Health and Medicine on Display: International Expositions in the United States, 1876-1904 (review)

Having worked in museums for over thirty years, I have often observed that our visitors have no idea what goes on behind the scenes. Exhibitions seem to magically appear, full blown and polished. Programs come off seamlessly, without a hitch. It is not unlike mounting a theatrical production: if done well, the public has no clue as to either the hard effort required to make this happen or the near-misses in getting our work presented to them in a timely fashion. The same could be said of our predecessors who crafted health and medical displays for America's first international expositions, or world's fairs. But now they do have a champion in Julie Brown, whose Health and Medicine on Display provides a fascinating glimpse behind the scenes at the medically themed components of international expositions. In the process, we learn much about the shaping and delivery of the health education message, and the refinement of various media for its communication. Brown takes things yet still further, intriguingly, by exploring the dynamics of each expo, as a "city within the city" with their own attendant health issues. From the breaking of ground to construct exhibition halls to the final wrap up months later, exposition entrepreneurs faced on-the-job accidents, issues of foul, unpotable water, toileting the tens of thousand of visitor in a pre-PortaPotty era, and the very real specter of epidemic disease that threatened to shut down the whole show. It is a story not yet told, and one that this reader found quite engaging and informative.

Brown begins her story with the Centennial Exposition of 1876 in Philadelphia, and follows it to succeeding expositions in Chicago (1893), Buffalo (1901), and St. Louis (1904). These were unprecedentedly large undertakings comparable perhaps only to mounting a military campaign. In contrast to expositions in Europe, which were government-run, those in the United States tended to be commercial ventures bound to municipal boosterism. Despite the uniqueness of each such venture, a common pattern emerged, according to Brown. Exhibitors could be grouped into three broad categories (spread over many different classifications within each respective expo): commercial, professional, and government. The first comprised manufactures of medical and surgical articles (instruments, prosthetics, drugs, &c), hygiene supplies and sanitary appliances (from water purification to toilets), and instructional media, predominantly models, manikins, and charts. The professional category encompassed practitioners of sanitary science and social economy, predominated by the American Public Health Association and various State Boards of Health. Curiously, medical congresses held during each exposition failed to take hold and become a central fixed feature. Government was overwhelmingly represented by very popular and extensive Army and Navy displays of hospitals and aid stations, and later the U.S. Marine Hospital Service (by 1902 known as Public Health-MHS) which screened immigrants and maintained quarantine stations. In just such a display at Chicago in 1893, the general public saw for the first time the tools of the bacteriologist and epidemiologist at work, while a decade later, in St. Louis, visitors could see a full size "model operating room," complete with white-gowned mannequins, of stark nature, showing the triumph of asepsis and antisepsis. Clearly showing rather than telling was the way to go.

Each exposition, in addition to providing public edification, confronted new challenges to the medical services established to care for visitors and staff alike. Tragedies and calamities marked each these expositions, ranging from an exhibition building fire in Chicago that left fifteen dead and forty-three injured, to the assassination of McKinley in Buffalo (where the on-site medical facility proved inadequate, lacking a properly functioning x-ray machine), or the collapse of two hundred foot twin towers in a freak windstorm in St. Louis. But each exposition coped and provided necessary medical services to keep the show up and running.

Incongruities and inconsistencies abounded in the displays...