Health Care: A Postcard History of Twentieth-Century Attitudes and Practices

Library and Archives Canada Cataloguing in Publication

Crellin, J. K., author, compiler

Health care : A Postcard History of Twentieth-Century Attitudes and Practices / John K. Crellin.

Includes bibliographical references.

Electronic monograph.

ISBN 978-1-77117-313-1 (epub).-- ISBN 978-1-77117-314-8 (kindle).--

ISBN 978-1-77117-315-5 (pdf)

1. Postcards--History--20th century--Themes, motives. 2. Postcards-- Collectors and collecting. 3. Medical care--Public opinion--History--20th century--Humor. 4. Medical care--Public opinion--History--20th century-- Pictorial works. 5. Medical care--History--20th century--Humor. 6. Medical care--History--20th century--Pictorial works. I. Title.

NC1878.M43C74 2014      741.      '830904

C2014-903508-X

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Foreword

This highly readable and thoughtful volume, composed of six chapters, takes readers on a twentieth-century journey of public views of health care. Carefully selected postcard images, along with their senders’ messages, offer satire, humour and documentation of changing health care.

A postcard collection offers more than trivial views of how health care – as a complex institution within a larger society – was seen at various times. Uncertainty about medical knowledge (customary vs. scientific), care and treatment, and the health institutions seems inescapable along the course. It is writ large in the diversity of health care options met today: conventional medicine, alternative and complementary medicine, and self-care as driven by custom and popular culture.

The cards presented here also invite reflection about their creators–artists and publishers. All were (and are today) embedded in sub-cultures of their societies. They helped shape popular culture influenced by commercial (community and industrial) interests. The author’s discussion of themes uncovered in the postcards is linked with related literature and societal trends to help readers appreciate the concerns and values of the cards’ creators, distributors, purchasers, and recipients. Whether sent or not, the cards’ images, often satirical, somehow resonated with their sender and/or those who received them.

Even if a postcard’s meaning and their sender’s purposes are not always entirely clear, the entire collection of cards gathered in this book is a striking way to provoke reflection (and amusement) about changing health care and the values that are expected by the public.

Raoul Andersen, Ph.D (Social Anthropology)

PUBLISHER'S NOTE: Due to the photo heavy nature of this publication, text will often be pushed forward to accommodate images, these formatting issues can be attributed to the digital presentation. Also, please refer to the search terms towards the end of the book, to further explore subjects covered within.

INTRODUCTION

Get well soon

Ever since their early twentieth-century Golden Age, postcards on both sides of the Atlantic have recorded popular culture. Through humor, views of urban and rural places, photographs of individuals, fantasy, advertising and succinct messages they have documented art and entertainment, social events, commercial practices, reform movements, political propaganda, and countless byways of society.¹ For famed American photographer, Walker Evans, the strident colours, eye-catching images, and visual appeal of cards revealed much about the century through their commonplace subjects, the generally humble quality of the pictures, and unsophisticated humor.² They are the centre of this account as it looks at key facets of daily life, the diverse efforts of individuals to maintain health and treat minor illnesses, their relations with physicians, and popular stereotypes of health care practitioners working inside and outside hospitals.

Readers who wonder whether the scope of cards is too limited to tell any story of health care will find that postcard publishers, in looking for commercial success, focused on topics they felt would resonate with the public. This certainly applied to countless humorous cards, some naughty, fruity or saucy, that circulated far more widely than medical jokes in such magazines as Punch or The New Yorker.³ Cards, then, reflect popular fascination with physicians, nurses, medical institutions, the body, illness, and the maintenance of health, albeit with the limitation of little attention to scientific and medical discoveries.

All readers, either for personal or professional reasons, will be entertained by the revelations on cards. General readers can reflect on their own attitudes toward illness and health care; physicians and other health care workers can contemplate why they mostly appear in questionable rather than positive images; historians can consider how cards add to the written record, for instance, the various ways health information infiltrates popular culture; and students of postcards can see the marketing appeal of medical cards. Perhaps a number of readers may wonder whether the cards chosen for comment and illustration are so ephemeral, even off-the-wall, as to be undeserving of attention. However, they can be reassured that those chosen are representative of innumerable others in similar vein.

The perspectives offered by postcards are broadened by senders’ messages, invariably, brief, pithy and sometimes indicating heartfelt sentiments.⁴ Aside from friendly enquiries about, or good wishes for, a recipient’s health (perhaps the commonplace Get well soon or Hope you are well), sufferers from colds might receive a humorous card about the ailment, maybe intended to raise their spirits. One card (1913), captioned Doctors orders − something hot to be taken at bed-time, depicts a man leaving a doctor’s office just as an attractive woman walks by; it prompted the sender to add: Hope cold is better. The Drs advice is not a bad one. On the other hand, hospital patients might hint at their stresses and hopes on a view card of the hospital, for instance, from the Baptist Sanitarium in Texas: After 24 days in Hosp & 2 operations I’m out again much the worse for wear but with the encouragement that they think they caused all my cancer to be disintegrated by this last radium, which they used in a new way.

The book is organized under three broad areas: (i) ways to maintain or restore health; (ii) changing options for self-treatment of minor illnesses; and (iii) coming under the care of a doctor, clinic or hospital. A final chapter adds further illustrations to a key theme, noted in earlier chapters, namely the medicalization of twentieth-century life. This is generally viewed as the growing dependence of citizens on professional health care providers and medical technology, sometimes for social as much as medical problems. The boxed vignettes in appendices to the chapters offer details on topics well-represented on cards, but which would over burden the main text.

Notes on cards and illustrations

The illustrations and interpretations about events, trends, and changes are drawn largely from mass-produced cards.⁵ However, cards published in limited numbers – for example, many printed photographically from a negative rather than from a block or plate on which the image is engraved – can be informative beyond the artfulness of the photograph. For instance, those used by a pharmacy for local publicity can add insights into the commercialism surrounding medicines.⁶ Finally, it should be added that the account is limited, with a few exceptions, to cards from both sides of the Atlantic – the U.S. (occasionally Canada) and Britain – where common attitudes and practices existed. Moreover, some publishers issued the same humorous card in the three countries though pirated versions also existed.

All cards illustrated or otherwise noted are from a private collection.

Ribald or saucy postcards The humorous saucy postcard, most closely associated with British seaside resorts, has aroused diverse reactions. Censorship existed in a few jurisdictions until the 1960s with some people wanting it to be more stringent. Since then sensitivities have changed. Nowadays, sexist jokes and stereotyping on cards are commonly viewed as tame compared with many current facets of popular culture. Nevertheless, some readers may view certain cards in this account as flouting political correctness. However, any such cards are to be understood in the context of the times when published, and that publishers, always seeking a profit, felt the humour would resonate with large sections of the public.

Dates All dates given are a guide to when the cards circulated. A specific date is either that published on the card, or when the card was mailed. A date range (e.g., 1930s, 1940s-’50s) is based on (a) comparison with dated examples, (b) information about the publisher,⁷ and (c) background to the topic of the card.

Unmailed cards Vast numbers from the early decades of the century – when untold thousands were mailed daily – also survive from the craze, as it was viewed, of collecting cards for albums. Over time, purchasers also bought cards as souvenirs of places and events, while purchasers of risqué cards perhaps thought twice (although many did not) about sending them through the mail.

Publishers and places of publication The country of publication is given with each card. Some major companies, however, such as Britain’s Bamforth and Raphael Tuck published the same cards on both sides of the Atlantic, at least up to World War II, hence U.S./U.K. (or vice versa).

Artists’ names Many humorous cards are signed, but only a few of the artists are noted such as Britain’s Donald McGill for his pervasive influence.⁸

Notes and references

Although the book is written primarily for general readers and health professionals, rather than academic historians, detailed references are provided both to document and amplify statements and interpretations. Many also serve for further reading.

ACKNOWLEDGEMENTS

W. H. Helfand, who has been generous in sharing his knowledge and friendship in joint postcard projects in the past, offered constructive comments on the initial manuscript outline. Paul Crellin diligently critiqued early drafts that contributed much to its revision. My colleague, Roaul Andersen has always been ready with judicious comments, while JDC has supported, as she has done over a lifetime, with her eagle eye in countless ways. Lastly, Flanker Press has been ready with their skills and support for which they have become well known.

Introduction: Notes and references

1   Many books, listed throughout the notes to each chapter, indicate the extraordinary number and variety of cards as well as their value as resources for social history and the part played by popular culture. Both general and academic readers are catered for as glimpsed in N.D. Stevens (ed.), Postcards in the Library: Invaluable Visual Resources, New York: Haworth Press, 1995.

2   Walker Evans was just one collector of postcards who extolled them as mirrors of American society, see, J.L. Rosenheim, Walker Evans and the Postcard, New York: Steidl/Metropolitan Museum of Art, 2009, p. 15 and other pages.

A number of histories of health care have approached, as do postcards, the social and cultural arenas where health is maintained and ill-health managed and endured. For example, L.M. Beier, For their own Good. The Transformation of English Working-Class Health Culture 1880-1970, Columbus: Ohio State University Press, 2008.

3   Topics satirized in Punch cartoons (c. 1900 to 1925), common to cards, centre around social differences between doctor and patients, fees, specialists, general practitioners, and miscommunication between practitioner and patient. For some discussion of medical illustrations in Punch (a few were reproduced on cards, e.g., from the British publisher, Wrench), see R. Porter, Bodies Politic. Disease, Death and Doctors in Britain, 1650-1900, Ithaca: Cornell University Press, 2001, pp. 262-271.

It is appropriate to add that postcard humour supplements and often draws on prints and drawings that have attracted much interest over time, see for instance, E. Holländer, Die Karikatur und Satire in der Medizin, Stuttgart: Enka, 1921; H. Vogt, Das Bild des Kranken, Munchen: Lehmanns, 1969; H. Steinbart, Artz und Patient. In der Geschichte in der Anekdote im Volksmund, , Stuttgart: Enke, 1970; W.H. Helfand, Medicine and Pharmacy in Political Prints (1765-1870), Madison: American Institute of the History of Pharmacy, 1978. For a seminal work on popular culture illustrations as an index of change: M.D. George, Hogarth to Cruikshank: Social Change in Graphic Satire, London: Allen Lane, 1967. Relevant review articles include W.H. Helfand, A Less than Loving Look at Doctors, in 1991 Medical and Health Annual, Chicago: Encyclopaedia Britannica Inc., 1990, pp. 22-39.

Many postcard images may be compared with those from literature and movies; for introductions: S. Posen, The Doctor in Literature, Oxford: Radcliffe Publishing, Vols. 1 & 2, 2005 and 2006. For films, P.E. Dans, Doctors in the Movies: Boil the water and just say aah, Bloomington: Medi-Ed Press, 2000.

Useful parallel reading to this book are attitudes toward health expressed through the media such as B. Hansen, Picturing Medical Progress from Pasteur to Polio, New Brunswick: Rutgers University Press, 2009 that emphasises medical discoveries and advances with public education in mind, . For a public health orientation: D. Serlin (ed.), Imagining Illness: Public Health and Visual Culture, Minneapolis: University of Minnesota Press, 2010.

4   The historical value of senders’ messages has been stressed by various writers. One useful resource, albeit without synthesis is T. Phillips, The Postcard Century. 2000 Cards and their Messages, London: Thames & Hudson, 2000. See also for linking the picture with a message, R. Carline, Pictures in the Post. The Story of the Picture Postcard and its Place in the History of Popular Art, London: Gordon Fraser, 1971, pp. 57-61.

5   While it is impossible to demonstrate, without precise information on sales, that the cards selected for this volume are truly representative of popular themes on the vast numbers published, readers can be reassured that they represent many years of collecting that allows generalizations. Assessment can also be made from the growing body of postcard collections in libraries and museums (cf. note 1), postcard books, and the ability to view large numbers of cards on the World Wide Web.

6   Cards printed from negatives are commonly known as real photo cards, see, for instance, R. Bogdan and T. Weseloh, Real Photo Postcard Guide, The People’s Photography, Syracuse: Syracuse University Press, 2006: also, In R.B. Vaule, As We Were. American Photographic Postcards 1905-1930, Boston: D. R. Godine, 2004. References to photograph cards in the following pages cover both real photo and commercially printed photographs.

7   Information on publishers is scattered in the postcard literature. A useful starting point is still T. & V. Holt, Picture Postcards of the Golden Age. A Collector’s Guide, London: MacGibbon & Kee, 1971, pp. 170-186.

8   Although Donald McGill is often chided for stereotyping physician pomposity and questionable behaviour, he was generally much less biting in his satire than many of his contemporary and later postcard artists. Notable among early artists publishing negative images was Xavier Sager whose French cards were collected in Britain and the U.S. It was, nevertheless, a coterie of later artists, often using pseudonyms, which reflected the more open attitudes to sex in society from the 1960s onward as well as a sharpening of public questioning of doctors’ values.

I

MAINTAINING HEALTH

But he’s taking Anti-Fat Now

Today’s preoccupation with healthy lifestyles is not new. It is merely another chapter in a long history of advice that commonly focused on air, diet, sleep, emotions and indolent habits. Given the frequency of such advice during the 1900s from health reformers, governments and public institutions, it is no surprise that the postcards that guide this chapter, when published, reflected and offered direct and indirect reminders of healthy living.

Nowadays, the cards encourage us to ask overlapping questions; for instance, How far did expert health advice/education permeate the everyday life of individuals? How much advice reached the working classes and, given their socio-economic conditions, was it practical? Who attended Russell James’ 3 Free Lectures in San Diego (advertised on cards during 1944), and how many actually pursued James’ plan for physical conditioning and more abundant living, and investigated how pep and vitality helped one to live longer, look younger, and get more out of life?

Such questions are not easy to answer with any precision, especially for the early years of the century when the pervasiveness of ill-health meant that many young men found themselves rejected for military service.¹ At the time, health maintenance was commonly viewed as building resistance to the infectious diseases then taking a heavy toll. Exercise and nutrition, as considered in this chapter, were two ways to accomplish this, as well as to develop a sound mind.² At the same time, since buying health has always been easier than following health regimens, such medicines as tonics and blood purifiers were widely used for the same purpose (see chapter 3).

I. PROLOGUE: PUBLIC WORRIES AND RESPONSES

Social conditions

Aside from tuberculosis, cards of the early 1900s avoided acute conditions, for example, diphtheria, smallpox, and typhoid. Nevertheless, reminders existed that minor ailments could be signs of a downward path. Additional to major factors undermining resistance like bad housing, sanitation, water and air, concerns existed over, for example, the adverse effects of civilisation; these ranged from industrialization to the quickening pace of society that could lead to run-down conditions linked to overtaxed nervous systems.³

In Britain, view cards sidestepped the worst of slum conditions, although glimpses of multi-storey tenements and other signs of poverty illustrated the many concerned voices over poor living conditions.⁴ Across the Atlantic, an occasional card fitted with Hollis Godfrey’s 1910 condemnation of the civic conditions in many cities as a working evil, and that the close connection between the slum and disease is too patent for question.⁵

Concerns at the time also included adulterated or contaminated milk and food. Views of, for example, the Chicago stockyards (Fig. 1.1) were likely reminders of worries created by Upton Sinclair’s celebrated 1906 book, The Jungle, an exposé of the unhygienic meat industry. Significantly, for some years after the book’s publication, meat consumption fell despite reforms.⁶ Incidentally, some early fantasy cards depicting cats, rats and personal effects caught by fly papers likely reminded many of their fears of house flies spreading disease from contaminated meat and food.

Worries over influenza and tuberculosis

During the early years of the century, cards, in covering the two conditions influenza and tuberculosis, captured public fears, hopes, preventive measures and treatments. Senders’ even hint at stoicism or fatalistic attitudes, an acceptance of outcomes as preordained. On 4 April 1919, a rather matter-of-fact message on a view card of the Lutheran Sanatorium and Hot Springs, South Dakota, hardly expressed the fears that must have existed in the community:

We are having trouble with the ‘flu’ again in this vicinity and a good many die with it. You remember that young man at Marche’s bakery? He died with it last week. I think you will remember him. He wore glasses and was a quite handsome young man. The baker also died there.

And, the sender of a humorous British card (1919) on food rationing at the end of World War I, asked, "How do you like the cold weather last week. We were