The doctor’s bag circa 1910

This doctor’s bag is in the London Science Museum. Though dated 1890-1930 much of its contents look very early 20th century. What it doesn’t contain is significant.

It belonged to John Hill Abram (1863-1933), a Liverpool physician who later became Professor of Medicine.  He was also president of the Association of Physicians in 1928 – perhaps it is likely that he was not doing many housecalls in his senior years.  But how difficult it would have been to diagnose kidney disease.

There is no way of measuring blood pressure.  Useful sphygmomanometers were coming into use only early in the 1900s after Riva-Rocci developed a pressure cuff device in 1896, and Korotkoff defined diastolic pressure in 1905.  By 1920 an impressive array of devices were available (Warfield 1920), but none of them feature in Professor Abram’s bag.

The spirit lamp and chemicals were presumably for detection of proteinuria. Dipsticks for this purpose were invented in the 1950s, and although test papers were invented in the 1880s it is not clear how widely they caught on.

The binaural rubber-tubed stethoscope became a standard accessory from the 1850s, developed from Laennec’s 1816 rigid tube device, very like the one shown at the back.  Abram’s stethoscope has only a bell; switchable bell-diaphragm devices were available in the 1920s.  He was a stethoscope enthusiast; an early diaphragm instrument is shown on the left.

It looks as if the Ever-Ready battery was to power the ophthalmoscope. Opthalmoscopy was invented by Hermann van Helmholtz in 1851, but electric bulbs made it a more practical reality early in the 1900s.  The first ophthalmoscope with a battery in the handle appeared in 1915 (Keeler). Widespread introduction may have taken some time, but Abram didn’t have one.

Drugs he carried included morphine, atropine, strychnine and digitalis.  Of course no diuretics.  You can also see a mercury thermometer, various syringes, microscope slides and a tongue depressor. The hand-made cigarettes and tobacco tin – to these we can only say ‘interesting’.

Suitable contents for a contemporary doctor’s bag are usefully described for trainees in General Practice by the Pennine training programme – more drugs, a non-mercury sphygmomanometer, and urine testing is simpler. But apart from a mobile phone, a hundred years later there is remarkably little novel technology.  In the near future medical bags will surely contain a compact ultrasound machine, which should be good for nephrology.

Further reading

Warfield LM. 1920  Arteriosclerosis and hypertension.  Mosby, St Louis. 2nd ed.  Chapter 3 describes available blood pressure devices.  Fascinating and free online (Project Gutenberg)
Low JA.  2012.  The doctor’s bag in 1911.  CMAJ 184:E100-102  A Canadian bag from the same era has similar contents but includes urethral catheters and a modern looking aneroid sphygmomanometer (patented 1904, advertised in 1920 by the Sanborn Company at $17.50). There is only one stethoscope but it has a switchable diaphragm and bell (later than dated therefore?).  His opthalmoscope has no integral light source.
History of the stethoscope: Wikipedia’s account of stethoscope history is very good.   See also specialist site, richly illustrated,
History of the ophtahalmoscope:  Keeler R. Royal College of Optometrists website

Image credit: Wellcome Images L0058360 (Creative Commons Attribution only licence)


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