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«The Reward of Courage (1921) A rediscovered cancer film of the Silent Era David Cantor, PhD Office of History, National Institutes of Health ...»

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I went back to Bethesda, and arranged with the National Library of Medicine for a copy to be made on safety film, and a few months later we sat down to watch a copy on the large screen, no magnifying glass this time, the actors and animation coming to life for perhaps the first time in 70 years or more. It was an exciting time for me and my colleagues at the Library, and I had little difficulty in planning a public showing of the film, and in commissioning a musical score from Maurice Saylor to make this 30-minute silent film about cancer appealing to a modern audience. The film may well have had musical accompaniment when shown in the 1920s, but the score has not survived, if there ever was a score since piano accompanists often played without sheet music.90 The first live performance of the Saylor score by the Snark Ensemble accompanied a screening at the National Academy of Sciences on November 10, 2011. The Snark Ensemble also recorded the score for the sound track of one of the versions of the film that accompanies this essay.91

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The remains of an unidentified bug found during the cleaning of The Reward of Courage by Colorlab in 2006. Source: National Library of Medicine.

I tell these stories to raise a more general issue. I’ve already mentioned at some of the problems with this film. It was a nitrate film, and in need of very careful care — a cold room, and a building far from many others, and it was so fragile that it could not be screened without potential damage. So the film had to be conserved and preserved before it could be screened. Remember, I first viewed the film frame by frame, winding it by hand from one reel to another over a light table with a magnifying glass. It was screened for the first time only when converted to safety film. In the process of making the film viewable, it turned out that the original nitrate needed some cleaning. Bugs had literally gotten into the works, and needed to be flushed out. (Fig. 11) Colorlab, the company that made the safety film copy, first had to clean the film, flush out the bugs, the dirt, oil and other detritus, repair sprockets, measure shrinkage, and inspect it for fogging and fading before it could make a safety copy.

The original nitrate film was modified in the course of conservation and still survives in some cold, dark corner of the Library of Congress. The copy that accompanies this essay is taken from the safety film, and went through a complex series of processes which means it only approximates the original.

First, the safety film was not a simple mirror copy of the original nitrate film.

The technique of making a copy involved first making a black and white negative of the film, from which a black and white positive was produced, onto which the colors were added later. The technicians who did the work had to find the right tints, match them to the original, and then add them onto the black and white print. Much of this was done using film analyzer, a tint log, and by eye.92 It was not dissimilar to matching the colors after a car repair; sometimes they are close, sometimes not so close to the original paintwork.

The process of preservation did not end here. The National Library of Medicine required two other copies be made—a high quality Betacam SP videotape to ensure that the safety film was not damaged with constant use, and a DVD for routine viewing to ensure that the Betacam SP tape was not damaged. In each stage there were judgments to be made, which made each stage as much an artifact as a faithful reproduction of the original nitrate film. In the case of the color of the film, it was not even entirely clear to what extent the colors on the original nitrate film from Australia had changed over time. As the technicians at Colorlab acknowledged, the colors in the nitrate film in 2006 might have been different to those at first showing in 1921. Nitrate films keep their color well compared to some other types of film, but there was evidence of fading in this print, with consequent knock-on effect for the colors in the copies.

In addition, it was not clear whether the colors would have been the same for all print versions of the film. The nitrate film turned out to have come from a film stock probably made in 1925,93 and there was no way to know whether the 1925 colors matched the original 1921 print: it depended, for example, on how the dyes were mixed and matched to the original. What you will see is a best guess of what the original 1925 film looked like, but a guess all the same by the technicians who did the conversion. Even their best guesses could not tell us whether the 1925 version matched that in 1921, nor could they take into account the vagaries of screening—colors may have varied depending on the bulb in the film projector (was it under- or over-lit?), and the screen onto which the film was projected, among other factors. It was also an expensive guess or series of guesses. The entire process of preserving the nitrate film, making a safety film, video, and DVD copies cost just under $6,900 for the whole thing, to say nothing about getting me to Dayton to view the film, which makes one wonder how much can be preserved at this cost.94 Thus one of the points of this essay is the artifactual nature of the preservation process. But there is a further final point, which is about how we go about choosing which films to preserve, especially given the high cost of film preservation and conservation. Part of the issue is that we know so little about the range of films that were made. In the case of utility or sponsored films such as The Reward of Courage, there is no equivalent of the various catalogs of entertainment films, which give an indication of the range of films produced, those that survived and those that did not.95 We know that a significant proportion of early entertainment films have vanished, and the proportion of early utility films that has survived is probably even smaller. But it is difficult to know which have been lost because there is no census of such films, and we risk losing a valuable part of our medical and scientific heritage as a result, for some that are lost may have survived, languishing in some unknown closet somewhere. As my example of the cancer film shows, I only knew that The Reward of Courage had once existed, and that it was in all likelihood the earliest-ever cancer education film, because I had compiled a list of all cancer films, those surviving and those which were lost, and was able to go looking for the missing film.





Such a census gives a clue as to how we might begin to make rational choices about which films to look for, and which to prioritize in terms of conservation and preservation given the high cost of this. These films are important resources for understanding the historical, visual, and material culture of medicine and science, but a vulnerable resource, costly to preserve and restore. Too many films have already been lost, and others are neglected, silently decomposing as I write.

Acknowledgments. Earlier versions of this paper were given at the D.C. Art Science Evening Rendezvous (DASER) at the National Academy of Sciences, Washington, DC, October 20, 2011, and at a special screening of The Reward of Courage also at the National Academy of Sciences, Washington, D.C., November 10, 2011. The preservation of this film would not have happened without the help of Zoran Sinobad, Ken Weissman, and Christel Schmidt at the Library of Congress; Elizabeth Fee, Paul Theerman, Sarah Eilers, Karen Sinkule, Nancy Dosch, and Margaret Kaiser at the National Library of Medicine; and Russ Suniewick, Jake Kreeger, Kevin Fallis, and Chris Hughes at Colorlab. At the National Institutes of Health, History Office, Hank Grasso cropped and edited the images from the film.

Further Reading Cancer education films in the 1920s Cantor, David. “Uncertain Enthusiasm: The American Cancer Society, Public Education, and the Problems of the Movie, 1921–1960.” Bulletin of the History of Medicine 81 (2007): 39–69.

Cantor, David. “Choosing to Live: Cancer Education, Movies, and the Conversion Narrative in America, 1921–1960.” Literature and Medicine 28 (2009): 278–332.

Cantor, David. “Between Movies, Markets, and Medicine: The Eastern Film Corporation, Frank A. Tichenor, and Medical and Health Films in the 1920s.” Paper presented at the conference Communicating Good Health: Movies, Medicine, and the Cultures of Risk in the Twentieth Century, Fondation Brocher, Hermance, Switzerland, May 26–27, 2011.

History of U.S. cancer control in the 1910s and 1920s Aronowitz, Robert A. Unnatural History: Breast Cancer and American Society.

Cambridge: Cambridge University Press, 2007.

Cantor, David, ed. Cancer in the Twentieth Century. Baltimore and London:

Johns Hopkins University Press, 2008.

Gardner, Kirsten E. Early Detection: Women, Cancer, and Awareness Campaigns in the Twentieth-Century United States. Chapel Hill: University of North Carolina Press, 2006.

Leopold, Ellen. A Darker Ribbon: Breast Cancer, Women, and their Doctors in the Twentieth Century. Boston: Beacon Press, 1999.

Lerner, Barron H. The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America. New York: Oxford University Press, 2001.

Löwy, Ilana. Preventive Strikes: Women, Precancer, and Prophylactic Surgery.

Baltimore: Johns Hopkins University Press, 2009.

Patterson, James T. The Dread Disease: Cancer and Modern American Culture.

Cambridge, MA: Harvard University Press, 1987.

Wailoo, Keith. How Cancer Crossed the Color Line. Oxford: Oxford University Press, 2011.

Notes Curtis E. Lakeman, “How the Public Health Nurse Can Help to Control Cancer,” Public Health Nurse Quarterly 8, 4 (October 1916): 14–26, p.16. See also “What Everyone Should Know about Cancer,” Health News. Monthly Bulletin New York State Department of Health New Series, 15, 2 (February 1920): 36–59, p. 38.

Osborne started at the ASCC on November 1, 1919, and was formally appointed executive secretary of the ASCC on November 5, 1919: “Appointment of a New Executive Secretary,” Campaign Notes. American Society for the Control of Cancer 1, 19 (November 1919): [2]. (Some of the early issues of some of the ASCC’s Campaign Notes are unpaginated; bracketed page numbers are my own pagination). Osborne’s biography comes mainly from this article and from “Frank J. Osborne, East Orange.” In Manual of the Legislature of New Jersey. One Hundred and Sixty-Eighth Session, compiler, John P. Dullard (Trenton: State of New Jersey, 1944), 370–71.

Frank J. Osborne, “Venereal Disease Control in the Oranges,” American Journal of Public Health 6, 6 (June 1916): 558–59. Frank J. Osborne, “A Health Exhibit for Men. An Educational Exhibit on Venereal Disease Control and Prevention Presented at Coney Island by the New York Social Hygiene Society,” Social Hygiene 3 (1917): 27–49. Frank J. Osborne, The Control of Venereal Diseases from the Public Health Standpoint (New York: The New York Social Hygiene Society, 1917). Frank J. Osborne, Community Control of the Venereal Diseases (New York: The American Social Hygiene Association, 1918). Frank J. Osborne, “The Law Enforcement Program Applied,” Social Hygiene 5 (1919), 83–96. Frank J. Osborne, “Venereal Disease Control as a War Measure,” Health News.

Monthly Bulletin of the New York State Department of Health New Series, 13, 10 (October 1918): 275–81. F. J. Osborne in Major A. N. Thomson, “The Problem of Venereal Disease Control,” New York State Journal of Medicine 18, 11 (November 1918): 451–55, p.453 & pp.454–55. Frank J. Osborne, “Education of the Public in Social Hygiene,” Health News. Monthly Bulletin of the New York State Department of Health, New Series 8, 4 (April 1918): 94–97.

“Health Coordination Committees,” Campaign Notes. American Society for the Control of Cancer 1, 19 (November 1919): [2–3], especially p. 3.

On the NASPT/NTA see Richard Harrison Shryock, National Tuberculosis Association, 1904–1954: A Study of the Voluntary Health Movement in the United States (New York: National Tuberculosis Association, 1957). Michael E.

Teller, The Tuberculosis Movement: A Public Health Campaign in the Progressive Era (New York: Greenwood Press, 1988). More generally on tuberculosis see Barbara Bates, Bargaining for Life: A Social History of Tuberculosis, 1876–1938 (Philadelphia: University of Pennsylvania Press, 1992). Sheila M. Rothman, Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History (New York: Basic Books, 1994). Cynthia A. Connolly, Saving Sickly Children: The Tuberculosis Preventorium in American Life, 1909–1970 (New Brunswick, NJ: Rutgers University Press, 2008).

American Society for the Control of Cancer, Facts About Cancer (New York City:

American Society for the Control of Cancer, 1914). “Surgeons Discuss Cancer Campaign,” Survey 31 (13 December 1913): 508–9, p. 509. Francis Carter Wood, “What Every Woman Should Know about Cancer,” Campaign Notes. American Society for the Control of Cancer 1, 9 (January 1919): [1–4], esp. pp.[1–2].

“Suggestions to State and Local Committees,” Campaign Notes. American Society for the Control of Cancer 1, 12 (April 1919), [1–4], p.[4]. For discussions of the connections between the ASCC and the anti-tuberculosis campaign see James T. Patterson, The Dread Disease: Cancer and Modern American Culture (Cambridge, Mass.: Harvard University Press, 1987), 53. Kirsten E. Gardner, Early Detection: Women, Cancer, and Awareness Campaigns in the Twentieth-Century United States (Chapel Hill: University of North Carolina Press, 2006), 22.

What Everyone Should Know About Cancer: A Handbook for the Lay Reader Prepared by a Special Committee of the American Society for the Control of Cancer (New York: American Society for the Control of Cancer, 1920), 8.

“Dr. Winslow and Cancer,” Campaign Notes. American Society for the Control of Cancer 2, 4 (April 1920): [3–4], p.[4]. C-E. A. Winslow, “The Untilled Fields of Public Health,” Science, 51 (January 9, 1920): 23–33, p.28.



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