An operating theatre for WWI

Due to be published online this summer are further editions of the Craigleith Chronicle, a hospital magazine produced by staff and patients of Craigleith Military Hospital during World War I. As a taster of one of the editions, part of an article by CW Cathcart from September 1915 is presented this week (LHSA ref GD1/82/8).  In it he explains how the operating theatre was developed when the hospital was converted from the poorhouse. Due to the war, the facility needed to have all of the equipment supplied locally. The problem of supplying sterilised water was one which was overcome by a number of interesting solutions. Two forty gallon water tanks designed for domestic purposes were obtained, where water could be sterilised by boiling before being used for operations. One of these had a coiled cold water pipe run through it so that the water could be chilled to provide cold sterile water. A high-pressure steriliser was donated by the Edinburgh Royal Maternity Hospital staff who said they could make do with an old steriliser in the meantime and a cast iron cattle trough (presumably new) was converted into a boiling basin by fitting it with an exit tap and a cover!

 

The images from the magazine show the water and bowl sterilisers, and a general view of the operating theatre.

Adjoining rooms were converted to create an X-ray department, an anaesthetic room, a sterilising room, a room for applying dressings and a dental room. The article states that between the end of August 1914 and mid July 1915, the theatre and dental room were used for 1,792 surgical and 1,324 dental operations, however these procedures were for the most part carried out to ‘fit recruits and Territorial soldiers for active service abroad’. This suggests that the health of young men in the Lothians was not great at the time. Cathcart concludes by thanking the theatre sister for her efficient service during his time in Craigleith, reminding us that carrying out operations was a team effort.

Sharing our skills (and learning some new ones too)

Taking part in the Preservation Advisory Centre’s ‘Essential Preservation’ course yesterday was a great opportunity to share LHSA’s experience of collection care with others new to the sector. We led a couple of sessions focusing on handling special collections and looking at the conditions that rare material should be stored in. A hands-on handling exercise proved to be particularly useful for attendees, having a go at carefully rolling and unrolling a damaged architectural plan (well, a piece of plain paper cut to the size of a plan and torn in a few places to simulate the real thing!).

But it wasn’t just a chance for us to help other archivists in the public sector get to grips with preserving their collections for the long-term, there was lots to be learnt from the other speakers too. One of the British Library’s preventive conservators talked about the development of their disaster plan and the Head of the Preservation Advisory Centre described various ways to communicate preservation issues to colleagues to get them involved in caring for the collection, so there were lots of top tips and great ideas to be had!

An exciting find

This week, our Wellcome Trust Project Archivist Louise gives an update on some surprising finds in the Dott case note collection:


Time is certainly moving on quickly in LHSA’s Norman Dott case note cataloguing project. With the first case note series catalogued (relating to Dott’s early hospital and private practice), I’ve now moved on to the largest series of over 22,000 records documenting Dott’s work at the Royal Infirmary of Edinburgh from the 1940s. But at the end of the first, early series something unexpected awaited me. Labelled ‘Spina Bifida Cases’, a final box contained collected summaries of spina bifida cases in children under two. Not only does this box contain a number of glass plate negatives, lantern slides and related photographs (exciting finds in themselves!), but the earliest of these patient records is dated 1922, making it the oldest in the collection to date.

Spina bifida is a fault in the development of the spine and spinal cord during a baby’s growth in the womb. In its most common form, the spinal column does not fully close, causing membranes and the spinal cord to push out to form a sac on the back of the baby (a meningomyelocele). Babies born with spina bifida are also at risk from hydrocephalus (excess cerebrospinal fluid in the brain), which was probably why Dott was keen to examine their heads as well as their spines.

LHB20 CC/20/PR1.1974 Encephalogram showing spine and meningomyelocele in young patient

The spina bifida case notes are records of encephalography, a now-outdated x-ray procedure through which cerebrospinal fluid was removed from the ventricles in the brain or the spinal cord and replaced with oxygen, allowing a clear image to be taken. Along with these images are notes describing the procedures and the implications of the x-ray findings. Notably, these young patients were under Sir John Fraser (1885-1947, and pictured in last week's blog), with whom Dott published on paediatrics in the early 1920s. Fraser served as surgeon to the Edinburgh Royal Hospital for Sick Children (R.H.S.C) from 1920 to 1925, eventually attaining the prestigious Chair of Clinical Surgery at the University of Edinburgh.

LHB20 CC/20/PR1.1974 Encephalogram of cranium of same patient showing ventricles in the brain

Dott showed a considerable interest in spina bifida cases and paediatric surgery throughout his career, becoming Honorary Surgeon to the R.H.S.C in 1925. These photographic materials and notes relate to cases seen as out-patients at the R.H.S.C before Dott took up his official post there and, although Dott occupied a number of surgery and lectureships at various Edinburgh institutions before 1925, the R.H.S.C was not one of these. Although I’m very busy cataloguing at the moment, these ‘gaps’ in Dott’s career which are not documented by our case note collections will be exciting to research in the future, particularly using the collection of Norman Dott’s private papers held by LHSA’s colleagues in the Centre for Research Collections.

Accessions Update

We’ve had a busy period of activity on the accessions front, with a mixture of large and small accessions arriving from the NHS and from private hands. Here’s a selection of those related to psychiatry and mental health.

 

Design for Young People's Unit, Royal Edinburgh Hospital, 1967

A fantastic set of designs for the Royal Edinburgh Hospital was received as part of the bicentenary archive appeal. Created by interior designer Margaret Campbell in 1967, they include proposals for MacKinnon House, the Young People’s Unit, and the Doctors’ Residence. They are a celebration of 1960s fashions, and include test fabrics, colour blocks, slides and drawings. Our thanks go to Margaret for kindly donating her work to LHSA – we expect it will prove to be a great resource for anyone studying hospital design during this period. 

Design for North Wing, MacKinnon House, Royal Edinburgh Hospital, 1967

Detail of design, Royal Edinburgh Hospital, 1967

Last week, the Oor Mad History papers were transferred to the Archive to join the oral history recordings collected earlier on in the project. Together, they form a comprehensive record of the mental health service user movement in Edinburgh and the Lothians from the 1980s onwards, and we look forward to this being a heavily used collection. 

And finally, today, the Archivist will be sampling late-twentieth century psychiatric case notes from West Lothian. These records are considered likely to have long term archival value, but given the huge quantity of them, a random sample will be selected for transfer to the Archive whilst the remainder will be securely destroyed by the NHS Lothian Records Management team, since they are beyond their legal retention period and have no further administrative or clinical value. More information on this can be found in Annex B of the NHS Records Management Code of Practice can be found at: http://www.scotland.gov.uk/Publications/2012/01/10143104/0.

If…stands for Index File

This week we provide an update on the re-ordering and review of LHSA case notes. 

Recent activity has focussed on the case note index card series, which consists of 34 series titles and over 300 boxes. The index cards were originally produced as manual finding aids for patient case records, however because they have not been catalogued in detail, they have not been routinely used for researching enquiries. The case notes themselves are, for the most part, ordered by date or patient name, so searching them is usually straight-forward, but index card series can contain names of patients whose case notes are missing and be used to find names within a date-ordered series if the date of admission is unknown.

The index cards had been re-housed into low acid boxes and labelled some years ago, so the first task was to look up handlists for the series which were written at this time. The series titles were reviewed and compared with existing case note collections and possible matches for them were identified. A sample of index cards was then tested to see whether patient records could be found using the information in the cards.

In some cases it was clear that no case note collection existed for the index cards and in others only a portion of the index card series was relevant to a particular collection. The 20,000 case note collection catalogued as relating to Sir John Fraser was found to have index cards relating to it under both John Fraser’s index series for years up to 1944 and under Mr Graham’s from 1944-1946, presumably because Mr Graham took over those wards from Fraser in 1944.

Sir John Fraser pausing from his work, c.1930s.

The index cards are usually ordered by patient name and also sometimes by disease, which may be of use for researching the incidence of particular illnesses. In total, 15 case note collections have so far been found to have an index card series which relates wholly or partially to them. Those index cards which do not relate to case notes are still of some use, as they confirm a patient’s admission to hospital. Also included in the index card series are some out-patient notes which cover patients who had been referred from other hospitals. These are not strictly index cards and form a type of case note collection in themselves.

This review of the index cards should greatly enhance the accessibility of the case note collections and enable LHSA staff to respond more efficiently to enquiries. 

Ten weeks work well done

This week, we hear from our hard-working interns, Charlotte and Fiona, about all the wonderful work they have been doing over the last 10 weeks. We'll certainly miss them:

Alas blog readers, this is our final joint blog for the LHSA. We’ve both had a tremendous time here. We have worked on very interesting projects and met some wonderful people. In this blog, we will tell you what we have achieved and what we have enjoyed in the past, very quick, 10 weeks.


Charlotte

Since our last blog entry, I feel like the project has really taken off. There has been a lot going on in the studio, and it has been really exciting to see finished items building up. From research and speaking to other conservators I decided the most appropriate treatment for making the parchment title deeds more accessible was to flatten them using only the moisture in the environment rather than introducing any to the parchment. I have been trying different methods to see which is the most successful including pressing with boards, weights used locally and more unusually…with magnets! While the selected title deeds have been flattening I have been able to do other treatments. Iron gall ink was identified when testing several of the paper documents which influenced treatment greatly. Documents were dry pressed and tear repairs were carried out using Gelatine (grade B) due to its potential to suppress the ink from corroding the paper.

Taking over the studio using weights and magnets to press creases

 Parchment before pressing

...and after

An important aspect of the project has been to create appropriate storage for the material. I have been making enclosures that give extra support to the parchment items, which will include protection for vulnerable seals. Something I am developing at the moment is a method of opening folded parchment items safely and securing them while viewing.

Folders were created with Velcro patches to secure title deeds

Alongside practical work I have had the opportunity to develop skills in other areas. A couple of weeks ago I prepared a training day for four students who were interested in potentially studying conservation. The session included the introduction to conservation principles practical activities. It was fantastic to get the chance to do this, I enjoyed the day greatly and the students did really well.

                                 

Training day participants with their beautiful folders!

I can’t believe it is our final week next week. It will be a busy busy week as I still have plenty I would like to do. I have learnt so much from this internship and will greatly miss the project and especially the team here!

Fiona

In my last blog I had begun creating the catalogue on Access. This is going well now and I’m picking up the pace with more and more entries. I now have the whole of the Edinburgh Dental Hospital and School, the Royal Edinburgh Hospital and most of the Bangour Hospital photographs catalogued. In regards to the rehousing, you can see the photographs for yourself. Below you can see the before and after of the re-housing of some of the dental hospital and, photographed just this morning, the whole Dental Hospital photograph collection re-housed.

The photographic collection... after (l) and before rehousing (r)

Completed Dental Hospital photo collection, re-organised, re-housed, re-labelled and ready to go!

These past 10 weeks have been a great experience for me and I have learnt a lot from it. I have learnt how to archive whole collections, learnt about disaster management and basic conservation techniques. I have also visited some grand buildings and attended interesting lectures. For me, this internship has been, and will be, extremely useful for my future, I can only hope that the work I have done here will be of benefit to the LHSA.

As with my previous blogs, I will finish it with a photograph. Some of you may recognise this one from the Facebook page, but now it’s going up on the blog because after 10 weeks of going through over 4000 images, this one is still my favourite.

Doctors hard at work

The Dott project on the road!

This week, our Project Archivist Louise tells us about her participation in a conference at the National Archives, Kew:

On Thursday 7th March, LHSA’s Norman Dott case note cataloguing project took its first trip out of Edinburgh to attend the UK Archives Discovery (UKAD) Forum held at the National Archives, Kew. Together with my colleague, Clare Button, Archivist for the Towards Dolly project (cataloguing materials related to the development of animal genetics in Edinburgh), I presented a poster explaining the way in which the Centre for Research Collections has been working to open up history of science records to new researchers.

Clare and I are both funded by the Wellcome Trust, and have been using the Encoded Archival Description (EAD) standard to create catalogues that reflect both the specialist nature of the scientific archives with which we work and the needs of the different groups of researchers who use them. EAD is based on eXtensible Mark-up Language (XML), ‘tags’ that allow text to be labelled and structured for online display. For example, the use of EAD in the Dott project allows me to highlight certain sections of catalogue descriptions for online searches and hide other information from public view that identifies patients.

The poster

The UKAD Forum is a chance to hear current thinking on the different ways in which archives can reach new and current audiences through information technology, enabling them to link data on their collections with other institutions and provide better finding aids for the public. The popularity of the day proved that making archive catalogues available and accessible, promoting collections online and securing the future of digital holdings and electronic records are essential aspects of the archivist’s role in the twenty-first century. Clare and I heard presentations from those at the cutting edge of online delivery of archival material (Google Cultural Institute, Wikipedia, Europeana and the BBC’s Digital Public Space) to smaller archives building up their own online presence through the imaginative use of blogs, Facebook and Twitter. During our poster session, Clare and I answered questions related to our projects and made valuable connections with archivists around the country working with similar records and sharing similar objectives.

All in all, it was a hectic but eye-opening day, and was wonderful to be in a position to tell fellow archivists about the work that LHSA is doing to highlight modern medical case notes as research tools.

Useful Links:

Dott project page: http://www.lhsa.lib.ed.ac.uk/projects/Cataloguingcasenotes.htm

Towards Dolly: http://towardsdolly.wordpress.com/

UKAD Forum 2013: http://www.ukad.org/forum2013/