All posts by Brock Stafford

“You Will Know You Are At The Right Place”: The Innovative Care of the National Surgical Institute of Indianapolis

Advertisement for the National Surgical Institute, Indianapolis News, May, 26, 1887. Hoosier State Chronicles

During the latter half of the 1800s, Indianapolis was served by one of the best surgical institutions in the country. Dr. Horace R. Allen and his team at the National Surgical Institute focused on improving the lives and medical methods for the treatment of individuals with physical disabilities and orthopedic challenges. Originally founded in Charleston, IL in 1858, the institute grew when they moved their operation to the much larger city of Indianapolis in 1869. For nearly forty years, the organization drew patients from throughout the country to receive specialized treatment while also serving the emergency medical needs of the industrialized city, eventually expanding to other sites throughout the country. A tragedy cut short the mission of the Indianapolis location, but their efforts to improve the lives of the public changed the medical landscape and opportunities for the citizens of Indiana.

Physical deformations and muscular/skeletal damage are a major part of our modern culture, and pain relief resulting from these issues has become a major industry. The rise of prescription medicine usage to treat these conditions, particularly opioids, had led to serious questions about appropriate ways to treat pain. Alternative care, such as chiropractic treatments, orthotics, and physical therapy are now commonplace for both the general public and athletes. Congenital issues like cleft palates and club feet are rare in adults or teenagers in America, often being treated relatively soon after birth with surgery. Even when adults suffer from issues like rheumatoid arthritis, modern medicine can often prevent the characteristic deformity of hands and other joints.

This was not always the case. In the mid-19th century, surgeries were still experimental in many fields and fatalities were high. One Washington Post article describes some of the challenges from medical care at the time, including untrained physicians, poor hygiene, and limited pain relief or anesthesia. Sadly, this often meant a lifetime of pain and isolation for individuals with these conditions.[i]  An article from Collector’s Weekly in 2015 addressed the prevailing attitudes of the mid-1800s for individuals living with deformities, including the attempts of society to “fix,” ignore, mock, and experiment on this population.

The National Surgical Institute of Indianapolis, and its founders Dr. Horace R. Allan and Dr. W.P. Johnson, attempted to change both conditions and attitudes. They believed orthopedic surgery was a specialty that many family physicians and other surgeons didn’t understand fully, and that treatments were often ineffective due to improper equipment and training. An 1885 pamphlet from the organization articulates the purpose for founding this organization:

Upon arriving in Indianapolis in June of 1869, the Institute settled on the corner of Illinois and Georgia Streets in the former “Farmers’ Hotel” building. Upon reaching Indianapolis, they partnered with Dr. Charles L. Wilson, a specialist in ear and eye care, as well as other specialized physicians in the city. Dr. Allen became the face of the organization, and often took the lead in administrative matters.

Early Advertisement for the Indianapolis location, Daily State Sentinel, October 5, 1869, Hoosier State Chronicles

 

The first medical emergency handled at the new location was the Sinker-Davis boiler accident at the State Fair Grounds, which were located at 19th and Alabama Streets at the time.  The sudden explosion of a boiler during a steam-powered saw-mill demonstration on October 1, 1869 killed between twenty and thirty individuals and injured many more. The Institute took in a large number of those affected by the accident and offered care for free, a practice that continued throughout their time in the city.

“A Terrible Calamity”, Daily State Sentinel, October 2, 1869, Hoosier State Chronicles

 

In fact, the Surgical Institute frequently treated patients for accidents and injuries due to their central location in the city, as many other hospitals were further from the city center. This was particularly important in a period of rapid industrialization, when workplace accidents were common, often resulting in major injuries, amputations, or death.

Article citing some of the benefits of the National Surgical Institute, The Indianapolis News, September 1, 1874. Hoosier State Chronicles

 

While the institute often served the public in general care or emergency cases, the National Surgical Institute specialized in the treatment of individuals with physical deformities. More than that, as many of their promotional materials suggest, they sought to remove some of the concerns that prevented individuals from seeking care, such as trustworthiness, cost, and convenience, for their patients. Trustworthiness was of prime importance due to the prevalence of under-trained doctors or skeptics of the profession. This excerpt from their 1876 self-published trade book explains the qualifications of the organization:

In the treatment of ordinary fevers and diseases of the country, your physician would doubtless excel us; but with Institutions of original and most approved character, with ample means and every conceivable apparatus and facility, and with varied and valuable experience of having treated over thirty thousand cases, we do not consider ourselves vain or boastful in saying that it is in our power to excel, and effect cures impossible to them.

Illustration of the National Surgical Institute display case at the 1876 Philadelphia Centennial, from a promotional pamphlet, 1885

 

The Surgical Institute often focused on changing body mechanics to strengthen and utilize areas that may suffer from deformation to help overcome limitations, rather than focusing on drug usage or unnecessary surgeries.[ii] Techniques utilizing atmospheric pressure were often applied to stimulate areas where muscle loss or minimal movement existed previously. They treated everything from spina bifida, to club feet, to rheumatoid arthritis. According to “The History of Indianapolis and Marion County,” Dr. Allen’s “mechanical surgery” treatment methods were adapted in England. The technology he developed even won an award for “Instruments of Medicine, Surgery, Etc.” at the 1876 Centennial Exhibition in Philadelphia. However, newspapers of the time rarely covered the stories of therapeutic treatment, other than to say that patients were treated by the National Surgical Institute.

The success of the organization in Indianapolis led to the development of other locations in the country. By 1875, the organization expanded to three other locations in San Francisco, Atlanta, and Philadelphia. Initially, sharing news of the Institute was difficult due to restrictions on taking out advertisements about medical treatments. However, heavy promotion in the 1870s, as well as direct promotion to potential patients, brought in many individuals. Rival surgical institutes began springing up throughout the country during the 1880s and ‘90s, including organizations in Terre Haute, Louisville, Champaign, Chicago, and Buffalo, all of whom sought publicity in Indiana newspapers:

German advertisement for a competing surgical institute in Buffalo, NY, Indiana Tribüne, February 13, 1886. Hoosier State Chronicles

 

This is not to say the Institute was beyond scrutiny. Several individuals reported patients on the sidewalks in front of the institute and were characterized as “advertisement” for the institute.  By the early 1890s, the NSI was still performing many successful surgeries, but a series of troubling incidents occurred with the building, including several small fires and the collapse of a chimney in 1891:

In an article discussing building failures in the early 1890s, the Surgical Institute was highlighted,
The Indianapolis News, June 26, 1891, Hoosier State Chronicles

 

This event was not isolated, and clearly there were issues with the safety of the building, despite assurances of safety from the owners. Unfortunately, a horrific fire in January of 1892 proved to be fatal, killing nearly twenty individuals and injuring several more. The Indiana State Sentinel, which had previously written glowing reviews of the Institute, was one of the local newspapers that called the building a “deathtrap” and suggested the building should have been condemned. Many blamed Drs. Allen and Wilson for allowing improper living conditions, but both were absolved from responsibility for the fire by the coroner a month later, (although not a popular decision at the time, as the deputy coroner resigned his post following the decision).

In March, Allen suggested he was considering moving the Institute out of Indianapolis in a letter to the Commercial Club, covered by the Indianapolis Journal. The letter indicated the weight that financial difficulties and public scrutiny from the fire put on Dr. Allen, and he did not feel supported in rebuilding the Institute in Indianapolis.[iii] Yet, by mid-May, plans for a new building were drawn up to be built on the corner of Ohio and Tennessee Streets (Capitol Avenue), directly across from the Indiana Statehouse. Dr. Wilson left the Institute by 1893 to start his own competing surgical institute in town, leaving Dr. Allen as the sole proprietor.

Image of the H.R. Allen National Surgical Institute on the corner of Ohio St and Capitol Ave, The Indianapolis News, December 6, 1894. Hoosier State Chronicles

 

Renaming themselves the “H.R. Allen National Surgical Institute,” the organization continued on for a few more years under the control of Dr. Allen. However, the financial strain on the organization led to the eventual closure of the Institute by 1898. The building was sold, eventually becoming the Imperial Hotel. Dr. Allen passed away two years later in Chicago, and is buried in Crown Hill cemetery in Indianapolis.

Despite the sad ending to the National Surgical Institute, tens of thousands of individuals were bettered by the work of the organization. Being at the center of a major city allowed them to be connected to the needs of the public in the area and convenient to people travelling for treatment. The prominence of this organization may have helped inspire the boom of surgical institutes throughout America in the 1880s and ‘90s, offering a new level of care and supporting the work of specialized care for difficult-to-treat conditions, as well as treating serious accidents. Most importantly, the National Surgical Institute placed patient interests at the forefront of their mission and goals, and sought to serve them with innovative care.

 

Works Referenced

Hix, Lisa. “Healing Spas and Ugly Clubs: How Victorians Taught Us to Treat People With Disabilities” from Collector’s Weekly, July 21st, 2015. Website, accessed on 03/04/2019. https://www.collectorsweekly.com/articles/healing-spas-and-ugly-clubs-how-victorians-taught-us-to-treat-people-with-disabilities/

Imperial Hotel, Indianapolis, Indiana, 1907. (Postcard) From the Joan Hostetler Collection of Indiana Album, accessed on 03/07/2019, https://indianaalbum.pastperfectonline.com/photo/1C3EE72F-8329-4BFC-BFB0-914722026138  

List of awards made by the United States Centennial commission to the American exhibitors, International exhibition 1876, at Philadelphia. (S.T. Souder & Company, Philadelphia, 1876). Accessed from Archive.com via Library of Congress, 03/04/2019, https://archive.org/details/listofawardsmade00unit/page/112.

National Surgical Institute (National Surgical Institute (publisher), Indianapolis, IN, 1876), p 39. Accessed from the U.S. National Library of Medicine Digital Collection, 02/12/2019. https://collections.nlm.nih.gov/catalog/nlm:nlmuid-66811200R-bk

Sarner, Moya. “Back pain: how to live with one of the world’s biggest health problems” from The Guardian, June 14, 2018. Website, accessed 03/04/2018, https://www.theguardian.com/society/2018/jun/14/back-pain-how-to-live-with-one-of-the-worlds-biggest-health-problems

Stone, Will. “Patients With Chronic Pain Feel Caught In An Opioid Prescribing Debate” from NPR (National Public Radio). Website, Accessed 03/04/2019, https://www.npr.org/sections/health-shots/2018/07/08/622729300/patients-with-chronic-pain-feel-caught-in-an-opioid-prescribing-debate

Sulgrove, B.R. History of Indianapolis and Marion County. (L. H Everts & Co.: Philadelphia, 1884)

The National Surgical Institute. Pamphlet, 1885. From the U.S. National Library of Medicine Digital Collection, accessed on 03/06/2019. https://collections.nlm.nih.gov/ext/dw/101532257/PDF/101532257.pdf

[i] Three previous Indiana History Blog articles, one focusing on Central State Hospital physician Dr. Sarah Stockton and a two-part article on Civil War surgeon and hospital designer, John Shaw Billings, help provide some context for medical conditions during and following the Civil War.

[ii] In fact, the Institute even suggested that they could cure opium addiction in the January 25, 1878 edition of the Indianapolis News. No details were provided of the treatment method, nor were there successful cases mentioned, but patients who attempted the cure were assured of “no charge” if it didn’t succeed.

[iii] For more information on the fire and the immediate reaction in the newspapers, read Libby Cierzniak’s Historic Indianapolis article, “Indianapolis Collected: After the Fire”.

The Politics of Publicity: Mayor “Lew” Shank and the Power of the Press

Social media today disseminates news faster than any other time in history. Our contemporary political atmosphere, dominated by the 24/7 news cycle and social media, often churns through stories faster than bills can be drafted and carefully-worded messages honed. One article from Mashable, entitled “The Future of Social Media and Politics”, examined how important social media outlets are to current grassroots campaigns and shaping political influence through direct communication with candidates. Another article, this time from The Atlantic, examines how charisma influences our perceptions of leaders and in what standing we hold them in.

These strategies, while utilizing the most up-to-date technology, are not new. The rise of John F. Kennedy over Richard Nixon was as much a response to his policies as it was his appearance in the first televised debates. The charismatic and good-looking Kennedy swayed many followers away from the established politician Nixon, and helped to shift the public perception on his ability to lead the country.[1] The power of messaging and personality is certainly a powerful tool in getting many leaders elected and crafting their image once in office.

Politics in Indiana during the first part of the 20th century was serious business. It was often dominated by political machines, the Ku Klux Klan, and larger-than-life political figures. However, two-time Republican Indianapolis mayor Samuel Lewis Shank, had no interest in either machine politics or joining the Klan. “Lew,” as he was called, did, however, like the idea of being a larger-than-life politician. Particularly during his first term as mayor, he frequently used the media as an outlet for showy political stunts and self-promotions. While he garnered a reputation as a colorful and outspoken figure, his well-covered tactics were not enough for him to go down in Indiana history as a masterful politician. Indeed, he resigned in late November 1913 with one month left of his mayoral term and was not elected to another political position for nearly a decade before one more stint as mayor.

The popularity of Lew Shank derived from the crafted image of his plainspoken nature, and the fact that he presented himself as the common man. This folksy-geniality endeared himself to the public, and the papers, for years. His career in auctioneering (which continued during both terms as mayor) and time on the stage as a vaudeville performer also provided him the skills to captivate crowds with outrageous stories. The unusual press Shank received during his years in politics, as demonstrated in Hoosier State Chronicles, certainly kept his name in the headlines, for better or worse.

The Indianapolis Journal, May 14th, 1904, p 15. Hoosier State Chronicles

 

Indianapolis Journal, June 27, 1903. Hoosier State Chronicles

 

Despite these somewhat unusual headlines, Shank was serious about politics. Shank’s political aspirations began at the age of eighteen. Shank attempted a campaign to become city councilor but was defeated. Undaunted, Shank mounted an ambitious campaign to not only raise his political profile, but also capture the seat of county recorder, wherein he was responsible for maintaining legal documents and records. This campaign included taking out self-promotional advertisements in local papers, partnering with companies to produce objects with his name imprinted on them, (like cigars and chewing gum), and engaging in several publicity stunts. These tactics not only won him the seat of county recorder, but also raised his popularity in local and national papers.

Example of Shank’s self-promotional use of advertisements. Indianapolis News, October 27th, 1902, p.12. Hoosier State Chronicles
Omaha Daily Bee, December 7th, 1902, p.15. Chronicling America 

 

The Philadelphia Inquirer, November 23rd, 1902, p. 44. Newspapers.com

 

Although a long shot (even for the Republican nomination spot), Shank was able to turn his success as county recorder into a viable campaign for mayor of Indianapolis in 1909. Edging out the favored Republican nominee and then his Democratic opponent, Shank won nine of fifteen wards of Indianapolis with a total of 1,625 votes. [2] Yet he was not above resorting to dishonest tactics to win. Shank recalled to the New-York Tribune in 1912 that he gained an advantage in the mayoral election with the African-American community by stating that his political opponent removed his daughter from an integrated school. He openly admitted lying—his opponent had no daughters at all. [3]

Once arriving in office, Shank had a great deal to prove to the citizens of Indianapolis and within his own party. He relied on theatrics and courted the media. One such effort included the enforcement of saloon laws in Indianapolis, particularly laws which prevented the sale of alcohol on Sundays. Shank, of course, handled the issue with his own particular brand of showmanship. Indeed, he insisted that Indianapolis saloon keepers’ licenses were revoked until they sat through a Sunday church service, among other requirements:

The Greenfield Republican, Greenfield, Indiana. February 3rd, 1910. Hoosier State Chronicles

 

Shank again entered the spotlight with his “High Cost of Living” campaign, a reaction to food pricing throughout the state. Shank, believing the mark-up of food to be excessive, went straight to the suppliers, purchased sundries, and then sold the products to the public at cost on the steps of the State Capitol building. What many could see as a cheap publicity stunt proved to be a boon to Shank’s popularity and actually led to lower prices of groceries in Indianapolis.

The Lake County Times (Hammond Times), Hammond, IN. January 27th, 1912. Hoosier State Chronicles

 

The San Francisco Call, San Francisco, CA, September 30, 1911. Chronicling America

 

The Day Book, Chicago, IL. December 23rd, 1911, Image 11. Chronicling America

 

However, his flashier tactics could not resolve the streetcar strikes in November of 1913, which ultimately led to his downfall. The Indianapolis Traction and Terminal employees began a wage and benefit strike. On November 2, the company president brought in strikebreakers, which led to open warfare. A violent clash between strikebreakers and striking workers led to injuries and two deaths. The owners of the line called in strike-breakers to get the lines running again, and requested help from the Indianapolis police department to protect the company men. Due to disagreements between Shank, the police chief, and officers, law enforcement did not provide an adequate response. This did not aid Shank’s standing for many in the city.

Collection of articles about the police situation, Indianapolis Star, November 27, 2013, p 8. Newspapers.com

 

Eventually, after threats of impeachment and another impending strike, Shank resigned his job as mayor, one month short of the end of his term. It is possible this too was a publicity stunt, as he had already signed a contract for, as the Encyclopedia of Indianapolis notes, “the vaudeville circuit with a monologue about his time as mayor.” It would be nearly nine years until Shank would be elected again to public office, and his exit was met with a generally negative response:

The Lake County Times, November 29, 1913, p 1. Hoosier State Chronicles

 

Opinion piece from The Lake County Times, December 1, 1913, p 4. Hoosier State Chronicles

 

During his second stint as mayor of Indianapolis in the early 1920s, he actively opposed the Klan through such methods as banning masked parades and burning crosses. [4] Although easily defeated, he ran in the Republican primary for governor in 1923 against the Klan-backed nominee (and eventual winner), Ed Jackson, in an effort to stem the statewide power of the Klan. Despite his non-traditional career path and aspirations for higher office, Shank’s rise in politics, led by his ability to capture media attention, was an improbable example of both the powers and limits of charismatic politics.


[1] For more information about the Nixon-Kennedy debates, see Time magazine’s article, “How the Nixon-Kennedy Debate Changed the World”

[2] The Indianapolis News, Wednesday Evening edition, November 3, 1909, p. 1.

[3] “Mayor Shank Tells How a Brace of Imaginary Daughters Helped Elect Him”, The New-York Tribune, February 25, 1912, p. 19. Accessed February 2, 2019. https://www.newspapers.com/image/467701598/

[4] “Samuel Lewis (Lew) Shank,” Encyclopedia of Indianapolis, edited by David J. Bodenhamer and Robert G. Barrows, (Bloomington:  Indiana University Press, 1994), 880.