Asleep: The Forgotten Epidemic That Remains One of Medicine's Greatest Mysteries (29 page)

Details about the London outbreak primarily came from A. J. Hall’s
Epidemic Encephalitis
(1924) and the
Memorandum on Encephalitis Lethargica
(1924), held in the History of Medicine Division, National Library of Medicine. Hall also published articles on the subject. I used four of his articles in researching the London outbreaks:

“Epidemic Encephalitis,” British
Medical journal
(October 26, 1918), “The Lumeian Lectures on Encephalitis Lethargica,”
Lancet
1 (1923), “The Mental Sequelae of Epidemic Encephalitis in Children,”
British MedicalJournal
1 (1925), and “Note on an Epidemic of Toxic Ophthalmoplegia associated with Acute Asthenia and Other Nervous Manifestations,”
Lancet
(April 20, 1918).

Facts about epidemiology were based on Charles Rosenberg’s
Explaining Epidemics and Other Studies in the History of Medicine
(1992). Hippocrates’ definition of epidemiology is from “The Nature of Man,” published as part of
Hippocratic Writings
(1984). Notable examples of epidemiology included John Snow’s mapping of cholera from Steven Johnson’s
The Ghost Map
(2007); Robert Koch’s biography on
www.nobelprize.org
; Walter Reed’s work with typhoid and yellow fever in my book
The American Plague
(2006); and Judith W. Leavitt’s
Typhoid Mary
(1996).

CASE HISTORY TWO

Chapter 4: New York City

Historical information about New York City came from a number of sources: Ric Burns and James Sanders’s
New York
(2003), as well as Burns’s “New York: A Documentary Film”; Nathan Silver’s
Lost New York
(2000); David Stravitz’s
New York, Empire City 1920-1945
(2004); Kenneth Jackson and David Dunbar’s
Empire City
(2002); and E. B. White’s
Here Is New York
(2005 reprint).

In addition to those sources, I used some original material like Elizabeth McCausland’s book
New York in the Thirties
(1939), featuring photos by Berenice Abbott; Mary Black’s
Old New York in Early Photographs
(1973); Laura Spencer Porter’s guidebook
New York, the Giant City
(1939); Tony Sarg’s
Up and Down New York
(1926); and William J. Showalter’s “New York: The Metropolis of Mankind,”
National Geographic
(July 1918). Often, it was through studying those books or photos from the 1920s that I found details like store names, carts selling particular goods, the chaotic streets, or other minor details.

To immerse myself in details from the time period, I also reread some classic novels about New York culture, like
The Great Gatsby
and
The Fountainhead.
They are filled with finer points like the fact that they used “ashcans,” not trashcans. Removing gloves and hats was the first thing anyone did upon entering a home. Milk came delivered in wooden crates. A number of textural details also came from
New York Times
articles. Although I read through the archives of most newspapers from the time period, like the
New York Evening Post,
the
Herald,
and the
Tribune
at the New York Public Library, I was able to access New
York Times
archives online, and so those archives make up the bulk of newspaper accounts.

It was Laura Spencer Porter’s guidebook,
New York, the Giant City,
that pointed out New York grew faster than any of the world’s largest cities.

The quotes from E. B. White came from the 2005 reprint of his original
Here Is New York,
page 40.

The historian who wrote New York was “the one place in the world where the hand of man shaped the environment as much as the hand of God” was Kenneth T. Jackson in an essay in Burns and Sanders’s book, page 307.

Words used to describe New York during that time period: colossal (Paul Bourget in
Outre-Mer: Impressions of America,
1895); magnetic (reporter Henry Tyrrell in
New York World,
1923); astonishing (New York reporter Alva Johnson); feverish (E. B. White); glittering (F. Scott Fitzgerald); an imperial city (Calvin Coolidge in 1925); the Niagara of American Life (Joseph W. Showalter’s “New York: The Metropolis of Mankind,”
National Geographic
July 1918); and poetry itself (Ezra Pound).

Laura Spencer Porter’s original 1939 guidebook provided information about the “City of Cities” and various neighborhoods, pages 24—25.

New York’s position after World War I was described in Burns and Sanders’s book as the financial center of world, page 315; publishing capital of United States, page 300; and fashion center, page 308.

Descriptions of and details about New York in the winter of 1917-18, the coldest on record, came from
New York Times
articles: “13 below Zero on Coldest Day” (December 31, 1917), “Drastic Action Increases City’s Supply of Coal” (January 4, 1918), “New Cold Wave Balks Railroads” (January 21, 1918), “Heat Ban Will Be Stricter” (January 28, 1918), “Workless Mondays” (January 30, 1918), “Coldest Winter on Every Count Record Breaker” (February 10, 1918), and “Coldest Winter Weather Bureau Has Ever Known” (February 10, 1918). Some of the descriptive details also came from personal observation during research trips I took to New York, including one during a February snow. Descriptions of New York street scenes during that time period came from old photographs and newspaper advertisements.

Details about the way people dressed, “facial forestation,” wide-brimmed hats, icy hems, mass-produced garments, the “bob,” and the need for “bobby pins” all came from Mark Sullivan’s
Our Times
(1937), pages 390—411.

Information about New York pollution and soft-coal grease appeared often in newspaper accounts. The “impassable yellow fog” was reported in the
New York Times
(January 19, 1926).

Biographical information about Frederick Tilney came from a variety of places. The Henry Alsop Riley Papers and the Walter Timme Papers held in Columbia University’s Augustus C. Long Health Sciences Library provided some of the personal details. Tilney’s obituary in
Time
magazine also provided essential pieces of information. The quote about the brain of modern man came from Tilney’s acclaimed book
The Brain
(1928).

Details like the “crown breezes,” fever boxes, and other early neurological practices came from Lawrence Pool’s
Neurological Institute of New York, 1909-1974
(1975). Pool was a neurosurgeon at the institute during some of its pivotal years. His book can be found in Columbia’s Health Sciences Library or the New York Academy of Medicine.

The story of Phineas Gage is well documented. I based my description on two sources:
www.brainconnection.com
and P. Ratiu and 1. F. Talos’s article “The Tale of Phineas Gage, Digitally Remastered,” New
EnglandJournalof Medicine
351 (December 2, 2004).

Additional information about neurology came from Arthur Link’s
Fifty Years of American Neurology
(1998).

All material about early radiology came from two sources: Joel Howell’s
Technology in the Hospital
(1995) and Bettyann Kevles’s
Naked to the Bone
(1997). The quote about the X-ray threatening the two holiest sanctums came from Kevles’s book, page 27, as did material about Clarence Dally and his death, page 47. Details like the coin-operated X-ray machines came from Howell’s book, page 137, and Foot-O-Scopes came from Kevles’s book, page 80.

Aside from the main biographical facts about Tilney, the story about young Fred Tilney as a medical student came from Roy Chapman Andrews’s autobiography,
Under a Lucky Star
(2007). Andrews later became the director of the American Museum of Natural History.

The quote about future generations calling the early neurologists “pioneers” came from Pool’s history, page 2. Tilney’s article “Professors of Government” appeared in the
Washington Post
(April 8, 1930).

Further details about the original Neurological Institute came from Pool’s book, as well as quoted descriptions of Tilney, pages 17 and 124. Tilney’s obituary published in
Time
magazine named him as “the country’s greatest specialist on brain function” (May 6, 1940).

The quotation about medical progress came from Sullivan’s book, page 60.

“Ruth’s” case was recorded as “Case V” in Tilney and Howe’s book
Epidemic Encephalitis,
published in 1920. Ruth was not her real name. All details about Ruth came from Tilney’s case history: her age, medical records, symptoms, treatment, and death. She first contracted the illness on December 19, 1918. She died eight weeks later. In his book, Tilney also described other symptoms, including the fact that patients could hear what was going on around them, as well as the “fixed expression” and waxy, “death-like” face. And, finally, Tilney recounted how physicians had stood around her bedside and remarked that she would probably not recover. It was then that Tilney saw tears running down the girl’s face.

In chapter 6 of his book, Tilney describes the case of the four-year-old boy who may have been one of the first cases seen in New York City—if not the first. The boy’s symptoms began in September 1916, which would have preceded the earliest recorded cases in 1918 in New York. Tilney’s quote about the “unusual and prolonged somnolence” is from his book, page 46.

Tilney’s typed medical form was found in the Matheson Files at the Augustus C. Long Health Sciences Library in the Columbia University medical complex.

The “effigy on tomb” description, although referenced in Tilney’s book, originally appeared in an article, “Epidemic Encephalitis,” by A. J. Hall in the
British MedicalJournal
(October 26, 1918).

According to Ruth’s chart in Tilney’s book, her pulse had raced higher than 170, and her temperature was almost 107 degrees when she died.

Chapter 6: The Neurologist

The account of Tilney’s medical relationship with Helen Keller was taken from three main sources: Dorothy Herrmann’s
Helen Keller
(1999), pages 241-44; Merlin Donald’s A
Mind So Rare
(2002), pages 234-37; and Emily Davis’s article “Helen Keller Shows Future of Brain,”
Science News-Letter
14, no. 387 (September 8, 1928), pages 142-44.

Reference to John Daniel, the gorilla, came from Tilney’s
The Brain,
page viii.

Details about Tilney treating
New York Times
owner Adolph Ochs came from Susan Tift and Alex Jones’s
The Trust
(2000), pages 108 and 140.

Material about Georgia O‘Keeffe’s stepdaughter as a patient of Tilney’s appeared in Benita Eisler’s
O’Keeffe and Stieglitz
(1992), pages 325-27.

Chapter 7: The Medical Investigators

Tilney’s February 4, 1919, “Address of the Retiring President: The Opportunity of American Neurology,” appeared in the
Minutes and Proceedingsof the New York NeurologicalSociety.
Tilney’s vision for New York as the neurological center of the world was also discussed in depth in Kenton Kroker’s article “Epidemic Encephalitis and American Neurology, 1919—1940,”
Bulletin of the History of Medicine
78, no. 1 (Spring 2004). Kroker’s article provides an excellent analysis of New York neurology and the role encephalitis lethargica played in its development.

Mention of sleeping sickness first appeared in the
New York Times
on March 11, 1919, “Dr. Copeland Tells of the Appearance of a Rare Disease.”

The quote asserting that “no occurrence in the field of neurology” was as illuminating as encephalitis was published in Robert Sheehan’s article “Epidemic Encephalitis,”
Psychiatric Quarterly
2 (March 1928). He also read the paper at the quarterly conference at Manhattan State Hospital on Ward’s Island, New York.

The quote about the coordination of neurological research coalescing around epidemic encephalitis came from Kroker’s article.

To immerse myself in New York’s public health system from the 1890s through the 1930s, I relied on several sources: David Rosner’s
Hives of Sickness
(1995); Sandra Opdycke’s
No One Was Turned Away
(1999); the
Annual Report of the Department of Health of the City of New Yorkforthe Year 1914;
the U.S. Department of Health and Human Services’
Public Health in New York City in the Late Nineteenth Century,
based on an exhibit at the National Institutes of Health (1990); and newspaper accounts.

The most astounding details like the seventeen thousand horses, mules, and cattle removed from the city, along with various animals such as an alligator and two camels, appeared in a
New York Times
article (April 15, 1923), but I used the reports of the
New York Sanitary Code, Sections 87-90.
The
New York Times
also reported on the public bathhouses and laundry trucks (November 22, 1925), bans on public funerals (February 14, 1921), open-air classrooms for TB patients (September 25, 1921), and the ill effects of smoking in public (February 2, 1922).

The majority of historical information about the health department was taken from Rosner’s book. Biographical material about William Park came from Morris Schaeffer’s “William H. Park (1863-1939),”
American journal of Public Health
17, no. 11 (November 1985).

The
New York Times
(April 29, 1918) followed the story of Tammany’s failed attempt at control of the health department during the flu pandemic.

Statistics about Ellis Island appeared in Rosner’s book, page 70.

Typhoid Mary’s tale is well-known in medical history, but it was also told in Burns and Sanders’s book, page 275, and Rosner’s book, page 109. I also used Manon Parry’s “Sara Josephine Baker,”
AmericanJournalof Public Health
96 (2006) and Judith W. Leavitt’s
Typhoid Mary
(1996). Additional information about the precarious relationship between the health department and immigrants was taken from Rosner’s book, pages 37 and 73.