The Worlds Fair

The Louisiana Purchase Exposition

Excerpted from

From the Hills:
An Autobiography of a Pediatrician

John Zahorsky, M.D.
St. Louis

One day, the latter part of August, Dr. Saunders called me into his office and asked:

"Doctor, could you arrange your practice so as to take charge of the Baby Incubators on the Pike?"

It was an unexpected shock. Naturally, I hesitated and asked, "Why should I be asked to take such a position?"

"The position will last only three months."

Again destiny! All my other plans destroyed.

Perhaps you remember the Pike was a wide street extending about a half mile along the northern border of the fairgrounds in Forest Park. It corresponded to the Midway at the Chicago Exposition and to the Trail at San Francisco. On both sides the street was lined with artistic buildings in which a great variety of "shows" had concessions to entertain the visitors. Yes, the people that visited the fair, as a rule wanted to be entertained, not instructed.

I had been chosen as the head physician for the "Baby Incubators on the Pike."

The Imperial Concession Company, a company formed principally by some St. Louis businessmen, with Mr. E. M. Bayliss, manager, opened the incubators to the public about June 1, 1904. While the purpose of this company was simply to make money, the character of the men governing the institution precluded the entertainment of the notion that the infants would be neglected in any way. These businessmen did not claim to know anything about the care of infants prematurely born, but they were willing to do anything that science taught to be necessary. Miss Kelly, a highly trained nurse who had considerable experience with premature and normal babies, was put in charge; also, a physician was procured who had gone East especially to study the care of premature infants, and only trained nurses were employed to take care of the babies.

Everything went very well until the summer hot weather arrived, then, through some error, a very virulent disease-producing germ or virus was introduced, starting a catastrophic epidemic of contagious diarrhea. The loss of newly born infants was increased by the death of several "graduates" and the mortality was altogether higher than was desirable. On September first the death rate had risen to fifty per cent, the attending physician resigned, and thereupon, another physician was asked to take charge.

Meanwhile, certain "specialists" of incubator exhibitions, probably chagrined by the fact that they had not secured the concession, began to assail the management in every conceivable form. Some sensational newspapers tried to make a scandal out of the baby incubator exhibition on the Pike.

The management and the officials of the Exposition took up the subject and a committee of local physicians was appointed to investigate the exhibit, and a few changes in the arrangements of the building were ordered. At great expense, a glass partition was installed, which separated the incubators from the public. But the catastrophe was almost over.

I took charge of the medical management on September first, and was ably assisted by Dr. O'Neal and later by Dr. F. N. Gordon. I made two, more often three, visits to the baby exhibit daily. All other prospective visits to the World's Fair had to be canceled, since I remained in charge until the close of the Fair, November 30, 1904.

The great death rate of the infants was undoubtedly due to a sick, infected infant from one of the foundling homes. Such catastrophies are inevitable sooner or later, unless the most scrupulous attention is paid to every nursing detail. A rigid aseptic technic is essential and this can be carried out only at an enormous expense. It cost fifteen dollars a day to take care of each infant.

Here I must refrain from explaining the scientific rules governing the feeding, incubating and nursing of premature babies, a science and art that has become a valuable adjunct to the obstetric division of all large hospitals.

Without boasting, our success at taking care of premature infants was very good indeed, our mortality rate dropped to less than twenty per cent, and most of the deaths occurred in infants weighing less than two pounds.

My qualifications as a proficient physician to take care of premature babies was acknowledged and this status had become generally known. Consequently, for many years, or until the facilities of our large hospitals for nursing premature infants had become first class, I was credited deservedly with being an expert on prematurity.

As a consequence of the accurate records kept of every baby, I was enabled to collect and tabulate scientific data which may be valuable even today. A series of medical articles published in the St. Louis Courier of Medicine (1905) embodied this research, in which all practical procedures, both historical and statistical, were given to the medical field. I ordered reprints of these articles, and my first book, Baby Incubators, was published, although it was never offered for sale. I still have several of these books on hand in my library. While I published more than a hundred articles later and three other medical books, I still believe that Baby Incubators should be given the prize as my best scientific work.

However, there was one cloud that obscured the professional acceptance of this book. Baby incubators for show purpose did not have the endorsement of the medical profession.

"What connection," wrote the editor of the London Lancet, "is there between the serious matter of saving life, and the bearded woman, the dog-faced man, the elephants, the performing horses and pigs, and the clowns and acrobats, that constitute the chief attraction of Olympia." (London)

In another article the Lancet published a letter from a showman who felt it was his "duty to warn members of the medical profession, also nurses, parents and public institutions not to entrust their children to any applicant whatsoever without first taking the precaution to assure themselves that they will not be made the victims of showmen, as well as inexperienced or irresponsible persons who seek to trade upon the established reputation of an invention (The Incubator) that has been recognized by both the medical and lay press." (Part of a letter of some "expert" showman.)

No doubt that was the principal reason why pediatrics at large rather frowned on this work, and did not add it to the recognized historical works on prematurity.

Oh, well! We cannot have everything. Some of my acquaintances, who envied my success, summarized my professional ability: "Well, he's a good one when it comes to shows."

Baby shows are no novelty now and certainly not the source of amusement. Visit any large hospital, find some excuse to be admitted to the obstetrical department, and you can see a baby show; some tiny ones are in incubators (or brooders). You can see the whole show, but there is protecting plate glass which separates you from the babies; the same restriction was enforced on the Pike.

For many years the care of the premature infant in the home was the pediatrician's task. To keep the baby at an even temperature, all sorts of extemporaneous devices were constructed! A market basket, or a small wooden box, padded and bedded, kept warm by beer bottles or Mason jars filled with warm water, or a box with one side removed set before a radiator, or a box heated by an electric light bulb. A thermometer was placed beside the baby and it was the attendant's task to keep the temperature steady at the grade prescribed. Human milk was obtained from needy mothers, ten to twenty cents for each ounce of milk. It was my privilege to know half a dozen women who had an oversupply of milk and were skilled in its manual expression. Of course, some additional help for the mother had to be hired, but it did not cost one-third as much as hospital care and our results were even better than in the hospital.

There must be at least a score of men and women, now fathers and mothers, whom I treated for prematurity after their birth. It is one of my pleasures to meet one of them on some social occasion and be told that I saved his life for, "I only weighed three pounds at birth."

The Pike, with its varied and awe-inspiring attractions, has completely disappeared, but we old men who walked the street everyday to assist in saving lives can still picture that brick fireproof building where the incubators stood in a row. The frontage was built of stucco. It was an artistic edifice with a tower on each side of a long Grecian colonnade half surrounding an open court, in the center of which stood a statue of Diana protecting several children. (N.B. The company that built and operated this concession lost a lot of money. Some of us were the winners, not in cash but in knowledge and prestige.)

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