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).