Tuesday, 15 December 2015

Christmas comes off the shelf!

In the final LHSA blog of 2015, Archivist Louise has been finding out how the festive season was celebrated in Edinburgh’s hospitals…

This week, I’ve been searching through our catalogues and going through archive boxes to find out how Christmas was marked in hospitals in our region. In the first three days of next week, I’ll be introducing what I found on Twitter – so don’t forget to join us on @lhsaeul…

When I was first asked to look out some festive-themed items, I must admit to being a bit stuck – after all, Christmas and hospitals are not exactly linked in people’s imaginations. However, simply by searching for the word ‘Christmas’ in our online catalogues, I found a surprising number of items reflecting the importance of the holiday in the hospital year.

Christmas was a time when staff went out of their way to make a normally family-centred time happy for their patients, and we’ve more than a few pictures of celebrations on the wards, as this image of Charles Falconer carving the turkey at the Western General Hospital in the 1970s shows:

Charles Falconer carves the turkey (GD28/8/3/73)

However, as early as 1826, it was recognised that medical staff needed to mark Christmas too, as James Hamilton Junior reminds us:

Letter from James Hamilton Junior (GD1/75/36) - I had to go into the Treasures' Room for this one!

Because the handwriting is a bit difficult, I thought I’d transcribe it:

‘It will save the very unpleasant task of examining Dr Hope as a witness if he will admit that in the beginning of Decr. 1815 and before the annual meeting of the Senatus Academicus he announced to his audience in his classroom that he and his colleagues of the Medical Faculty had agreed that in future the medical students should have Christmas holydays.’

Christmas is also traditionally a time for giving and, in a time before the NHS when many hospitals relied on donations for their livelihoods, institutions put out special Christmas appeals in order to boost their coffers:

A Christmas calendar, sold in aid of the Royal Edinburgh Hospital for Sick Children (LHB5/20/3/7)

After 1948, hospitals carried on fundraising at Christmas, as shown by this card sold in order to raise funds for the Edinburgh Royal Hospital for Sick Children’s TASK appeal to build a new wing for the hospital:

Christmas card sold in aid of the TASK appeal LHB5A/6/4/9

So don’t forget to join us on Twitter next week to see what other items I’ve unearthed from Christmases past and present. There’ll be some familiar-looking items and some festive surprises... For example, can you guess who this is?

This is GD1/15/12 - that's all I'm saying... for now!

In the meantime, Merry Christmas and all good wishes for 2016 from the LHSA team - Ruth, Becky, Paul and Louise!

Friday, 11 December 2015

Coughing, kissing, and the spread of tuberculosis

As winter draws in and coughs start spreading, our Project Cataloguing Archivist Rebecca looks at how a cough could be both a symptom and a cause of tuberculosis.

Just as nowadays we are told to seek medical advice if we have a cough for more than 3 weeks, patients would often report to the Royal Victoria Dispensary with a troubling cough. A productive cough could often be a symptom of tuberculosis along with haemoptysis, or coughing up blood. Patients would be tested for exposure to tuberculosis bacteria and have their chest x-rayed to see if any of the characteristic signs of tuberculosis were present in the lungs. For many patients, no signs of disease were found and they were sent home with instructions to return in a few months to check for changes in the lungs.

A cough was a characteristic sign of tuberculosis (think of the ominous cough developed by many a period drama character), but it was also a key vector in the transmission of the disease. The bacteria could be present in any phlegm coughed up, and therefore be spread through airborne transmission the same as any other infectious chest disease. Studies in the 1920s showed that tuberculosis bacteria could live outside the body and intermingled with dust for several days. This is why patients were encouraged to sparsely decorate their homes, and why twentieth century sanatoriums were built with far less decorative flourishes than their nineteenth century predecessors.

A WWII-era poster informing the British public of the dangers of coughs and sneezes. © IWM (Art.IWM PST 14154)

Coughing into a handkerchief could prevent the bacteria spreading in the air, but the handkerchief would need to be fully sterilised after each use in order to stop the tuberculosis bacteria from lingering, difficult to achieve in a domestic setting. It was widely acknowledged that the best solution in a domestic setting was to kill the bacteria with fire. Patients at home were told either to cough into disposable paper handkerchiefs or into disposable paper flasks, which could be burnt in a closed stove. Patients would also have been given sterile 'sputum flasks' to cough into. These could have disposable liners, or in hospitals they could be collected and sterilised on site.
The Royal Victoria Dispensary handed out informational leaflets to patients including this and other advice. The images below are some examples, and they really convey the strict rules which patients were expected to follow in order to prevent the spread of tuberculosis. Instructions to keep windows open, avoid kissing, and for the patient to sleep alone in a large, airy room all seem unfeasible in different ways, particularly in a cold Edinburgh winter, so it is likely that they weren't always followed; they do, however, represent the ideal behaviour of the tuberculous patient to do their part in not spreading the disease.

A card handed out to patients at the Royal Victoria Dispensary, with strict rules on hygienic living. (LHSA slide collection)

Advice for Royal Victoria Dispensary patients on living well. (LHSA Slide Collection)

Friday, 4 December 2015

An Invitation to the History of the Royal Edinburgh Hospital

In this week’s blog Paul highlights some of the interesting items he has uncovered during his first month converting the Royal Edinburgh Hospital Catalogue (LHB7).

For my second blog as a Catalogue Conversion Assistant at LHSA I thought that I would use the opportunity to highlight some of the items which I have found interesting when consulting the Royal Edinburgh Hospital (REH) collection. Now that I have crossed the halfway point of this rather large catalogue I have had the chance to look at quite a broad section of different material relating to the hospital. However, one box of items really stood out in particular, that being Hospital Pamphlets and Brochures, 1866 - 1999 (LHB7/16).

At first, this small collection of invitations, programmes, posters and brochures caught my attention due to their visual appeal and how these items changed aesthetically from the middle of the 19th century to the end of the 20th. However, after closer inspection I started to think about how items such as these can provide us with snapshots of the history of institutions such as REH. They cover important events such as the opening of new buildings and departments, lectures from influential practitioners in the field of psychiatry and celebrate the careers of key members of staff in the development of the hospital.

A programme and invitation from the Royal Edinburgh Hospital Collection (LHB7/16/7/1 & 4).

One of the earliest programmes which relates to a significant event in the history of the hospital lays out the day’s events for the “Laying of Commemoration Stone of New Craig House” on the 16th of July 1890 (LHB7/16/7/1). The company were to meet in front of Old Craig House and then, rather symbolically, “proceed to the platform on the new building where the stone is to be placed.” The stone was to be laid by the Earl of Stair using a silver trowel and a casket containing memorabilia from the period was to be buried under the stone. The programme itself reflects the elegance and grandeur of the new building, which was intentionally designed to be more like a country hotel than a hospital in order to house the asylum’s wealthier patients.

The next item I would like to highlight is an invitation to the “Royal Edinburgh Asylum Centenary Celebrations, 1807 – 1907” (LHB7/16/4). The invitation gives a small summary history of the asylum, noting important events from the first 100 years of its existence (including the laying of the New Craig House commemoration stone and the opening of the building itself in 1894). However, one of the more notable features of this invite for me, is the way in which it leaves a blank space for the name of the invited guest with the printed words “and Lady”. Looked at in this way items such as these remind us of the gender and class inequality which permeated British Society at the time.

Complimentary Dinner and Presentation to T.S. Clouston (LHB7/16/7/6).

There is also a rather striking menu for a “Complimentary Dinner and Presentation to T.S. Clouston” from 1908 (LHB7/16/7/6), which unfolds to reveal a picture of the celebrated Physician Superintended with the signatures of subscribers both present and not present at the dinner. Guest where not only to be served a fine selection of food and drink but also an assortment of cigars and cigarettes.

Focus on Change, The Royal Edinburgh Hospital brochure (LHB7/16/1).

In contrast to the grandeur of the late 19th and early 20th centuries is the modernism and efficiency of the 1960s. This decade played another pivotal role in the development of REH with a stream of new buildings and departments opening by its close. These included The Andrew Duncan Clinic, The Professorial Unit and the Department of Psychiatry of Edinburgh University in 1965, the Young People’s Unit in 1968, and the Unit for the Treatment of Alcoholism in 1969.

The programme for the “Opening of The Andrew Duncan Clinic…” by the Queen Mother (LHB716/3) tells us that this was still quite a grand affair with a number of distinguished guests including the Lord Provost of Edinburgh and the Joint Parliamentary Under-Secretary of State.  It also includes a printed sheet of “General Information”, noting exhibitions on display and other points of interest for the guests, as well as asking them “to refrain from smoking in the Lecture Theatres” or “in the staff dining room until Her Majesty has left the hospital”!
Programmes for the openings of The Andrew Duncan Clinic and Young People’s Unit (LHB7/16/3-4).
I would like to end this blog by sharing another few items from the collection. There is a poster advertising a lecture by Anna Freud, a programme for the 1966 REH sports day and, I know it’s a bit early but, a very minimalist Christmas card from the REH.




Friday, 27 November 2015

Threats to Openness in the Digital World

This week our Project Cataloguing Archivist, Rebecca, has been in Newcastle to learn about one of the challenges facing records professionals in the digital era…

Earlier this week I attended a fascinating conference on ‘Threats to Openness in the Digital World’ at Northumbria University. The conference aimed to “consider and debate issues surrounding growing threats to citizens’ rights to access public archives in the digital world.” As a body that holds public records there were some interesting points raised that may affect LHSA in the future.

The move towards digital recordkeeping poses many issues for archivists not least because of the hugely increased and fragmented volumes of data, and this was the subject of the first session and a theme which ran through the whole event. Instead of coherent and carefully filed units of paper records, it was reiterated that digital records are often stored with multiple versions in non-standardised shared folders, or in email chains which are stored in multiple locations and not filed anywhere. The ease of creating digital records means that the number of records has increased massively, and this makes the job of the archivist much more difficult.

Potentially sensitive materials, such as those which contain sensitive personal data such as medical information or information regarding political affiliations, are usually reviewed prior to being made publicly available so that the record can be closed or sections redacted, and some of the panellists spoke of their experiences with these sensitivity reviews. With public records, which are open under Freedom of Information legislation unless specific exemptions apply, being able to process records is vital to determine if they meet those exemptions or to judge if their release would breach the Data Protection Act. Reviewing paper records can be time consuming and resource heavy, and the challenge of scaling up the sensitivity reviewing process to cover the massive volumes of unorganised digital records of all types that are being produced is going to be a major challenge for records professionals in the years to come.

Although information which could aid this process could theoretically be embedded in digital materials from creation, it was noted that in reality it can be difficult to persuade record creators to go through this process. The nature of the digital environment also poses a problem for records professionals: Determining the sensitivity of records relies heavily on understanding the context of a record, meaning that it is not suited to automation in the current computing context, but conversely it was highlighted that the use of search tools hugely increases the risk of sensitive material coming to light when it shouldn’t. Ultimately, the volume of materials and the requirement for access could mean that blanket destruction of digital records is carried out, if they are kept at all – a huge problem for governmental accountability, as illustrated in a fascinating talk by Mary Daly, President of the Royal Irish Academy, and for the archives of the future.

This is only a small part of what was covered at the conference, which you can read more about on the Threats 2 Openness blog: https://threats2openness.wordpress.com/. Overall it was a great event which generated lots of discussion and, after the final session, practical action points to take forward. It is clear that a strong recordkeeping culture is needed if we are to tackle these challenges, but we ended on a note of optimism that we should have faith in future technology to support our work as archivists.

Friday, 20 November 2015


It's Explore Your Archive week, a national campaign to raise awareness of archives and their collections (for more information please see http://exploreyourarchive.org/). In today’s blog Ruth talks about what we've been doing to celebrate archives this week and a bit of exploring of her own…

We’ve been taking part in Explore Your Archive week on social media, and today Louise and I have set up camp at the UK Clinical Research Collaboration Conference 2015 (held at the John McIntyre Conference Centre here in Edinburgh) – we’re talking to delegates about our collections and their research potential, and Louise has been tweeting as @lhsaeul. In honour of this year’s campaign theme of ‘democracy’, we’ve also put some relevant collection items on display alongside some fantastic material from the University’s archive. The mini exhibition, on the sixth floor of the Main Library, will continue beyond Explore Your Archive week, so do take a look if you're passing. 

Our display at the conference today, complete with hovering campaign badge!

And talking of taking a look while you're passing, I was in Aberdeen last week to see the Glucksman Conservation Centre at the University’s Library and popped in to see Fiona Musk, the Archivist for NHS Grampian, who is also based there. We meet fairly regularly as fellow custodians of NHS archive material, but I'd not had the chance to see her collections in person before. Fiona gave me a tour of the store and it was great fun to see all the similarities between our collections. Lots of familiar looking book bindings and types of record, just for hospitals that are a bit further north than ours! If you'd like to find out more about NHS Grampian’s collections see http://www.abdn.ac.uk/library/about/special/nhs-grampian-archives/ or follow Fiona on Facebook at https://www.facebook.com/NHSGrampianArchives/?fref=ts.

Visiting the fabulous conservation facilities in the Library mirrored the quality of the stores Fiona showed me. The four conservators there work on Aberdeen University’s collections of rare books and archives within their own particular paper, book and collections care specialisms. I took a few photos to try and capture the scale and high spec of their conservation studio - the first is of the main studio (with their no-adhesive book cradles in foreground), and the second is of the area dedicated to photographic documentation.

I wasn't the only one on the tour – there were about 15 other conservators who were shown around the relatively new Library, which also included the exhibition gallery, the Special Collections reading room and the education spaces, and we had lunch in a room on the seventh floor with great views out over Aberdeen until the clouds and rain came in! With such a concentrated group of conservators in one place, it was also a good opportunity to swap ideas and find out about new treatment options that I can bring back to our collection.

One of the architectural features of the Library
The conservators admiring the view shown in the image above this one
All in all an interesting and useful day spending time with archive collections and learning from those that look after them - exactly what #explorearchives is all about!

Friday, 13 November 2015

Building pride and fighting prejudice

Glasgow University student Samantha Smart has been with LHSA for the past two weeks as part of her MSc in Information Management and Preservation. The course is one of a handful across the country offering an accredited qualification in archives and records management (with which you can become a professional archivist!) We've handed over the blog to Sam this week so she can share her work with us, which will turn into an assessed component of her degree:

For the last two weeks, I have been working on cataloguing and repackaging the papers of Waverley Care Trust, an Edinburgh-based organisation set up in 1989 to provide support to those affected by HIV and AIDS. Their remit later broadened to include work with individuals diagnosed with Hepatitis C, while their geographical reach has expanded beyond the Lothians to cover the whole of Scotland. Regular blog readers might remember the post from earlier this year introducing Waverley Care and its key services, and showcasing a selection of collection items.

Besides key administrative records like business plans and annual reports, the collection includes a great deal of visual and ephemeral material that adds additional detail to the picture of the charity’s day-to-day work. Items like flyers and invitations, for example, provide a tangible connection to events recorded officially elsewhere; they suggest particular moments or interactions. Posters and postcards demonstrate the outward-facing work of Waverley Care: raising awareness, contributing to the public understanding of HIV and developing links to the larger community.
Invitation to ‘Pride & Prejudice’ exhibition (1999). GD36/4/1/7.
Taken together, all of the records within this collection document the extraordinary range of services, initiatives and activities facilitated by staff and volunteers. While working my way through the material, I found references to tai chi, sculpture, quilting, mask-making, line dancing, poetry writing, walking, reflexology, papermaking, video editing, singing and stained glass design (a non-comprehensive list!). Many of these activities were run as part of the Arts Project, an ambitious programme which began in the early nineties, administered jointly through the SOLAS Centre and Milestone House. The Waverley Care collection includes snapshots and samples of some of the end-products of this project - two printed booklets of participants’ writing, posters for public exhibitions of artwork, photographs of a completed stained glass window in situ at Milestone House - but also goes some way towards recording the equally (or more) valuable process of creation. 

Papermaking workshop in progress, and completed sheets of handmade paper (1996). GD36/3/3/2/4/22.

Looking at the changing types of services offered by Waverley Care over the 1990s and 2000s reveals the organisation’s responsiveness to both the needs expressed by their users and to developments in HIV treatment and care. From its establishment, the Information Centre at SOLAS allowed users to carry out their own research into treatment options, a particularly important function in the years before widespread internet access. Waverley Care’s annual review for 1995 notes excitedly that ‘the Information Centre is about to join the Worldwide Internet’ (capitals original!), while the report for 1997 contains the news that they are ‘looking forward to the installation of a second Internet terminal’, possibly reflecting increased demand for up-to-date information about drug treatments in the early years of combination therapy.
Information leaflet for World Aids Day. GD36/4/1/4.
Having examined and described each of the records within the Waverley Care Trust collection, I was left with a clear sense of the organisational ethos and of the ways in which staff, volunteers, service users, families, carers and others involved with the work of the charity were able to form a network of mutual support. They tell of imagination and encouragement, of enthusiasm and vitality. Equally, these records tell only partial stories, and there will have been many encounters and experiences on which they are silent - narratives that rely on the memories of those with a personal connection to the charity and its work. Cataloguing, though, represents a step towards initiating these potential conversations and towards putting the Waverley Care records into dialogue with items from LHSA’s related collections, which will in turn allow further aspects of the collective response to HIV and AIDS in Edinburgh and the Lothians to be brought to light.

Friday, 6 November 2015

Treating bone and joint tuberculosis at Southfield Sanatorium

In this weeks blog we hear from Rebecca, who will be sharing some of what she has learnt so far from cataloguing tuberculosis case notes...

Work on the Tuberculosis Case notes project is progressing well, with well over 1000 records catalogued. The bulk of the records so far have been from Southfield Sanatorium, covering patients admitted between 1921 and 1953. It’s been really interesting in these case notes to see the range of diseases that people would be admitted with, as the sanatorium would treat patients with non-tuberculous chest diseases as well as extra-pulmonary tuberculosis (that is, tuberculosis of organs other than the lungs). One of the most frequent types of extra-pulmonary tuberculosis in these case notes is osteoarticular tuberculosis, or tuberculosis of the bones and joints.

A front view of Southfield Sanatorium (P/PL41/TB/022)

Osteoarticular tuberculosis can affect virtually any bone or joint in the body, including the vertebrae of the spine. It is caused by a spread of the disease from the lungs, though it can take a while to develop so in about half of cases it appears after the disease has ceased to be active in the lung. Spinal tuberculosis occurs when tuberculosis bacteria spread through the blood and into the vertebrae. If the disease spreads through the vertebrae to affect an entire disc, the disc can collapse. In some cases of osteoarticular tuberculosis, “cold” abscesses can form, which would have been aspirated in order to try to remove the infection.

Treatment of this condition at Southfield Sanatorium was chiefly through rest and immobilisation. The affected limb would be set in a plaster cast or a “shell”, and the patient’s position would be manipulated in order to provide the greatest advantage. Patients would be immobilised in this way for months at a time to give the treatment time to work. For patients who needed to remain mobile, braces and plaster jackets were used so that they could move around whilst still receiving some of the benefits of immobilisation.
Examples of braces used to treat spinal tuberculosis.
By Internet Archive Book Images [No restrictions], via Wikimedia Commons
Immobilisation worked on the basis that the affected area would heal through a process of increased resistance due to prolonged rest. This would enable the formation of fibrous tissue which could diminish the supply of blood to the diseased area, meaning that the disease would not be able to spread. Immobilisation also assisted the patient by preventing inflamed areas from rubbing together, which could lead to pain and erosion. Immobilisation was widely regarded at the time as the best cure for this type of tuberculosis, particularly in children, and whilst surgical treatments such as bone grafts were available for adults, this was not used at Southfield Sanatorium, which tended towards the more conservative treatments.
Sir Henry Gauvain, ‘Treatment of bone and joint tuberculosis’, Tubercle, 17, 8, 1936, pp. 360-363
C. Lee Pattison, ‘The local treatment of acute tuberculous disease of the hip joint and vertebræ’, Tubercle, 5, 4, 1924, pp. 162-167
McDonald and Sexton, ‘Skeletal tuberculosis’, http://www.uptodate.com/contents/skeletal-tuberculosis

Friday, 30 October 2015

Creating clearer catalogues...

This week, we've an introduction from a 'new' member of the LHSA team. In fact, you may recognise Paul Fleming from previous blogs, although in the past two weeks, he's started a new role with us:

The University of Edinburgh is the first European developer of ArchivesSpace, a next-generation web-based archives information management system, and LHSA is taking part in the adoption process. There have been a number of blogs detailing the more technical side of things, so I will focus more on introducing my role as Catalogue Conversion Assistant, putting LHSA catalogues into the new system.

Paul: pictured in the LHSA stores. There's nothing like the official LHSA staff photo to let you know you've arrived!

Naturally, LHSA has been involved in discussing how the Centre for Research Collections will use ArchivesSpace to highlight their collections, with Louise (LHSA Archivist) being a member of the project team. The move over to this new system is no small task with Phase One alone seeing the transfer into ArchivesSpace of 17,000 catalogue records and 22,000 authority terms describing archive collections across the CRC. Yet the enhanced service which this will provide for our users and staff will be worth all the hard work.

I feel very humbled to now be playing a small role in the adoption process as Catalogue Conversion Assistant at LHSA. Over the next four months I will be converting existing LHSA finding aids from Microsoft Word format into ArchivesSpace with the aim of improving user access to our collections and better representing LHSA on the new system.

Friday, 23 October 2015

New opportunities at LHSA

The blog this week is from Ruth, with a shameless bit of advertising for two new posts we’re recruiting for!

The first post is a Project Cataloguing Archivist – maternity cover for our Wellcome Trust funded project to catalogue Norman Dott’s case notes. There have been lots of really interesting blogs about this project from my colleagues over the past couple of years so I won’t go into too much detail here about what’s involved – check out the blog archive and our project pages on http://www.lhsa.lib.ed.ac.uk/projects/Cataloguingcasenotes.htm for more information. This post is fixed term for six months with the possibility of extension, and would be ideally suited to an archivist in the early stages of their career. The vacancy will go live on the job pages of Edinburgh University’s website (http://www.ed.ac.uk/schools-departments/human-resources/jobs) on Monday, and we’ll be updating Facebook and Twitter as soon the application process is open.

Our second post will be open for applications from later on today (at the University URL above). We’re looking for an Access Officer to join the team, and work with us to answer enquiries about our collections and services, and help open up the Archive to new audiences. This is a part time post, which is likely to be a good fit with someone who is interested in pursuing an archives career and would like to work in the sector whilst completing a distance learning qualification. 

If either (or both) of these posts are of interest please have a look at the University job pages for the full details including job description, person specification, grading and timescale. And if these jobs aren’t for you, but you know someone who might be interested, please do pass the info along. We’re really pleased to be able to offer these exciting opportunities within the archive sector, and look forward to welcoming two new people to the team here at the Centre for Research Collections.

Friday, 16 October 2015

The Man Behind the Edinburgh Scheme

In this week's blog, Project Archivist Rebecca learns more about the founder of the Royal Victoria Dispensary...

Work is progressing well on the tuberculosis case notes cataloguing project so I thought at this stage it might be a good idea to learn a bit more about the man who started it all, Sir Robert William Philip.

Sir Robert Philip, 1857-1939
Born in 1857, Philip graduated from the University of Edinburgh with a degree in medicine in 1882. Further studies took him to Leipzig, Berlin and Vienna, where he took the opportunity to view the recently discovered tubercle bacillus. Prior to this discovery there had been much debate about whether tuberculosis may be hereditary. The discovery of the bacillus proved that it was an infectious disease, and Philip was quick to realise the implications of this discovery for treatment. Following his return to Edinburgh and the establishment of his medical career at the Royal Infirmary, Philip retained an interest in tuberculosis, hypothesizing that the various lesions caused by tuberculosis were symptoms of a systemic infection. Coupling this theory with his understanding of tuberculosis as an infectious disease, Philip began his life’s work of establishing a co-ordinated system of tuberculosis treatment in Edinburgh.

He opened the Royal Victoria Dispensary on Bank Street in 1887, which came to operate at the centre of a range of co-ordinated services in a system known as the Edinburgh Scheme.  A large part of this scheme was identifying contacts of tuberculous patients and promoting good hygiene to prevent the spread of the disease. (For more information, see my earlier post.) The success of these institutions added credibility to Philip’s advocacy for a notification scheme, which influenced tuberculosis policy throughout the UK throughout the early twentieth century, particularly the national requirement for the notification of patients with tuberculosis and other infectious diseases. His work in Edinburgh also led to the bringing together of one of the first herds of tuberculosis-free cows, diminishing the spread of bovine tuberculosis to children. His influence was acknowledged in 1913, when he was awarded a knighthood.

Royal Infirmary Summer Residents, 1883. Robert Philip is the first seated gentleman on the left-hand side.

Philip’s career was not limited to his work at the Royal Victoria Hospital, which was handed over to the City of Edinburgh in 1914. In 1917 he was the first to take the Chair of Tuberculosis at the University of Edinburgh where he led a compulsory course of lectures for medical students, spreading his influence to the next generation of doctors. As well as his specialism in tuberculosis, Philip worked as a physician at the Royal Infirmary until 1921, where he taught clinical medicine. He served as president to many medical associations, and sat on the council of the International Union Against Tuberculosis.

Sir Robert Philip died in 1939, leaving a permanent influence on the treatment of tuberculosis and preventative medicine through his advocacy for notification of tuberculosis patients and surveillance of their contacts. His influence was not limited to Edinburgh, or even the UK, but was felt far afield in countries such as the USA, where his insight was well-respected. Even after the discovery of effective antibiotics led to a new cure for tuberculosis, Philip remained respected by physicians for the correctness of many of his theories and the effectiveness of his work.
Plaque commemorating Sir Robert Philip at 13 Bank Street, the original site of the Royal Victoria Dispensary. (P/PL41/TB/035)

Munks Roll: http://munksroll.rcplondon.ac.uk/Biography/Details/3541
NAPT, Sir Robert W Philip 1857-1939: Memories of his friends and pupils (1957)
Steve Sturdy, ‘Philip, Sir Robert William (1857–1939)’, Oxford Dictionary of National Biography, Oxford University Press, 2004; online edn, Jan 2011 [http://www.oxforddnb.com/view/article/35505, accessed 15 Oct 2015]

Friday, 9 October 2015

Towards a healthy city

In this week's blog, Archivist Louise learns how 'auld reekie' cleaned up from LHSA's public health collections:
You may have seen our recent social media promotion of a very special event at the Royal College of Surgeons of Edinburgh on 21st October celebrating 150 years of the ground-breaking 1865 work, Report on the Sanitary Conditions of Edinburgh, by the city’s first Medical Officer of Health, Henry Duncan Littlejohn (1826 – 1914). Ruth (LHSA Manager) and I are going along to the symposium, not only because the content will be fascinating and deals directly with our work, but also because we’re raiding the LHSA stores to take along some items for the afternoon to bring the history of public health in our city alive.

The symposium programme begins with a talk on the history of the development of public health in Edinburgh since Littlejohn’s 1865 report, followed by an account of the current health of the city delivered by NHS Lothian Director of Public Health, Professor Alison McCallum. The day finishes by discussing the legacy of Littlejohn’s work, and whether in 2165 (150 years from now), we will continue to capitalise on Littlejohn’s innovative legacy.

Luckily for everyone, I’m not a doctor, so cannot help with the city’s current ills, and I definitely can’t see into the future, but I can help to shed light on the history of public health changes in Edinburgh through LHSA collections. We’re taking along items that span the period from Littlejohn’s time until the developments in healthcare with the coming of the NHS, including images of nurseries and the school medical service in the 1940s, a letter-book describing insanitary houses in Leith in the early twentieth century and mementoes and memories of Littlejohn as a lecturer at the University of Edinburgh Medical School (Littlejohn was appointed to the Chair of Medical Jurisprudence at the University in 1897).

Henry Duncan Littlejohn was appointed Medical Officer of Health for the city in 1862, a post that he occupied until 1908. Born in Leith Street and educated at the University of Edinburgh Medical School (from which he graduated in 1847), Littlejohn was appointed as the city’s Police Surgeon in 1854.  Littlejohn’s career developed as he lectured at the Royal College of Surgeons of Edinburgh and appeared in the judiciary courts as a crown medical examiner. However the November 1861 tragedy in the High Street in which a tenement collapsed killing 35 people brought Edinburgh’s appalling housing and sanitary conditions for the poor into sharp relief. The Town Council put the appointment of a Medical Officer of Health to the vote and, by the narrowest of margins (only one vote), Littlejohn and his department began to transform birth, life and death in our city.

My favourite item from those I’ve chosen for the display is the Report on the Evolution and Development of Public Health in the City of Edinburgh from 1865 to 1919 (LHB16/2/1). Admittedly a bit of a mouthful, the report by John F Young details the progress in making Edinburgh a cleaner, happier and healthier city since Littlejohn’s 1865 report. Report on the Sanitary Conditions of Edinburgh was the result of painstaking work by Littlejohn and his sole clerk. It was based on data that they collected in 1863 on death rates, disease and housing conditions in 19 districts that Littlejohn defined in Edinburgh. The report also included recommendations on steps that could be taken to improve the poorest areas of the city, such as decreasing overcrowding, lowering the height of tenements, improving existing housing and creating space for more sanitary new houses and streets.
The Report on the Evolution and Development of Public Health in the City of Edinburgh from 1865 to 1919 takes a ‘then-and –now’ approach, comparing the conditions and immediate improvements made in the late nineteenth century with life for Edinburgh’s residents in 1919:

The first pages of Young's report comparing the nineteenth century conditions for those with infectious diseases in Canongate Poorhouse to the green fields and (then!) modern facilities at the City Hospital, opened with Littlejohn's help in 1903 (LHB16/2/1).

Young recounts the dire conditions described in Littlejohn’s 1863 research, such as a tenement called Middle Mealmarket without sink or WC yet housing 248 individuals, and that Edinburgh had 171 cow-byres located directly below human dwellings. He also traces the development of Edinburgh’s sanitary and living condition since Littlejohn’s appointment, particularly listing the legislation which came as a result of his work, such as the 1867 City Improvement Act (a slum clearance scheme), the 1889 Notification of Diseases Act (particularly important in being able to trace the impact of infectious diseases such as TB) and the City Act of 1891 which empowered authorities to removed healthy people from infected houses.

Indoor and outdoor case for TB patients at the City Hospital (LHB16/2/1).

The 1919 Report on the Evolution and Development of Public Health in the City of Edinburgh shows the growth of the Public Health Department from Littlejohn and his clerk in 1862 to a range of functions, including a public health group, a tuberculosis group (comprising infectious disease dispensaries, disinfecting stations and hospitals), food and drugs inspectors, a sanitary department, a VD scheme, a veterinary department (checking the conditions of animal husbandry and slaughter) and a child welfare department. Young’s report was written just as Edinburgh’s pioneering Maternity and Child Welfare Scheme was developed (on which I’ll be writing another blog shortly), a system of care prompted by the number of infant deaths attributed to premature birth and nursing conditions. This scheme was developed under Edinburgh’s second Medical Officer of Health, Dr A Maxwell Williamson, and the necessity of its foundation makes up a large section of Young’s survey:

Table showing deaths of children under five in Edinburgh by area, 1911 - 1915 (LHB16/2/1).

LHSA does not hold a physical copy of Littlejohn’s Report on the Sanitary Conditions of Edinburgh (although you can read a digitised copy here), but we do have an impressive collection from the Public Health Department. The collection covers Medical Officer of Health reports, photographs, as well as documents covering the main roles of the Public Health Department in sanitation, prevention of disease, housing and child welfare. Its potential as a research resource is huge. In fact, it’s currently a major source for a University of Edinburgh contribution to a collaborative public health research project, using the collection to map the lives of those born in Lothian in 1936.

There are still a few free tickets left for the 21st October Symposium on public health's history, present and future in Edinburgh, which you can sign up for here - so come and visit us to see some of LHSA's collections!

Public health on the move: a motorised ambulance and a disinfecting van in early twentieth century Edinburgh (LHB16/2/1). 

Friday, 2 October 2015

Tan! Teine! (Fire! Fire!)

In this week’s blog, Ruth reflects on a recent training event held by the Scottish Council on Archives (SCA) all about fire in the archive: preventing fire, and responding to it. 

The training wasn’t delivered in Welsh and Gaelic, as the blog title might suggest, but there were excellent speakers from Aberystwyth and Glasgow who talked about their experience of fire and how it impacted on their buildings, archive collections and services. They were joined by a representative from the local Scottish Fire and Rescue Service, and the day brought together a wealth of experience that those attending could draw and on and take back to their own organisations.
The day of lectures and question and answer sessions began with an introduction from Linda Ramsay, National Records of Scotland, who highlighted the role of the SCA in relation to the preservation and conservation of the nation’s archives. (If you’d like to find out more about SCA, see their website on http://www.scottisharchives.org.uk/, and for their group dedicated to preservation, http://www.scottisharchives.org.uk/preservation.)
The first speaker was Iwan Bryn James from the National Library of Wales, who talked about their 2013 fire. The presentations will be made available online – so look out on the SCA website if you want to find out more - but the main thing that I took from Iwan’s talk was the need to be fully prepared: have an up-to-date plan that sets out what you would do if your building and/or collection was affected by fire, and make sure you have all the materials and kit (especially protective equipment for staff) ready to go just in case. Because they were so well-prepared, staff at the Library were able to start co-ordinating their response while the fire service was still putting out the fire – not a moment was lost, which meant that they were able to save the vast majority of the collections that were affected by the fire.
We have a robust and detailed disaster plan in place, and boxes of materials that we could use if we were ever faced with a similar situation, but Iwan’s talk gave me lots of food for thought and has resulted in a list of tweaks and minor additions that I’d like to make to our plan to make it better still!
Susannah Waters then talked about the more recent fire at Glasgow School of Art. Like Iwan, Susannah described how the fire started, what damage had been done and what their response had been (and continues to be). Also like Iwan, preparation was key to their response, but Susannah also highlighted the need to think about how you would co-ordinate offers of volunteer help and how you utilise, and react to, social media. So a few more things for me to add to my list of disaster plan tweaks!
The day finished off with Gavin Gray, an experienced firefighter, talking us through the legislation that governs fire safety and our responsibilities within it. It was extremely useful to hear from someone with a different perspective on the topic and his talk drove home the necessity for high quality, up-to-date information, that you can give the fire service on arrival, about your building’s layout and your priority collection items for salvage.
I had thought that listening to others talk about threat and damage to their wonderful collections would make for a depressing day at best and cause me a sleepless night at worst – but that was far from the case! The willingness of fellow sector professionals to share their experiences so we could all learn from them was really inspiring, and much of what they talked about was all the positives that can come from these difficult situations – a surprisingly large percentage of collections affected by fire can be repaired, community spirit can be fostered, current and new audiences can be engaged and, ultimately, resilience and value can built in to the response in order to come out as a stronger archive service.


Wednesday, 30 September 2015

Conservation of Tracing Paper

Over the past few weeks, I have been working on a collection of architectural plans on tracing paper. These are often in fairly bad condition due to the inherent fragility of the paper. Papers from the 19th and early 20th century were made transparent by either impregnating the paper with oils (such as linseed or poppy), treating them with a strong acid, or by over beating the fibres. These manufacturing processes result in a weak paper sheet that is at high risk of tearing and creasing.
Architectural plan on tracing paper, before treatment. Shows extensive tearing and creasing.
The treatment of tracing paper is complex. Most tracing papers are very sensitive to moisture, which means that traditional paper repair techniques such as using wheat starch paste and strips of Japanese paper are not suitable, as the repair is too damp. Also, due to the transparent nature of the tracing paper, these kind of repairs can be highly visible and distracting.

There are a range of alternative repair techniques available to stabilise tracing paper such as using a heat set tissue with a synthetic adhesive or preparing remoistenable tissues with adhesives such as Klucel G (which uses a solvent to reactivate the adhesive) and isinglass and Japanese paper. I decided against these methods as the heat set tissue tends to not create a strong bond and may fail. I was also cautious of using Klucel G and solvents, due to the effect it may have on the oils in the paper. Isinglass is slightly trickier to handle as it must be kept warm whilst in use, but must not exceed a temperature of 60°C, otherwise its adhesive properties are reduced.

Architectural plan on tracing paper, before treatment.

I wanted a repair technique that I could prepare relatively quickly and would stabilise the tracing paper, without being visible from the recto. I decided to use a bridge repair method that involves taking individual fibres from Japanese tissue and adhering each end across the tear with wheat starch paste. To do this I ripped up a small piece of Japanese paper and soaked it in water. I then drew out individual strands using tweezers and dried them on a glass weight, before cutting them to size with a scalpel. I then adhered these fibres across the tear with a dot of wheat starch paste at each end. I then pressed these locally under Bondina™, blotter and weights and left them to dry.  
Architectural plan on tracing paper, after treatment.
Architectural plan on tracing paper, after treatment. Detail of verso showing bridge repair.
This repair creates a surprisingly strong bond, which quick and easy to carry out while being sympathetic to the material. The plans are now much easy to access and view.

Architectural plan on tracing paper, after treatment. Rehoused in a polyester sleeve.


Friday, 18 September 2015

Almost time to…Call the Midwife

Project Cataloguing Archivist, Clair, shares a her final blog with us before she goes on maternity leave.

This is my last blog for a while, as well as my last day before I go off on maternity leave! But before I go I thought I would take one last chance to explore some the unique collections that we hold at LHSA, as I will definitely miss being surrounded by all things old when my bundle of all things new arrives!
I could not resist taking a look at the midwifery records that we hold and reading more about the history of the development of maternity provision over the last 200 years in Edinburgh. From the LHSA website and past blogs you can also read further about the establishment of maternity hospitals in the city, as well as their related records that LHSA hold, here.

Edinburgh Royal Maternity Hospital drawing

Mothers and babies on the ward
Briefly, the first planned maternity hospital, Edinburgh Royal Maternity Hospital and Simpson Memorial Maternity Pavilion, opened in 1879 which was the fist purpose-build maternity hospital, where women could have their babies under medical supervision in hospital. Care was also provided from hospital staff for at home deliveries. The Hospital was staffed by physicians as well as midwives and medical students, since the 1886 Amendment to the Medical Act made midwifery a compulsory course in the medical curriculum. By 1910 the Hospital was dealing annually with 616 indoor and 1227 district cases. As the twentieth century progressed efforts were continuing to be made to combat maternal deaths, pregnancy illness such as eclampsia and infant mortality. On 1st March 1939 the old Simpson closed and the Simpson Memorial Maternity Pavilion, which was incorporated into the RIE, assumed responsibility for maternity services. In the new Pavilion the principle of isolation as a means of containing infection was fully implemented and by 1979 the number of beds had increased to 225 while the hazards of childbirth and perinatal mortality had been drastically reduced.

Nursery in the Elsie Ingles Memorial Maternity Hospital, c1930s (LHB8A/9).

Another famous Edinburgh hospital that became responsible for maternity care throughout the twentieth century was the Elsie Ingles Memorial Maternity Hospital. This hospital was set up to commemoration Dr Elise Inglis and her pioneering work for women's medical care as well as her work in setting up the Scottish Women's Hospital units. They provided medical assistance in countries such as France and Serbia during World War One.
The establishment of such hospitals enabled maternity care to improve and develop within Edinburgh but what of those that actually worked in maternity provision and took on the role of midwife? Amongst the gift and deposit collections that we hold at LHSA, we are lucky enough to also have personal collections of those that served in Edinburgh's maternity hospitals. They provide a fascinating insight into midwifery training and education. The following photographs come from GD1/131, the papers of Midwife, Pearl Stacy. She was a student of midwifery at the Simpson Memorial Maternity Pavilion from 1July 1944 to 1July 1945. She went on to have a career in midwifery and health visiting in the London Borough of Richmond until her retirement in 1977.

 This was the Central Midwives Board for Scotland Case Book which Stacy used to record details of patient and child, as well as provide her own review of the case. 1945 (GD1/131/2).
Above is Stacy's workbook which includes beautifully illustrated handwritten lecture notes. These were divided into different parts of her midwifery education, including anatomy, pregnancy, labour, peurperium, baby and mechanisms. 1944-1945 (GD1/131/1).

This is the Central Midwives Board for Scotland Examination Paper. c.1944-1945 (GD1/131/4). The questions examine the student on both medical and ethical decision-making.

Finally, here is Stacy's State Certified Midwife medal engraved with PEW Stacy on reverse.

Over the last year with LHSA, I have had the privilege of exploring and working with different historical collections from many areas of  medicine and health provision. From our HIV/AIDS collections, to Norman Dott's Neurosurgical case notes and to catching a glimpse into personal collections such as the above, I will miss them as much as my lovely colleagues whist on maternity leave!