February 27 2017

Spit Spreads Death: What can a bedpan tell us about a pandemic?

Jane E. Boyd, Ph.D., is an independent curator and writer based in Philadelphia. She is the guest historical curator for Spit Spreads Death, the Mütter Museum’s forthcoming exhibition on the 1918 influenza pandemic. She was a guest curator for the Mütter’s current long-term exhibition, Broken Bodies, Suffering Spirits: Injury, Death, and Healing in Civil War Philadelphia.

What can a bedpan tell us about a pandemic? 

Historical museum exhibitions rely on objects to tell their stories, but some events leave few objects behind. This is one of our challenges as we develop Spit Spreads Death, an upcoming Mütter Museum exhibition on the influenza pandemic of 1918–19 in Philadelphia.

Though the pandemic was among the worst disease outbreaks in history, infecting more than 500 million people worldwide and killing up to 50 million, it happened quickly. The severe wave that hit Philadelphia in late September of 1918 lasted only about five weeks. By November 11, when an armistice ended the fighting in World War I, the pandemic was winding down in the city. By the time the outbreak was over the following summer, the virus had sickened an estimated 500,000 Philadelphians, with nearly 16,000 dying. 

Documents

As we put together the exhibition, we are gathering first-person accounts from letters and diaries, newspaper stories, photographs, medical records, death certificates, and other documents that were created while the pandemic was raging. We are also looking at later recollections and writings, including oral histories, public health reports, and articles in medical journals. But objects specifically connected with the pandemic are harder to find; it seems that people generally did not want to keep souvenirs of such a traumatic time, except perhaps for items that reminded them of deceased loved ones. The objects may remain, handed down in a family, but many of the stories have been lost. 

Medical Instruments

We have a similar issue with medical instruments. We know from first-person accounts and medical texts that physicians used thermometers during the pandemic, since high fever was a symptom of influenza. Patients often contracted secondary infections, mainly pneumonia, so doctors used stethoscopes to listen to breathing. They also tried a wide array of medications, from vaccines to injections to pills and throat sprays, but nearly all were ineffective.

The Mütter Museum has examples of thermometers, stethoscopes, hypodermic syringes, and medications from the early twentieth century, but if any of them were used during the 1918–19 pandemic, no one documented that connection. This doesn’t mean, however, that we can’t display those objects. Since they are from that era and we know that similar items were used to diagnose and treat influenza patients, we can display the items, if we explain that they are not actually linked to the pandemic.  

Nursing

Nursing was a critical part of medical care during the pandemic. By this time, the professionalization of medicine had divided practitioners along gender lines. Nearly all doctors were men, and nurses, who handled the mundane, messy, and smelly aspects of taking care of the sick, were almost all women.

During the pandemic, people who were too feverish and weak to get out of bed needed to be fed, cleaned, and bathed, and have their vomit, urine, and feces carried away. This required such unglamorous tools as cups and dishes, cloths and sponges, basins for vomit, and urinals and bedpans. Some doctors recommended “the free ingestion of water and hot drinks” and “brisk flushing of the bowels” to clear out patients’ systems. This high volume of “purgation” would have kept nurses busy emptying and washing basins, urinals, and bedpans.

Influenza ward, Walter Reed General Hospital, Washington, D.C., circa 1918. Photograph by Harris & Ewing, Inc. Courtesy of the Library of Congress Prints and Photographs Division, LC-DIG-hec-14088

Influenza ward, Walter Reed General Hospital, Washington, D.C., circa 1918. Photograph by Harris & Ewing, Inc. Courtesy of the Library of Congress Prints and Photographs Division, LC-DIG-hec-14088


Influenza Hospitals

Not surprisingly, descriptions or photographs of hospitals rarely include lowly bedpans. A news photograph of an influenza ward at Walter Reed General Hospital, the principal military hospital in Washington, D.C., depicts a screened porch lined with metal hospital beds, separated by sheets. A nurse in a long white gown, her mouth and nose covered with a gauze mask, uses her pocket watch to time a man’s pulse. A small folding table covered with a cloth holds an enameled metal mug and covered dish, along with letters and a wrapped package. An illustrated newspaper rests on the chair nearby.

This is a clean and orderly scene, likely posed for the photographer. A more candid snapshot shows a temporary influenza hospital in the Municipal Auditorium in Oakland, California. Beds with a variety of quilts and blankets (evidently brought from home or donated) fill the stage; some have chairs next to them holding cups, cloths, and other items. Basins and what look like bedpans are visible at the far right. A large spill in the center of the image, perhaps vomited liquid, hasn’t been cleaned up yet. A few of the masked doctors and nurses are moving so quickly that their figures are blurred. Most temporary influenza hospitals probably looked like this one, improvised and a bit untidy, with overwhelmed staff and volunteers doing what they could for the sick. 

The Oakland Municipal Auditorium, California, in use as a temporary influenza hospital, circa 1918. Photograph by Edward A. “Doc” Rogers. Courtesy of the Oakland Public Library, Oakland History Room and Maps Division, via Calisphere, copl_058

The Oakland Municipal Auditorium, California, in use as a temporary influenza hospital, circa 1918. Photograph by Edward A. “Doc” Rogers. Courtesy of the Oakland Public Library, Oakland History Room and Maps Division, via Calisphere, copl_058


Bedpans

Bedpans, then, are an important part of the story of the pandemic. Fortunately, over the years, the Mütter Museum has collected these kinds of everyday hospital items. In a room on the lower level of The College of Physicians where thousands of medical instruments are stored, I opened a gray metal cabinet and found a variety of bedpans and urinals, carefully arranged on the shelves. The bedpans are made of enameled metal or ceramic; the urinals, male and female models, are glass or enameled metal. 

But how do we choose which bedpan to display? As a conscientious historian, I don’t want to show an object that was made long after the pandemic. Most bedpans, though, are anonymous, mass-produced items; manufacturers didn’t bother giving them model names or dating them. And unlike fancy furniture or other decorative arts, it’s tricky to assign a date by looking at style alone; there’s no timeline of bedpan design on the Museum of Modern Art’s website!

I did, however, discover that there is a serious collector of bedpans: Eric Eakin, who lives near Cleveland, Ohio. His collection of more than 250 items includes bedpans, urinals, and related memorabilia—even greeting cards and bedpan-shaped salt-and-pepper shakers. Specialty collectors like Eakin, who have in-depth knowledge of particular types of objects, can be valuable sources for exhibition research. In an interview, he stated that ceramic bedpans are generally older than metal ones. He had heard a story about a salesman dropping an armful of metal bedpans in a hospital corridor. When nurses looked out, startled by the loud clatter, the salesman told them that metal bedpans were better, since ceramic ones would have broken. 

A ceramic bedpan, then, would probably be earlier than a metal one. Wearing nitrile gloves (to avoid leaving fingerprints), I picked up a large ceramic bedpan, which was quite heavy. On the inside, the proud maker, Meinecke & Company of New York, had stamped the firm’s name, the model name and a description (“‘Perfection’ Bed and Douche Pan for Hospital and Home”), adding a grandiose claim: “The Most Comfortable and Sanitary Bed-Pan in the World.” There was also a U.S. patent date of June 9, 1900. This was a good find, since it’s plausible that a durable bedpan patented at the turn of the century was still being used eighteen years later. And even if older bedpans had been “retired,” I could imagine that a crisis like the influenza pandemic would have sent hospital staff to storage closets to dig out all the old basins, bedpans, and other items they could gather. 

I’ve added the bedpan to the list of objects we may display in Spit Spreads Death. This common, ordinary object can shed light on big-picture historical issues like gender divisions in medicine. But it can also help to tell the personal, intimate stories behind the statistics—stories of suffering and caregiving that reveal the human side of the pandemic.

For further reading

Bristow, Nancy K. American Pandemic: The Lost Worlds of the 1918 Influenza Epidemic. New York: Oxford University Press, 2012.

Oatman-Stanford, Hunter. “World’s Foremost Bedpan Collector Celebrates Objects Most People Pooh-Pooh.Collectors Weekly, November 10, 2014. 

Starr, Isaac. “Influenza in 1918: Recollections of the Epidemic in Philadelphia.Annals of Internal Medicine 145 (2006): 138–40.

Spit Spreads Death: Going Viral Behind the Scenes

We’re inviting you to get an exclusive view of the Mütter Museum and see an exhibit that doesn’t exist…yet! Follow along as we explore, research, and develop a new centerpiece exhibition. We'll give you access to behind-the-scenes discussions, artifacts, and interviews with key curators and artists.

This unique project will be a unique collaboration, incorporating contemporary art with medical history, joining together an artist, an art curator, and a historical curator. The exhibition is planned for 2019, in commemoration of the centennial of the devastating medical event that plagued Philadelphia in the early 20th century, and will integrate science, history, art, and personal narratives while exploring contagion, fear of infection, compassion for fellow citizens, and the behavior of a population under extreme stress.

The Mütter Museum helps the public appreciate the mysteries and beauty of the human body while understanding the history of diagnosis and treatment of disease.

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