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.”

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

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.

Introduction to The King’s Fund Digital Archive

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By Ruth Nitkiewicz, Information Specialist, The King's Fund (r.nitkiewicz@kingsfund.org.uk)

 


 

Selection of documents that have been scanned and are available through the King's Fund Digital Archive

 

The King's Fund is a charity that works to improve health care in England. Established in 1897 as an initiative of the then Prince of Wales, the initial purpose of the Fund was to raise money for London's voluntary hospitals, which at the time offered the only health services available to poor people in the capital. The charity has been renamed over the years (firstly, King Edward's Hospital Fund for London and then later, The King's Fund) and our role has evolved accordingly, reflecting the significant and ongoing changes to health care in England.

Our digital archive records nearly 2,000 digitised King's Fund publications dating from 1898. This unique resource not only records our history and our work, but also the health of people living in the capital and the development of the NHS. The collection doesn't contain any medical records, but it does provide a rare insight into the early voluntary hospital system in London. In the early 20th century, before the NHS was established, there was no central body responsible for collecting information about hospitals, such as bed numbers, costs and expenditure. However, the considerable funding provided to London hospitals gave the Fund influence to achieve reform and improvement. For example, the Fund made it a condition of awarding grants to hospitals that they produce, for the first time, standardised accounts and hospital statistics.

While our digital archive reflects the nature of our work, I should point out that it is really a digital repository for King’s Fund publications. We don’t use the system to store any archival material (our original archive collection is kept in the safe custody of London Metropolitan Archives), so effectively it is a digital library. However, we called it a ‘digital archive’ to reflect the nature of the collection within and to differentiate it from our extensive physical library collection, which includes non-King’s Fund publications. As a former archivist, I originally found the title hard to accept, but I admit that it does have a better ring to it than ‘digital repository’.

We currently use E-Prints as the underlining repository system for the digitised images, and the Universal media viewer (originally the Wellcome digital player) for rendering the images into viewable packages on our library website. At the moment, we are investigating other digital repository systems as we want to expand the collection to include new materials, such as images and born-digital documents and files. One system we’re interested in is the open-source Hydra repository, particularly because of its ability to utilise plugins that enhance collection management and curation. It’s a new area that we are excited to explore, as it will allow the library to showcase these materials in more dynamic ways.

 

Explore The King’s Fund digital archive here: http://archive.kingsfund.org.uk

The Neurosurgical Case Notes of Sir Geoffrey Jefferson

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By Karen Rushton, Wellcome Archivist/Curator, University Archive & Records Centre, The University of Manchester (Karen.rushton@manchester.ac.uk)


 

At the University of Manchester thanks to a generous Wellcome Trust grant we are currently working to catalogue the case files of 20th century neurosurgeon Sir Geoffrey Jefferson (1886-1961). Jefferson was the UK’s first Professor of Neurosurgery who spent most of his career at the Manchester Royal Infirmary (MRI).

 

The case files we hold cover Jefferson’s time working at the MRI between 1927-1940 on a wide range of neurological disorders including brain tumours, epilepsies, neuralgias, head injuries, and congenital spinal deformities. We also see references to lingering war injuries from WWI, occupational and traffic accidents, neurosyphilis, and the use of surgical and diagnostic techniques later considered to be controversial. The files themselves contain a number of record types including detailed case notes and accounts of surgery, correspondence, x-rays, and both clinical and pathological photographs.

Neurosurgery lecture, with Sir Geoffrey Jefferson on the back row second from the left & Norman Dott on the second row from the back on the left, n.d. ref: JEF/1/10/3

 

Going into the project the first major decision centred on what information we wished to record. The Lothian Health Services Archive in Edinburgh have recently completed a similar project centred on the case files of neurosurgeon Norman Dott (1897-1973) and so it was very helpful to be able to talk to staff there about their approach to the records. Most importantly we recognised that the Jefferson collection is one of a number of neurosurgery collections held across the country and it was important to recognise its part in a wider research web and so make our catalogue comparable to that of the Dott Collection.

 

When dealing with relatively modern patient records considerations surrounding data protection were paramount and procedures are in place to produce a public facing catalogue with all personal information removed and a complete catalogue for use in-house and to be accessed by approved researchers. MeSH has been employed throughout for indexing purposes and provides an invaluable tool for selecting files based on conditions and symptoms. It is here where expert advice from a neurologist based within the University has aided us in creating accurate indexing terms and updating old-fashioned terminology. However, the major barrier with MeSH has arisen regarding the potential indexing of surgical procedures. As a neurosurgeon rather than a neurologist the procedures that Jefferson performed were seen as being a very important factor in the descriptive content of the catalogue, but whether or not it was appropriate to index them or not was another matter. As a thesaurus of modern medical terminology MeSH essentially is not fit for this purpose. Whilst old-fashioned terms for conditions can be updated there is no appropriate terminology for now obsolete surgical procedures such as the frontal lobectomy.

 

Having worked on other medical case note projects in the past, namely the Stannington Project at Northumberland Archives dealing with children’s TB files, I was well prepared for the kinds of challenges we might encounter. Nonetheless there is an inevitable variation in the content of the records and in turn the approach to outreach activities and potential researchers. As all the Stannington files related exclusively to children many of the former patients were still alive meaning we were fortunate enough to be able to interact directly with subjects of the records. Equally the subject of TB feeds very well into existing narratives on public health and has many links to social history. Neurosurgery on the other hand is much less overtly approachable to those with a non-scientific or medical background and it is here where interpretative events and blogs have been essential in drawing out less obvious themes and material such as the possibility of the use of visual material in the files by artists working in the medical humanities.

 

Illustration of a brain aneurysm by Dorothy Davison, c.1940s, ref: uncatalogued

 

The cataloguing process is nearing completion but conservation and outreach work will be on-going as the project continues. As part of the Wellcome funding we will also be tackling several other medical collections including the work of 20th century medical illustrator Dorothy Davison, medical artwork from the teaching collections of 19th century obstetrician Thomas Radford, and papers relating to the pioneer of the artificial hip Sir John Charnley.