Friday, 22 September 2017

Something a little different for a Friday afternoon…

This Friday’s blog comes to you from Ruth, the LHSA Manager.

I originally trained as a fine art conservator, and as a manager of an archive I draw on that training when we repair individual items as well as when providing wider collections care for all the material in LHSA. The foundation for making sure that collections care is appropriate and to the highest standard possible is in knowing what you have in your collections, what those collections are made of and, therefore, what they may be particularly vulnerable to so you can work to ensure their stability for the future.

A couple of Fridays ago we had a demonstration of a piece of equipment that can help us understand what an object is made of by identifying the elements in it: a portable x-ray diffraction spectrometer…

We got a brief introduction into the science behind the equipment – x-rays displace inner shell electrons in the object you are analysing and that displacement is measured to identify the element(s) present. Once you know what elements are there you can start to work out what the object is made of. And we got some practical demonstrations of this….

We started on something slightly less significant – an office mousemat! – and from there we moved on to some real collection items to see how we might use the equipment in practice. Scans of a bound volume with metal decoration showed that the metal was brass and therefore not likely to be a more modern addition, and scans of a flute showed that though it had been described as crystal when it had been originally manufactured and sold, there was no lead present, so we’ll have to describe it as a glass flute from here on!

We do a lot of materials identification during the course of our work with rare and unique collections, and it was really interesting to see the options that such a sophisticated piece of equipment like this can offer.

Friday, 15 September 2017

Reading by Moon's type...

This week, Louise has been finding out about just how much reading can mean to those with sight loss, and how systems of reading for the blind are reflected in our archive...

A couple of weeks ago, we were lucky enough to receive an invitation from our friends at the Royal National Institute for the Blind (RNIB) Scotland to attend an event at the Edinburgh International Book Festival with author Graeme Macrae Burnet. The event was a recording of a special edition of Connect Radio, RNIB's online radio station, based around talking books. We've worked with RNIB Scotland before as well as holding their archive. We've participated in their Seeing Our History project by indexing Edinburgh's Register of the Outdoor Blind from the beginning of the twentieth century, and also hosted researchers around the project.

RNIB is dedicated to opening up books to people with sight loss, by providing braille and giant print editions or talking books that can be accessed by digital download or through a USB drive or CD. Titles are available free to borrow from RNIB's online library. The event started with an interview with Graeme Macrae Burnet hosted by Connect Radio presenter Robert Kirkwood. You can borrow both of Burnet's current books from the RNIB library - the first, The Disappearance of Adele Bedeau and his latest, His Bloody Project. His Bloody Project made the Man Booker Prize shortlist last year, and as such was available in accessible versions. RNIB work in partnership with prize organisers every year to make sure that the six shortlisted novels are available to those with sight loss in talking book, braille and giant print versions. His Bloody Project is based around (fictional!) 'found documents' from the archives, and the very real career of police psychiatrist and criminology pioneer James Bruce Thomson, so that immediately peaked my interest...

The interview was then followed by a panel discussion about how much having access to reading through RNIB has meant to individuals, both those born without sight, and those having to deal with progressive blindness. It brought home how reading in whatever form has the ability to lift people feeling isolated and alone, especially those coping with deteriorating vision. Reading can be a form of imaginative escapism and widening horizons, and blindness can limit access to those experiences, not to mention the possibility of being unable to participate in the way that books weave themselves into daily life and culture.

Attending the Book Festival event made me think of much earlier evidence about promoting access to reading reflected in the RNIB archive. The earliest example that we have is Moon's Type. William Moon (1818-1894) invented a simplified system of raised type (the Braille system of dots is also raised type, more familiar to us now).

William Moon, 1873 (GD52/3/1)
 Moon had lost the sight in one eye at aged four. After leaving school his sight deteriorated until he was completely blind by aged 21, scuppering his ambitions to become a missionary. Following many failed experiments dating back to as early as the sixteenth century, raised type as a system of reading for the blind started to gain ground in late eighteenth century France. Moon himself mastered reading in raised type, but was distressed to find that some people could not. There would have been a couple of different versions at the time, including Lucas's Alphabet and Alston's Alphabet. Moon instead invented a simplified form of raised type alphabet, using fourteen different shapes at different angles. 

Dr Moon's Alphabet for the Blind, c. 1850s (GD52/1/1/1)
At first, Moon printed texts himself. From the beginning, the invention of the type was tied into Moon's evangelical Christian faith - he wanted to bring scripture to those whose lack of sight meant that they couldn't read the Bible in conventional ways. Moon's Alphabet was also adaptable to many different languages (particularly helpful to the travelling evangelical mission community), as shown below.

Moon's Alphabet in different languages (GD52/3/3)
Moon not only traveled around the UK, but also in Europe and as far afield as Australia  to promote his system of reading. One list of Moon's texts in English and other languages from his own lifetime was made up solely of scripture, texts on scripture or raised maps:

A map in Moon's System (GD52/3/1)
Another more extensive catalogue does feature memoirs (of religious figures and royalty) and poetry, although'poetry' is mainly made up of hymns! However, there were also teaching materials for children in Moon's Alphabet:

Geometry taught using Moon's Alphabet (GD52/3/3)
Helped by donations from wealthy patron Charles Lowther, Moon's system spread, and was received extremely favourably compared to previous, more complicated alphabets. Moon also drove the rise of the Home Teaching Society initiative, where blind people would be encouraged to read in their own homes, spreading Moon's Alphabet to those outside the Blind Asylums (institutions to provide work and lodging to blind people). Edinburgh had a Home Teaching Society (founded in 1856), the Edinburgh Society for Promoting Reading Amongst the Blind at their Own Homes on Moon's System, reflected in the earliest reports we have in the RNIB collection.

Early reports from the Edinburgh Society (GD52/1/1/1) 

Perhaps unsurprisingly for a document that was meant to fuel charitable donations, the reports we have from the Edinburgh Society are full of praise for Moon's system. A bit more unusually, though, they cite experiences from partially sighted people themselves (albeit mediated through the testimonies of their tutors). This is one case study from the 1858 report:

"Mr. ------ has been blind for eight years. A few months ago a friend sent him Moon's Alphabet, but having no one to explain it, he could at first make nothing of it. A few weeks afterwards, however, meeting a blind member of the congregation with whom he is connected, he mentioned the circumstance. His friend happened to be a reader by Moon's system, and in one lesson had the pleasure of remving all his difficultues. Mr. ---- can now read with ease and comfort." (1858)

The 1860 report featured a direct statements from the male inmates of Edinburgh's Blind Asylum:

"The character is simple, easily felt and easily remembered. We are warranted in stating that individuals of any age can easily acquire a knowledge of it with the least possible trouble."

The sheer variety of texts, formats and ways to consume reading (without being treated as an object of pity or potential vessel for conversion) offered by RNIB shows just how far reading for partially sighted people has come since the earliest examples we hold. If you're interested in helping more people with sight loss to access the lifeline of reading, you can learn how to sponsor a talking book here.

Friday, 1 September 2017

Nights on the ward - the Night Superintendent's Report

This week, Alice has been looking at a little-used but fascinating set of records that shed light on the daily workings of the Royal Infirmary of Edinburgh

In order to reform nursing and nurses training at the Royal Infirmary of Edinburgh (RIE), in the 1870s trained ‘Nightingale Nurses’ were recruited and a training program instituted. Under this new system, the nurses reported to the Lady Superintendent of Nurses, rather than individual ward doctors. In addition to the Lady Superintendent there was the Night Superintendent, who monitored staff and patients throughout the night.

As there was little cross-over in their hours, the two used small bound notebooks as a means of communication between night shift and day shift. The left-hand pages of each book contains instructions recorded by the Lady Superintendent at the end of her day; and on the corresponding page the Night Superintendent would record the happenings of the night).

These little volumes are a fascinating way to supplement some of the other records we hold. Some pages contain snippets about staff which paint a vivid picture of the differing personalities of nurses, such as this entry:

27th-28th March 1876
“I made 3 rounds, nurses all in their places but Louise of 4 M[edical] I found her twice in one hour absent from her ward. She was with the night nurse in 5 M[edical] each time. I told her I would report it to you…
Nurse McLeod was not well at 5am but thought she could do her work so I let her” - (LHB1/103/7)

LHB1/126/50 - Christopher's entry in the General Register of Patients
Others add life to the lists of patient names that are recorded in the General Registers. For example, where in the register 8 year-old Christopher Yeoman appears as one name amongst many, this small detail from the Night Superintendent’s report paints a picture:

30th – 31st March 1876
Lady Superintendent: “The mother of the child in 3 S[urgical] is staying with him tonight so Nurse Black is not there”.
Night Superintendent: “The boy has had a quiet night; he is always much better with his mother”.

 The job of nurse was a risky one; often, the Superintendents’ notes to each other either request or provide details about unwell colleagues. There are numerable instances of nurses falling ill, and and Mary Anne Barclay is one such nurse.
LHB1/97/1 - Nurse Fraser's training record shows the perils of the job
Mary Barclay entered the RIE as a probationer on 19th January 1876 having previously been employed for a time at Chalmers Hospital in Banff. According to her training record, she spent three months working in the Infirmary’s medical wards before she fell ill.

LHB1/97/1 - Nurse Barclay's training record
The first mention of Nurse Barclay’s illness in the Night Superintendent’s reports comes at the start of April 1876. As part of her general instructions for the night of the 6th April, the Lady Superintendent requested that the Night Superintendent “please visit Nurse Barclay [in] 1 lower dormitory”. The return reply records that “Nurse Barclay has not had a bad night – Nurses Brown and McLeod each gave her a fermentation”. The following days’ correspondence suggests continuing concern for her well-being:

7th - 8th April 1876
                Lady Superintendent: “Nurse McDonald will stay on duty with Nurse Barclay til Dr McLeod has seen her.”
Night Superintendent: “Nurse Barclay had some sleep but had pain when awake so I told Nurse McDonald to stay with her.”

The next night shows a further downturn as Nurse Barclay was admitted into the hospital as a patient:

8th - 9th April 1876
Lady Superintendent: “Nurse Barclay was warded in 14 M[edical]. Will you report of her in the morning.”
Night Superintendent: “Nurse Barclay has been quiet but has not slept much : she looks very bad.”

Her recovery was slow but ultimately successful, with her training record noting that she was “about ten weeks absent” before continuing her training with “nine months in surgical wards”. Ultimately, her hard work and commitment to the vocation paid off. She was described as “patient, obedient and industrious, of slow intelligence but very painstaking, high principled and kind”, and after two years working on the night staff of the RIE she left to take up the post of Matron of Wallasey Cottage Hospital in Birkenhead.

The Superintendents were also there to offer guidance and mentor the novice nurses and support them in carrying out an often difficult vocation, as can be seen from these snippets:

                19th – 20thth April 1876
Lady Superintendent: “Bad case in 3 M[edical]. The nurse there is timid, please assist as often as you can”
Night Superintendent: “3 M[edical] - The poor old man died at 3.40am”

                1st – 2nd May 1876
Lady Superintendent: “Nurse Collins being off duty, Nurse Munro is in 16 S[urgical]. Nurse Macrae is also off duty, and Nurse Wyllie is on 4 M[edical]. Both these are young nurse and will need some looking up, especially as there is a sharp typhoid case in 4 M[edical]”

                8th – 9th May 1876
                “7 M[edical] - Nurse Small is taking charge of the tracheotomy case and Nurse Callow to do the rest of the work. The latter being new to us, give good heed to this ward.”

Although intended as administrative records, these volumes are a wonderful way to experience more of life on the ward, and the nurses’ concern for their patients really comes through. 

Friday, 25 August 2017

Tuberculosis and the Health Visitor

Project Cataloguing Archivist Clair looks at the role of the health visitor in the fight against TB.
August sees the return of LHSA’s RVH vs. TB, Wellcome Trust funded cataloguing project.  The project which began in August 2015, sets out to catalogue c.25, 000 case notes from the Royal Victoria Tuberculosis Trust and associated hospitals. Covering the period of c.1920 – 2000 the records provide a detailed account of the fight against pulmonary TB at a time when the disease posed a serious threat to public health. The collection contains four series of which two have already been catalogued and I will completing the cataloguing project by the end of April 2018.

I have now worked with a few different case note collections belonging to different medical specialisms. Although we have been implementing the same methodology in order to catalogue these collections, there is always going to be some variation in the types of documents found in the case notes. The fourth series of the TB case notes holds c.2000 individual patient case files from the Royal Victoria dispensary for Diseases of the Chest. Within the case notes I have found a few different types of documents that I have not come across in other collections, in particular health visitor reports and contact sheets. Being an infectious disease, tuberculosis was deemed a matter of public health and public authorities had to take action to stop the spread of the disease. This included keeping track of all the persons who had been in contact with an infected patient, mainly their family but also their landlord and neighbours when applicable. If a person was deemed at risk they were recorded in the patients file, normally on a contact sheet or in the health visitors report.

TB Health Visitor Report 1958.  PR4.1686
The health visitor report itself provided an interesting insight into the patient’s lifestyle and social circumstances, containing data such as:

  • Demographic information  
  • Previous TB investigations
  • Milk intake (including no. of pints drunk per day)
  • Home reports (including type of housing, condition and occupancy)
  • Family history of TB
  • Work or school information
  • Leisure activities
  • Hairdresser information
  • Regular public transport used

 At the end of the report there a section which suggests the action that must be taken, in consideration of the information gathered from the report, depending on how severe the risk of infection was. Interestingly this could stem from simple hygiene changes, for example, disinfecting the home or ‘laundry disposal’, to extreme measures, including, applying for rehousing or removing children from the home.  The health visitor reports are really interesting because they reflect on the medical state of a patient in relation to the environment they and their family lived in. Moreover they lend themselves to potential social research because of their in depth analysis of standard of living and lifestyle.

TB health visitor visiting elderly lady 1952.         

Audience at TB public health campaign, New Victoria Cinema, Edinburgh 1947.
Throughout the TB project, myself and former colleagues have touched on different methods employed by public authorities to help in the fight against TB, such as, the Edinburgh scheme, Mass Miniature Radiography, BGC vaccination schemes and public health campaigns but the role of the health visitor was important too. The health visitor crossed the boundary of the medical and social worker, and therefore, their main role was to provide advice and encouragement (not judgment), to help families do the best that they possible could to prevent the spread of the disease. This could include a programme of health education and recommendations in disease prevention, such as, milk, extra nourishment and improved sleeping arrangements.  If the patient was uncooperative with the health visitor’s advice and had a chronic tuberculosis infection they were a source of danger to their families as well as the wider public. Even in extremely impoverished conditions with overcrowded homes and poorly maintained housing, the health visitor’s role to help families reach achievable habits of healthy living should be recognised in the public fight against TB. As one tuberculosis health visitor remarked:

TB health visitor visiting elderly lady 1952.  

“The chief responsibility for controlling tuberculosis lies within the community. This is a social disease.”[1]

[1] Buchanan, S. The Health Visitor and Tuberculosis (1955), p.21.

Friday, 18 August 2017

A poetic patient

In this week's blog, Archivist Louise looks at hospitals from a different angle...

The current BBC series, Trust Me, follows staff nurse Cath Hardacre from Sheffield to Edinburgh. Suspended for whistle-blowing down in Yorkshire, she seizes a chance for a new life when a job is advertised working for 'South Lothian NHS Trust' at the 'Southern General Hospital' (some death certificates actually do state this institution, which was possibly an early twentieth century name for the infirmary at Glenlockhart poorhouse). The only snag is, the post is for an A&E doctor, not a nurse - but Cath's doctor friend Ally has just left Sheffield for New Zealand, fortuitously leaving her CV prominently in the bin. Cath plucks the document out, watches a few YouTube videos, applies for the Edinburgh job under Ally's name and is soon enough installed in a very nice flat with a view of Arthur's Seat. After all, being a doctor in A&E can't be too hard, can it??

The series, filmed right here at the University (you can see the Library where LHSA is based in this week's trailer), made me think about the portrayal of hospitals by artists and writers. I've recently become aware of William Ernest Henley (1849-1903), for example, who was a patient of the Royal Infirmary of Edinburgh (RIE) in the 1870s. Born in Gloucester, Henley developed tuberculosis as a child, leading to his left leg being amputated below the knee when he was just 16. In young adulthood, he started to write, but the tuberculosis infection returned when he was 23, and he was faced with amputation of his other leg. In a last-ditch attempt to save his leg, he traveled to Edinburgh, where he'd heard that a doctor called Joseph Lister was making great strides with aseptic surgery. Lister accepted him as a patient on a Reserved Ward of the RIE, where Henley stayed from August 1873 to May 1875, undergoing an operation that scraped out the dead bone from his infected leg, which was then packed with lint soaked in carbolic. Whilst Henley slowly recovered, he had plenty of time to write, including these lines on Lister himself:

"His brow spreads large and placid, and his eye,
Is deep and bright, with steady looks that still.
Soft lines of tranquil thought his face fulfil -
His face at once benign and proud and shy."

From A Surgeon, later The Chief)

A young Joseph Lister (sitting, centre) when a trainee doctor in the Infirmary, 1854 (LHSA photograph collection)

Henley wrote 28 poems in all during his time in the RIE; some first published in The Cornhill Magazine as Hospital Outlines: Sketches and Portraits. The poems also give a view of the other patients around Henley ('Through the loud emptiness and airy gloom,/A small, strange child, so old and yet so young!/Her little arm besplinted and beslung,/Precedes me gravely to the waiting room.'), nursing staff in the process of professionalization ('Her plain print gown, prim cap and bright steel chain/Look out of place on her'), and the general atmosphere of the hospital ('A square squat room that stinks of dust and drugs'). However, unfortunately we only have a very scant record of Henley's time in hospital in our records, with only one page of the Infirmary register filled in for his line, out of the usual two:

Henley's original admission record from 24th August, 1873 (third down). The second page of the register, which records information about medical condition and discharge date. is blank (LHB1/126/39)
One Infirmary patient mentioned in Henley's poems was 'John Gallagher', who 'Fell, some eighteen months ago/Smashing his shin'. No 1870s' case notes survive in the archive - however, from Henley's description, we get an idea of Gallagher's character that we just could not glean from institutional records:

"He like a collier swears, prays like a child,
Roars like a bison, laughs like something wild,
And makes us all like, pity, and despise him."

From A Patient 

According to his biography, Henley also went on to marry Anna Boyle, whom he'd met when she was visiting her elder brother, who occupied the next bed to Henley. Captain Boyle was in the merchant navy, son of Edward Boyle. The only Boyle I found mentioned in our records coinciding with Henley's time in hospital who could match the description was this gentleman:

Admission for an Edward Boyle, 'master mariner', admitted on 2 March 1874, bottom line (LHB1/126/40).
Henley's hospital stay inspired more new relationships - his poems prompted a visit by Robert Louis Stevenson, with Henley becoming the inspiration for Long John Silver. Henley remained a prolific writer until his death in 1903, and his obituary was even published in The Lancet, which praised the accuracy of his descriptions of general hospital life. His view of the sights, sounds and personalities of the Infirmary might not be widely known, but they provide a precious patient perspective into a changing world of hospital care:

"This is a ward in hospital. You see
The Field where Science battles with Disease,
And Hope - sweet Hope - succumbs to Death alone."

From The Ward

Friday, 11 August 2017

The Cockenzie Mystery - more insights from the Royal Edinburgh Hospital

We continue our journey into the Royal Edinburgh Hospital case books with our second volunteer blog. This one is from Carmen, a first year history student at the University of Edinburgh.

Since I began volunteering for Lothian Health Service Archives in April of this year, I have discovered a whole new perspective of eighteenth-century psychiatric treatment. Having the opportunity to access the Royal Edinburgh Hospital records has allowed me to have a glimpse of the lives of those who needed said treatment, and also the attitudes towards them.

When I first started cataloguing the volumes I was looking at mostly pauper patients – those whose treatment was funded by their parish – and I really resonated with many of those who found themselves suffering from mental illnesses. There was one patient in particular who stood out to me as she had lost 4 children within the space of a year because of diseases such as tuberculosis and typhoid. I remember thinking that any person would find themselves mentally vulnerable if they had lost so many loved ones in such a short period of time. There were also other records of other women who had been admitted because they had symptoms of what we today would diagnose as postpartum depression. By just looking at these records, it is clear that we have come a long way in terms of both diagnosing and understanding mental health problems. 

Since finishing my first volume, I have now moved onto one of the Hospital’s volumes that was specifically for private patients. What is most interesting about this volume is that because these patients were paying significant sums of money for their treatment, the doctors were more likely to include information about their personality. For example, it was said that one patient was “the most generous of men” and was known for buying magazines and newspapers for everyone in the ward. Others were not described so kindly, with one being labelled as “a moody, taciturn old man” who entertained himself by scribbling on any pieces of paper he could find; and another “sullen” for refusing to speak to any doctor but Dr Clouston, the director of the entire hospital. Another patient was admitted because she had “delusions” that she had been seduced when she was young - whether this was actually a “delusion” or not is questionable. Information like this is invaluable in helping historians understand the lives of those who suffered from mental health issues in a time where knowledge on the subject was limited. If not for these insights from contemporary doctors, we would not know what the people who were treated at these hospitals were really like.

Another interesting discovery I had when looking at these volumes was the fact that many of these patients seemed to go to “Cockenzie” for several weeks at a time, and little else of the place is mentioned. When I brought this up to Alice, the Archive’s Access Officer, she suggested that the patients may have had something like a holiday home - as Cockenzie is by the coast – and may have gone there to get into the open air and get a break from the city. If this is true, this is fascinating as it shows that Clouston could put another of his theories into practice. Dr Clouston was a strong believer that people had to have a positive environment in order to have a positive mind, and he tried to ensure that his patients lived in the best conditions possible because of this. Since volunteering at the archives, I have been fortunate enough to also read several of Clouston’s published works, including one in which he explains that his inspiration for the asylum layout came from a luxurious Swiss hotel. However, as the volume I am cataloguing has not been looked at in much detail yet, the archivists here at LHSA still know little about Cockenzie and what that actually meant for the patients at the Royal Edinburgh Hospital. Nevertheless, that is one of the best things about working in archives and handling contemporary material: we may never know what Cockenzie actually was, but by looking at the records we have in our collection, we do know that it existed and was of some significance to the daily life of the hospital.

Overall, I have loved every minute of volunteering at the LHSA Archives and think it is fantastic that the University offers its students the opportunity to look at the wealth of material that they have in their collection. I have been able to learn even more about the city that I now live in and love, all the while gaining invaluable skills that will prepare me for my dream job in the heritage sector. 


One of our wonderful Twitter followers has unraveled this mystery for us! Kirsty Nicol (@Kirsty_Nicol) dug into census records for Cockenzie and found a property called Hawthorn Villa, with residents who gave their occupations as Medical Students and one Asylum Matron. She then checked this information against digitised map collections held at the National Library of Scotland, and found that Hawthorn Villa was a property on the Western edge of Cockenzie. This certainly seems like a likely candidate for a convalescent-type home!

Many, many thanks to Kirsty for her outstanding detective work – and what a fabulous example of the benefits of digitising collections!

Tuesday, 1 August 2017

The dangers of tea-drinking: highlights from the Royal Edinburgh Hospital

We're handing over to our volunteers over the next two weeks to hear a little more about the Royal Edinburgh Hospital case book indexing project they've been working on. Starting us off is Iona, who recently graduated with a first-class history degree from the University of Edinburgh. 

Since April I have been helping with the Royal Edinburgh Hospital Case Book indexing project to create a database of patients admitted between 1840 and 1932.  Every week I work on my own volume detailing the cases of women admitted from the late 1850s. I have gleaned amazing details of what these women’s lives were like across social strata within the wider framework of Victorian attitudes towards medicine and gender. Every case illuminates the perception of women’s greater susceptibility to different forms of ‘mania’, many related to life-cycles of puberty, menstruation, childbirth, menopause, and old age.

Working through the case entries, I am very aware of looking at a top-down source; the female patients are viewed through the prism of the medical institution and the men that run it. At times, it is almost as if I am reading a novel with unreliable narrators, trying to prise the text apart to catch a glimpse of the patients’ point of view. Despite this limitation, many stories are harrowing, dramatic, even amusing, with a strong sense of each woman’s individual character. This interplay between the patients’ experiences, the narratives of the medical men, and my own subjective interpretations is fascinating, a unique way of bringing history alive.

The index to casebook volume 13
The intertwining of morality and medicine pervades the volume, from the formulaic language describing patients’ everyday behaviour as ‘industrious’ or ‘slovenly’ to diagnoses of ‘moral insanity’. The unsettling combination of familiarity and strangeness in the way that the doctors evaluate their patients is highly compelling. Through my modern lens, it seems straightforward to identify symptoms of alcoholism, post-partum depression, and the simple need for people to receive more care as they get older. The doctors’ assessment of these cases range from comparatively up-to-date understandings to the down-right odd, my favourite example being the condemnation of dissipation through excessive tea-drinking.

The following are my highlights from my case book volume. I have chosen just a few examples to demonstrate some of the themes I have found particularly interesting during my time at LHSA.

Work, work, work
Each entry makes some reference to the patient’s occupation and class, revealing the social roles of women at the time. The entries often identify patients by their husband’s profession, such as brewer’s wife or sailor’s widow, and if employed are most often domestic servants or seamstresses. I have found tantalising exceptions among these common entries, such as Clara the London stage-dancer and Helen the map-colourist.

In addition, cases like that of 26-year-old Christina reveal contemporary wariness of female education and ambition. Her ‘acute mania’ was caused by ‘something which had excited her beyond ordinary’, which turns out to be ‘the study of composition’ and her attempt to write a novel. This diagnosis connects Christina to many women of the later nineteenth- and early twentieth-century whose literary energies were medicalised in connection to their mental health. Two of the most famous examples of this are Virginia Woolf and Charlotte Perkins Gilman, who both wrote about the frustrations of their medical treatment. In 1882, the Royal Hospital’s own Dr Clouston gave a lecture entitled ‘Female Education from a Medical Point of View’, which demonstrates the widespread disapproval of these developments. He states that new school curricula have ‘warped the woman’s nature, and stunted some of her most characteristic qualities’, not only to the detriment of the female population but to the health of the nation itself. In this way, Christina’s case and Clouston’s lecture hint at how women’s bodies became ideological battlegrounds over medical practice and appropriate gender roles.

Medicine and moral sensibility
The doctors’ descriptions of their patients’ cases frequently act as moral commentaries on their way of life and their place in society. I came across one woman called Mary Ann who used the name Jane as an alias; this factor and her diagnosis of ‘moral insanity’ perhaps hints at a criminal past. Although the previously-mentioned Clara is ‘naturally of a cheerful disposition and steady industrious habits’, the entry notes that ‘employment as a dancer on the stage might not be considered advantageous for this development.’

Instances of alcoholism elicited condemnation as a manifestation of both physical and moral degradation. In another lecture given at the University of Edinburgh, Clouston describes women as more predisposed towards alcohol abuse because they possess ‘less resistive power’, as well as the ‘nervous disturbances incidental to the female sex and to motherhood, and the climacteric period.’ The case of a woman called Flora with an ‘inclination for stimulants’ caused a great deal of trouble for the Hospital as the staff debated over her treatment. After escaping to go drinking, Flora was investigated by the Board of Lunacy and examined by several doctors. When contacted, her family requested that she remain at the Hospital because she was ‘quite unable to keep from drinking and from disgracing herself and them by her conduct’. The Board released Flora, however, because when sober she was ‘not at present a lunatic in the statutory sense and therefore however doubtful they may be as to the manner in which [she] may comport herself when free from control they have no alternative but to order her discharge.’
As the previous cases show, most often the entries convey the attitudes of the hospital staff, yet some details display the strong moral compass of the patients’ themselves. Helen was engaged to a ‘respectable young man’ but ‘began to entertain fears that…he was not a Christian.’ This led her to postpone the marriage but ‘the delay of her lover in assuming the Christian character threw her into a deep melancholy.’ Interestingly, her postponed marriage also led Helen to ‘adopt the idea of going as a missionary to the Indians.’ I like to think that perhaps her work as a map-colourist encouraged her desire to travel as well as her deep religious sensibilities.

The cup that cheers and inebriates
One of the most bizarre attributed causes of mania I have found in my casebook is the effect of excessive tea-drinking. For example, another patient called Christina sought refuge ‘in the inordinate imbibition of tea, which she takes in the form of a strong decoction several times a day’, a good summary of my own tea habit.

LHB7/51/13 - when tea drinking becomes a threat to health...
The case of Joan, a dressmaker from Glasgow, also hints at a class dimension that may have influenced the doctors’ attitudes towards her tea consumption. The record states: ‘She has led a very unhealthy life, having subsisted like many of her class almost entirely on tea taken at every mealtime and seldom supplemented by more than bread and butter, and the occasional salt herring.’ Like Christina, Joan’s ‘indulgence in tea seems in her case to have amounted to dissipation, leaving her, after the stimulant effects pass off, in a state of considerable depression.’

As with alcoholism, the risks of tea were linked to women’s natural weakness and susceptibility. This is also suggested by an article entitled ‘The dangers of tea drinking’ by a Dr J E Cooney published in the Windsor Magazine in 1895. Cooney writes: ‘Warm tea-drinking is very popular with women, and is quite an institution in this country. It is drunk at all hours – even before rising in the morning – but the climax is reached at about 4pm. Many, in the course of paying their afternoon calls, drink no less than a dozen cups of tea…that one is naturally left in astonishment of the depravity of their sense of taste, without contemplating the terrible consequent ravages their respective constitutions must inevitably undergo.’ To me, Cooney’s focus on women’s daily social rituals conveys a sense of uneasy disdain not just for tea drinking but for codes of female behaviour in general. This is heightened by the next paragraph, evoking the image of a deviant female cult: ‘Tea-water worship, carried on by its fair devotees in the prettiest of drawing-rooms, in the smartest of tea-gowns, with the daintiest of paraphernalia in the form of silver and china, may to a large extent disarm them as to the real nature of this insidious but implacable fiend, but nevertheless it is there.’ The article further reinforces the dangers of this ‘implacable fiend’ through its illustrations, which juxtapose rough men drinking from bottles on the street with well-dressed women before trays and teacups. Although this connection of tea with ill-health and morality is funny with hindsight, it provides a fascinating example of how medical attitudes could be bound up with ideas of class and gender.

This blog has been only a small taster of the remarkable stories of women admitted to the Royal Edinburgh Hospital in the nineteenth-century. My attitudes towards history have been greatly enriched by this experience; I have thought much harder about the many filters that lie between the past and present, and about my own subjectivity as a researcher. I encourage anybody interested to volunteer with LHSA for the privilege of spending time with these fractured but powerful voices of history.


J E Cooney, ‘The dangers of tea drinking’, The Windsor Magazine 2 (1895), pp. 218-22,

Friday, 21 July 2017

Medical Records Revived!

In this week's post, Archivist Louise talks about a very special event taking place today...

This afternoon, we'll be launching the results of our neurosurgery cataloguing project. Not only are we celebrating by holding a public launch, but a case note catalogue will be released online. We've been cataloguing case notes from Edinburgh neurosurgeon Norman Dott since autumn 2012 with funds from the Wellcome Trust and, although we've had some pauses along the way (as staff have changed), it's wonderful to see the effort of all those involved in the project realised. The project could not have been completed without the hard work of cataloguing archivists, staff from LHSA and the Centre For Research Collections, interns, volunteers, University staff, project advisors and the help of the Wellcome Trust Research Resources team.

Cataloguing Norman Dott's Neurosurgical Case Notes (1920-1960) has produced a public, online catalogue to Dott's case notes (which hides patient identities in these mostly-confidential records) and a full catalogue, which includes identifying details and can only be seen in the LHSA reading room by legitimate researchers with special permissions from NHS Lothian. It's the first time that medical case files have been catalogued like this in a UK medical archive (in fact, I can't find a precedent anywhere else in the world!).

The Dott case notes are particularly special to me because I started my LHSA career as the Project Archivist cataloguing them. With the help of a Project Steering Group and LHSA staff, I was tasked with developing a methodology to catalogue the cases as well as doing the actual cataloguing- so deciding what would be recorded in a catalogue entry, how the entry would be structured, and how long it would take to describe each case note. I remember how overwhelmed I felt looking at the cases for the first time in the University Collections Facility - shelves filled floor to ceiling with blue boxes! Not only did the sheer number of records seem scary at first, but the case notes were written in very specialised medical language, with clinical abbreviations and terminologies from more than half a century ago!

Do you understand what this means? I didn't when I started cataloguing....
However, after getting to grips with the cases, I developed a way of describing them that conveyed their key content in language that could not risk identifying patients, whilst using 'labels' to mark details for redaction that we wanted to record but couldn't be revealed to the general public (like patient names, for example). After this, cataloguing began in earnest...

Although I  became Archivist at LHSA in early 2014, I went on to supervise the day-to-day work of the project, so I've been lucky enough to be 'working with' Norman Dott for nearly five years now! My job lately has involved redacting the 28,000+ catalogue entries so colleagues in the CRC Archives and Learning and Development teams can work on developing a web presence for the catalogue.

So I'll be sad to say goodbye to Norman Dott, who's been a bit of an obsession for five years (I try to diagnose neurological conditions on TV medical documentaries, it's gone that far..), but over-the-moon to see the catalogue online for the first time! 

You can try the catalogue for yourself here. We're also cataloguing case notes from other specialisms (including our tuberculosis and diseases of the chest case notes), which will appear on the site as catalogues are completed and redacted.

Friday, 14 July 2017

'Even finding an envelope takes so long...'

This week's blog is from Kim, our Employ.ed intern, who gives us an insight into letters from our Ernst Levin collection that make difficult reading:

It’s Kim again, the Employ.ed on Campus intern working with LHSA on Ernst Levin’s personal archive. Last week marked the mid-way point for my internship here in the CRC, which has made me feel somewhat nostalgic, it feels like I started yesterday! In the last five weeks, I have made incredible finds in the uncatalogued mountains of correspondence, particularly in relation to the themes of German-Jewish immigration and refugee history. Over the first few weeks, once I had got to grips with the general outline of Ernst’s story, I identified areas of interest in the collection worth closer inspection. Often this was a series of letters or correspondence of particular value, such as the letters sent between Ernst and his daughter whilst he was interned as an ‘alien’ on the Isle of Man in 1940. I have now almost completed the process of drafting these various ‘narratives of interest’ into blog posts which will constitute my final outreach resource. Hopefully, this will generate some interest in the collection to secure the funding it so greatly deserves. Keep following LHSA's blog and social media for the address of the final resource!

Wartime letter to Ernst, who was interned on the Isle of Man in 1940 (GD8/2)
This week has been very busy with exciting events: the University of Edinburgh hosted the British Association of Jewish Studies ‘Jews on the Move’ conference from Monday to Wednesday, with expert speakers on the subject of Jewish history, immigration and refugees, which supplemented my research into Jewish History as a context for this collection.

The following is an example extract of the kind of content which will feature on the resource I'm compiling about Ernst. Below is a series of letters written to Anicuta Levin, Ernst’s wife, by an old friend called Grete Vester, who was struggling to survive in war-torn Munich in the immediate aftermath of WWII from 1946-47.
Anicuta Levin, c. 1930s (PG8)
 At the end of the Second World War, with the Nazi’s defeat, the three major allied powers entered Germany from different fronts. German civilians, especially women, faced the wrath of victorious allied forces: horrifying stories of rapes across Berlin abound. The Russians liberated Berlin from the East, whilst the British moved through France. Munich, the Levins’ home prior to emigration, was a US occupied zone, as evidenced by the censorship stamps on the letters Anicuta received from an old friend Grete Vester. 
Censor's stamp on a letter from Grete, 1946 (GD8/2)
Germany entered a period of extreme economic devastation and hardship, and the people suffered under the extreme war reparations claimed in compensation for the horror of the Holocaust. Trials were held across the country to punish ex-Nazi officials and purge Nazism from society: this process, as Grete writes, was called ‘Entnazifierung’ [de-nazification].

A series of letters from Grete Vester in Munich, with envelopes marked ‘American Zone’, and stamped with ‘U.S. Civil Censorship’ were sent to Anicuta Levin in Edinburgh between summer 1946 and 1947. These embittered letters from the Levins’ old friend show the extent of damage to war-torn Munich and the suffering of Germans in the extreme economic hardship of 1946 and 1947. Grete Vester, identified as one of the ‘old group’ of Munich friends in which Anicuta and Ernst socialised, is described by her sister Marla as having had three strokes throughout the course of the war.

This series of letters touches on the major theme of German post-war identity – Grete expresses extreme anxieties around being deemed a Nazi by ex-neighbours and friends who had fled Germany due to persecution. She ardently claims that she was not a collaborator and in an angst-ridden tone bemoans the fate of German ‘innocents’. She describes post-war Germany as a ‘living hell’: the embittered people are murdering each other like savages. On several occasions, Grete expresses suicidal thoughts, reflecting the unbearably desolate circumstances in the ruins of central Europe.

Typewritten letters from Grete (GD8/2)
4th April 1946:
“After six years of never-ending bad luck and abandonment, I am now writing to you full of hope and joy … in 1939 I had the bad luck to have a stroke and have been paralysed in my left side since then, although I can move again now, though with difficulty. In this state I spent the war, although I was evacuated to [Bad] Aibling. Now I am back in war-torn Munich, which you would barely recognise. Through the wretchedness, everywhere you look the people have become mean and embittered. The only thing I now long for is death. Kluger of course left me a long time ago, married a woman and had a child with her, though they are divorced already now. Obviously he already has someone else, because men always fare better in this matter”
“Oh, Anicuta, what did we live through! … I actually barely know what I should write, it cannot be expressed in words! … I would love to come and stay with you, and help with the housework”

(undated) April 1946:
“For God’s sake stay where you are! Don’t even consider trying to alleviate your homesickness for Germany! … I, a nazi-hater, as you know, should actually have a say in their [the Nazis] punishment! But the so-called ‘entnazifizierung’ [‘de-nazification’] is in someone else’s hands completely. Even us, the blameless, are suffering! I truly marvel at the fact that I didn’t end up in a concentration camp because of my big mouth [anti-Nazi discourse]. I guess that’s luck, or bad luck, however you might see it now”

16th August 1946:
“The letters which I so undeservedly receive from abroad are like balsam on my wounds … I was evacuated to Bad Aibling after a heavy attack on Munich … in the bomb shelter, everybody was drinking and flirting … they wanted to live their last hours with courage, or at least in the spirit of gallows humour … the basement doors flew open and the sounds of the bombs exploded in my ears and I waited for the end to come at any moment. But it passed, as you can see … When the Americans came, we were glad”

19th August 1946:
“I am constantly completely alone, at best Marla stops by with a cold face and the oft-used words “I don’t have much time, will need to leave in a few minutes””
Writes that her sister Marla tends to her out of a sense of duty, but there is no compassion or kindness behind it. Sadly she is reliant on her sister for vital supplies. Grete pleads with Anicuta not to mention her complaints in her reply as Marla reads through her letters.

5th October 1946:
“I am living with complete strangers, not good or bad, just very uninteresting and also uninterested in me, we were just stuffed in here by the housing department, regardless of what you want. Otherwise you have to sleep in the street. The room is tiny, 2.5 – 4.5 metres, so I can’t put my few possessions anywhere … You cannot imagine what the city looks like now … I only get visitors when I have cigarettes and coffee from my American parcels”
[speaking of an old friend she has corresponded with] “Sadly I get the feeling that she holds us all in contempt, even me, who was anything but a Nazi. This hurts me as I cannot be to blame for being German, and cannot change this”
“The Unolds are somewhere in the countryside. Did you know Grete’s sister, Mrs Keis? She died and recently her son was murdered and robbed on a train. These things happen often these days. This is what desperation does. It doesn’t make people better. No one dares to walk the streets after dark, especially not women”

11th October 1946:
“I have been wanting to write to you about how I live, because I think this isn’t uninteresting to you. I think that all of you who left Germany, have no idea how it is here. Firstly, there is the devastation of the ‘luftkrieg’ [air raids], which is indescribable, although some people say that Munich is gold in comparison to some cities like Frankfurt [hit more intensely] … I need cod-liver oil and vitamin C. Of course you cannot get these in Germany, so I’ve written to New York and Switzerland and have received some already. We’ve had this appalling food for years and Hitler had been giving us low-quality food since 1933.”
“The atmosphere among the people is indescribable. It is as though one were among savages, no it is worse, since savages probably have na├»ve qualities that make them worthy of being alive … even the so-called ‘qualified’ people leave a lot to be desired. The whole of Germany has been completely ruined by the Nazireich”
[Grete asks Anicuta repeatedly not to be angry at her for requesting so many times that she join them in Scotland.]

2nd November 1946:
“As you can see, I am already writing on your new paper. Yesterday your package arrived. I thank you warmly and am so happy that at least this worry is alleviated. Sadly the package had been broken into and the typewriter ribbon was stolen out of it. But we are used to these things now … the ribbon clearly showed through the wrapping and someone decided to steal it. Here, people take everything. The people are so poor, that even an old cloth isn’t safe, if it can still be used to clean things with. Hitler left us a great country and through desperation, the people have not improved, but the opposite. This is the reason I can hardly bear it here anymore. Do you understand? … Even finding an envelope takes so long, because you have to go into many shops before you finally have the luck to find one or two”

17th November 1946:
“Today I have a big favour to ask you. In Edinburgh there is surely a phonebook for London, where you can find an address which I don’t have here. It’s the address of Dr Philip Hochschild, who emigrated there. He is a very wealthy man, and could I please ask you to write to him explaining my situation and asking him to help me a bit. I was often with him in the time of the Hitlerreich and so he knows, that I wasn’t a Nazi, which means he might be prepared to help me, considering my illness. From abroad, you can send a care-package through the Red Cross … [pleads Anicuta not to think worse of her because of this request] … we are starving and freezing. We don’t have access to the most basic amenities. Often we don’t have any light because the electricity goes. Then we also can’t cook anything, because we don’t have enough gas or fuel. We don’t even have any candles and not enough matches!”

26th December 1946:
“I received your long-awaited letter yesterday. It was truly the most wonderful Christmas gift. Hopefully it won’t just be a seasonal occurrence … letters are my only joy, and I receive them so rarely. So please don’t be so sparing! Remember than I am alone and lonely. Maybe then it will be easier for you to write more often”
“I am interested to see what we still have to live through, before life is over for us. Sometimes I think, I must have been a real piece of work in a past life, to have deserved such a punishment … no one laughs here anymore, at best cynically, which isn’t so nice”
“There are still Jew-haters here, Hitler really created long-lasting effects. It is awful. Us Germans are really suffering from this, even if one wasn’t a Nazi. And I think that won’t ever change, at least in my lifetime”

13th January 1947:
“My dear Anicuta, I thank you warmly for your last letter from the 18th December. I think I have already answered it, but am not completely sure, as I think of you almost all day long and therefore no longer know, whether I wrote to you or just meant to and thought of you intensely. I am alone for days on end. Marla often doesn’t come for a week, because as she says she has no time. And I sit here in my lonely room with hardly any wood to burn and a great sense of fear … Life is nightmarishly hard. I never dreamed that things would turn out this way. Maybe you can tell, that I don’t want to be alive anymore. But I am scared of death too. Do you understand this? There are also other things which I can’t write about. It would be such a joy if I could see you again … don’t be angry that I’m starting with all this again, because I really do think this would be the only thing that could save me now”

27th February 1947:
“You can hardly imagine what wretched lives we must lead now, even us, who were never Nazis! … You know, of course, what I thought [of the Nazi regime] and how I often opened my mouth to speak against them, even though I was spared the concentration camps. Even in Bad Aibling, where my hatred of the Nazis was well known! It seems disgraceful to have to re-iterate this to you, who knows all of this so well! But when one reads and hears how so many Nazis are trying to wash themselves clean [of their crimes], one thinks, perhaps even friends like you might believe this of me”

15th September 1947:

“I hardly dare to ask, if I couldn’t come to you [in Scotland], you seem to stall which makes me very unsure. Please don’t be offended, but just say yes or no. It is awful in Germany. You can only get medicine in very extreme cases, and life is horrible”