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THE DOCTOR'S BAG |
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Dona Barnett December 9, 2003 The Doctor's Bag
The handle worn to a smooth shine and the leather sides creased from frequent opening, the medical bag belonging to the University of North Carolina Special Collections in Ramsey Library holds more than tools of the trade. It provides us with a tangible link to a time when the relationship between physicians and their patients was personal, although perhaps less efficient.1 The full contents of the bag are listed in Appendix A. Some of the contents are self-explanatory like the forceps. Intriguing as they are, occasionally hospitals even today have them in use. But the cyanide tablets? Why would a country doctor carry those alongside tongue depressors? The contents of this traditional leather bag indicates that the original owner delivered babies at home and also was prepared for other general emergencies. Digging further reveals a little about the man and the woman with whom he shared his practice. The inside top pockets contain some prescription envelopes all marked with the following: "Dr. Joseph E. Osborne, M.D., D.D.S. Rosman, NC UNion 2-7121". The Union 2 exchange was changed to 862 sometime after 1958 when Bell Telephone began the campaign to drop all letters from telephone numbers.2 So we know that this office in Rosman, NC was established well before1958. His prescription tablet is printed with the even older telephone number of 3406. The four-digit telephone number dates back to the 1930's when there was not enough people with telephones in Rosman to warrant the use of an exchange.3 There were, however, enough to warrant Dr. Osborne's medical practice. He was not only a medical doctor but also a dentist as his title suggests. He must have been a versatile man. According to his obituary he came to Rosman in 1931 after a ten-year stint as a dentist in his home town of Shelby, North Carolina.4 He came as possibly the only doctor/ dentist in town. Such a person would need these skills to be able to meet the local medical needs. In other parts of the United States at this time there was a trend in medical practices that leaned toward specialty areas5 but as a country doctor, Dr. Osborne would be "thrown on (his) own resources" and " to learn to make use of that which is at hand, and not to rely on machine made thought and appliances."6 He served Rosman for four years before marrying a woman named Edith Culler, an R.N. and exceptional woman in her own right. They had quite an adventuresome marriage, traveling extensively and even doing some big game shooting.7 These must have been much needed excursions since their duties at home would naturally be exhausting. His medical bag was packed and ready for emergencies but the contents of the bag today indicates that it was mainly used for home child birth. His doctor's bag has some old medicines that bear expiration dates during 1956. One of these is a box of 1cc ampoules (tiny glass vials) containing Posterior Pituitary Injection. This is a drug used to speed up a slow labor.8 There is Thytuitary and Pitocin ampoules, both used in modern obstetrics for toning and stimulating the uterus during labor.9 There is Vitamin K to stop bleeding after delivery and Ergotrate to stimulate Post-Partem contractions.10 The jar of Tincture Green Soap was probably used for a quick wash of the hands and perineum just before delivery. There are five once-white linen towels for extra clean up. Some of the more interesting tools Dr. Osborne used include the heavy forceps for when the baby needed to be turned or helped through the birth canal. Forceps were used in 5% of births at the time.11 There is also a light-weight spring- operated vaginal speculum for pelvic exams, an umbilical cord clamp complete with sterilized tape in a bottle, a scalpel for performing the now infamous episiotomy12, a bulb syringe to clear the baby's air passage, a glass hypodermic syringe, a flashlight with a 1/2 inch glass lens for extra light, a bottle of oil probably used to douse the top of the baby's head just at the point of emergence to lubricate its passage (an old midwife trick)13 and a stethoscope with a ceramic fetoscope attachment used to hear the baby's heartbeat inutero. There are some drugs still in the bag that are not as easy to figure out. These were labeled by an unknown person, presumably the donor of the bag. The labels make the following explanations: Magnesium Sulfate in 20cc ampoules, possibly to reduce brain pressure in high fever victims; Corpus Luteum Extract to stop a miscarriage; Sodium Amytal, to anesthetize the patient; Caffeine sodio-benzoate, to wake the patient up; packets of Sulfanilamide, the only anti-biotic available at the time14; Silver Nitrate 1% used to cauterize wounds; and those cyanide tablets. Country doctors were called upon for many things and it could be that these tablets brought a swift humane end to a suffering animal possibly with exposure to rabies, a common problem in a time without rabies vaccines. Having a practice in the same town for so many years would give a country doctor a unique view of his patients. Dr. James Elliot, a country doctor in Virginia, stated, " Since I was in practice a long time, my work …sometimes came full circle, and I found myself delivering babies for women that I had ushered into the world years before." 15 He may have had to educate the residents in hygiene as many doctors had to do in rural areas in the early part of the century. Dr.B.E.Washburn, a country doctor in Rutherford County in 1913, felt that he made great gains in only 14 months to teach his patients to wash, get fresh air, and was especially pleased to bring marked improvement in obstetrical work. He discouraged the "superstitious practices of midwives" and replaced them with new methods of living. "The women were quick to recognize the benefits of cleanliness and to note the decrease of childbed fever as well as the more rapid convalescence in cases where the …practices of midwives were not employed."16 By the 1960's the medical community began to work with midwives but usually appearing only when the case was beyond the midwife's skills.17 This was probably also the situation with the Osbornes. Dr. and Mrs. Osborne attended many births, some of which are recorded in an Attendant's Birth Memorandum, also in the bag. This little book has "#2" written on the inside front cover. Presumably, this means that there was also a book #1 filled with entries. Book #2 has documentation of home births from Feb. 16, 1958 to October 2,1959, and one last one on October 3, 1967, eight years later. All the entries appear to be in the same handwriting, probably that of Mrs. Osborne. She was known to be acting as nurse alongside Dr. Osborne, the recorded birth attendant of these home deliveries.18 According to the Transylvania County Book of Records, Dr. Osborne died on May 25, 1966.19 Edith C. Osborne is on the record as the birth attendant of the last birth recorded in the Attendant's Birth Memorandum a year and a half after Dr. Osborne's death.20 It would appear that she made one last home delivery. It was for good reason that she was known as "Mama Doc".21 Oddly, she was named Lord Mayor of Rosman on July 18, 1967, the same year as the last recorded birth.22 Not very many mayors also deliver babies! Dr. Osborne practiced medicine and dentistry for 45 years, 31 of which he shared with his wife, Edith Culler Osborne, all their married life. Sadly, no children are listed in his obituary as survivors but only his wife, a brother and two sisters.23 It is ironic that together they assisted so many children into the world but had none of their own. They served the community by being on call day and night, making home visits for delivering babies and medical emergencies. They were also accessible in town to bind a wound, dispense a prescription or pull a tooth. The leather medical bag, still holding their tools of the trade, tells their story. Appendix A: Contents of Doctor's Bag
Written or printed records:
Instruments:
Miscellaneous Supplies:
CHEMICALS
Notes
1. Jeff. Forster, "Packing Up and Packing In, the Doctor's Black Bag" (editorial) Medical Economics (Dec. 28, 1998) v75 i25 p4 (1) 2. Tom Farley, History of Telephone Exchanges <http://www.privateline.com/TelephoneHistory3A/numbers.html> (September 15, 2003) 3. . Tom Farley 4. "North Carolina Deaths and Funerals" (obituary column), Asheville Citizen, May 28, 1966, 24 5. Charlotte Borst, Catching Babies, ( England: Harvard University Press, 1997), 139 6. L.H. Pelton, "Too Early Specialization?" Wisconsin Medical Journal 22 (1923-24): 446, quoted in Charlotte Borst, Catching Babies, (England: Harvard University Press, 1997), 139 7. "Woman of the Week", Asheville Citizen, September 25, 1967, 2 8. Michael J. O'Dowd and Elliot E. Philipp,The History of Obstetrics and Gynaecology, (New York: The Parthenon Publishing Group 1994 ) 26 9. O'Dowd and Philipp, 26 10. O'Dowd, and Philipp, 26 11. O'Dowd and Philipp, 27 12. O'Dowd and. Philipp, 27 13. Stanley E. Sagov, M.D. et al., Home Birth, (Maryland: Aspen, 1984), 188 14. O'Dowd and Philipp, 239 15. James W. Elliot, M.D. Secrets of a Country Doctor, ( Tennessee: Overmountain Press, 1992) , 68 16. Benjamin Earle Washburn, M.D., A Country Doctor in the South Mountains, (North Carolina: Spindale Press, 1955) , 16 17. Borst, 135 18. Transylvania County Registry of Births, Book 45, page 76 19. Transylvania County Registry of Deaths, Book 52, page 74 20. Transylvania County Registry of Births, Volume 53, page 212 21. "Woman of the Week" 22. "Woman of the Week" 23. "North Carolina Deaths and Funerals"
Bibliography Borst, Charlotte, Catching Babies, England: Harvard University Press, 1997 Elliot, M.D., James W., Secrets of a Country Doctor, Tennessee: Overmountain Press, 1992 Farley, Tom, History of Telephone Exchanges <http://www.privateline.com/TelephoneHistory3A/numbers.html> (September 15, 2003) Forster, Jeff, "Packing Up and Packing In, the Doctor's Black Bag" (editorial) Medical Economics (Dec. 28, 1998) v75 i25 p4 (1) "North Carolina Deaths and Funerals"(obituary column), Asheville Citizen, May 28, 1966, page 24 O'Dowd, Michael J. and Elliot E. Philipp, The History of Obstetrics and Gynaecology, New York: The Parthenon Publishing Group 1994 Pelton,L.H., "Too Early Specialization?" Wisconsin Medical Journal 22 (1923-24): 446, quoted in Charlotte Borst, Catching Babies, (England: Harvard University Press, 1997), 139 Sagov, M.D.,Stanley E. et al., Home Birth, Maryland: Aspen, 1984 Transylvania County Registry of Births, Book 45, page 76 Transylvania County Registry of Deaths, Book 52, page 74 Washburn, M.D, Benjamin Earle, A Country Doctor in the South Mountains, North Carolina: Spindale Press, 1955 "Woman of the Week", Asheville Citizen , September 25, 1967, page 2 |
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