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Piecing Together Books from Penn’s Past

Before book“Holy moly! Look what we have!”

That’s what Irving Nachamkin, DrPH, MPH , exclaimed when he and his colleague Kathy Montone, MD, both division directors and professors of Pathology and Laboratory Medicine at Penn Medicine, pulled away the humble brown paper holding a small group of late 19th century books together.

They were told that some interesting things were found during renovations in the Perelman School of Medicine business office and labs of Pathology and Lab Medicine, but didn’t know what exactly to expect. They certainly weren’t expecting to find five historic books, including the meticulous notes of esteemed William Pepper, Jr., MD, the father clinical pathology here at Penn and an important provost for the University of Pennsylvania as a whole.

Founded in 1895, the William Pepper Laboratory of Clinical Medicine eventually grew into what today is Penn’s department of Pathology and Laboratory Medicine. Nachamkin said Pepper was exceedingly dedicated and funded much of the new laboratory building from his own pocket. Decades before, Pepper helped create the Hospital of the University of Pennsylvania after studying medical education across Europe.

Pepper wasn’t just instrumental in Penn’s medical endeavors. As provost, he established the Wharton School of Business and the Graduate School for Arts and Sciences and by the time he was done at Penn, he grew the university from a staff of just 42 faculty members to nearly 250 and the student base had grown from about 1,000 to more than 2,600.

Nachamkin and Montone now had in their possession the five books from his era, all in dire condition from a century of improper storage. Many, if not most, of the pages were damaged and the book covers were in really rough shape. Regardless of their condition, the contents and their historic importance made it clear. These books needed to be saved.

Acting on a suggestion from Ian Bogus, MacDonald Curator of Preservation at Penn’s Van Pelt Library, Nachamkin and Montone took the three most important books to the Conservation Center for Art and Historic Artifacts (CCAHA), a nonprofit in Philadelphia’s Fitler Square neighborhood dedicated to historic restoration and conservation and frequent point of contact for the library. With support from department leadership, they were able to have two of the books, The Clinical Cases of William Pepper Jr. and a ledger of autopsy records, fully restored.

The restoration process, to say the least, is comprehensive. Chemical tests were done of the paper, pagers were masterfully stitched back in place and new spines were constructed from handmade materials. Perhaps most important though was the extensive photographic documentation of the books, each and every page, so their contents would still be usable by everyone. Nachamkin said it’s their goal to put these books on display, and the photos will allow curious readers to flip through the books safely.

Nachamkin said the department hopes to use these books for a special grand rounds in which the pathology team will present the cases as they were recorded and as if they were real, giving doctors today a unique educational opportunity to try cases from a hundred years ago.

“It’s important to have a perspective on where your field started and how you’ve advanced over time. You can also see how detailed physicians were in the care of the patients,” Nachamkin said. “In this age, where we act quickly and use shorthand, they took time and effort back then. It was the only way to document these cases.”

The restoration plans for the other three books are currently on hold. All that work to bring the books up to snuff isn’t cheap at about $7,000 to $8,000 per book for the restoration work and the photographic library. Nachamkin and team are raising money right now to cover those costs. Money raised will also go towards a special cabinet to house and display the books. You can find out more about the restoration project here.


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