Feminist Crafting with LHSA

Hi there! It's Samar, LHSA's Skills For the Future Trainee. To celebrate the holiday season the LHSA team got crafty this week! As a zinester, I was keen to introduce my colleagues to the joy of zine-making. After our zine making session, I also made a digital zine (shared below) about the LHSA team's favourite items from our archive. Before we share our fabulous creations, I thought I'd let you know a little bit about zines and their connection to archives.

What are zines?

Zines are mini music-themed magazines that were originally created by members of the punk rock scene in the late 1980s and 1990s. These zines typically included music reviews, press releases and information on gigs, venues and musicians. Once produced by hand, the zines were then Xeroxed and distributed within the community for a small fee, or if possible, for free. The punk ethos tied to zine production separates zines from other forms of self-publishing because, in contrast to their traditional self-publishing counterparts, zinesters (people who make zines) do not wish to participate in corporate or mainstream publishing and they do not want their product to come out looking like a book from a traditional publisher. In fact, in contrast to most writers, zinesters often choose to reject offers from corporate publishing houses. Therefore, people who create zines are not only people who have been relegated to the margins, but also people who have chosen to claim the margins. This insistence on claiming the margins is due to punk culture’s Do It Yourself (DIY) ethic, which is also reflected in the DIY aesthetic of zines.

The cover of a riot grrrl zine from 1991.

Who makes zines and why?

Zines were written by marginalised people who were often young and economically disadvantaged, and whose ideas fell outside the mainstream. People who were under- or unrepresented in the mainstream media worked to document the voices of those too politically radical to appeal to the corporate media through the production of zines. The most famous and influential zines which remain in circulation today are those from the riot grrrl movement. The riot grrrl movement comprised of a group of smart angry women who emerged from the punk scenes in Washington during the early 1990s. These women went to punk shows, took photographs, read feminist books, wrote essays on the “male gaze”, and developed fierce life-changing friendships with each other. As a movement, riot grrrl was established in direct response to sexism in the punk scene, calling for the liberation of young women by taking control of the means of subcultural production and, in pointed contrast to mainstream - and underground – culture, sought to unify women and to revivify feminism. The movement achieved this by encouraging women to play instruments, start bands, share experiences in the safe all-girl spaces of the riot grrrl meetings, and most significantly, to write and distribute zines.

A riot grrrl zine from the 1990s.

What do zines have to do with archives?

By producing zines during and about the riot grrrl movement, the riot grrrls created ephemeral feminist materials that documented their experiences in their own terms. In collecting and preserving these zines, which are now considered primary sources, feminist archivists are able to firmly place the riot grrrl movement into the historical record. The most well-known archive to hold feminist zines is The Fales Library & Special Collections in New York. Lisa Darms, who was a riot grrrl in Olympia during the 1990s, and is now an archivist, created this collection of zines, called the Fales Riot Grrrl Collection, in order to document the riot grrrl movement of the years 1989 to 1996. To see some zines locally, Glasgow Women’s Library and Glasgow School of Art Library hold a large collection of zines in their archives. If you'd like to make zines with me, you can do so at two feminist zine-making events that I'm running for LHSA on the 20th February and 22nd February 2017.

A selection of zines at Glasgow Women's Library.

So, what did we make?

We made two things! First: my colleagues at LHSA, who had never made a zine before, sat down together to make a zine each. The zines did not have to follow any specific theme, so everyone picked their own topic, and, armed with glue, old magazines clippings, pens and paper, everyone went forth and created a zine! I think the results are really stunning:

After our zine making session, I made a zine which can be read online, about our favourite items in LHSA's archive. Read it below, and make sure to open the zine on full-screen mode so that it's legible:

To read more of LHSA's digital publications click here.

The 'pointing finger'...

In this week’s blog, Archivist Louise has been…. cataloguing!

Cataloguing – describing the holdings that we have and ‘numbering’ items – is vital to users of archives and those caring for them. It sounds obvious, but without knowing what we have, users won’t learn about the fascinating records that we hold, and we won’t have the knowledge of LHSA material that is vital to our jobs.

Uncatalogued collections are particularly frustrating to readers, particularly when there’s a tantalising set of records which is not described in detail, as is the case for GD16: documents, artwork and photographs amassed by the heads of the Royal Edinburgh Hospital (the ‘Physician Superintendents’)  from the 1850s to the 1980s.

Having a collection without a detailed description makes the archivist’s job more difficult as well. We love people contacting us and wanting to use our material, but the nature of what we hold means that we have to abide by certain access restrictions. With uncatalogued records that date well into the twentieth century (as many in GD16 do), we cannot give access to readers without detailed checking to make sure we’re not breaking the Data Protection Act (1998) or Scottish Government guidelines on protecting patient information. And that takes up the valuable time of both archive users and archivists. 

Uncatalogued collections are often housed to sit safely on store shelves until further intervention can take place rather than being ready and robust enough for regular handling in the reading room – and this is certainly the case for the hundreds of letters from patients in GD16 collected by the Physician Superintendents, which could risk getting damaged or disordered if consulted often.

From my first volunteer experience in archives (actually here at LHSA!), I’ve always loved cataloguing – you gain a privileged insight into what you’re working with, and usually come out with a new ‘specialist subject’ because you’ve delved into the life of a person or institution in so much detail. So I was delighted when the expansion of our team meant that I had a chance to get up close and personal with one of our collections – and GD16 seemed the most obvious place to start. 

Although the Royal Edinburgh Hospital (REH) institutional collection (LHB7) is our most in-demand group of records, we often recommend some of the material in GD16 to readers interested in the history of psychiatry. Whilst hospital records in LHB7 tell a clinician’s view of psychiatric care, many items in GD16 were created by psychiatric patients themselves, such as artwork:

Artwork by psychiatric patients John Willis Mason (top) and Andrew Kennedy (bottom) in GD16

We also have some images of patients in GD16 (sometimes from institutions outside Edinburgh), which are not represented anywhere else in LHSA:

Photograph of brothers and sisters in Hallcross Asylum, Musselburgh (1860s) from GD16 

GD16 begins with draft texts and lecture notes by the second Physician Superintendent of the REH, David Skae (1814 - 1873), who headed the hospital from 1846 to 1872:

David Skae (1814 - 1873), PH8/43

Skae was keen to turn the REH into a centre of excellence for the study of psychiatry (or ‘alienism’, as it was then known), and began a series of lectures around the study and treatment of mental illness. These were eventually published in the Edinburgh Medical Journal (which we have in our REH Physicians' Library collection), but the handwritten versions allow us to see the development of Skae’s thought as his lectures developed and were adapted year after year:

Skae's handwritten lecture notes (GD16/1)

The first page of Skae's introductory lecture text, showing revisions (GD16/1)

Skae was primarily remembered for his ideas on the classification of mental illness (in his definition, a ‘disease of the brain affecting the mind’), which divided ailments into main categories, often linking psychological factors to physical ones. This system was not widely adopted outside the REH, but a space to record ‘Skae’s classification’ still appeared in REH casebooks years after Skae had died.

Skae was remembered as an amiable and kind man, and the touches that I’ve seen in his manuscript bring his personality closer than reading his work in print in nineteenth century journals. On more than one occasion, for example, I’ve seen Skae’s illustration of a small hand, prompting him to show a visual aid:

Skae's 'pointing finger' symbol (GD16/1)

These small interventions bring his text off the page, making you imagine yourself as a nervous lecture presenter or keen observer. Written prompts to himself (such as to ‘bring [a] table’ of statistics) also bring him closer, in a way that I might set a computer reminder to put a back-up memory stick in my bag before a setting off to give a public talk!

As I delve further into the lives of the patients and physicians of the Royal Edinburgh Hospital in 2017, I hope to bring some more personalities out from GD16’s boxes and into the world!

LHSA v TB

This week, Project Cataloguing Archivist Rebecca looks beyond the case notes of the Royal Victoria Hospital to see what else LHSA holds on tuberculosis.

Over the past year-and-a-bit we’ve written extensively about the tuberculosis case notes which form the RVH v TB cataloguing project. But, did you know, these aren’t the only records relating to tuberculosis we have at LHSA?

East Fortune Hospital (LHB39)

East Fortune Hospital, in East Lothian, was established as a tuberculosis sanatorium in 1922, serving patients in the south east of Scotland until the 1950s, when it changed in function to house the mentally handicapped (minus a brief interlude in WWII when it functioned as an RAF airfield, and patients were transferred to Bangour Hospital).

Many of the records we hold from East Fortune deal with the hospital after its change in purpose. However, there are admissions and discharge registers from the hospital’s time as a sanatorium. These aren’t as detailed as the RVH case notes, but contain brief details about the patient’s age, occupation, length of treatment, diagnosis, and the reason for their discharge.

 

East Fortune Sanatorium Admissions Registers, 1922-1958 (LHB39/1/1-2)

City Hospital (LHB23)

The City Hospital was not a dedicated tuberculosis hospital, but rather was a hospital set up to treat patients suffering from infectious diseases. It is apparent from the RVH case notes that there was some relationship between the two institutions, as patients with an advanced degree of tuberculosis were often sent here. While the hospital was primarily dedicated to the treatment of patients with infectious diseases such as meningitis, diphtheria, measles, scarlet fever, etc., there was a sanatorium for the treatment of TB patients.

Pavilion for advanced cases of tuberculosis, City Hospital, Edinburgh

Sanatorium registers (LBH23/3) contain details of the history and state of patients on admission and the results of their treatments. Again, they are not as detailed as the case notes, but they do provide information on the patient’s age and occupation, the duration and severity of their illness, tests and treatments given, and the result of their treatment.

Page from the  City Hospital Sanatorium Register 1941-1971 (LHB23/3/2)

 

Public Health Department of the City of Edinburgh (LHB16)

Edinburgh was the first Scottish local authority to appoint a Medical Officer of Health in 1862, and in 1872 a Public Health Committee was set up by the Town Council, responsible for sanitary matters and the control of infectious disease. In an earlier blog post I discussed the notification of TB patients as part of the Edinburgh Scheme; the Public Health Department is to whom the patients were notified.

We therefore hold a collection of notification registers for Edinburgh and the Lothians (LHB16/3/1), which run to as recently as 1993 (though not continually). The information collected on each register changes according to the local authority, but they include similar information to the other registers listed above.

Detail from a Tuberculosis Notification Register, 1954-1959 (LHB16/3/1/14a) 

 

This collection also contains a report on the state of tuberculosis in Edinburgh in 1952 (LHB16/2/82). This is only a small report, but it reflects a lot of the information contained within our case note collections.

Tuberculosis in Edinburgh report, with charts showing a decrease in TB death rates compared to a rise in notifications (LHB16/2/82)

World AIDS Day in Lothian

University of Glasgow student Megan Buchan spent two weeks with us at the start of November as part of her MSc in Information Management and Preservation. Students are asked to catalogue a small collection according to their host institution's cataloguing standards - this work is then used towards an assessed component of their degree. In this week’s blog, Megan shares some of her thoughts on the collection:

Over the course of my two-week placement, I was given the opportunity to catalogue and rehouse the records of the World AIDS Day Organising Committee [WADOC] (Lothian), an Edinburgh-based organisation set up in November 1999. The purpose of the organisation was to advance the education of the public, particularly in relation to World AIDS Day and HIV and AIDS issues, ultimately raising awareness of the disease in the city.

WADOC Lothian committed itself to ensuring World AIDS Day [WAD] was commemorated in Edinburgh on 1st December every year. As part of this, the organisation worked on WAD to: provide an indoor event for participants; to display and distribute information on HIV and AIDS services available in the area; to organise a candle-lit march to an outdoor location for the placing of candles and standing remembrance; and to provide post-vigil hospitality for participants. WADOC was responsible for launching a publicity campaign through the issue of press releases to Scottish media, and for publishing and distributing publicity information to various entertainment venues, schools, health centres, libraries, and community centres.

  

Placing candles in remembrance. 

The collection itself proved an interesting insight into the organisation’s work – as well as expected administrative documents, such as minutes of meetings and financial accounts, the records also included a wide range of correspondence showing the extent of their endeavours. Organising WAD events took much planning, with permissions, support and performers to arrange, and from cataloguing the collection and seeing the correspondence first hand, the magnitude of the group’s energies can be seen. The collection also included printed materials such as posters and leaflets promoting the organised events, and photographs from some of the processional candle-lit marches, bringing the collection together in a full-circle – from the organisation to the outcome!

WADOC were responsible for raising sufficient funds to meet the costs of organising and providing the annual WAD events in Edinburgh themselves, and the collection also includes correspondence, applications for grants, and examples of the money raised from fundraising in the city to continue providing their services.

As well as raising their own funds, WADOC also encouraged other organisations to plan events around WAD, and was able to award funding in the form of their Small Grant Awards to appropriate agencies, groups and individuals for promotion, education, and the support and care of those people living with HIV and AIDS in the Lothians.

 

Order of Perpetual Indulgence packs. GD53/6/3/1

Within the collection, there were numerous applications for these Small Grant Awards, and for one smaller HIV and AIDS related agency, an example of the outcome of the funding they received was included in the collection. The Order of Perpetual Indulgence, a LGBT group dedicated to ending prejudice, used their grant from WADOC to produce safe sex packs, containing health information cards, male and female contraception, latex gloves and lubricant. These packs were then handed out for free to the public in celebration of WAD, and as well as battling stigma and encouraging safe sex, they allowed for people to find out more about the local health services available to them in their area.

While the organisation’s aim was to provide services around Lothian, from cataloguing the collection I found the group recognised its efforts did not represent fully its title as the World AIDS Day Organising Committee, and from this, there were steps made to recognise the needs of those further beyond Edinburgh. With HIV and AIDS being a major issue in third world countries, the group set about to change one of the terms in its constitution in order to donate 10% of its profits to those in need of assistance in the developing world too.

WADOC operated until June 2006, when the dissolution of the organisation became official after it was felt the charity had served its purpose in promoting and educating the public on the issues surrounding HIV and AIDS.

Sample Naming Tree postcard. People were invited to write a message to a loved one lost to HIV/AIVS, and the cards were then hung on a Naming Tree at the Ross Bandstand. GD53/6/3/2

Having had the chance to examine and order each one of records within this collection, I’ve been able to really appreciate the ethos of WADOC in working to raise awareness of HIV and AIDS, provide and distribute health information, and donate to groups to help further those in need of support. This year’s campaign for World AIDS Day is ‘Not Retro, Just Wrong’, aimed at tackling the stigma of being diagnosed with HIV. Keep an eye out for fundraising tins and red ribbons to help continue the fundraising and awareness of HIV and AIDS – something WADOC worked so hard to contribute to.

Sharing ideas at the Scottish Records Association conference.

     As you may know if you follow LHSA blog, three weeks ago part of our team went up to Perth to attend the Scottish Records Association conference about healthcare in Scotland before the NHS. As Alice has outlined, it was a very enriching experience and today I would like to expand a bit on our contribution and what I got out of the conference.

     

     The projects I have been working on for almost a year, along with my co-worker Becky, were relevant to the subject of the conference: indeed, both the Norman Dott project and the RVH v TB project deal with medical case notes which partly predate the creation of the NHS. Moreover, the cataloguing methodologies we use could be of interest for anyone working with medical archives of a similar nature. We therefore took the opportunity of this conference to disseminate and explain our projects. For this purpose, we created two leaflets presenting the scopes, aims and methodologies of the projects for the delegate packs, and we put together a 10-minute long PowerPoint that was shown during the breaks. We were also available for any questions or enquiries about the projects and/or LHSA – I did receive an enquiry about Norman Dott from a lady whose relative had worked with him several decades ago, and it made me glad to know that this great surgeon was still remembered and talked about in Scotland more than 40 years after his death.

The LHSA PowerPoint at the conference.

     All talks were very interesting and covered different subjects that helped to understand the theme from different points of view. One in particular caught my attention: the talk of Sarah Bromage and Alison Scott about the archives of the Royal Scottish National Hospital, held by the University of Stirling. The Royal Scottish National Hospital was established in 1862 and provided education and medical care for mentally impaired children in Scotland in the 19th and 20th centuries. Their collection consists of case notes, correspondence, reports and registers as well as a little over 3000 applications for admission. The latter contain information on the family’s circumstances, the child’s health, behaviour and educational abilities. The format of these documents reminded me of the case summaries we find in the Dott and TB collections: a high number of short, standardised forms with biographical and medical information on each individual. I found it interesting to see how they were being catalogued, to spot any difference and/or similarity with our own method: for example, the use of index terms for medical information, and the closure period of 100 years for clinical records. It also made me wonder how our own cataloguing methodology could be adapted and applied to such a collection, which is slightly different but also deal with sensitive data, a high volume of personal information, and medical records. Indeed, one of the objectives of the Dott and TB projects was to develop a methodology that could be used for similar medical archive collections.

The programme of the conference.

     Overall, it was very interesting to hear about archives to which our methodology could potentially be applied. It is exciting to think about the sheer volume of information that could be made accessible to the public, and the opportunities for research and family history this represents. This is why going to conferences and learning about other projects, in addition to being really educational and enjoyable, is essential.

     To find out more about the Scottish Records Association, click here .

Out and about with LHSA

Those of you who follow our Twitter feed will know that the last few weeks have involved a lot of travel for the LHSA team! Alice gives an overview of what she’s been up to…

On the 4^th of November, Samar, Aline, Becky and Alice travelled up to Perth for the ScottishRecords Association conference. This year’s conference was focused on the use of archival records to research the provision of healthcare before the NHS – so naturally we were all very interested! As LHSA’s records are predominantly focused on healthcare in the Lothian area (the clue is in the name!), it was useful to situate our collections, approaches and practices into a wider context, and consider how they inform and are informed by Scottish healthcare in other areas.

This really struck me when listening to Caroline Brown present Dr Patricia Whatley’s paper on the provision of healthcare in the Highlands and Islands. She explained how an 1852 enquiry found that many doctors were working for salaries that were small and insecure, and how this was exacerbated by the physical environment they were working in. Doctors might have to travel great distances over several days (in often treacherous weather) to reach their patients, with no guarantee of remuneration afterwards. This meant that doctors could find themselves penniless as a consequence of the profession they had entered into, unable to save for a pension and professionally isolated. Based as we are in Edinburgh, it’s hard for me to imagine a similar fate befalling the doctors that are found in our records – on the contrary, they were in the heart of the medical world with resources, peers and opportunities on their doorstep. This was just one of the excellent talks we heard – you can read the full twitter coverage on our Storify page.

Craigleith Chronicle, March 1916
 [GD1/82/13]

The following week saw me approach archival materials not from a research point of view, but using them as springboards to discussion instead. I took part in a workshop at Glasgow’s beautiful Mitchell Library that was run by Scottish Council on Archives, and was centred on using WWI records in education in creative ways. We were asked to take along a selection of WWI records from our collections and then explore as a group how they might be used. As the attendees ranged from archives, to libraries, to heritage centres, there was quite a selection of resources to consider, and a whole range of backgrounds that informed our discussion! I was particularly interested in how WWI records can be used to explore the domestic experience of war – although we tend to think of those on the front line as being the ones affected, there are glimpses in the records of the impact that war had on life at home. For example, this article from a Craigleith Chronicle describes how the Hospital was set up and staffed by volunteers – some of whom didn’t have particularly strong stomachs when they began their new medical careers!

This Monday Aline, Samar and I were treated to a behind the scenes glimpse at the collections in the RoyalCollege of Surgeons of Edinburgh archives. Their collections date back to the 1460s, and include a continuous run of Minute Books from 1581. Like LHSA, their collections are vast, ranging from institutional records to the papers of notable individuals and organisation involved with medicine and surgery. A particular highlight for me was the photo album of Craigleith Hospital – I got very excited when I saw that there were names written in the album! Although we hold a lot of photographs relating to Craigleith, few have names, so hopefully we can one day identify some of the men and women in our collection.

Thanks to @RCSEdArchive for the sneak peak at their collections today, followed by an afternoon in @surgeonshall. So much to see! #histmed pic.twitter.com/nvQf6UGrMT

— LothianHealthArchive (@lhsaeul) November 14, 2016

A huge thank you to the Scottish Records Association, the Scottish Council on Archives and the Royal College of Surgeons of Edinburgh for hosting some brilliant events this last month!

Historic Housing Day: A Wester Hailes Story

Samar has joined LHSA for a year on the Scottish Council on Archive's Skills for the Future Programme. As a part of her traineeship, it is encouraged that she completes training days at a variety of archives in order to gain a broad understanding of the archive sector.

As a part of my traineeship, I had a day out of the office attending an event for Housing History Day, which was jointly run by the Tower Block Project and the Our Place in Time Project. I had a really great time, and learnt lots of new things that I thought would be worth sharing with you!

The morning was spent at Historic Environment Scotland (HES), which is an organisation that investigates, cares for and promotes Scotland’s historic environment. We participated in a series of workshops about the history of housing in Scotland, which were led by Diane Watters and Dawn Ewers. During our workshops, we were given an introduction to the Tower Block Project. Through the Tower Block Project, HES is creating an interactive visual archive of Britain’s multi-storey public housing with the aim of recording every tower block built, including those that have already been demolished. The project is being run by Edinburgh College of Art and recently received funding from the Heritage Lottery Fund to help digitise photographs and support local outreach initiatives which encourage high-rise residents to tell their stories, and aid them in telling community histories. In order to expand the Tower Block Project’s collection, HES have also been collaborating with Our Place in Time, a project based in Wester Hailes which aims to record the constantly evolving history of the Wester Hailes estate.

Archive Images of Wester Hailes courtesy of Prospect's Facebook page.

We also attended a seminar which provided us with guidance on how to research the history of buildings in Scotland, with a specific focus on local history and housing. HES have a number of diverse resources available on architectural history, including preservation registers, publications, building surveys and inventories, aerial photographs of Scotland from several time periods, as well as 18^th and 19^th-century etchings, drawings and paintings of residential buildings and estates. After the workshops, we were given a tour of HES’ archive and library, which gave us an opportunity to see some of these materials in person.

Archive Images of Wester Hailes courtesy of Prospect's Facebook page.

In the afternoon, we travelled to Wester Hailes together to visit Our Place in Time’s archive. Our Place in Time has not only collaborated with HES, but a variety of community organisations in Wester Hailes and West Edinburgh, as well as other institutions within the wider Edinburgh community. One of these community organisations is Prospect, a community housing information service which houses Our Place in Time’s archive. When we arrived at Prospect, we were given a presentation introducing the Our Place in Time project. We learnt that in the process of recording the history of Wester Hailes, the project ensures that all Wester Hailes residents, past and present, can contribute to the documentation of their history. The information gained by this project also hopes to help plan for, and secure, future opportunities for the Wester Hailes area and community. In order to ensure this, Prospect have created a blog entirely dedicated to the project which includes articles, images of archive materials, community maps and a timeline of Wester Hailes’ history. In addition, Our Place in Time also provides online access to their archive materials through their own website and very popular Facebook page ‘A Wester Hailes Story’.

Archive Images of Wester Hailes courtesy of Prospect's Facebook page.

The archive material I most enjoyed exploring at Prospect was the ‘Sentinel’ collection. The Sentinel was a community newspaper which ran in the Wester Hailes area from the late 1970s through to the year 2000. The Sentinel provided a voice for the community, both within Wester Hailes and out to the rest of Edinburgh city. The Sentinel archive is now fully digitised, broadening its reach to a global community. After the digitisation project was launched online, local social media activity led to a relaunch of the newspaper as a digital news service. Citizen journalists around Wester Hailes collect stories on smart phones and tablets and upload them to the relaunched Sentinel.

Archive Images of Wester Hailes courtesy of Prospect's Facebook page.

We ended the day with a social history walk around Wester Hailes, which was led by Eoghan Howard, one of the partners of the Our Place in Time project, and a Wester Hailes resident. The walk demonstrated the area’s history, the history of post-war housing in Wester Hailes tower blocks, and the narrative of Wester Hailes as told in the Sentinel.

My favourite site that we visited on the walk had to be the totem pole next to Union Canal. It was installed in December 2012 and is a symbolic “ladder to the clouds” which represents all the information about Wester Hailes which is now in the digital “cloud” online. The pole includes 5 quick-response (QR) codes which, when scanned with a smart phone, links passers-by with all the online resources about Wester Hailes made available through the Our Place in Time project. The pole was designed by local people who decided what images represented Wester Hailes, and the carving of the designs was also done by the local community through a series of workshops organised by community-led arts charity and social enterprise WHALE Arts Agency. You can watch the ceremony in which the totem pole was raised online. 

A picture we took by the totem pole courtesy of Prospect's Twitter account.

Mass Miniature Radiography

On return from maternity leave, Project Cataloguing Archivist, Clair Millar, gives us an insight into joining the RVHvsTB project.

In what has seemed like a very quick year, I am very pleased to be back working on LHSA’s Wellcome Trust funded projects. I am now working on our RVHvTB case note project, with fellow Cataloguing Archivists Becky and Aline. I will be working to complete cataloguing of the third part of the collection, LHB41/CC3 ‘Regional Hospital Board National X-Ray Campaign case files’. This series relates to the Edinburgh X-ray Campaign of 1958, a collaboration between the Department of Health for Scotland, the Regional Hospital Board, the Edinburgh Corporation (now Council) and the residents of Edinburgh.

As early as 1944 there was a build up to this campaign, which recognised that alongside the introduction of new drugs in the efforts to combat TB, there was also a need for detection of the disease through concerted screening of the population at risk. Thus, Mass Miniature Radiography (MMR) was born which in essence was mobile units, in vans, that carried X-ray screening equipment and set up in community areas to encourage as many people as possible to be screened for TB and other abnormalities. This was effectively a ‘mobile hospital’ that would come to you and had particularly successful results in Edinburgh. The evidence of these efforts can be seen within the series that I am cataloguing which consists mainly of referral notes with patients’ results of the screening process. Below is a fairly typical (redacted) example of one of the referral letters.

 

 Before taking a more detailed look at Edinburgh’s 1958 X-ray campaign lets return focus back to the history of MMR. As Becky and Aline have already mentioned in previous blog posts, throughout the twentieth century major transformations were taking place in the fight against TB, including antibiotic drugs and the BCG vaccination. However, a final push was needed to bring the disease under control and an emphasis was made on the importance of finding undiagnosed cases that were potentially new sources of infection[1]. In theory this would not only lead to referrals for follow-up treatment but also raise awareness of the infectious nature of the disease that threatened the population. The first MMR units had been operating across Scotland since 1944 but on a very small scale. It was not until 1956 that the Scottish Secretary of State announced a more ambitious MMR campaign which aimed to make a more valuable response at tackling the disease via a fleet of MMR units and enhancing publicity of the campaign. [2].

National investment into MMR units was a way of creating a rapid survey which reflected the extent of the spread of TB. By literally using miniature X-ray equipment, in the form of a 70 mm wide film and by using low doses of radiation, it meant that the process of screening could become portable. A mobile van transported the MMR units and they could go straight into the heart of public hotspots, such as workplaces, schools and community areas. X-ray screening could produce relatively quick results to catch active TB and it was also used to detect any other abnormalities mainly in relation to chest and cardiovascular diseases. In either case, referrals were then made for the patient to go to the appropriate medical specialists, in the form of a Chest Clinic or their GP for further investigation and treatment.  

 

Men and women queuing up outside an x-ray screening van. P/PL41/TB/005

The two year MMR campaign was eventually launched in Edinburgh in 1958 and proved to be very successful due to good organisation and effective publicity. It was recognised that alongside increasing the number of mobile units on the ground, public co-operation and support was key to making progress. This concept laid the foundations for what was to be labelled a ‘Community Campaign’, where the public played an important role not only by attending screenings but there were also many volunteers recruited to co-ordinate screenings and help persuade people to attend[3]. This raised awareness led to a success rate of 84.4% of Edinburgh’s population being screened and contributed to the permanent decline in the rate of TB.

 

Edinburgh Castle with illuminated x-ray promotional sign. P/PL41/TB/042

Interestingly, I came across a piece of correspondence amongst the MMR case notes that mentioned entry into a prize draw for those X-rayed throughout the campaign. Upon further research into the Edinburgh MMR campaign, it appears that many incentives were used to encourage the public to attend a screening, including awarding them with both a badge and a raffle ticket that entered them into a special prize draw. There were some serious prizes that were donated to the cause up for grabs. Coming in at number one was a £3000 house, followed by a car, £2 per week pension for life, a bedroom suite, and a lounge suit, as well as numerous other smaller prizes. In just three weeks a total of 55,000 people in Edinburgh were also enticed to attend a screening, when a ‘Big Top’ circus tent was erected in Princes Street Gardens to provide entertainment for those awaiting X-ray.[4] These methods of persuasion were further enhanced by the general publicity promoted by the Campaign. Banners, posters, press releases, cinema and radio advertising, as well as an illuminated sign projected across Edinburgh Castle contributed to a well-executed public health campaign in Edinburgh and highlighted the importance of public participation in the fight against TB.

The 'Big Top' circus tent in Princes Street Gardens. P/PL41/TB/004

---

[1] F Ryan, Tuberculosis: The Greatest Story Never Told. Bromsgrove: Swift Publishers, 1992, pg 381.

[2] I Levitt, “TB, Glasgow and the Mass Radiography Campaign on the Nineteen Fifties: A Democratic Health Service in Action,” A paper prepared for Scottish Health History: International Contexts, Contemporary Perspectives Colloquium, 2003, pg 1-6.

[3] H E Seiler, A G Welstead, and J Williamson, “Report om Edinburgh X-ray Campaign, 1958,” Tubercle, vol. 39, 1958, pg 340.

[4] Ibid, pg 343.

The 'Lady Students', Impropriety and the Mess Stallion

The University of Edinburgh has just welcomed its latest intake of medical students, a new wave of young faces eager to begin their medical careers. Around 60% of these new students are female, but when Sophia Jex-Blake applied to study medicine in 1869 she was denied - it was not considered practicable to make alternative arrangements for one lone woman. Undeterred, she advertised for more women to join her, and eventually gathered a group who would become known as the ‘Edinburgh Seven’. These seven began their medical education on 2^nd November 1869.

All seven performed well in their first exams, with Edith Pechey topping the class and qualifying for a prestigious scholarship, but the staff had noticed a growing sense of unhappiness amongst the male students, and awarded it instead to one of them in an effort to quell this. As the events of 1870 would show, this was not particularly effective…

Then, as now, the time spent on wards was crucial for producing well-rounded doctors - as any medical practitioner will know, there is a big difference between learning the theories of diagnosis and treatment, and the reality of dealing with disease ‘in the flesh’. The female students wanted to be able to experience the wards alongside their male counterparts, and requested that they be allowed to join the clinical classes that were taught on the wards. To many of the male students, however, the idea of a female element in their midst was nothing less than horrifying, and a petition was presented to the Board of Management of the Royal Infirmary of Edinburgh (RIE) in protest. In total, five hundred and four students had signed the petition, with the petitioners being keen to point out that four hundred and ninety of those had been gathered in the first seven hours…

The issues hinged on the question of propriety. Was it proper for a lady to be present on a ward, where medical examinations were taking place? Would the men be able to comfortably discuss medical concerns in the presence of women? The petitions didn’t think so:

"many subjects of the gravest medical importance will be imperfectly treated, or omitted altogether" [LHB1/1/25]

The Board of Management was divided. It was decided that the opinions of the Physicians and Surgeons of the RIE should first be sought. In the meantime, Jex-Blake wrote to the Board. In a letter that sounds both begging and defiant, she suggests that only those physicians and surgeons who want to teach the ‘Lady Students’ would have to – “both as a matter of courtesy and because we shall already be provided with sufficient means of instruction”:

LHB1/1/25

The infamous Surgeons Hall Riotoccurred two days later.

The matter remained unsettled for some time. Under pressure from some influential contributors, the Board were convinced that the female students should be allowed access, but the question remained of how to implement this without resorting to objectionable and improper mixed classes. This question continued for a number of months – in October 1872 opinions were sought from the medical and surgical staff, asking whether they were in favour of admitting the women at all, and if so, how they proposed this medical instruction could take place. The responses varied; while some were encouraging, many could not see their way clear to the women being present and involved in medical examinations:

"I am not prepared to give clinical instruction to mixed classes, on account of my own feeling of its impropriety and fear of evil results following" - letter to the Managers of the RIE from J Matthews Duncan, 31 Oct 1872
[LHB1/73/1/6]

We’ll be sharing more of these letters over on our Twitter page over the course of the next week.

Eventually, the board agreed to allow women to attend classes on the wards, but these were held at different hours to the men’s’; they were only allowed to visit certain wards; they were permitted no access to post -mortems, surgical operations; and they were not allowed to work as clerks or dressers as this could lead to “inextricable confusion”:

[LHB1/1/26]

A further example of women’s fight to be accepted by the medical society of Edinburgh can be seen in the minute book of the Medico-Chirurgical Society of Edinburgh (GD3). In 1892, Grace Cadell wrote to the Society requesting a form for membership. This appears to have prompted something of an urgent discussion amongst the members, and Grace soon received a letter informing her that “the Society has passed a law asserting that its membership shall be confined to Medical Practitioners of the male sex”.

 

[GD3/2/3]

 Although the number of women studying medicine had been growing steadily over the next thirty years, it was the outbreak of WWI in July 1914 that brought about a dramatic increase in the number of female students. Even with 373 female students studying in 1918/9, there was still no provision for the full instruction of women – mixed classes on medical wards began in 1927, but it wasn’t until 1933 that they were allowed access on surgical wards.

The barriers to the education of women weren’t always as regulatory, though. Women were granted the right to apply for residency placements (working as an appointed House Officer in a hospital) in the 1920s, but were not permitted to live in the Residency itself until the late 1940s. As the residency rules show, this was an environment very much geared towards its male inhabitants. I wonder how easily a woman would have fitted in with this bunch…

 

Rules of the Residency [LHB1/114/2]

The fight to be fully accepted in the medical community continued well into the 1950s. Both the Bruntsfield Hospital and the Elsie Inglis Memorial Maternity Hospital (EIMH) were closely associated with the idea of providing practical medical experience to young female doctors. Indeed, Bruntsfield Hospital took its name from Bruntsfield Lodge, Sophia Jex-Blake’s former home. In 1957, the resignation of a consultant physician at Deaconess and Longmore Hospital prompted the Regional Health Board to reconsider staffing arrangements across the Lothian area. A suggestion was put forward that a locum physician could work between EIMH, Bruntsfield Hospital & Deaconess Hospital – which could result in a male doctor working in the two women’s hospitals. This proposal was met with some anger. As Gertrude Herzfeld pointed out at a Board meeting on 9^th November, “if a woman was not appointed, there would be no woman consultant physician in the Edinburgh Area to whom woman patients could be referred and there was a definite demand for the services of a woman consultant physician in the area”.

 

[LHB9/1/9]

Others argued that allowing a man to take over such a role would “contravene, certainly the spirit, n and probably the terms of the trusts upon which these great hospitals were founded”, and Arthur Woodburn, MP for East Stirlingshire, suggested that “part of this trouble lies in the resistance of the male members of the medical profession to the entrance of female consultants into the higher grades of the profession”.

Instrumental in the campaign against this appointment was Helen Miller Lowe. Lowe was one of the first female chartered accountants in Scotland, and had a lifelong interest in the medical profession, acting as treasurer of both EIMH and Bruntsfield Hospital when they were transferred to the NHS. The GD34 collection contains correspondence, campaign papers, press cuttings and reports relating to the campaign she spearheaded. This garnered support from those both near to home and further afield (with some encouragement coming from a familiar name!)

 

[GD34/1/4]

 

The campaign was a successful one, with the RHB capitulating in Feb 1958 and agreeing that all of the vacant posts at the Brunts & EIMH be retained for women only.

 

[LHB9/1/10]

 When considered in light of the history of the medical education, it seems no small feat that 60% of the current medical student intake are female. The collections that LHSA hold illuminate a small part of the fight for women’s place in medicine, and we’re pleased to be able to show them to a wider audience.

For more information, check out the Wikipedia pages on Women in Medicine.