Friday, 21 April 2017

Case Note Cataloguing Continues ...

In this week’s blog Project Cataloguing Archivist, Clair, elaborates on LHSA’s newest case note cataloguing project.

As has been mentioned in a recent blog post, I am now working at LHSA through the University Collections Facility (UCF) Rationalisation project. This means I get to take forward the case note cataloguing skills that I have developed from working on our Wellcome Trust funded, Dott and TB projects to help open up other case note collections we hold at LHSA. After a trip to the UCF I was able to see the physical extent of LHSA’s case notes and this gave me a chance to properly scope the potential collections that could really benefit from being catalogued. The choices had already been narrowed down by LHSA Archivist, Louise, according to their size as it is important that within our project timeframe we complete cataloguing of an entire collection, opening it up to item level. This was a difficult choice to make as each potential collection from different time periods and medical specialities were wholly interesting within themselves. However, in the end I chose to work on Sexual Dysfunction case notes from the Gynaecological Out-Patient Department at the Royal Infirmary of Edinburgh (1973-1994) with around 1249 individual patient case notes to catalogue.

Fully re-housed Sexual Dysfunction case notes.

This is the most modern case note collection thus far to undergo cataloguing at LHSA but we are able to adapt our now well established case note cataloguing methodology to this different medical specialism. The methodology provides a template that allows us to capture a high level of detail from each individual patient record but also enables search functionality through the whole collection. It is flexible and therefore can be adapted to suit the specific characteristics of different medical specialisms. For example, I have decided to catalogue the type of medical treatments that were provided at the Sexual Dysfunction clinic in more detail than can be found in other case note catalogues. This is because the types of treatment were extensive and could be quite varied, from a course of sexual therapy to various urogenital surgical procedures. The Sexual Dysfunction case notes are also particularly interesting because the medical conditions of many patients are often linked to other physiological conditions or reflect on their social circumstances.

Of course, as with all other case note cataloguing projects we catalogue with the highest levels of confidentiality and patient records are closed according to appropriate dates under the Data Protection Act and Scottish Government guidelines on health information of deceased patients. However non-confidential information from the case notes will eventually be able to be accessed through an online redacted catalogue and provide a new way into another medical speciality.

Thoracic-Cardiac Surgery case notes before re-housing.
The project started in February and will run until July. Within this timeframe, we will have a lot of work to do but thankfully come next week I will be joined by our latest LHSA Intern for eight weeks, who will also be case note cataloguing. The internship aims to provide a recent archives graduate with experience in developing skills in cataloguing in the digital age and basic archival rehousing. Specifically, they will be cataloguing Thoracic – Cardiac Surgery case notes (1951-1958) that came from Dr Andrew Logan’s Thoracic Unit at the Royal Infirmary of Edinburgh. Unusually from our pervious case note cataloguing projects, which have always been beautifully rehoused for us before we begin cataloguing, this collections is in its original state. Therefore our Intern will be getting their hands dirty but will learn some important techniques about collection re-housing. Look forward to hearing more about our Intern and the work they will be doing in future blog posts!

Friday, 7 April 2017

Feminist Activism and Scotland's National Childbirth Trust

Our Skills for the Future Trainee will be sharing a bit about our National Childbirth Trust records with you this week…

Hi again, it’s Samar!

At LHSA we hold the archive for the Edinburgh branch of the National Childbirth Trust (NCT), which gives us an insight into women’s experiences of childbirth and maternity care from the early 20th century to the present day. I’ve been cataloguing this collection since January, particularly focusing on the labour reports written by Scottish mothers in the 1960s.

The NCT was founded by a woman called Prunella Briance in 1956. That year, Prunella had lost her baby during childbirth, and was outraged by the way she had been treated by hospital staff during this harrowing experience. As a result, she put an advertisement in The Times newspaper calling for mothers all over the UK to work together to prevent tragedies like this from happening again – and so the NCT was formed.

Our collection holds archive material such as committee minutes, correspondence, birth announcements, newspaper clippings, financial records, event timetables and articles and journals about natural childbirth. Significantly, the collection also holds labour reports written by Scottish mothers about their experiences of childbirth and hospital care. In many of these labour reports, women share unhappy stories of childbirth that ring true with Prunella’s experience.

NCT Committee Minutes Book 1965, featuring a child's drawing [Acc 13/045]

In the labour reports, we learn that many women had gas and air forced upon them against their will:

"I think I may have managed myself had it not been decided otherwise."

“[Hospital staff] told me I was getting too much oxygen from breathing technique - yet in the end had to give me oxygen."

“[I was] half doped throughout."

Babies were taken away from mothers right after giving birth:

"I was disappointed not to be given the baby after birth."

Women were left to labour for hours alone and without beds to lay in:

"I found I wanted to push, and was rather frantic as there were no beds free. All the nurses were very busy.”

Fathers were not permitted in labour wards, even if the mother requested they be allowed:

“… if only husbands could be at delivery."

Angered that so many women shared these experiences, the NCT organised educational classes that would provide expecting mothers with a network of peer support and information on childbirth that they couldn’t get anywhere else. The expectant fathers were heavily encouraged to attend classes with their partners, so that they could help and support the women as they prepared for birth.

The NCT’s classes aimed to make expectant parents better educated on what to expect during childbirth and also promoted natural childbirth techniques based on the teachings of Grantly Dick-Read. These teachings equipped the women with breathing exercises that would help them control their contractions, relax their muscles and get the oxygen they needed when giving birth. Many women also reported that these exercises helped them stay calm and focused during childbirth. Another reason why the NCT encouraged this method was because it helped the women avoid interventions such as inductions, episiotomies (cutting of the perineum) and enemas. This activism was particularly vital, as it was shortly publicised that some doctors were inducing women early during festive periods, to ensure that they wouldn’t have to work during that period.

NCT Committee Minutes Book (II) 1970-1982 [Acc 13/045]
Many women who attended the NCT’s classes reported that they felt relaxed during childbirth, that doctors and hospital staff greatly admired the method, and that in some cases, the women managed to avoid sedation and intervention. Some women even managed to convince staff to let fathers into the wards with them too:

"This nearness to my baby's birth gave me a special kind of excitement and I found that day very useful. I cleaned my house (again); I re-packed my cases (again); and most important of all, I read and read and re-read the sheets of notes I had collected over the months at my relaxation classes."

"... the nurses were very glad to see I was managing to control the contractions. One of them commented that she wished her sister, who was pregnant, could see how well I was managing. I had been trying to tell the other women in the labour ward (4 beds) about the breathing and by this time the ward sounded like a railway station with all the puffing and blowing."

"The pupil midwives were full of praise and said I had done very well. They enjoyed having (my husband) there and said he was a great help. He was given a cup of tea before me!"

"I didn't feel at all tired and would willingly have had another baby the next day."

"Alas, my difficult son decided to make his trip into the world with one hand on his head, which not only made the transitional stage rather painful, but rather hampered his actual delivery. Having said all this, I may say that I feel the training still made all the difference in the world..."

"Both the sister, who recognised the method - and a nurse who stayed with me gave every encouragement and were most impressed."

"Had I not trained under this method, I would have been overwhelmed by genuine pain in back and tummy. It could have been a ghastly time, but I was so glad I had practiced hard and read plenty."

"Midwife told doctor that due to attending breathing and relaxing classes, I was an excellent patient."

"I seem to have rambled on and on but I was pleased to write and tell you of the success of the method - as far as I am concerned. The Doctor said to me this morning that she was sure I wouldn’t have needed the gas and air if (the baby) had been of an average weight and that the nurses and herself thought the breathing was very helpful to them and I was completely relaxed from the waist down."

"It was only the knowledge of controlled breathing and also that I was well on that kept me in control."

The NCT continues to run today, campaigning to improve maternity care and ensuring that better information, services and facilities are provided to new parents. In April 2010, they joined a campaign calling for companies producing baby bottles to stop using Bisphenol A (BPA), a chemical that could leach out of plastics into food or liquid in tiny amounts and be absorbed by the body. The NCT also had a strong influence on The Equality Act, which now gives women in Britain the right to breastfeed in public without being discriminated against. They have also repeatedly lobbied for improved parental leave, supporting campaigns for increased paid maternity and paternity leave.

Friday, 31 March 2017

Basecamp without the mountain

In this week’s blog, Ruth reflects on her visit to the Skills for the Future trainees’ basecamp held over three days last week in Edinburgh (so no mountain but seven hills instead!).

Samar, our Skills for the Future (SFF) trainee, has been with LHSA since the autumn, and as part of her programme the trainees in the Scotland and England cohorts get together twice over the year to re-group, reflect and participate in some intensive training to set them up for their archive placements (hence the basecamp analogy that the SFF programme has adopted). The London basecamp was early on in their respective traineeships, and the Edinburgh basecamp at around the half-way point.

I was invited to attend part of the Edinburgh basecamp as one of Samar’s supervisors for her traineeship, and I spent an interesting and informative morning at the National Records of Scotland. I sat in on a session about action learning sets: using a particular methodology to utilise a group of people’s shared expertise and support to help each individual in that group achieve personal and/or professional goals or overcome challenges. It’s a technique that I hadn’t come across before and from the relatively short period of time we could experience it in the basecamp context, it looked like it could have real benefit to the trainees for their next steps after their placements.

I really enjoyed the second part of the morning’s session – two previous trainees gave presentations on their placements and what they had gone on to do afterwards, and then a panel question and answer session where the current trainees could find out more. It was inspiring to see what these past trainees had gained from the programme and how it had contributed to their subsequent career paths. And that very different cultural heritage paths can be followed from this shared traineeship experience (a post in a university archive and a PhD on sound archives). I also got some great hints and tips to bring back to LHSA, primarily to help Samar get the most out of the second half of her traineeship but also to contribute to our wider LHSA work (primarily in collecting oral histories and in developing activities that use our collections in new ways).

I didn’t take any photos at the basecamp, but since it was all about Skills for the Future I wanted to take the opportunity to celebrate Samar’s award-winning zine-making workshop pictured below!

Samar is in the bottom left of the image, and I really like that this photo captures a group of women working together with shared purpose in front of one of the paintings in the University’s Fine Art Collection which also shows women working together (but this time beating newly-woven tweed).

Samar ran two of these workshops last month as part of the University’s Festival of Creative Learning and she won the ‘most impact’ award for them. Samar and her workshop participants looked at the under-representation of women in archives and looked to redress the balance through feminist zine making. Samar will be digitising the zines to make them available online soon so watch this space, and you can find out more about zine making in one of Samar’s earlier blogs at

Friday, 24 March 2017

Looking at TB - World Tuberculosis Day

Since it's World TB Day today, Archivist Louise shares some of the stand-out images from the archive and gives a preview into work to make our catalogue entries more visual, too...

We've had a lot of posts about our work to catalogue records from the Royal Victoria Hospital recently as part of our major Wellcome Trust-funded project - from the early days of treatment under the pioneering Edinburgh Scheme to the wonders of Mass Miniature Radiography.

As well as our case notes, we have a set of slides recording TB treatments in the first half of the twentieth century, and these are some of my favourite images in our collections. They show the early days of TB nurses coming into families' homes (which were often over-crowded and un-sanitised, though notably not in this early publicity image):

Royal Victoria Dispensary nurse visiting a 'consumptive's home', 1900s (P/PL41/TB/001)

and the open, airy wards that were eventually opened in institutions like the Royal Victoria Hospital and City Hospital:

Ward in Royal Victoria Hospital, c. 1910s (P/PL41/TB/023)

There are also records of the physical exercise that was promoted as essential in the final stage of recovery:

'Respiratory drill' in the Royal Victoria Hospital grounds, 1910s (P/PL41/TB/071)
Our case note cataloguing is going on a small break, but work on information from the cases still very much goes on in another form. Intern, Kiersten Hay (through funding from University of Edinburgh Information Services), is taking on the challenge of turning our case note catalogue descriptions into charts, word maps and graphs to help researchers really get to grips with the information our cases present as a whole. She's working with the Library Digital Development Team on these data visualisations, using the same redacted information (through which patients can't be identified) that we'll feed into our public TB case note online catalogue when the project is complete.

A redacted TB case note catalogue entry, showing the type of  XML data Kiersten will be working with. - and the basis of our forthcoming public online catalogues
We'll update you with more news of how Kiersten is making our case note data more visual and accessible as the weeks go on - showing that images in archives aren't always black and white...

Friday, 17 March 2017

Edinburgh Dental Hospital and School

This coming Monday 20th March sees the dental industry celebrate World Oral Health Day. In this week’s blog, Alice looks back at the history of the Edinburgh Dental Hospital and School.

Visiting the dentist now may still be a scary prospect for some, but prior to the 1878 Dentists Act it was undoubtedly more terrifying. Dentistry had traditionally been carried out by ‘barber-surgeons’, and generally took the form of ‘drawing’ or removing teeth. As surgeons and physicians moved away from being seen as traders and became recognised as professionals (through the founding of the Royal Colleges, for example), so did dental surgeons. By the late 1870s the profession had begun to organise and regulate itself, and in 1878 the Dental Reform Committee was successful in campaigning for the titles of “dentist” and “dental surgeon” to be restricted to registered practitioners. Furthermore, registration was reserved for those who could show they had practiced dentistry for at least five years.

Given Edinburgh’s established role at the forefront of medical education, it was only a matter of time before a dental school was opened in which to train the dental surgeons of the future, and the Edinburgh Dental Dispensary was an obvious choice. The Dispensary had first opened in January 1860 at 1 Drummond Street, and by 1862 it was “agreed that the success of which had attended the experiment of opening such an institution seemed to warrant an extension to its arrangement and support” and a move was made to new premises in Cockburn Street.

LHB25/1/1 - Minute book of the Edinburgh Dental Dispensary, 14 Jan 1862

Branching further into education, the Dispensary joined forces with the Scottish Dental Education Committee and on 30th October 1878 a Dental Hospital and School was established at 30 Chambers Street (known then as Brown Square). Due to a high demand and increase in student numbers, the School moved briefly to Lauriston Lane in 1889. LilianLindsay (the first qualified female dentist in Britain and first female president of the British Dental Association) described the Lauriston Lane hospital in glowing terms as one of the best in the country: “I entered the school at the end of 1892, and had visited those in Leicester Square and Great Portland Street, London, which were greatly inferior”.

A further influx of students again required the School to find larger premises, and on 13th December 1894 the Lord Provost opened a new School at 31 Chambers Street, next to the original site.
LHB25/5 - Prospecti showing the different locations of the School

The Edinburgh Dental Students’ Society dates back to the Lauriston Lane days of the School, and produced a number of different publications. My favourite of these, White Jacket, began in 1933, and provide a colourful insight into student life. As with most student publications, they’re tongue-in-cheek and often fall on the frivolous side, and were sold just to cover the costs of publishing. On occasion, ‘charity numbers’ were produced with slightly more lavish designs, and the proceeds donated to deserving causes:


As well as providing its resident artists a chance to shine, White Jacket also provided regular sporting commentary, albeit in its own mischievous way…
LHB25/12/26 - This recurring joke appears in at least 4 issues that I've found....
…and the adverts for dental equipment, clothing and other items (such as sporting attire) really stand out as being both beautifully composed and rather of their time:
Today’s advice for World Oral Health Day couldn’t be more different – tobacco is definitely a no-no! Check out the FDI World Dental Federation’s website for more advice and guidance on how to Live Mouth Smart:

Friday, 10 March 2017

Food for thought

This week, Archivist Louise has been looking at just what was on the menu for patients in the Royal Infirmary of Edinburgh:

We’ve recently been in contact with the team behind the People’s History of the NHS resource  -  part of a Wellcome Trust-funded project based at the University of Warwick to research the cultural history of the NHS in time for its 70th anniversary in 2018. The project aims to delve into the meaning of the National Health Service in all our lives, exploring how the Service has impacted on our ideas, health and identities.

Because the team are looking into hospital food at the moment (including tea!), I couldn’t help but mention the evidence we have of how patients were fed at the Royal Infirmary of Edinburgh (RIE), a national leader in the science and practice of dietetics.

Badge from the RIE School of Dietetics, c. 1930s (LHSA object collection, O225)
The first Dietetic Department in the whole of the United Kingdom opened in the RIE in 1924. Thanks to the Department, by the dawn of the NHS in 1948, patient diets in the hospital had moved on considerably since its foundation in the eighteenth century, when principle foodstuffs were oatmeal, barley, milk and baps. In 1920, the RIE Board of Management appointed a special committee to consider diet in the hospital, recommending the appointment of a dietician with general responsibility for patient diets. As a result, Sister Ruth Pybus became the Senior Dietician in the new department. Dietetics was a growing strand of science around the world, and this infant department reflected this new interest in the chemistry of patients’ food. It also roughly co-incided with the first use of insulin to treat diabetes (in Canada in 1922), which was prescribed along with special diets in an attempt to keep the disease in check.
A diet leaflet for diabetics produced by Lothian Health Board, 1980s (LHB1/89/5/5)
In 1925, Pybus won a Rockefeller Foundation grant to observe kitchens in the United States – the Rockefeller Foundation also funded the building of the Infirmary’s metabolic unit with a diet kitchen.

RIE diet kitchen, c. 1950s (P/PL1/S/395)
Some of the diets prescribed by the kitchen would turn modern stomachs – the ‘spleen diet’ for example, involved serving pulp scraped from the fibrous part of the spleen, tossed in oatmeal and fried! Great care was taken with meal plans for diabetics, with fats and carbohydrates strictly calculated. This kitchen soon reached beyond the specialist wards attached to it, supplying food across the hospital – and continued to do so until a larger kitchen was eventually opened in 1966.
Nurses in the RIE diet kitchen, 1960s (LHB1/89/6/1)
In 1934, the first School of Dietetics was opened in the Infirmary, offering specialist training in clinical diets for the first time in the United Kingdom. The School offered a Diploma, open to State Registered Nurses, students with domestic science qualifications or with a BSc. in Household and Social Science. From our syllabuses and prospectuses, we know that the course consisted of lectures and practical elements, covering cookery, biochemistry and chemistry, ward work, anatomy, patient observation, medicine, physiology, dietetics and bacteriology. Students were also tested on social and environmental aspects of nutrition, including the impact of poverty on health. The School operated until the 1950s – perhaps a victim of its own success, since dietetics was by then routinely included in nurse training.

Prospectuses from the School of Dietetics, 1930s (LHB1/89/3/2)
Some of the most popular material that our archive users ask for from the Dietetic Department is undoubtedly evidence of special diets. We have a quite a number of recipes from the 1950s for savoury dishes:

Selection of diet sheets, 1950s (LHB1/89/4/1)
And some for sweet:

Diet sheets for sweet foods, c. 1950s (LHB1/89/4/1)
Even the making of drinks had strict rules attached:

The first rule of beef tea club is.... (LHB1/89/4/1)
The kitchens also shared their expertise beyond their own dietetic wards. There were diets formulated for expectant and new mothers in the Infirmary’s maternity section, for example:

Diet formulated for use in the Simpson Memorial Maternity Pavilion (LHB1/89/4/2)
Some of the sources in the collection reflect attitudes to food education at home, including this 1946 leaflet used in the Department, produced by the Ministry of Food:

Ministry of Food public information leaflet, 1946 (LHB1/89/5/5)
An American influence (probably since dieticians from the Infirmary were awarded scholarships to research in the States) is also represented in the information collected by the Department. A particular “favourite” (please note inverted commas) of mine is this small booklet on weight control for women:
An 'introduction to slenderness' from across the Atlantic, 1950s (LHB1/89/5/1)
But my highlights from the Dietetic Department archive tell us about recommended food for older members of the community, shared outside hospital walls for the benefit of everyone. This 1956 edition of Old People’s Welfare Scottish Bulletin reprints a diet table for the elderly from the Infirmary:

Royal Infirmary of Edinburgh diet table for the elderly, and cover of Old People's Welfare Scottish Bulletin, 1956 (LHB1/89/7/6)
Whilst the People’s Journal in the same year published Infirmary diets given to the Edinburgh and Leith Old People’s Welfare Council, with recommendations for those with or without an oven… and with or without teeth!

Infirmary diet tables reprinted in People's Journal, 1956 (LHB1/89/7/11)
If you’d like to know more about diet in the Royal Infirmary, you can search our collections (for LHB1/89) online here or here

Friday, 3 March 2017

From LA to the UCF

Though the blog title may suggest that we’ve been off to the west coast of America, the content of this blog will be a little closer to home – this week, Ruth will be concentrating on developments in one of our stores…

The Library Annexe (formerly abbreviated to LA) is getting a lot of good attention at the moment, and is transforming itself into the University Collections Facility (UCF). Material held there is being reviewed to make sure that it is in good condition, stored well and accessible for use now and in the future: a collections spring clean if you will!

While a lot of the work will concentrate on the University’s fine art, musical instruments, rare books and archives, here at LHSA we wanted to make sure that we’re in on the action too. We’re very pleased to have Clair (who you will know from blogging on our Dott and TB projects) stay on a little longer with us to take part in some of this rationalisation work in the UCF. We’re boxing clever and making sure we use Clair’s expertise to best effect – she’ll be continuing her case note cataloguing work on another series that has previously received Wellcome Trust funding to conserve it. We also hope to look at some of our other collections in the UCF and make improvements to storage to help preserve the collections for the long term and make best use of available shelf space. We’ll be working with Helen (the UCF Rationalisation Project conservator) to do some rehousing and re-organisation. So keep an eye out for future blogs from Clair (on these page) and Helen where you will see more of this rationalisation work in action.

Friday, 24 February 2017

Time to say goodbye to LHSA!

     Time has flown by and today is my last blog as a project cataloguing archivist at LHSA, so I thought I would write something a bit more personal about my experience here, including my favourite items and the skills I’ve gained!

     I started working as a project cataloguing archivist here exactly one year and one month ago, but I was actually already familiar with LHSA thanks to my 10-week internship in Spring 2015. This is when I started working on the Norman Dott project: I catalogued 1200 case notes from the Brain Injuries Unit in Bangour General Emergency Service Hospital in Broxburn, dating from 1943 to 1949. It was the first time I was working on records from the Second World War, and it was truly fascinating to read all the tales of war and life stories – I will always remember, for example, this Polish patient who lost all her family in the Warsaw Ghetto, was sent to the concentration camp at Dachau where she actually fell in love with a man, whom she met again and married in Paris after the liberation. It was amazing to read her story and to realise that it wasn’t a movie or a book – it was a real woman whom Norman Dott had examined and listened to 60 years ago. Which just goes to show that medical case notes are far from containing only technical documents and abstruse descriptions!

Aline working on a case note.

    The knowledge and skills I had gained during the internship made me the right person to finish cataloguing the Dott case notes as a project cataloguing archivist LHSA a few months later. I catalogued 4944 case notes in just over six months. I felt very honoured to be the person to catalogue the very last one of the 28313 case notes of the collection, as it had been such an impressive team effort that had started more than four years ago. This time the case notes I had catalogued didn’t date from the war, but were just as interesting: I particularly enjoyed finding clinical drawings and learning more about the use of the leucotomy procedure in the 50s.

Clinical drawings of an acoustic neuroma operation (PR2.21345) (all personal details have been redacted)

     I also had the opportunity to work on another LHSA case note cataloguing project, RVH v TB, alongside the other project cataloguing archivist Becky.  The case notes were a bit different; they were often shorter and covered less medical conditions, and didn’t always delve into patients’ lives so extensively. However I enjoyed cataloguing them as well – they’ve made me smile, wince, or sigh with sadness. I have also been able to participate in a number of activities related to both projects, which has been an excellent way for me to gain dissemination skills. It was also very gratifying to be able to share my enthusiasm and knowledge on something I had worked on for several months. A good example would be our day at the Scottish Records Association conference in Perth on the 4th of November 2016, on the subject ‘Public Healthcare in Scotland before the NHS’. Both LHSA project cataloguing archivists, accompanied by LHSA access officer Alice Doyle and SFF intern Samar Ziadat, attended this conference. We created dissemination material about LHSA cataloguing projects for the delegate packs, and prepared a PowerPoint presenting the projects that was shown during breaks. We also openly requested feedback and were available to answer any questions. It was a very interesting day where we learnt a lot about other medical archives projects, and got to talk about our own!

The very last box of the norman Dott case notes.

Next Tuesday will be my last day at LHSA, but I am happy to say that I am not going very far: on Monday 6th of March I will start my new job as cataloguing archivist at the CRC, here in the Main Library of the University of Edinburgh. From CRC intern to project cataloguing archivist at LHSA, and soon cataloguing archivist, I feel like this has been a very enriching and continual progression and I am delighted to be starting this challenging new role soon! I have really enjoyed my time working at LHSA; I am certain the skills and experience I have gained will help me to do my very best in my new role, and I am very grateful for all the opportunities and support I have received.  

Aline Brodin, Project Cataloguing Archivist.