DC -- Natl Museum of Health and Medicine (Walter Reed):
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Copyrights: All pictures were taken by amateur photographer Bruce Guthrie (me!) who retains copyright on them. Free for non-commercial use with attribution. See the [Creative Commons] definition of what this means. "Photos (c) Bruce Guthrie" is fine for attribution. (Commercial use folks including AI scrapers can of course contact me.) Feel free to use in publications and pages with attribution but you don't have permission to sell the photos themselves. A free copy of any printed publication using any photographs is requested. Descriptive text, if any, is from a mixture of sources, quite frequently from signs at the location or from official web sites; copyrights, if any, are retained by their original owners.
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Specific picture descriptions: Photos above with "i" icons next to the bracketed sequence numbers (e.g. "[1] ") are described as follows:
NMHM_050618_004.JPG: Left to right: (1) Model SC Iron Lung, 1954 (respirator)
(2) Fluoroscope, 1948 (diagnostic X-ray)
(3) Electrostatic generator, 1890 (used to power early X-ray tubes)
(4) Dermatex X-ray machine, 1938 (therapeutic X-ray used to treat skin conditions)
(5) [brown machine in front] Shoe fluoroscope, 1930 (X-ray machine used to help customers determine fit of their shoes)
(6) [in back on right] Dental X-ray equipment, 1925
NMHM_050618_020.JPG: Dermatex X-ray machine, 1938 (therapeutic X-ray used to treat skin conditions)
NMHM_050618_025.JPG: Shoe fluoroscope, 1930 (X-ray machine used to help customers determine fit of their shoes)
NMHM_050618_034.JPG: Suspended Self Portrait, Carolyn L. Henne
"Suspended Self Portrait" is an interactive sculpture that consists of 89 vinyl sheets painted with cross-section images taken from the Visible Human data set.
To determine the cross-sections, artist Carolyn Henne made of mold of herself and sliced it. Then she painted a corresponding Visible Human cross-section -- organs, muscles, fat, bone -- on each sheet.
From a distance, the body seems to float in three dimensions. Closer up, the internal organs seem to assemble and disassemble as the visit moves around it. Blowing on the sheets or running fingers along the edges causes the figure to subtly move as if floating or breathing.
The use of information from the Visible Human dataset allowed the artist to literally depict the internal being. Like much of Carolyn Henne's work, "Suspended Self Portrait" involves an attempt to portray facets of the inner self that are often unclaimed by the self that must maintain its profile in the real world.
"Suspended Self Portrait" was part of a larger installation called "There's Here." "There's Here" was a contemplation of the here and now via a depiction of the afterlife. This installation incorporated a number of interactive elements fixtures. "Suspended Self Portrait" was suspended between the underworld and the heavens.
NMHM_050618_057.JPG: Bloodletting.
Cupping set with scarificator and pump used by William Shippen, Jr. first Surgeon General of the United States Army, ca. 1825.
Bloodletting:
Bloodletting has been a controversial element of traditional medical practice for thousands of years. Its popularity has waxed and waned in nearly all cultures. Ancient Greek physicians equated health with a balance of the four humors of the body -- black bile, yellow bile, phlegm, and blood. Accordingly, they prescribed bloodletting to alleviate any imbalance of these elements. Although the procedures were delicate and often did not restore health, bloodletting remained an important technique into the twentieth century for treating some circulatory and pulmonary disorders. Today, bloodletting is undergoing a resurgence for limited therapeutic purposes, such as for polythermia vera (excess red blood cells) and after microsurgery.
There are two basic types of bloodletting: general and local. General bloodletting uses a fleam, lancet, or spring lancet to open a vein or artery. Blood flows freely from cuts made by these instruments. Local bloodletting severs only capillaries at a specific site and requires a suction device to promote blood flow. Scarificators for producing multiple shallow cuts, pumps, air-evacuated cups, and real and artificial leeches are used in local techniques.
NMHM_050618_062.JPG: (left) Artificial leech, 1887
(right) Spring lancets, ca 1850-1880
NMHM_050618_072.JPG: Cautery handle with interchangeable irons, ca 1880.
Cautery.
Just as physicians developed methods for bloodletting, they also investigated numerous devices to stop the flood of blood resulting from injury or surgery. Bandages, tourniquets, and cautery are some examples. Tourniquets have been used since several hundred years B.C. to control bloodflow to or from a wound site and continue to be important circulation management tools. They work by compressing a blood vessel when applied around an extremity.
Cautery predates tourniquet use by several thousand years. The technique uses the application of a hot object, a caustic substance, or an electric current to destroy tissue and cause coagulation. Many cultures have adopted cautery for different purposes. Egyptian surgeons used heated knife blades to help control bleeding during surgery and ancient Greek physicians developed a number of different shapes for iron cautery devices. In the eleventh century, Islamic physician Albucasis developed many more iron shapes and wrote several treatises prescribing cautery for over fifty diseases, including migraine headache, hernia, harelip, epilepsy, and elephantiasis. Surgeons of the late Middle Ages used scalding irons to help control bloodflow from gunshot wounds and later surgeons relied on the technique to keep edges sterile and sever vessels without under bleeding.
NMHM_050618_092.JPG: Elephantiasis of the leg: This is the leg of a 27 year-old man from Buffalo, NY, who suffered from elephantiasis for twelve years. His leg was amputated in 1894 after it had become extremely painful, and he recovered from the operation without complications. Doctors were unsure how he contracted the disease because he had no history of visiting countries where the parasites that cause elephantiasis are common.
NMHM_050618_103.JPG: Female (left) and male (right) pelvis. Female ones are broad, allowing passage of the infant through the birth canal. The male pelvis is narrow and allows efficient bipedalism.
NMHM_050618_106.JPG: Apothecary Shop Mannequin.
During the 17th and 18th centuries when traditional Japanese physicians attempted to deduce the workings of the body from outward appearances in accordance with Asian traditional medical beliefs and practices, they used mannequins to explain to patients the effects of medicines. This model depicts anatomy along the lines of a flow chart rather than a literal representation of different organs. "Hollow" (yang) organs were the gall bladder, stomach, large intestine, small intestine, bladder, and "triple burning and heating system" that regulated the flow of energy through the body. More "solid" (yin) organs were the heart (red), lung (white), and kidney (black). The different colors of these organs in the mannequin have meaning and correspond to constituents of the universe and other elements.
Within Japanese culture, the belief existed that the universe, society and the human body were interrelated.
Just as there were five elements: fire, earth, metal, water and wood, so the human body had five viscera: heart, lungs, liver, spleen, and kidneys. And as fire ruled the universe and a monarch ruled the country, it was the heart that ruled the human body.
NMHM_050618_120.JPG: Anatomical Mannequin:
With the establishment of Dutch trading colonies in Japan during the 18th century, differences between European and Japanese concepts of the body became apparent. This spurred an interest in the formal study of anatomy. In 1754, Yamawaki Toyo, Court Physician of the Shogun, performed the first recorded human dissection in Japan. As dissection became more common, knowledge of human anatomy spread throughout Japan. This mannequin depicts a more literal representation of human anatomy; it was made for a physician in Nagasaki, Japan sometime in the early nineteenth century.
NMHM_050618_135.JPG: This is a painting of the Walter Reed Medical Annex out in Seminary Park, Maryland. During World War II, it was used as a hospital for soldiers.
NMHM_050618_139.JPG: The brain and spinal cord were removed from a cadaver, and preserved in formaldehyde. The two large cerebral hemispheres, normally encased in the skull, can be seen. The base of the hindbrain leads continuously into the spinal cord, which can be seen to extend several feet towards the region of the hips.
NMHM_050618_146.JPG: Walter Reed, M.D. (1851-1902)
Walter Reed, M.D. (1851-1902):
Walter Reed is best known for his work in controlling yellow fever. From 1899 to 1901, he led a team of Army doctors in Cuba who proved that yellow fever was transmitted by mosquitoes. Eliminating stagnant breeding pools sharply reduced transmission of the disease. This discovery enabled workers to complete construction on the Panama canal and led to the eradication of yellow fever in the southern United States.
Born in rural Virginia, Reed studied at Bellevue Medical Hospital in New York City before joining the Army Medical Corps in 1875. After numerous posts on the western frontier, Colonel Reed joined the Army Medical Museum (predecessor to the National Museum of Health and Medicine) as curator in 1893. Following his work on yellow fever, Reed returned to his duties at the Museum and was about to assume its directorship when he died suddenly from a ruptured appendix.
Reed's close friend, Dr. W.C. Borden, who attended him in his final illness, was the driving force behind creating Walter Reed Hospital. In 1909, Borden succeeding in having the hospital named after his friend.
NMHM_050618_168.JPG: Conjoined twins. The process of twinning occurs in the two weeks following conception. Normally, the dividing cells will split into two separate embryos. Conjoining arises when this separation is incomplete. The sutures seen in this specimen are the result of autopsy.
NMHM_050618_180.JPG: Cyclopia. This defect causes a several malformation of the face and brain, and results in a single eye and other internal abnormalities.
NMHM_050618_188.JPG: Achondroplastic dwarfism. This condition is caused by errors in the DNA that are passed from parents to offspring and occurs in one in 40,000 births. The condition results in shortening of the limbs, short stature, and a large skull.
NMHM_050618_201.JPG: Plaster casts of Carleton Burgan before (left) and after (right) his operations.
NMHM_050618_207.JPG: Penelope:
The Penelope Surgical Instrument Server is the world's first autonomous, intelligent, computer-vision guided surgical assistant robot. In 2001, Michael Treat, MD, recognized the need for a robot to assist the surgeon by delivering and retrieving instruments and free up valuable nurses and technicians for more patient-oriented tasks. Treat, a general surgeon with over 20 years experience in the operating room, led a team of talented designers and engineers at Robotic Surgical Tech, Inc,., to conceive and build Penelope 0.0 as a cardboard mock-up to determine the shape and size this completely new machine should have.
In April 2002, the first functional Penelope 1.0 was demonstrated at the "Engineering the Future of Surgery" symposium sponsored by the Telemedicine and Advanced Research Center (TATRC) of the United States Army. Penelope 2.0 later demonstrated physical improvements, yet the software was still slow and required a large computer to run well. Additional work consisted of overhauling software (including motion control, vision, and main control systems), the integration of the camera system information into the main body of the robot code, and redesigning the shoulder, upper arm, and elbow to eliminate structural inaccuracies. New software allowed the robot system to run much faster and on a small laptop computer. The resulting robot, Penelope 2.5, was exhibited at TATRC's display at the American Telemedicine Association meeting in April 2003, where Penelope earned broad validation and the endorsement of many attendees, including members of the military, who realized the utility of this important tool as a platform for investigating a range of new technologies. ...
The system's basic function is to hand surgical instruments to the surgeon when a verbal request for the instrument is made by the surgeon, and then to automatically return that instrument to the instrument tray when the surgeon is finished with it. Penelope is indicated for use in open surgeries such as inguinal hernia repair, breast biopsy, excision of lipoma and others. Penelope uses voice recognition to respond to a surgeon's request for a surgical instrument. The system uses a robotic arm equipped with an electromagnetic gripper to pick up the requested instrument from the instrument tray, and to move it to a point where the surgeon can retrieve it. When the surgeon is finished with the instrument and puts it down on a designated area of the operating field (known as the transfer zone), the system uses machine-vision to recognize the position of that instrument so that the robotic arm can be directed to retrieve the instrument back to the instrument tray. Machine-vision refers to the use of special software and two digital cameras that looks at the surgical field. The software-camera combination (the machine-vision system) enables Penelope to retrieve the instrument that has been put down by the surgeon regardless of where on the "transfer zone" the surgeon places the instrument.
NMHM_050618_226.JPG: Battlefield Surgery 101: From the Civil War to Vietnam:
"But one great Cannon at one shot may spoyle and kill an hundred men... [T]his infernall Engine roares, sending at one and the same time the deadly bullet into the breast and the horrible noise into the eare. Wherefore we all of us rightfully curse the author of so pernicious an Engine; on the contrary praise those to the skies, who endeavour by words and pious exhortations to dehort Kings from their use, or else labour by writing and operation to apply medicines to wounds made by these Engines."
-- Ambrose Pare, 16th century French Military Surgeon
Medicines and how they were applied to gunshot wounds have changed considerably from Ambroise Pare's day to the present. But a bullet to the chest has remained a serious, if not fatal, wound. Surgery on the battlefield has always been practiced under the harshest of conditions. Frequently the operations were successful with lives being saved, but all too often the best efforts of the surgical team were in vain as they witnessed their soldier-patients die due to the severity of their injuries.
This exhibit of over 100 photographs spanning about 100 years from the Civil War to Vietnam deals with surgery on or neat the battlefield. Objects dating from the early 1900s to the present accompany these images.
Battlefield Surgery 101 reveals the evolution of the military operating room and the challenges of the men and women who work there. Drawn from the holdings of the National Museum of Health and Medicine, Armed Forces Institute of Pathology, this exhibit examines the breadth and depth of military surgical activities.
Many of these images are being displayed to the public for the first time. Due to the graphic nature of some of them, visitors may be shocked. In selecting the photographs, the exhibit's curators tried not to be sensationalistic. Rather, they wished to present realistic perspectives of the danger and challenges facing both fighting soldiers and the men and women whose duty it is to care for them when they are in harm's way.
NMHM_050618_234.JPG: Golden Hour? -- Golden Five Minutes!
With civilian trauma, there is a saying that death can be prevented if treatment and care begin within 60 minutes of the victim's injury -- the so-called "golden hour." Military data suggests that in combat conditions, 80% to 90% of deaths occur within the first hour after wounding. Worse, 70% of fatalities happen within the first five minutes. One veteran military surgeons concluded that if there is a "golden period" in combat casualty care, it is a "golden five minutes." This difference has been attributed to the nature and severity of combat injuries.
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2005 photos: Equipment this year: I used four cameras -- two Fujifilm S7000 cameras (which were plagued by dust inside the lens), a new Fujifilm S5200 (nice but not great and I hated the proprietary xD memory chips), and a Canon PowerShot S1 IS (returned because it felt flimsy to me). I gave my Epson camera to my catsitter. Both of the S7000s were in for repairs over Christmas.
Trips this year: Florida (for Lotusphere), a driving trip down south (seeing sites in North Carolina, South Carolina, Florida, and Georgia), Williamsburg, and Chicago.
Number of photos taken this year: 147,000.
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