Friday, 12 April 2013

An exciting find

This week, our Wellcome Trust Project Archivist Louise gives an update on some surprising finds in the Dott case note collection:

Time is certainly moving on quickly in LHSA’s Norman Dott case note cataloguing project. With the first case note series catalogued (relating to Dott’s early hospital and private practice), I’ve now moved on to the largest series of over 22,000 records documenting Dott’s work at the Royal Infirmary of Edinburgh from the 1940s. But at the end of the first, early series something unexpected awaited me. Labelled ‘Spina Bifida Cases’, a final box contained collected summaries of spina bifida cases in children under two. Not only does this box contain a number of glass plate negatives, lantern slides and related photographs (exciting finds in themselves!), but the earliest of these patient records is dated 1922, making it the oldest in the collection to date.

Spina bifida is a fault in the development of the spine and spinal cord during a baby’s growth in the womb. In its most common form, the spinal column does not fully close, causing membranes and the spinal cord to push out to form a sac on the back of the baby (a meningomyelocele). Babies born with spina bifida are also at risk from hydrocephalus (excess cerebrospinal fluid in the brain), which was probably why Dott was keen to examine their heads as well as their spines.

LHB20 CC/20/PR1.1974 Encephalogram showing spine and meningomyelocele in young patient

The spina bifida case notes are records of encephalography, a now-outdated x-ray procedure through which cerebrospinal fluid was removed from the ventricles in the brain or the spinal cord and replaced with oxygen, allowing a clear image to be taken. Along with these images are notes describing the procedures and the implications of the x-ray findings. Notably, these young patients were under Sir John Fraser (1885-1947, and pictured in last week's blog), with whom Dott published on paediatrics in the early 1920s. Fraser served as surgeon to the Edinburgh Royal Hospital for Sick Children (R.H.S.C) from 1920 to 1925, eventually attaining the prestigious Chair of Clinical Surgery at the University of Edinburgh.

LHB20 CC/20/PR1.1974 Encephalogram of cranium of same patient showing ventricles in the brain

Dott showed a considerable interest in spina bifida cases and paediatric surgery throughout his career, becoming Honorary Surgeon to the R.H.S.C in 1925. These photographic materials and notes relate to cases seen as out-patients at the R.H.S.C before Dott took up his official post there and, although Dott occupied a number of surgery and lectureships at various Edinburgh institutions before 1925, the R.H.S.C was not one of these. Although I’m very busy cataloguing at the moment, these ‘gaps’ in Dott’s career which are not documented by our case note collections will be exciting to research in the future, particularly using the collection of Norman Dott’s private papers held by LHSA’s colleagues in the Centre for Research Collections.

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