Guest Post

‘Approaches to Opening Up Medical Archives’ and welcome to the Wellcome-funded projects group blog post for HARG

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Victoria Haddock, Wellcome Project Conservator, Boots Archive

The professional seminar ‘Approaches to Opening Up Medical Archives’ hosted at London Metropolitan Archives on 19 January 2018 was an insightful collection of talks around the project management and conservation of two important collections: the Foundling Hospital medical records at LMA and those of the St. Mark’s Hospital Archives held by St. Bartholomew’s Archive. Both projects have received funding from the Wellcome Trust Resource Resources awards to enable their conservation and cataloguing, with the aim of opening up access to these collections – whether by allowing them to be a in a more stable condition to be viewed, or to be digitised.

The Foundling Hospital project at LMA focused on a distinct subset of the Foundling collection which was unfit for consultation and required much-needed treatment to enable it to be digitised safely. In addition to this the LMA was successful in its application for a public engagement fund which will allow a year-long programme of events to link in with the project including an academic conference, events for schools and an exhibition.

The St. Marks collection is over 50 linear metres of archival items which all require full cataloguing, which will begin in February 2018. Their conservation has been worked on since July 2017 by their project conservator, who gave an insightful talk on her approach to working on such a large collection. The usefulness of having the time to thoughtfully and accurately survey a collection was detailed along with an interesting example of the development of stationery bindings from the mid-nineteenth century.

Both were great examples of the variety of challenges that may happen during these kinds of projects and we all got the chance to see some fantastic examples of the conservation work done by the conservators on these projects, from full rebinding examples to more minimal preventive approaches such as bespoke book jackets.

It was a great morning to hear about these projects and sparked many questions and debates. It was also a really great opportunity to meet others in similar situations who have the same sort of issues to confront within medical archives.

The timing of this event was also fortuitous as recently a group has been set up in the hope to connect previous and current conservators and archivists that have worked on short-term projects funded by the Wellcome. Since beginning work on a rehousing project at the Boots archive, Nottingham, in January 2017, I was struck by how many projects similar to mine had been funded by the Wellcome Trust. But there was nothing out there to tell us where we all were and no central body linking us together, even though we were all linked by the Wellcome’s funding and the fact that we are all medical, pharmaceutical or scientifically based archives. This struck me as a wasted opportunity for collaboration as many of us may have been facing the same kinds of challenges and there might have been someone else who has found the answer already and may be able to share this experience.

Personally, as an emerging conservator who has only recently graduated, I was struggling with the context of the project I was working on being the only conservator – and the first and only conservator the archive had ever had – and so was faced with a lot of responsibilities and decisions to make without having that opportunity to consult with a team of conservators with greater experience than me, that others might have in a different institution. But I also discovered mine was not an unusual case at all, there being many conservators out there with short-term project based work being one of their first ‘proper’ jobs after graduating from a postgraduate qualification or similar.

So this led me to begin drawing together a network of conservators, archivists and others, who were currently or had previously worked on projects such as mine. It has been initially a closed group on Facebook and an emailing list. After the event in the morning those of us that wanted to meet up to discuss the group were able to do so by the kind offer of a meeting space at LMA.

Many topics were discussed such as what we want to do with the group, how best to do this, what kind of information do we want to share such as project reports, as well as shorter blogs or images to show what we are working on, and are there any skills or training we would like to get that would benefit us a group and our particular situations. To be honest we only just touched the tip of the iceberg!

Many more thought-provoking topics were raised such as the general nature of project work from both the perspectives of those working on projects and those hiring for and managing those projects, how case studies and reports about Wellcome funded projects are not made available for those thinking of applying for funding, or those currently in that process to give applicants a greater understanding of the nature and scale of what conservation projects might become, and also how archivists and conservators could and should be working together in partnership.

This is just the beginning of what I hope to be a really useful network for people working on short term projects that want to have a place to voice their questions, successes and feel part of a wider supportive community.

If you have any questions about the group or would like to join the mailing list please email victoria.haddock@boots.co.uk.

Guest Post

Topical Press Agency Medical Collection

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Historic England is the public body that looks after England’s historic environment. We champion and protect historic places, helping people understand, value and care for them.

 

The Historic England Archive has recently discovered a collection of over 4,000 photographs taken by the Topical Press Agency. Dating from 1938 to 1943, the photographs document medicine and health care in England shortly before and during the Second World War, and immediately prior to the foundation of the National Health Service. The photographs document medical procedures, equipment, wartime hospital wards, evacuated children, patients and staff.

 

We are currently undertaking a project to preserve, catalogue and digitise the collection. The resulting catalogue and digital images will be made available to users online through the Historic England Archive website. The completion of this project will coincide with this year’s 70th anniversary of the founding of the NHS.

 

Historic England would like to track down people who may have stories to tell about working in health before the founding of the NHS or during its formative years, with the aim of recording interviews about their experiences. If you think you could contribute, we’d love to hear from you. Please contact gary.winter@historicengland.org.uk.

 

A patient smoking and reading a newspaper in a saline bath, whilst staff and nurses work in the background at the Queen Victoria Hospital, East Grinstead, 20 December 1940 [ref: MED01/01/1338]
The original caption on the reverse of the photograph reads:
The modern treatment of burns. Picture shows the patient comfortably resting in the saline bath after the dressings have been removed. He is allowed to smoke (through a holder to keep the smoke away from his eyes); can read the paper; and is given warm milk. The length of stay in the bath is from one hour upwards. On the left Sister is seen testing the salt content of the saline bath, while on the right an orderly watches the temperature control.
Copyright: Historic England

 

Guest Post

Medical treasures from the Cambridgeshire and Huntingdonshire archives

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In this post, Tiff Kirby, archives assistant at the Cambridgeshire and Huntingdonshire Archives, selects some of the notable items relating to history of medicine within the archives.


 

  1. Midwife Certificate of Elizabeth Ratford, 1717, AH27/6/271/278 Huntingdonshire Archives

From the sixteenth century, the Church certified both surgeons and midwives, and certificates from the Archdeaconry of Huntingdon are held at Huntingdonshire Archives. This certificate tells us Elizabeth Ratford’s mother was a midwife, and her father a surgeon, and that she learned her medical skills from her family. Other women testify to her expertise, and appear to have signed their own names – these are likely to have been other midwives. The certificate emphasises Elizabeth’s mother, who was for nearly forty years an approved midwife, and experienced in surgery.

  1. Composite Parish Register of All Saints Parish Church, Cambridge, 1635 – 1702, P20/1/2 Cambridgeshire Archives

This register is very small, but its contents for the year 1666 trace the epidemic of plague through the parish, with page after page of deaths. Beginning with George Thompson, 95 people died between the 1st July and the 26th November. While cause of death was not routinely recorded in parish registers, ‘buried of the plague’ is written next to the entries at the beginning, becoming increasingly abbreviated, until simply a ‘p’ is written against the final burial.

  1. Fulbourn Hospital Admission Register, November 1858- December 1870, KHF/3/1/1/1

The case notes of the earliest patients at Fulbourn Hospital (originally called the County Pauper Lunatic Asylum for Cambridgeshire, the Isle of Ely and the Borough of Cambridge) were destroyed by fire in the 1940s, which makes the earliest admission register particularly important. The first page records that Elizabeth Pain, a needlewoman from the Parish of St Andrew the Less in Cambridge, was admitted with mania of unknown cause. Elizabeth is indicated to be in otherwise good health, but we can see in the far-right hand column that the outcome wasn’t discharge and recovery, but that she died there in 1896 having spent decades in the Asylum. There are a variety of patients, on the same first page a lawyer, a shoemaker, a child of nine, with the largest group being labourers. Most admitted are described as having mania, melancholia, dementia and epilepsy, although these terms were not necessarily used consistently and changed their meaning over time.

  1. Transactions of the Huntingdon Medical and Surgical Society, 1793 – 1801, 4715

 This volume shows the shift towards medical professionalisation, and an emphasis on scientific method. The physicians share cases, observations and best practice, such as how to use pulleys for shoulder dislocations. One of the most remarkable cases is that of John Gillett, a wagoner from Baldock who contracted rabies. Having been bitten by a dog in December, he himself made the connection to the bite when he became ill on the 7th May. He then suffered extreme hydrophobia, unable to consume any liquids, the closest he could bear was redcurrant jelly. Despite every effort by the attending physician, John Gillett died on the 9th May. In the physician’s observations he identifies the disease as a virus, although his understanding of this would have been an infectious substance produced by a diseased body. He notes the time interval between the bite and the symptoms, and believes this was because it took time for the virus to reach the heart. We know in rare cases rabies may not produce symptoms for over a year, because it takes time for the disease to reach the central nervous system. He talks of the importance of “regular and well conducted experiments,” to understand the disease in dogs, and in the meantime, they must use the little knowledge they have to establish “data.” While concluding his observations he says, “it surely behoves us all to strike out new paths for ourselves form’d on the most rational theories.”

Guest Post

The John McLean Archive: A Living History of Dentistry

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Professor Stanley Gelbier

Hon Professor in the History of Dentistry

King’s College London


 As well as being an eminent dental practitioner Dr John McLean OBE (1994-95)[1], a past-President of the BDA, was a noted researcher.  He was feted in many countries and was a visiting Professor in Fixed Prosthodontics and Biomaterials at America’s Louisiana State University.  His particular research interests were in developing white filling materials.  Subsequent to being appointed Clinical Consultant to the Laboratory of the Government Chemist, John, together with Dr Alan Wilson, introduced glass-ionomer cements to dentistry.  This development opened up many new exciting possibilities for white fillings and established a new field of research and development in dental materials science.

John McLean (1925-2009)

When he died in 2009[2] John left money in his will to a number of organisations, including  the British Dental Association.  However he did not specify how it should be used, other than to promote research.  So the question was how best to spend it.

John loved his profession.  It was therefore decided to study and record the dental profession through the voices of living people, dentists and others.  The studies were to take two forms: witness seminars and oral histories.

The concept of Witness Seminars in relation to medicine and healthcare came to the fore in the early 1990s and was developed by Professor Tilli Tansey at the Wellcome Institute for the History of Medicine and later at Queen Mary University London.  In the Group’s 21st anniversary year they produced an excellent review booklet of the whole series.[3]  Having been at the Wellcome for eight years I learned a great deal about these seminars.  So together with Rachel Bairsto (Head of Museum Services at the BDA) and Professor Nairn Wilson (former President of the General Dental Council) we formulated a programme to examine aspects of dentistry: to collect memories and insights into the world of dentistry in the UK especially, but not only, from the time of the onset of NHS dentistry in 1948.

Following discussion with the family and the BDA it was agreed to create an Archive which the Association’s CEO, Peter Ward, stated would be “the beginning of what we hope will provide a highly authoritative and valuable asset to future generations and thereby satisfy that aspiration”.  He said the BDA intended that the Archive “will live and grow and metamorphose into a continuing story that maps the development of dentistry over years to come”.

Obviously Witness Seminars require a lot of planning.  A number of appropriate people were approached, told of the topic and asked if they would participate; also asked if they could recommend anyone else who might have something to contribute to the discussion topic.  The BDA appointed an administrative assistant to deal with all the arrangements: booking rooms and refreshments, telephone calls, letters and emails, arranging for recording equipment and typing.

On each day there were four hours of discussion, interspersed with breaks for refreshments.  There were no papers but several people took a lead for specific topics, speaking for between three and five minutes.  The chairman ensured people did not stray too far from the topic and that no one hogged the discussion.  Every word spoken at the seminars was recorded and typed up.  After initial editing by the chair for clear errors attendees were sent the typed script from their seminar to ensure accuracy and to add any afterthoughts (which could be inserted as footnotes).  They were told that any of their filed papers or documents could be added as appendices.  The documents were then revised and published in book form, with plans to make them accessible via the BDA website.

The publications are:

   The regulation of the dental profession by the General Dental Council,

   Changes in dentistry since 1948

   The changing role of dental care professionals

   The history and impact of development in dental materials over the last

   60 years

   The dental press

All were authored by NH Wilson and S Gelbier as part of the series ‘Reports of a Witness Seminar’, London: British Dental Association 2014.

Website with access to oral history transcripts and list of publications (https://bda.org/McLeanArchive)

In addition a number of oral history interviews have been recorded of both leading members of the profession, routine general dental practitioners and some ancillary workers.

So John McLean has provided the means to develop an excellent archive[4]  before so many of the people concerned are no longer alive.

For further information about the witness seminars and for access to the recordings and associated documentation please contact the BDA Dental Museum museum@bda.org​

 


[1] PM Frost, Dr John McLean: His life and times, Dental Historian 2007; 44: 5-19.

[2] Obit John Walford McLean OBE, British Dental Journal 2009; 207: 187.

[3] EM Jones and EM Tansey (eds.) for The Trustees of the Wellcome Trust, Monoclonal antibodies to migraine; an A to Z of modern biomedicine, London: Queen Mary London University, pp 223.

[4] https://www.bda.org/McLeanArchive/john-mclean

Guest Post

Life and death in 1960’s Civil Service: Whitehall Study I collection now available

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Chris Olver, Cataloguing Archivist, London School of Hygiene & Tropical Medicine


The London School of Hygiene & Tropical Medicine has been at the centre of excellence for epidemiology and medical statistics for 90 years. Researchers at the school have contributed to our understanding of disease outbreaks, effectiveness of drug and vaccination treatments and effect of environmental and lifestyle choices on population health. The papers of one of the most renowned longitudinal studies on population health, Whitehall Study, is now available for consultation at the School’s Archive Service.

Infographic showing clinical procedure for health screening of the Whitehall Study volunteers. 

The Whitehall Study I, also known as the ‘Health Survey of Male Civil Servants aged 40 or over’, was a longitudinal health survey of male Civil Servants, aged 40-60, based in London, conducted from 1967-1970 by the London School of Hygiene & Tropical Medicine and Guy’s Hospital. The study involved a mass health screening of 18300 subjects selected across 38 departments conducted in a special screening centre situated in Whitehall. The initial purpose of the study was to identify early signs of cardiovascular, respiratory and metabolic diseases and refer at risk patients onto medical services. The second phase of the study involved selecting subjects for a series of controlled studies on effectiveness of intervention methods, these included weight loss trials, exercise trials and a smoking cessation study involving 1445 men. The entire study cohort were then monitored and tracked by the survey team, through the Office of Population Censuses and Surveys (OPCS), with any deaths and certain disease diagnoses recorded.

Table showing smoking habits of Grade I (Administrators). The questionnaire asked volunteers about current smoking habits, previous smoking history along with a supplementary section for pipe and cigar smokers.

 

It was through the analysis of the resulting mortality data that the most famous finding of the study was revealed. Sir Michael Marmot noticed that lower grade employees were a third more like to die from various mortality causes than those employed at higher grades. This finding showed a clear social gradient in mortality and led to a second Whitehall Study being created that focused directly on the extent and causes of the social gradient. The Stress and Health Study, or Whitehall II, followed a new cohort of 10,308 male and female subjects, aged 35-55, from 1985 to the present day.

 

The archive collection provides an invaluable resource of the data collection, monitoring work and analysis conducted on the original Whitehall Study. The majority of the papers include raw data from the health screening, primarily questionnaires but also clinical test results including electrocardiograms, X-ray and blood results. Mortality data includes photocopies of death certificates, medical coding and computer coding forms and sickness absence reports collected from across the participating departments. Other material includes follow-up studies, primarily relating to the smoking cessation trial and graphs, tables and working papers regarding data analysis. The collection also includes a rich holding of material from preceding health surveys conducted at the School including material relating to General Post Office (GPO) health trials, 1964-1993, and the survey on the effects of air pollution on rates of chronic bronchitis in the Civil Service, 1950-1958.

 

Blank questionnaire from 1966 General Post Office health survey

The Whitehall Cataloguing Project sought to preserve, catalogue and make available the Whitehall Study collection for wider access. It was undertaken by the LSHTM Library & Archives Service between January and September 2017, with funding provided by a Wellcome Trust Research Resources grant. The catalogue description is available on the London School of Hygiene and Tropical Medicine online catalogue and can also be viewed on the AIM25, Archive Hub and the National Archives Discovery catalogue.