dealers in rare medical books, a remarkable array of materials.
In 1956, Trent's widow, Mary D.B.T. Semans '39, Hon. '83, donated the Trent collection—4,000 books and 2,500 manuscripts—to the medical library. In addition to the Trent Collection, the History of Medicine Collections comprise 8,000 volumes of medical journals and books donated by the Georgia Medical Society, rare and historical manuscripts, a collection of works by Duke authors, and non-print materials that range from a medicinal herb garden to bloodletting equipment to a wooden stethoscope with an ivory earpiece.
The collections contain the only known copy of The Four Seasons, four seventeenth-century copperplate engravings that illustrate human anatomy over four stages of life. Also included: one of the last surviving hand-colored copies of the first edition of George Bartisch's Ophthalmodouleia (1583), the first systematic work on eye diseases and surgery, and manuscripts by William Osler, a Canadian physician and co-founder of the Johns Hopkins Hospital (Wilburt C. Davison, the founding dean of Duke's medical school, studied with Osler as a Rhodes Scholar from 1913 to 1916).
"Even though our collection is relatively young," says Porter, "we have virtually all milestone works in the history of Western medicine." She points out her own favorite item: a bas relief memento mori from the mid-seventeenth century. Carved from a single piece of ivory and based on anatomical illustrations by Andreas Vesalius, the intricate artwork depicts a skeleton, a flowing scarf draped around its neck and arms, contemplating the eventual fate of all mankind. At its feet, symbols of wealth and social status—a knight's helmet, a farmer's working tools, a king's crown—are scattered about in a jumble of earthly refuse. Vesalius' De Humani Corporis Fabrica, published in 1543, was a comprehensive study of the human body, widely considered to be the first anatomically accurate medical textbook.
Just off the main reading room is the Trent Room, built in 1956 in honor of Josiah Trent. Originally housed in the Davison Building, the room was dismantled and rebuilt in its current location in 1975. Heavy curtains, a decorative fireplace, and row after row of historic volumes evoke an English country house circa 1720. The walls of the cool, dark room are covered in pine paneling that originally had been installed in the library of the Duke of Richmond's house in Plaistow, England.
The room houses select, rare volumes from the Trent Collection and a variety of medical artifacts and objects from several other collections. Hanging in the far corner of the room, almost out of sight, is a Japanese ink-and-wash scroll showing a malevolent beast unleashing chaos onto the burning, panicked city of Hiroshima below. The scroll is part of the Warner Wells Hiroshima collection. (Wells '34, M.D. '38 was a surgeon who translated Japanese physician Michihiko Hachiya's eyewitness account of the 1945 bombing of Hiroshima.) It is one of only a handful of non-Western pieces in the collections.
Visitors are drawn to different aspects of the vast holdings, Porter says. When guest scholars or distinguished physicians are expected, she selects examples of the collection's most unusual holdings in that person's area of interest to show them.
As part of the first-year medical school curriculum, students are required to attend a special lecture on the history of medicine and concepts of disease that culminates in a trip to the History of Medicine Collections. Gray Lyons, a third-year medical student, says his curiosity about medical history was piqued by the experience. Lyons, who was an English major before switching to premed his junior year of college, says that the writing and research he has conducted using the collection has nurtured his need for creative expression.
"You could go all four years of medical school without writing an essay," says Lyons, who is pursuing joint M.D. and Ph.D. degrees. "I write for my own mental health." His essay on artistry, iconography, and ideas in sixteenth-century, pre-Vesalian anatomical illustrations was selected for publication in the spring 2007 issue of The Pharos, a quarterly journal published by the Alpha Omega Alpha medical honor society. And he's working with Porter to bring the work of British immunologist Edward Jenner to a wider audience by creating a website devoted to Jenner that features some of the collections' holdings. The site will include scanned excerpts from Jenner's diary, prescriptions he wrote for patients, and his landmark research into developing a smallpox vaccine.
During the Ming Dynasty, segregation between the sexes was strictly enforced, so female patients would mark the location of their ailing body part on an ivory "doctor's lady" that Chinese physicians used for diagnosis
Peter English '69, M.D. '73, Ph.D. '75, a professor of history at Duke, is among the faculty members who use the collections in their teaching and research. A medical historian, English has taught courses on the evolution of diseases and other public-health issues. He's also used the collections to research books he's written on the histories of pneumonia, diphtheria, and rheumatic fever.
"Medicine is a profession with a long ethical and historical tradition, and that history changes over time," English says. Today's students might be tempted to view our forebears' understanding of disease as falling along a spectrum that runs from prescient to misguided, he says. But that approach misses the point. The volumes in the History of Medicine Collections, which English calls "spectacular, one of the best in the country," were the leading-edge books of their day, he says. If you look closely, you'll find in their pages medical discoveries and experiments that begin in the Renaissance and lead to today's operating rooms and research labs.
As much as we pride ourselves on the miracles and accomplishments of modern medicine, our current thinking about diseases like AIDS or SARS will inevitably evolve in the years and decades to come. As they do, collections like this one will help future physicians and historians understand those pandemics from cultural and scientific perspectives. As English observes, "The history of medicine is still being written."