Nurse Janet Porter- nursing at the RIE before the 'Nightingale takeover'

Lauren writes about a much beloved nurse and the state of nursing before the implementation of the 'New System of Nursing'.

August 12th marked the anniversary of Florence Nightingale’s death. Having a particular interest in the history of nursing, and being in the unique and privileged position of having immediate access to the archives, I took the opportunity to investigate the state of nursing at the Royal Infirmary of Edinburgh (RIE) before the introduction of the Nightingale nurses and the training school for nurses. I came across several mentions of a Mrs Janet Porter, a staff nurse at the RIE for a total of 47 years. She lived through the incredible changes which took place at the RIE in 1870s with the introduction of the ‘New System of Nursing’.

Dr Joseph Bell painted a rather bleak picture of nursing before the introduction of the Nurses’ Training School: 'Without apparent exaggeration, it is almost impossible to convey to this generation the depths of disgraceful ignorance and neglect in which nursing lay in hospitals in 1854.'

There were nine nurses total in the surgical wards which housed 72 patients. These nine women were-'two staff nurses, each with about thirty six beds to look after, and seven so-called night nurses who had also to do the scrubbing and cleaning of the wards and passages.'

Joseph Bell (1837-1911) was a Scottish surgeon and advocate for the training of nurses.

Bell’s description of the staff nurses Mrs Porter and Mrs Lambert is rather flattering: 'wonderful women of great natural ability and strong Scottish sense and capacity, of immense experience and great kindliness. Up to their strength and opportunity, probably no two finer specimens of the old-school nurse could be found. All honour to their pluck and shrewdness!'

But he spares no punches when describing the other seven nurses: '…poor old useless drudges, half-charwoman, half field worker, rarely keeping their places for any length of time, absolutely ignorant almost invariably drunken, sometimes deaf, occasionally fatuous—these had to take charge if our operation cases when the staff nurses went off duty. Poor creatures, they had a hard life!'.

I had done some research on nursing for the digital resource list on the history nursing and one of the first things I learnt was that the general perception of nurses during the 18th and better half of the 19th century was incredibly negative. Figures like the fictional nurse Sarah Gamp from the Dicken’s novel Martin Chuzzlewit perpetuated the untrained, incompetent and drunk stereotype of the Victorian nurse. The RIE minute books (Nov 1967-Nov 1869 and Nov 1869-May 1871) confirm that there were instances where nurses were caught intoxicated on the job, and there were quite a few complaints made in regards to the general conduct of the nurses.

A dishevelled nurse with her disgruntled patient. Coloured lithograph by W. Hunt. c. 1825. Credit: Wellcome Collection. 

"The Nurse"; anonymous. Credit: Wellcome Collection

Angelique Lucille Pringle was the second Lady Superintendent of nurses. Trained at St Thomas', she was widely considered to be Florence Nightingale’s favourite. LHSA holds Angelique Pringle’s diary from 17th to 23rd Nov 1872, which she kept during a visit to the RIE while Elizabeth Barclay was Lady Superintendent. It is an invaluable record which vividly captures both the state of nursing at the time and the tensions and prejudices between these new, highly trained and educated nurses and the ‘old school nurses’. 

Pringle makes mention of nurses being intoxicated. In one instance, a night nurse called Annie Fisher is caught asleep on the job. After many attempts to wake the nurse up, Mrs Barclay asks Fisher “what about your patients, nurse?” Laughing, Fisher replies “Oh, I had nae mind o’ them”, which Pringle writes is a 'skillful epitome of the state of nursing'. After Pringle and Barclay wake up a Day Nurse to take charge of the ward, Annie Fisher follows the two women, enraged and screaming that she “had seen a good many out and she would see us out too!”

Typescript copy of Miss Pringle’s Diary LHB1/112/2 

RIE Minute Book LHB1/1/24- complaint regarding the conduct of Syme's night nurse, mention that she "has been indulging in intoxicants".

RIE Minute Book LHB1/1/25- report of nurse Janet Houston who had "been found intoxicated and unfit for duty" 

RIE Minute Book LHB1/1/25- nurse Jane Riddoch had been found in a state of intoxication

Much like Bell, Pringle lays it on pretty thick with her description of the nurses and her comments are often cruel and ignorant by today’s standard: 'Two of these nurses were hideously deformed in face, quite unsuitable on that account alone for their post. Their wards looked nice however.' The classism is so abundant within her descriptions of the nurses that it’s a bit hard to stomach at times- 'These were very pale all of them, some were sodden, some were stupid old women, some slovenly young ones of the lowest class.'

It would appear that the nurses bore the brunt of such animosity, when it was the system and the terrible working conditions which were mainly to blame, and no doubt played a part in the general incompetence of the nurses' work. The nurses at the RIE pre-1870s 'were poorly housed, ill-fed, underpaid and over-worked, and many of them were regarded as attendants and servants rather than nurses'. Shockingly, the night nurses’ shifts were extraordinarily long- they would come on duty at 11 o’clock at night and their shift would not end until 5 pm the next day! Their shifts were so long because, after completing their nightly nursing duties, they would still have to make breakfast and clean the dishes and wards and give patients their food.

Improvement to the conditions of nursing was largely overlooked by medical staff at hospitals during the first half of the nineteenth century. Florence Nightingale famously described the state of nursing at this time as a profession for ‘those who were too old, too weak, too drunken, too dirty, too stupid or too bad to do anything else’. 

LHB1/1/25 RIE Minute Book, complaint of nurses diet.

Angelique Pringle mentions Mrs Porter a couple of times in her diary: 'One head nurse, Mrs Porter, looked quite a dear old lady but her wards were not nice. She has been 27 years here and has now one of the heaviest charges.'

LHB1/112/1 Angelique Pringle's diary

Before the introduction of the New System, it would appear that unruliness and chaos were not uncommon in the wards of the Infirmary. It also seemed to be pretty normal for nurses to be dismissed: 'On asking the nurses their length of service, we found several who had been only two days in the house ‘since that night’ said one of them ‘when so many of the nurses got drunk’.'

Even Mrs Porter’s conduct, according to Angelique’s diary, did not seem to comply with the Nightingale model of cleanliness and order: 'We found nearly all the gas blazing, the day nurses running about and a perfect riot of laughing and talking going on among the nurses and patients. Nurse Porter’s wards were the noisiest, the old lady herself being very loud.' Although she isn’t exactly reverential about the “old lady”, she does seem to acknowledge a certain ‘spark’ that seems to have captivated so many people.

Even Florence Nightingale herself wrote a letter to Angelique in which she expresses a fondness for nurse Porter:

'Please give her my kindest Christmas wishes and tell her I remember her perfectly and her care of me 16 years ago when Mr Syme took me over the infirmary. How long ago!'

Nightingale's letter to Pringle. LHB1/111/3a

Another interesting record is 'Biographical notes on Nurses not trained under the new system here, on duty Sep 1887': 'Dear old Mrs Porter, the crown of the staff, who needs no other description.'

LHB1/112/9 Notes on early nurses- nurse Porter is described as 'the crown of the staff'

Mrs Porter provided inspiration for the poet W E Henley who was a patient of Joseph Lister at the Royal Infirmary from 1873 for three years. He wrote the following poem about Porter titled ‘Staff Nurse- Old Style’:

THE greater masters of the commonplace,

REMBRANDT and good SIR WALTER — only these

Could paint her all to you: experienced ease

And antique liveliness and ponderous grace;

The sweet old roses of her sunken face;

The depth and malice of her sly, grey eyes;

The broad Scots tongue that flatters, scolds, defies,

The thick Scots wit that fells you like a mace.

These thirty years has she been nursing here,

Some of them under SYME, her hero still.

Much is she worth, and even more is made of her.

Patients and students hold her very dear.

The doctors love her, tease her, use her skill.

They say ' The Chief' himself is half-afraid of her.

GD1/8/2 Pamphlet, 1957

Henley was a patient during a time of great change at the RIE, when the structure and training of nurses was undergoing a historic transformation. He immortalised these sharp contrasts of the ‘Old Style’ and ‘New Style’ nurse (as he would coin them), in his poems. This one is called ‘Staff-Nurse: New Style’-

BLUE-EYED and bright of face but waning fast

Into the sere of virginal decay,

I view her as she enters, day by day,

As a sweet sunset almost overpast.

Kindly and calm, patrician to the last,

Superbly falls her gown of sober gray,

And on her chignon’s elegant array

The plainest cap is somehow touched with caste.

She talks BEETHOVEN; frowns disapprobation

At BALZAC’S name, sighs it at ‘poor GEORGE SAND’S’;

Knows that she has exceeding pretty hands;

Speaks Latin with a right accentuation;

And gives at need (as one who understands)

Draught, counsel, diagnosis, exhortation.

Here, we can see the marked differences between the two nurses, the 'New Style' nurse is represented as a more educated and ‘genteel’ woman.

Photograph of Janet Porter (middle) c.1870

P/PL1/S/257 Photograph of Angelique Lucille Pringle, with a group of senior nursing staff c.1880

I find it incredible and quite moving how cherished Janet Porter was. She was neither an innovator nor was she a reformer but she seemed to have made a deep impression on those around her. Who says that one has to be a trail-blazer in order to deserve recognition, poems and portraits?

She certainly seemed deserving of recognition- her care no doubt changed many patients' lives. Nurse Porter was clearly very good at her job, although untrained to the degree of the Nightingale nurses, she gives me the impression of having been hard-working and committed to building relationships with those around her- staff, students, patients and professors alike. The fact that she was kept on even after the introduction of the training school is evidence of that. She was an exemplary nurse at a time when nursing was vastly underappreciated and nurses were regarded with distrust. 

Janet Porter was Lister's staff nurse from 1869 to 1877. When the new RIE opened in 1879, she was kept on in the position of a "retainer" rather than an active nurse. She died in 1890 at the age of 80. A bed in Ward 9 was named the Janet Porter Bed and her portrait, subscribed for by the nurses who had been associated with her and presented to the managers in 1890, was hung in the main corridor of the surgical hospital in the vicinity of the ward.

RIE Minute Book LHB1/1/35- report on the passing of Janet Porter. "...true to a marked characteristic of her nature she died literally "in harness"". The Managers unanimously agree to name a bed after her in Ward 9.

The Fascinating History of Anatomical Study

Our Access Officer Lauren writes about her recent trip to the Anatomy exhibition at the National Museum of Scotland.

Virtue's Household Physician Vol I (1927) Acc10/024

If you’re from Edinburgh, or if you’ve lived here for a while, you’ve probably heard of Burke and Hare at some point or other.

I’ve seen Burke’s skeleton a number of times at Surgeons Hall museum (as well as the pocket book made of his skin!) and I've peered numerous times at his death mask at the National Portrait Gallery. I used to work on a jewellery stall on the Royal Mile and would have to listen to a gazillion tour guides theatrically describe how the duo would suffocate their victims and sell their corpses to the anatomist Dr Robert Knox for dissection. I thought my knowledge regarding this gruesome slice of Edinburgh history was pretty solid when I walked into the exhibition Anatomy: A Matter of Death and Life. But I walked out of the exhibition postively inspired and brimming with new knowledge and better still- a thirst for more!

The first (surviving) Register of Dissections 1842 GD20/2/8

I was particularly pleased to see a lot of material from the University’s archive, things I had the pleasure of consulting and handling when working at Research Services. A highlight for me was the vellum scroll, a petition signed by over 200 Edinburgh University medical students, for more cadavers for anatomical study. The petition was created in 1828, the same year as the West Port murders. Anatomical study depended on the supply of corpses of criminals who had been executed for murder (in Edinburgh, foundlings or unclaimed bodies could also be used for dissection). Edinburgh had amassed a very high number of medical students due to the medical school’s success and the demand for corpses outweighed the city’s supply. The trade of human corpses was therefore a very lucrative business, a corpse costing £7- a lot of money back then! The long scroll petition is placed close to a mort safe, a heavy iron box placed over a coffin to deter would-be body snatchers. Both are roughly the same length. I loved seeing the objects from the archive displayed like this, in a way which helps contextualise their place in history.

History of Anatomy by Alexander Monro (Primus), 1747. The handwriting is thought not to be Monro’s GD1/2

Another item on display is one from the LHSA collection, the volume Collection of Engravings Designed to Facilitate the Study of Midwifery from 1796, showcasing exquisite obstetric anatomical drawing. I was particularly captivated by the anatomical drawings, which included Leonardo Da Vinci’s studies, an engraving of a dissection by Hogarth and an image I will never forget- an incredibly detailed depiction of the dissected corpse of an unknown pregnant woman. It’s quite something to feel taken aback by an illustration in this day and age, especially by one which was created in 1774.

The West Port murders and the ensuing scandal had a significant impact on the distrust felt by the public towards dissection and the medical community. In Helen MacDonald’s book Possessing the dead, the artful science of anatomy, she describes the aggression which erupted during a violent snow fight at the steps of the College between university students and members of the public in 1838. MacDonald suggests the snow fight incident is proof of the tensions which lingered as a result of the anatomy school's role in the murders.

The Anatomy Act of 1832 would further this distrust, especially among the poor. Whereas before one had to be a murderer in order to be legally dissected, it was now possible for medical schools to buy unclaimed corpses from public institutions, namely prisons, hospitals, asylums and workhouses. The poor didn’t have access to the benefits of medical training and teaching, and dissection was still seen as a violation of the body, and post 1832, as a form of punishment for being poor.

The Anatomy Act 1832

“They tell us it was necessary for science. Science? Why, who is science for? Not for poor people. Then if it is necessary for science, let them have the bodies of the rich, for whose benefit science is cultivated”

- William Cobbett, a critic of the Anatomy Act.

Rebecca Burrows writes in The Anatomy Act of 1832: The Story of Bodysnatching, Dissections, and the Rise of Anatomy:

“Out of 57,000 bodies dissected within the first hundred years of the Act’s implementation, less than half a percent came from anywhere other than institutions which housed the poor.”

The Act did create a steady supply of corpses, but did little to curb the public’s general revulsion towards the practice. Although the Act allowed for people to donate their bodies, by 1842 only 6 people had done so. I was particularly moved when I read that the introduction of the NHS in 1948, “coincided to an increase of body donation, partly because people saw it as giving back to a system which now cared for them for life."

GD1/112

By the 70s, institutions no longer relied on unclaimed corpses for anatomical study.

This wonderful exhibition inspired me to run a week-long social media campaign examining anatomy-related material from the LHSA collection. I absolutely loved finding material to share on our social media platforms and I'm eager to run another themed campaign at some point again- watch this space!

The Case of Charles Altamont Doyle

Charles Altamont Doyle’s artistic career never quite took off during his lifetime. His brother Richard ‘Dicky’ Doyle on the other hand, was a frequent contributor to the London magazine ‘Punch’ and even designed the publication's masthead. Charles would also never reach the levels of fame bestowed upon his son, the much celebrated author Arthur Conan Doyle. Although a gifted and creative artist, his chances of success were no doubt hindered by his declining mental health, his epilepsy and struggles with alcoholism. These all played a part in him being interned (or as he would write, ‘imprisoned’) within a total of three asylums - Sunnyside Asylum (Montrose Royal Lunatic Asylum), The Royal Edinburgh Hospital (REH) and Crichton Royal in Dumfries, where he would eventually pass away.

"Honey Suckle, how unlike any other plant. But it's a creeper/Another sort of creeper not so nice as above"
Page from 'The Doyle Diary' by Charles Altamont Doyle and Michael Baker

During the 2020 lockdown, I stumbled across one of Charles’ drawings while sucked in to the usual time-killing, rabbit-hole internet searches. I quickly became fascinated with his sketches of flora and fauna, his propensity for puns, his dark humour, and his whimsical depictions of supernatural beings such as fairies and elves. I went on to purchase the book ‘The Doyle Diary’ which reproduces one of the sketchbooks Charles kept while he was a patient at Sunnyside Asylum.

My trusted second-hand copy of 'The Doyle Diary'

"9th April 1889 Delightful walk at Sunnyside" 

Living in Granton I can relate on a personal level to this drawing.

Page from 'The Doyle Diary' by Charles Altamont Doyle and Michael Baker

Fast forward several months, and I am the Modern Apprentice at the Centre for Research Collections, being given a socially distanced introduction to the varied collections at Lothian Health Services Archive by Louise Williams, the archivist for LHSA. She shows me a great deal of fascinating collection items, including a case book from the Royal Edinburgh Hospital. I am reminded of Charles Doyle’s sketches and I ask her if there might be anything relating to him within the case books. She said there should be a case book entry for him, as he was a patient for a time at REH, shortly before his death 1893. She invited me to contact LHSA to gain access to the records. I had meant to do so for a long time but never got a chance.

Fast forward again to almost two years later and I currently find myself working at LHSA as their interim Access Officer and I decide that the time has finally come to look at Charles’ case book entry (which definitely felt like a circle closing!).

The case books are invaluable resources for researchers and genealogists as they contain a wealth of precious information on past patients such as; dates of admission, profession, marital status, home residence, religion, description of illness, duration of attack, treatment carried out, updates of their condition and dates of discharge or death. Even appearance is recorded in some cases. For Charles we have that he was “Tall, thin. Dilated capillaries on nose” with “Greyish yellow" eyes and “Dark grey” hair."

Case Book
LHB7/51/56

Doyle was interned within the asylum involuntarily as suggested by his certification paper, which was filled out by his wife Mary Foley Doyle. 

Certification Paper
LHB7/52/706

"Mary, my ideal home ruler/ No repeal of the union proposed in this case"
Drawing depicting Charles and his wife Mary. Doyle was of Irish background and this drawing alludes to the Irish question.
Page from 'The Doyle Diary' By Charles Altamont Doyle and Michael Baker

He would be a patient at the REH from 23^rd January 1892 to 26^th May 1892. He was then transferred to Crichton, the last case book entry stating: “Transfer Certificate, His memory and general intelligence are very much enfeebled".

I was hoping that there might be some artwork in the archive that Doyle made while a patient at the REH but unfortunately nothing of the sort has been unearthed as of yet.

"Something queer both in head and heart/Lost 'em both./By no means unusual"

Page from 'The Doyle Diary' by Charles Altamont Doyle and Michael Baker

There were also a couple of enclosures which originally lived in the case book but for preservation purposes, have been neatly re-housed in melinex folders. The enclosures can range from photographs of the patient, correspondence, various types of ephemera, medical charts and more. For Charles there is a letter from the assistant medical officer at Sunnyside to his physician at the REH, regarding his transfer.

There is also a newspaper article, written shortly after his death. The article does not mention his internment within the asylums, simply stating that he “gave up residence in this city”, suggesting his actual whereabouts was kept from public knowledge, perhaps to avoid scandal. The article recognises Charles’ artistic talent but not without knocking his technical abilities: “While possessing a great force of natural genius as an artist, his colouring and composition were somewhat crude, but in expression of humour and pathos he had a great facility”. The article goes on to say that “Personally, he was a most likeable man, genial, entertaining, and amusing in conversation. Possessing a fertile imagination, it was always enjoyable to listen to his anecdotes”.

Enclosures
LHB7/51/56

The case of Charles Doyle is rather a sad one. It's likely he lacked self-esteem and perhaps felt over-shadowed by the more illustrious members of his family. To have spent the last years of his life isolated from friends and family must have been incredibly difficult.

Self-portrait of C. A. Doyle.
 "Busting out"

"Trying to get out of quod (prison)"

"Succeded"
Pages from 'The Doyle Diary' by Charles Altamont Doyle, Michael Baker 

I’m pleased that over time, interest in his art and life has piqued. Personally, his story has served as a rather nice segue into my new role at LHSA, combining three of my big loves: Art, archives, and research!

Lauren McKay

Further reading: "What became of Arthur Conan Doyle's father? The last years of Charles Altamont Doyle" by A Beveridge

Introducing Speaking Out!

 

Hello! My name is Louise Neilson and I am Project Archivist on LHSA’s Wellcome Trust funded project Speaking Out: Cataloguing advocacy, support and empowerment in the Lothian Gay and Lesbian Switchboard archives. If you are a regular reader of our blog or you have contacted us in the past you may recognise my name as I have been Access Officer here since April 2018 and will be conducting this project as a secondment and returning to that role in April 2023.

What am I doing?

Lothian Gay and Lesbian Switchboard (LGLS) opened on 2 March 1974 and was the UK’s first gay helpline and Scotland’s first gay charity. It was an activist-run mental and physical health service for LGBT+ people in the Lothians and beyond, yet despite this pioneering history, LGLS archives remain largely invisible to researchers due to their current uncatalogued state… which is where I come in!

As Archivist for the Speaking Out project I will be working hard over the next 11 months to open up the collection through cataloguing, rehousing and selectively digitising the LGLS collection. The process of cataloguing will allow confidential records to be identified and closure periods applied where necessary, but it will also allow non-confidential material to be opened for access by researchers.

I will also be working collaboratively with local LGBT groups to produce a public exhibition based on the LGLS archive which will also exhibit new work created as a response to the collection. In additional to this I will be hosting a series of workshops in the Centre for Research Collections from creative writing to zine making!

Switching the Changes, Gay Scotland, Issue 26 (Mar/April 1986)

Information about Edinburgh Gay Switchboard

What have I done so far?

I am now four weeks in to the project and to get started I thought it would be best to scope the collection, get a sense of what’s in there, and then create a detailed box list. After looking through the 44 boxes, folders, and box-files (and getting completely engrossed in almost everything I came across) I have created a structure that will allow me to begin cataloguing the collection.

The collection is in very good condition but before cataloguing starts I will be checking in with LHSA’s Manager and accredited conservator, Ruth Honeybone, to bring up any concerns and to discuss the best way to store the different materials that form the collection.

What is in the collection?

The collection comprises of records created and collected by LGLS which includes things like minutes, correspondence, call logs, resources for volunteers and promotional materials.

Reading minutes and correspondence has been helpful in getting a sense of how LGLS was organised and how it operated. It has also been useful to read through the press cuttings collected by LGLS volunteers and editions of Gay Scotland as these provided a wider context of LGBT+ lives, activism and politics across Scotland and internationally during the 1990s and 2000s.

Gay Scotland, Issue 21 (Jul 1985)

Call logs form a large proportion of the collection and capture one of the core functions of LGLS – to provide a listening service for people struggling with issues or difficulties relating to their sexuality.

Call logs come in different formats including bound log books and individual index cards. Each log contains a summary of the call including notes on what advice was given, updates on subsequent calls, or details of any in-person meetings between caller and an LGLS befriender. By the nature of the service LGLS provided the logs can contain confidential, and often sensitive information. Anonymised transcription will be used to allow access to a selection of call logs while ensuring we adhere to data protection legislation and maintain the confidentiality that was so crucial to the work of LGLS. 

First Log Book (1974)

It is going to be a privilege to work on opening up this collection and spreading the word about this ground-breaking organisation and its important place in LGBT+ and Scottish history. Keep an eye on our Facebook and Twitter pages, and of course this blog, for further updates (and plenty more pictures)!