Category: Rare Books

Notes on Nursing

notes on nursing title page
Notes on Nursing: What It Is, and What It Is Not
by Florence Nightingale
(12 May 1820 – 13 August 1910)
• New York: D. Appleton and Company
•1860
•Nightingale is the founder of modern nursing.
•Nightingale thought nurses should learn through both experience and training. She founded the Nightingale School and Home for Nurses at Saint Thomas’s Hospital in London (today known as the Florence Nightingale School of Nursing and Midwifery at King’s College London) in 1860.
•The opening of this school marked the beginning of professional nursing education.
•She transformed nursing into a respectable profession and set the standards for clean, safe hospitals worldwide (her book Notes on Hospitals deals with aspect).
•Notes on Nursing spells out the principles of nursing and served as the cornerstone of the curriculum at the Nightingale School.
•Nightingale was also a statistician and is credited with inventing the pie chart, to dramatize the needless deaths caused by unsanitary conditions during the Crimean war.

Opticks

Featured work from our Rare Book Collection:

Sir Issac Newton
Opticks: or A Treatise of the Reflexions, Refractions, Inflexions and Colours of Light
London: S. Smith and B. Walford
1704

This book details Newton’s work in the field of opticks, the study of the behavior and properties of light including its interactions with matter and its detection by instruments. It is considered by some to be the one of the most influential works of science in history.

Atlas of Surgical Operations

Started by Elliott Carr Cutler and central Ohio surgeon Robert M. Zollinger, the Atlas of Surgical Operations is a standard textbook used around the world to demonstrate anatomy and surgical techniques.

The Medical Heritage Center (MHC) has a 5th edition of the Atlas of Surgical Operations that contains Dr. Zollinger Sr.’s handwritten notes for how he was going to revise the material for the 6th edition. The book plates are the originals.

Currently, in its 9th edition, the MHC has twenty-seven atlases in various editions in seven languages.

Robert M. Zollinger, MD

Robert Zollinger

Robert Milton Zollinger, M.D., 1903 – 1992

Robert Milton Zollinger, M.D. was one of the giants of American Surgery. With a career that spanned much of the 20th century, Dr. Zollinger was respected by his peers, feared by his students and loved by his patients. Zollinger had a knack for being successful at whatever he did. He was the president of almost every society he belonged to, including the American Board of Surgery, the American Surgical Association, the American College of Surgeons and even the American Rose Society.

Born September 4, 1903, Zollinger was raised on his family’s farm in Millersport, Ohio.  He attended grade school in a one room schoolhouse a mile from his home. For high school, he had to travel three miles into town, so he rode his pony, Bob, and stabled him at the barbers during classes. Zollinger was industrious, even at an early age. Utilizing his pony and a cart, he developed a thriving business delivering milk and vegetables from the farm to his neighbors.  This was considered his job and he had to tally his receipts each night after supper with his parents. Besides running his business, he also found time to letter in basketball while in high school. Zollinger learned all of the plays during lunch, since his delivery route and farm chores kept him from staying after school to practice.

As a young man, Zollinger wanted to attend West Point. That dream faded when he decided to become a surgeon, even though he hated the sight of blood. When he told his parents his plans, his father gave him one piece of advice, “If you’re going to be a doctor, be a good one.” His parents always expressed an absolute confidence that he and his brother Richard would be successful at anything they attempted and they instilled this belief in their sons. This was a trait that Zollinger carried into his adult life, always expecting the best from everyone and keenly disappointed when he did not get it.

Showing early on that he was not afraid to do things differently, Zollinger was the first person from his high school to attend college. He graduated from the Ohio State University in 1925 with his B.A. and earned his M.D. two years later. After graduation, he was offered an internship at the Peter Bent Brigham Hospital (PBBH) in Boston, under the tutelage of another surgical master, Harvey Cushing. Cushing sent Zollinger to Western Reserve in Cleveland for six months before he began his internship to work with one of Cushing’s favorite pupils, Elliott C. Cutler. Their association would span the next twenty years and Cutler would become one of the great influences in Zollinger’s life. At Western Reserve, Zollinger worked in the dog labs as a voluntary assistant. His main job was to classifying Cutler’s collection of brain tumors. This work led to his first publication, an article in the April 1929 issue of The Ohio State Medical Journal.

Zollinger returned to PBBH in 1928 to begin his internship. There he was regarded as a country boy from that “cow town” Columbus. He was determined to know the answer to every question in order to prove that his education was every bit as good as his Ivy League peers. This endeavor proved time consuming, but provided Zollinger with a strong core knowledge of his subject matter. When his internship was over Zollinger renewed his association with Cutler by returning to Western Reserve in 1929 for his residency. That same year he finally married Louise Kiewet; while he had been at PBBH interns were forbidden to marry. Louise supported the couple in their early days of marriage by teaching, since Zollinger was only making $50.00 dollars a week as a resident.

Dr. Cutler returned to PBBH to take over for Cushing as the Moseley Professor of Surgery in 1932. Zollinger went with him as his chief resident and by 1939 he was an Assistant Professor of Surgery. During their time together at Harvard and PBBH, Zollinger and Cutler would publish the first of nine editions of the now famous Atlas of Surgical Operations (the Medical Heritgage Center has 27 volumes in 7 languages of various editions of the Atlas). Zollinger did much of the work on the text; yet, Cutler’s name appeared first on the cover. When Zollinger asked him whose name should be first Cutler had responded that they should be listed alphabetically.

Zollinger joined the army in 1941, when war seemed imminent for the United States. In so doing, he gave up a thriving practice and four years with his family. He felt that if he joined the Harvard Unit so would many of his younger colleagues. Zollinger hoped to be commissioned as a colonel and the commanding officer of the unit. Instead, he was made a major and the Assistant Chief of the Surgical Service. Immediately upon reaching camp in Ireland he called upon his early farm experience and began planting a garden. He had gathered money from everyone in the unit and purchased seeds before they had left the U.S. Because of this foresight he was soon appointed the Post Beautification Officer, a job which allowed him to nurture another of his passions, roses. Over the next four years, Zollinger would rise to the rank of colonel and the command of the 5th General Hospital. He would also earn the Legion of Merit Award, for the development of mobile surgical teams, and Battle Stars for Normandy, Northern France and Rhineland.

Zollinger returned to Harvard in 1946 and was soon offered a position as a professor of surgery at The Ohio State University. Within a year he became the chairman of the Department of Surgery at his alma mater, beginning a nearly thirty year reign. In 1955, working with Edwin Ellison, he discovered the Zollinger-Ellison Syndrome, which dealt with the relationship between non-beta islet cell tumors of the pancreas and diseases of the gastrointestinal tract. He also started the medical illustration division as a part of the Department of Surgery. This was surely influenced by the need for new illustrations for each subsequent edition of the Atlas of Surgical Operations.

Despite his busy schedule Zollinger was the editor-in-chief of the American Journal of Surgery from 1958 to 1986. He traveled the country lecturing on Zollinger-Ellison Syndrome and received numerous awards for his efforts. He was the recipient of honorary degrees from the University of Lyon, France (1965) and held honorary fellowships in the Royal College of Surgeons of England (1965) and the Royal College of Surgeons of Edinburgh (1966). The American Medical Association bestowed their highest honor, the Sheen Award, upon him, recognizing him as the Outstanding Doctor of Medical Science in the United States for 1977. Zollinger was even offered the presidency of The Ohio State University, but turned it down. He felt that he would not have any time left for surgery. Besides, he reasoned, “There are a lot more out of work college presidents than surgeons.”

Zollinger was a difficult taskmaster who expected nothing less than perfection from himself and his colleagues. On rounds he was known to fire a resident on the elevator for some misdemeanor, only to rehire them by the time they had reached the 7th floor. As hard as he was on his students, he was equally kind to his patients. He believed that they should always be the top priority of a surgeon. When he felt that his staff was moving away from that principle, he often felt the need to remind them. He once had a large chart made showing the golf handicaps of each surgery department member, clearly showing where he felt that their priorities lie.

Outside of surgery, Zollinger was a man of many interests. He raised prize-winning gourds. He loved roses and was an accredited rose judge. He constantly grumbled that his frequent lecturing and travel kept his roses from winning first prize. He also developed a passion for photography, which he indulged every winter on Sanibel Island.

Despite his numerous honors and international recognition, Dr. Zollinger never rested on his laurels. Even after his retirement in 1974, Zollinger continued to lecture around the world. He remained involved in the Department of Surgery as Professor and Chairman Emeritus. His quest for excellence continued up until his death in 1992 from pancreatic cancer. Perhaps he is best described in his own words. Once, when asked how he would like to be remembered he replied, “They should write on my tombstone: ‘teacher, surgeon, soldier and farmer.’ And my wife may remember that she says I’m an amusing fellow to live with.”

De Humani Corporis Fabrica Libri Septem

Vesalius Portrait

Author: Andreas Vesalius
Title: De Humani Corporis Fabrica Libri Septem (On the Fabri of the Human Body in Seven Books)
Publication Information: Basileae: Per I. Oporinum, 1555

Published when he was only 29 years old, Vesalius revolutionized not only the science of anatomy but how it was taught through this work. Vesalius provided a fuller and more detailed description of human anatomy than any of his predecessors in this book. He corrected errors in the traditional anatomical teachings of Galen which had been obtained from primate rather than human dissection. Vesalius’s most lasting contribution to the teaching of anatomy was the principle that only through human dissection could the physician learn human anatomy in sufficient detail to be able to teach it accurately.

The title page and the series of more than 200 anatomical woodcuts spread throughout the book, which is written in Latin, remain the most famous series of anatomical illustrations ever published. Vesalius never named the artist, but Jan Stephen van Calcar is the only named artist definitely known to have worked with Vesalius, so the illustrations are often attributed to him.

The 1555 version in the Medical Heritage Center collection is a copy of the second printing of the book. The first version was done in 1543. Each book is covered in a different material including silk and human skin. The MHC volume is covered in pigskin.

For more information about Vesalius and his famous work, please visit the links below.

http://vesalius.northwestern.edu/

http://www.nlm.nih.gov/exhibition/historicalanatomies/vesalius_home.html

Florence Nightingale

Florence Nightingale (12 May 1820 – 13 August 1910)
Nightingale is the founder of modern nursing. She transformed nursing into a respectable profession and set the standards for clean, safe hospitals worldwide. Nightingale was also a writer and statistician. She is credited with inventing the pie chart, to dramatize the needless deaths caused by unsanitary conditions during the Crimean war.

Nightingale’s Calling
When Nightingale was 24 years old, she had a calling from God. She decided her calling was to help the sick and the poor by becoming a nurse. Nightingale came from a wealthy family and was not expected to work. It was especially unacceptable for her to work as a nurse because nursing was not a respectable profession at the time.

Nightingale went to the Institute of Deaconesses in Kaiserswerth, Germany, to learn about nursing. At this time, nurses learned through experience, not through training. She treated sick people, distributed medicine, and assisted during operations.

Crimean War
In 1854, England entered the Crimean War. Nightingale and a team of 38 nurses went to Crimea to help the wounded soldiers. The military hospitals were dirty and run down. Nightingale made sanitary improvements which helped bring the death rate down from 40% to 2%.

Nightingale was kind and gentle with the soldiers. She would talk with them and comfort them as she made her rounds. When Nightingale made her rounds at night, she carried a lamp with her to light her way and became known as “The Lady with the Lamp.”

Hospital Improvements
During Nightingale’s time, the hospitals were overcrowded, poorly run, and disease infested. They were doing more harm than good. She thought hospitals should help patients, not hurt them. This was a revolutionary idea at the time. Nightingale became an advocate for the improvement of care and conditions in the military and civilian hospitals in Britain.

One of her books, Notes on Hospitals, deals with the correlation of sanitary techniques to medical facilities. She believed hospitals needed better ventilation, more windows, improved drainage, and less cramped conditions. With Nightingale’s guidance, hospitals became clean and sanitary places where lives were saved, not lost. Nightingale also became an expert on designing hospitals. Foreign rulers sought her advice when building their hospitals. Soon, hospitals throughout the world were being built according to her ideas.

Nightingale Training School for Nurses
Nightingale thought nurses should learn through both experience and training. With a fund raised in tribute to her services during the war, she founded the Nightingale School and Home for Nurses at Saint Thomas’s Hospital in London (today known as the Florence Nightingale School of Nursing and Midwifery at King’s College London) in 1860. The opening of this school marked the beginning of professional nursing education. Prior to her reforms, nurses were largely untrained personnel whose job was considered a menial chore. Through Nightingale’s efforts, the stature of nursing improved dramatically with the establishment of high standards of education and important responsibilities. The mission of the school was to train nurses to work in hospitals, to work with the poor, and to teach. The nurses were called Nightingale Nurses.

Nursing becomes a Respectable Profession
Nightingale created high standards for the nursing profession. These standards helped transform nursing into the respectable profession it is today. Her book, Notes on Nursing, spells out the principles of nursing and served as the cornerstone of the curriculum at the Nightingale School. Nightingale’s writings continue to provide excellent resources for nurses and health care providers today.

The Medical Heritage Center holds several editions of Notes on Nursing.

More information about Florence Nightingale can be found online at the Florence Nightingale Museum website: http://www.florence-nightingale.co.uk/cms/