Friday, 21 October 2016

Let's get social: Using case notes to explore Edinburgh's social history

This week, Project Cataloguing Archivist Rebecca looks beyond the medical information provided in the RVH v TB case notes, to explore what they can teach us about Edinburgh's social history.
The case notes we’ve been looking at in the RVH v TB project reveal more than just medical history. The bulk of the Royal Victoria Hospital case notes cover the 1920s-1950s, a period of great social upheaval in Britain, and by recording each patient’s name, age, gender, and occupation they provide evidence for many of the changes that were happening. This was by no means the intention of the hospital and dispensary staff, who were recording this information for medical purposes, but it is a great example of how well-maintained information can be reused.

It is important to remember that most of the patients who were seen in these case notes did not have tuberculosis, or in most cases any diseases – the possibility was just being ruled out. These case notes therefore represent a very broad cross-section of society, including those in perfect health.
A clinic held in the Royal Victoria Dispensary, Spittal Street. The case notes from this dispensary provide the basis of much of this blog post. c.1950.

Living conditions:
Each case note provides the address a patient gave at their first examination, which we are recording in the catalogue as being in one of 5 areas within the city. What surprised me about this is how little the geography of the city has changed within the past century – the vast majority of addresses given in the case notes can still be found today, with a few significant exceptions. In the immediate post-war period, patients were referred who lived in the camps established to provide temporary accommodation to those left homeless due to a housing shortage after the war. There are also a number of patients who lived in now-demolished slum tenements in the Dumbiedykes area, even throughout the 1950s, which highlights just how recently the slum clearances took place. Speaking of which, the case notes often record how many adults and children lived in a household, and if they were sharing rooms. Typical of urban living, they also reveal a large community of lodgers, either in private homes or boarding houses.

Photograph from an album by David Kay, showing The Vennel, West Port, Edinburgh. This housing is typical of that found in the Old Town. c.1900.

A woman’s place:
For those thinking of the stereotypical representation of the 1950s housewife whose place was “in the kitchen”, it could come as a surprise to see how many of the women of Edinburgh were in employment. In the Second World War, huge numbers of women worked in the factories, to free up men for the armed forces. But even after the war women stayed in the workplace in a variety of roles, from housemaids to shop assistants to nurses to civil servants. This was often true for young women, or those who were not yet married, as one might expect, but what’s really interesting is that some women were still working after they got married. This was usually in what we might think of as ‘working class’ roles such as cleaners, suggesting that this was women in poorer families working to keep the family above the poverty line, but it still reinforces the fact that social ideals are usually just that, an ideal rather than the reality for many people.


This final point is one that can be difficult to pin down when using archival records. Until fairly recently, the ethnic or national background of patients wasn’t recorded, which means that many people of colour or people from non-British backgrounds are ‘hidden’ in the archives. However, by looking at names we can see evidence of (mostly European) immigration into Edinburgh during this period – from the longer-standing Italian Scots families to the newer groups of Polish and German immigrants who arrived during and after the war. This includes men who served in the Polish Air Forces during World War II, young German women who were being examined on behalf of the Ministry of Labour, and even Polish families who settled here in the post-war period.  There is also evidence of emigration to countries such as Canada, the USA, South Africa, and Australia, as potential emigrants were required to provide proof that they were not infectious before being allowed to move to their new countries.  

The waiting room in the Polish or Paderewski Hospital, created in 1941 after the President of the Polish Republic issued a decree officially instituting the Polish School of Medicine, and the University of Edinburgh signed an agreement with the Polish exiled government. 120 beds were made available for soldiers and civilians, while clinical medicine was also taught.

 The RVH case notes, therefore, don’t just teach us about tuberculosis and chest diseases. They contain a wealth of information about a variety of social factors, which one might not expect to see in a medical archive.


Lothian Health Services Archive, LHB41 CC/2/PR2 – photographs and recollections of Edinburgh

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