MUSC library raising money to preserve Black medical history
The spidery cursive scratched into the handwritten journal from 1834 is difficult to read, but under "Recipe for a cough" the remedy calls for 60 grains of saltpeter, which was one of the components of gunpowder.
The journal from a plantation in Berkeley County is one of the riches inside Waring Historical Library at the Medical University of South Carolina. The library is beginning a fundraising effort to restore the building to its former glory but also make it more accessible. An international resource for scholars, the library is also seeking to expand and diversify its collection with the records and history of medical treatment of Black people in the South in segregated hospitals and clinics, records missing from most archives but which could have relevance on health disparities that persist to the present.
The library building itself is hard to miss on MUSC's downtown campus because it looks like a castle turret, which Curator Brian Fors describes as a blend of neo-Gothic and Renaissance architectural styles. The martial appearance is deliberate — it was built in 1894 as a part of Porter Military Academy. MUSC acquired the building and the surrounding land in 1963 as part of a major expansion, and what were once parade grounds in front of the building are stacked with modern buildings. But inside, it is a step back amid dark wood shelves and cabinets perfumed by the smell of old books.
The historical library houses rare books and special collections for the university, such as the Isabella Sarah Peyre Porcher Plantation Recipes and Prescriptions, the journal whose cover identifies it as coming from the Sarrazin Plantation in Berkeley County. A 19th-century doctor might have visited infrequently, so, as the woman in charge, "she would have been responsible for the day-to-day treatment," Fors said. While Porcher would have drawn on her own experience, "usually in the enslaved population, there was a healer who had knowledge, and she would have likely learned from that person, as well," he said. "And then there are also unknown, native indigenous peoples' remedies for illnesses. They would have drawn on that as well because of the uniqueness, the newness of the kinds of illness (they encountered)."
For instance, they would have likely faced a lot of dysentery, an intestinal illness from food or water contaminated by bacteria, which often results in bloody diarrhea. The remedy includes cream of tartar and rhubarb, among others, with the instructions to "dose according to violence of dysentery."
Of course, there was no pharmaceutical industry to draw from, so the people of that time would have used what they had, which was plants. Porcher's son, Francis, would build on that. He became a doctor, and during the Civil War, he joined the medical corps of the Confederate Army. Many of the Southern ports, including Charleston, were blockaded during the war, so outside supplies, including medicines, were hard to find.
Francis Porcher "develops and publishes alternatives to the medicines based on Southern plants because of the blockade," Fors said. While originally a Confederate guide, Porcher republished it after the war as "Resources of the Southern Fields and Forests," with the subtitle "Medical Botany of the Southern States."
While that was 150 years ago, that work is still relevant today, Fors said. It's called botanical therapy, or complementary medicine, or even Eastern medicine now.
"The knowledge that was developed at that time hasn't been lost," he said.
The Waring is not a museum, and while it is open to the public, it is by appointment only. But the rare books and archives, mostly from the 18th and 19th centuries, form an important resource for scholars on what could be broadly termed the Atlantic medical world, covering diseases and conditions not only along the Southern coast, but into the Caribbean, Western Europe and West Africa as people and trade passed between them. One book in the archive, for instance, is a bound collection of reports from surgeons aboard ships of the British Navy on the diseases they encountered, treatments and outcomes over 20 years.
The library already serves as a resource for researchers both in the U.S. and the United Kingdom.
"The Waring Library and its collections are the essential archive for the history of medicine in South Carolina and one of a highly select group of standout facilities for historical research in the health and medical humanities in the United States," said Dr. Stephen Kenny, a senior lecturer on 19th- and 20th- Century North American History at the University of Liverpool.
One of the goals of the library Strategic Plan through 2024, part of the OneMUSC Strategic Plan, is to enhance that national and international profile by further developing its collection and its connections with scholars.
It is also an important record of the health of Charleston, as detailed by local doctors in a series of bound reports that became the Charleston Medical Journal. A peek inside one from 1848 shows a detailed cataloguing of what people died from that year, a long list headed by the curious terms "apoplexy" or "mania." Apoplexy, "we would just call it a stroke now," Fors said, and mania was likely a catchall for any mental illness. There were a number of fevers — congestive fever, country fever, remittent fever — carefully documented for study.
"They're trying to figure that out, but the whole concept of bacteria and viruses doesn't exist at this time," he said, and would not come for decades.
Even as it works to raise $1.2 million to restore the library building, the Waring is working to diversify its collections. Most of the work from that time was written by White males, but women "were very active in the medical world," with 7,000 female medical doctors by 1900, Fors said. Black doctors and nurses were forming their own institutions, such as the Cannon Street Hospital and Training School for Nurses in Charleston, which was founded in 1897. Later, there was the McClennan-Banks Hospital, named after famed local leaders, that lasted until 1976.
Yet there are "very few records" from those and other Black hospitals and segregated medical facilities that have made their way to archives such as those at Waring or state archives, Fors said. And there is a great need for them to be collected, studied and known, he said.
"There is this big gap with the Black community seeing their story told," Fors said. "My hope is (those records) are out there and we'll find them and get them into some institution."