BLOG: Comparative Research: The Example of Tuberculosis in Philadelphia and Buenos Aires by Vera Blinn Reber

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I am happy to continue our series on transnational research. If you are interested in contributing to this blog, click here. Vera Blinn Reber (Ph.D. University of Wisconsin, Madison), taught for 38 years at Shippensburg University and is now Professor Emerita. She is author of British Mercantile Houses in Buenos Aires, 1810-1880 (Cambridge: Harvard University Press, 1979) and over twenty-five articles. Four of the articles have received awards including “The Demographics of Paraguay: A Reinterpretation of the Great War, 1864-1970,” HAHR 68, no. 2 (1988) which received the Arthur P. Whitaker Prize of MACLAS in 1988; and “Misery Pain and Death: Tuberculosis in Nineteenth Century Buenos Aires,” The Americas 56, no. 4 (2000), the Conference on Latin American History Tibesar Prize. Reber’s recent monograph, Tuberculosis in the Americas, 1870-1945: Beneath the Anguish in Philadelphia and Buenos Aires, Routledge Studies in the History of the Americas (New York: Routledge, 2019), a comparative study, informs this post.

Comparative Research: The Example of Tuberculosis in Philadelphia and Buenos Aires

Latin American history can benefit from using a comparative methodology. It helps define significant questions and important historical issues. Comparison provides a framework for research and it aids in the formation of conclusions. Historians regularly engage in comparison; in fact, they cannot avoid it. The issue is whether the comparison should be explicit. 

Comparative research involves specific challenges. One must frame questions, define events or issues that lend themselves to comparison. How similar or different should topics be? For example, public health policies affecting diseases such as tuberculosis or COVID-19 are regularly compared across diverse nations. If one is to do major research on a given disease, is it necessary to decide on how similar the city or state should be? Should the countries have similar health systems? Similar institutions? Similar demographics? Similar policies? Similar governments? Similar time periods? What role do differences play? Are similarities in one issue more important than in others? 

Once the comparisons are explicitly defined, one must be prepared to do research on at least two different cities or nations and become knowledgeable about distinctive research institutions. Cities and countries have diverse ways of organizing and preserving their material. The nature of the topic also defines the appropriate library or archives. My previous research in Buenos Aires focused on mercantile houses and their roles in both international trade and domestic development in nineteenth century Argentina. The Archivo General de la Nación (AGN), banking archives, and nineteenth century library collections proved central. But when I chose to focus on disease, even though I was interested in the economic impact, only the National Archives proved useful. I knew the geography and significant research institutions of Buenos Aires better than Philadelphia, but the challenge of doing research in Buenos Aires was not that different from Philadelphia.  

As a Latin American historian whose research has primarily been in Paraguay and Argentina, I hoped to utilize secondary sources for my study of tuberculosis in Philadelphia. To my surprise, Philadelphia, a city significant in the development of United States, was under researched and I was forced to do primary research. In both cities it was necessary to find institutions that had materials on disease. Because I was interested in patient experiences and in statistical information on who contracted the disease, and variation in mortality by age and gender, I needed diverse sources on tuberculosis. Future users should note that the same libraries and archives that have information on tuberculosis for the late nineteenth and first half of the twentieth century will also provide material on a diverse diseases and health issues.   

Historical research into disease in the U.S. should start with the National Library of Medicine in Washington D.C. The Library of Congress has transferred most medical materials to that library. The National Library of Medicine has manuscripts of public health and policy, personal papers of scientists and physicians, rare foreign medical journals, medical newspapers, medical photographs and video, international conference reports, United Nations and League of Nation reports, and most major secondary monographs on disease. To my surprise the National Library of Medicine had a substantial number of issues of Spunk, a magazine produced between 1909 and 1963 by the patients of Mont Alto Sanatorium of Pennsylvania. 

Several other repositories proved helpful. The Historical Medical Library of the College of Physicians of Philadelphia, particularly strong on public health and medicine in Philadelphia, held the missing issues of Spunk and a useful pamphlet collection. If one lives in or near New York City, the New York Academy of Medicine is worth a visit. State libraries should be visited for annual reports of state commissioners of health. Finally, city archives should be patronized for state reports on public health and disease.

One source is particularly important for health and disease in Philadelphia—Annual Message of the Mayor. Although Philadelphia mayors are still reporting on city issues, it is the Annual Report of the Board of Health, a section of the Message of the Mayor, 1891-1938, that provided extensive statistical information on diseases that infected Philadelphia residents. A few volumes are online: for example, 1892, 1893, 1917, and 1918. To limit the necessary time in Philadelphia archives, online volumes could be used to set up statistical tables and determine what information is available. Together the Philadelphia City Archives and Temple University’s Special Collections Research Center provide a complete collection of the Annual Message of the Mayor.

Because I was interested in patient perspectives, I needed first person patient accounts. These were difficult to obtain. Physician papers may include correspondence with patients and if read carefully provides insight into patient perspectives. The best source for Philadelphia was the extensive correspondence of Dr. Lawrence Francis Flick, 1856-1938, who developed tuberculosis as a student, recovered, and went on to treat the tubercular. He also founded both the Pennsylvania Society for the Prevention of Tuberculosis and the United States National Association. The Medical Library of the College of Physicians of Philadelphia holds some of his papers, but the more extensive correspondence is held by The Catholic University of America’s American Catholic History Research Center and University Archives.

In Buenos Aires, the AGN had records of Argentine sanatoriums and the Sociedad de Beneficencia. The Liga Argentina de Lucha Contra la Tuberculosis owned the entire collection of La Lucha Antituberculosa, founded in 1901. But the most important research institution was the Biblioteca Central Facultad de Medicina de la Universidad de Buenos Aires. Not only did the library have Argentine medical journals and newspapers such as Semana Medical but it also possessed the theses written by students to obtain the title of Doctor of Medicine at the National University. Theses written between 1899 and 1936 described diagnosis, prognosis, and treatment of tubercular patients. The most useful statistical material was the Anuario estadístico de la ciudad de Buenos Aires, published between 1885 and 1920, and Nicolás Besio Moreno’s Buenos Aires: Puerto del Río de la Plata, capital de la Argentina: estudio crítico de su población, 1536-1936.

Research in comparative history is rewarding. It requires travel and research in at least two different cultures. It encourages the researcher to ask new questions. It represents a unique methodology which can lead to practical applications and significant new conclusions. It provides a methodology to view social, economic, and political environments through a new lens. Comparison keep historians from over emphasizing the uniqueness of historical events and provides a broader context in which to examine specific case studies. In my research, I concluded that patient perspectives and public health policies in Buenos Aires and Philadelphia were similar. Within the history of medicine, comparison leads to a more complete view of a disease’s effects on individuals and society. 



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