Friday, 5 February 2016

The Impact of Patronage in the First Few Decades of the Creation of the Victorian Hospital

This week's blog comes from Colin Smith, a part-time volunteer at LHSA. He is currently pursuing an MSc in Book History and Material Culture at the University of Edinburgh. Recently, he has been revising the administrative history of the Royal Victoria Dispensary, Hospital, and Tuberculosis Trust (LHB41) and the Royal Victoria and Associated Hospitals Board of Management (LHB10), which will soon be appearing on the LHSA website. This blog on patronage stems from his research he uncovered while volunteering:

History credits Robert William Phillip with founding the Victoria Dispensary for Consumption and Diseases of the Chest in 1887, the first ever clinic dedicated to helping patients fight Tuberculosis. Yet the clinic could not have gotten its first start without the generous backing of financial benefactors. What this blog post seeks to outline is the story of the Royal Victoria Hospital from the end of the 19th into the early 20th-century and how it inextricably was connected to local, noble and royal patronage.

The first patrons of the Tuberculosis Hospital were local and close. They were, in fact, personal acquaintances of Robert William Philip. This local and familiar patronage follows in line with the modest beginnings of the hospital. Both, that is, were small proceedings. The reputation and mission, however, of the clinic began to expand. Seven years later in 1894, the Victoria Hospital for Consumption at Craigleith House was opened with the help of Lord Stormonth Darling, former Member of Parliament of University of St. Andrews and Edinburgh. Unlike the initial benefactors, this patron was part of Scottish politics and law. During 1894, for example, Stormonth was part of the Senators of the College of Justice. He attained this position after undertaking the role of the Solicitor General of Scotland, deputy to the Lord Advocate. Political backing by a former Parliament Member and Solicitor General suggested that the hospital was beginning to make a name for itself in Edinburgh. In a 1897-8 ‘’Report for Year,’’ there lists six patrons and patronesses connected to the Victoria Hospital For Consumption and Diseases of the Chest including: the Duke of Argyll; the Earl of Aberdeen; Lady Susan Grant Suttie; Hon. Lord Kinnear; Hon. Lord Kyllachy; and, the Lady Mary Hope.   
Front page of the 1897/98 Annual Report, listing the patrons and patronesses of the (then) Victoria Hospital for Consumption (P/PL41/TB/060)

 In 1903, another prominent patron supported the hospital. Archibald Philip Primrose also known as Lord Rosebery supported the expansion of the Victoria Hospital. He was joined by Lord Provost Sir James Steel in the proceedings. Lord Rosebery was 5th Earl of Primrose and by 1903 was formerly a Prime Minister for the Liberal Imperialist sector. Repeated invitations by notable politicians no doubt improved the recognition of the Hospital and reinforced its mission to fight Tuberculosis.

These two respected patrons were matched, however, by a royal patronage given to the hospital one year later (in 1904) by King Edward VII. To pay homage to the royal benefactor, the hospital changed its name and officially adopted the more familiar title that we know today called the Royal Victoria Hospital for Consumption. According to the Fifteenth Annual Report of 1904-5 for the Royal Victoria Hospital for Consumption, included in the patronage list next to the King is (excluding the Duke of Argyll) the five patrons of 1897-8 again.

Front page of the 1904/05 Annual Report, reflecting the royal patronage bestowed on the hospital. (P/PL41/TB/061)
The reappearance of patrons and patronesses show a continued support for the fight against Tuberculosis. Three years after the royal patronage, the Right Honourable Mr. Arthur Balfour helped open new extensions to the hospital on 25th October 1907. Like Lord Rosebery, Balfour too was an Earl and former Prime Minister.

What the patronage of the Hospital signals therefore from the end of the 19th and into the early 20th-century is a willingness of a community and a nation to back a righteous cause to fight Tuberculosis. It points to the effectiveness of how Philip’s small movement to end Tuberculosis gained esteem with the generous help of financial benefactors.  

 Source List:
Sturdy, Steve. “Philip, Sir Robert William (1857–1939).” Steve Sturdy. Oxford Dictionary of National Biography. Ed. H. C. G. Matthew and Brian Harrison. Oxford: Oxford University Press, 2004. Ed. Lawrence Goldman. Jan. 2011. 2 Nov. 2015 . Web.


Friday, 29 January 2016

Welcome Back to Aline

In this week's blog, we welcome LHSA's new Project Cataloguing Archivist, Aline Brodin...

My name is Aline Brodin and I am very pleased to be back at LHSA to work on the project “Cataloguing Norman Dott's neurosurgical case notes (1920-1960)” until the end of July 2016. Indeed, I have started working as Project Cataloguing Archivist at LHSA on Monday 25th January, but I am already familiar with both LHSA and the Norman Dott project since I did a 10-week CRC internship from April to June 2015, during which I catalogued the Norman Dott case notes. This very enriching experience enabled me to develop my cataloguing skills and to gain good knowledge of the historical and administrative context of the project.

Aline working on a case note

I trust that these cataloguing skills will enable me to see my task through to completion, all the more so that thanks to this internship I am already familiar with the content of the case notes themselves, including their specialised medical jargon and very technical documents. However, my objectives as an intern and my objectives as a project cataloguing archivist are somewhat different. Indeed, although my time during the internship was mainly focused on the Norman Dott project, my supervisors Ruth Honeybone and Louise Williams made sure I acquired lots of experience in a wide range of archival activities to help my future career. But this cataloguing post is in a way more challenging and is entirely focused on cataloguing the Norman Dott case notes: indeed, the project is coming to an end and the deadline is rapidly approaching. Thus, I have six months to finish cataloguing between 3267 (low estimate) and 4267 (high estimate) case notes, which represents an average of 35 per day. Case notes can be more or less detailed: some relate to cases spanning on several years and contain all kinds of handwritten notes, reports, charts, letters, photographs etc., while others can consist in a typed case summary of one single page. For each case note, I record carefully selected information that I then enter into the XML editor oXygen to create, eventually, an online catalogue. The recorded information is designed to be useful for future researchers whilst protecting patient confidentiality.

A typical case file from Norman Dott’s collection (our reference LHB40 CC/2/PR3.2121). Identifying details have been removed.
During my internship, I was cataloguing the Bangour series, that is to say the case notes from the Brain Injuries Unit in Bangour General Emergency Service Hospital in Broxburn, dating from c. 1939-c. 1945, in the midst of the Second World War. This time, I will be cataloguing the series LHB1 CC/24 and LHB1 CC/22. LHB1 CC/24 covers Dott’s work at the Royal Infirmary of Edinburgh between c. 1941 and c. 1959, whereas LHB1 CC/22 covers case notes from various stages in Dott’s career that have been filed by the condition of the patient and that date from c. 1925 to c. 1955. The differences between the Bangour series and the ones I am cataloguing now are not very substantial; the most noticeable change would be that in the Bangour series the patients are mostly soldiers or military auxiliaries, whereas in the R.I.E series they are almost exclusively civilians. Therefore, not only are there much more women and children, but there also are more “everyday life” accidents: for example, head injuries tend to be more the results of car accidents and kids bickering rather than gunshots or explosions… But in both cases, the case notes give a very interesting insight into a period and into people’s lives.

The Norman Dott project is a large-scale project that has involved many people over the years and that will greatly help to make LHSA collections visible and accessible; this is why I am very excited to take up the challenge to finish cataloguing this great collection, this time not as intern but as a project cataloguing archivist.

Thursday, 21 January 2016

Welcome to Alice!

In this week's blog, we welcome LHSA's new Access Officer, Alice Doyle...
My name is Alice Doyle and I’m just coming to the end of my first week here in the brand new role of Access Officer.

I’m originally from Suffolk on the south-east coast of England, and first came to Scotland in 2008 to study Classical Civilisation at the University of Glasgow. I suffered my first bout of ‘archive fever’ when I worked as a volunteer researcher for Ipswich Museum’s Ipswich at War exhibition, and I absolutely loved poring over registers of evacuees and tracing their subsequent movements across Suffolk. I was fascinated by how aspects of an individual’s life can find their way onto the pages of a dusty tome, and in how many ways this collected information can consequently illuminate our views of society past and present. During my undergraduate degree I secured a brief placement with the University of Glasgow Archive Services, which introduced me to the basic tenets of archival practice. I knew then that the bug had well and truly bitten me, and in November 2015 I completed an MSc in Information Management and Preservation.
Alice hard at work...

My first week has involved trying not to get lost in the maze of corridors, getting an insight into what everyone does and how the services fit together, and trying desperately to remember lots of names! I’ve also had an introduction to the stores and collections, and on Wednesday I had the chance to help Louise set up a session for some History undergraduates. This was to familiarise them with the basics of archival research and how primary sources can be used. After a bit of guidance on how to handle archival items, Louise introduced the students to four different types of material that can shine a light on perceptions of insanity in the Victorian age: letters written by patients at the Royal Edinburgh Asylum; the Morningside Mirror, which contains articles compiled and published by patients and staff; a book of press cuttings, often compiled by staff, of articles relating to the treatment and attitudes surrounding mental health; and patient certification papers, which give us an insight into how an individual could come to be admitted into the asylum.

This session also brought home how varied the items in the collections are, and how personal some of them can be. A particular favourite of mine was this letter written by a patient to a woman ‘on the outside’, in which he apologises for promising to marry her, and for dancing at a ball “as my dancing may have hurt you”. Cognizant of his illness, he acknowledges that his promise was a delusion but affirms his love for her as “no delusion, (it is truth I love you)”. This human aspect to archival work reminds us that - while they may seem like one among many - each name on the lists of admitted patients represents an important and very personal moment in these individuals’ lives.


Letter from Royal Edinburgh Hospital Casebook (LHB7/51/52 p. 169)
I’m incredibly grateful for all the support and guidance I’ve received from the staff here in LHSA and in the wider Centre for Research Collections teams, and I’m looking forward to learning more about how I can help to increase user access to and awareness of the fascinating collections held here, whether that’s through responding to enquiries, conducting archival research or helping out with organising engagement and outreach activities.

Friday, 15 January 2016

In with the new…

As the old year passes and the new one comes in, we’ve a host of behind-the-scenes tasks to complete here at LHSA. It’s a bit of a frantic welcoming-in to each January, but it’s vital if we’re to be in good shape for the year ahead.

One of these tasks is to check up on the new items that we have taken in over the last twelve months. We call these new additions to the archive ‘accessions’ and we can take them in in two ways, which reflects how our material is organised. Since we’re the archive for NHS Lothian and all our holdings are owned by them, the first way we take things in is by direct transfer from the health service. This could be from individual hospitals or from NHS administration. For example, in April 2015 we received a wonderful accession from the Royal Hospital for Sick Children (REHSC), including late nineteenth-century nurse training records (and this less-than-glowing report!):

Entry in REHSC Probabtioners' Report Book, 1900 - 1902 (from Acc15/007)

Since LHSA collects more general material that can help us understand the history of health in Edinburgh and the Lothians, we also receive gifts from non-NHS organisations and private individuals. We take in gifts of nursing and midwifery badges from Edinburgh-trained nurses quite often, as we did this year:

Central Midwives Board for Scotland badge, c. 1950s (from Acc15/004)

Every new collection that reaches us has its own story: sometimes, a hospital building is closing and staff contact us with important records that reflect that institution’s history – as has happened with the imminent transfer of REHSC services from their current site in Sciennes Road to Little France. This year, we hope to work more closely with our NHS colleagues in order to identify material that, once transferred to us, can make the archive bigger and better for the future.

In other cases, we can be contacted by individuals or organisations from our area who may have papers relevant to the understanding of the history of medicine. For example, last year we added to our papers from neurologist Ernst Levin with some more personal material about the medic’s life. Levin was born in 1887 in Berlin, but left Germany in 1933 (he then practised in Munich) after the rise of the National Socialists. Levin then worked with Edinburgh neurosurgeon Norman Dott and in the Western General Hospital. Our new accession covers most phases of his life, amongst the most fascinating of which are his own photographs from German First World War trenches where he served as an assistant surgeon:

Photographs from the German lines, c. 1915 (from Acc15/001)

I’ll be saying more about these images in the Centre for Research Collections blog, Untold Stories, later this year.

However, it’s important that archives are not just passive recipients of donations, but also seek out new additions to collections lest unique histories are lost. Dr Mike Barfoot, one of LHSA’s previous archivists, saw this very clearly, especially in the chance to collect material about Edinburgh’s fight against HIV. The combined efforts of the NHS, council bodies, charities, police and voluntary groups in our region to combat the spread of the virus and care for those affected had no precedent before or since (a fact which has been brought home to me by speaking to those involved in early patient care and HIV prevention). In collecting materials from individuals and organisations before they were lost, Mike saw a chance to build an unrivalled set of resources for future researchers.

The determination to collect did not end when Mike retired, but was carried on by his successor, Laura Gould (who worked towards eleven of our HIV/AIDS collections being recognised by UNESCO in 2011) – and I hope that I can carry on this tradition of active collecting in my time here.

This year has been no exception, and some of my favourite collections record the history of Edinburgh’s services to combat HIV. Firstly, we’ve been creating archives ourselves in the form of oral histories – part of a programme of recordings which I hope to add to as 2016 goes on. This effort was admirably started by Iain Phillips who was with us through a secondment from John Lewis’ Golden Jubilee Trust programme – but since Iain’s secondment was completed, I’ve been having a go myself! I started by speaking to Lothian Regional Council HIV Team education workers, John Young and Kerstin Phillips who started a pioneering educational programme in secondary schools by training young workers to pass on their first-hand experiences of relationships and HIV. Kerstin was kind enough to donate some material used during her work in the 1990s, including books aimed towards children living in families affected by the virus:

Children's book explaining a parent's visits to the clinic, 1998 (from Acc15/028)

This year, we’ve also received ten panels made for the Edinburgh Names Project at HIV and Hepatitis C charity, Waverley Care – these are textile collages meant to be put together as part of a large quilt to act as a memorial to those lost through AIDS-related illnesses.

As we move into 2016, I’m already preparing to receive our first accession of the year. We never know what we are going to be contacted about next, but I’m sure that there will be more than a few surprises to bring to you. If you want to see what new material we've taken in over the last few years, you can find us on The National Archives' lists of accessions to repositories (where LHSA accessions from 2015 will soon be up to view).

Friday, 8 January 2016

Happy new year from LHSA!

It’s the first blog of the year, and a chance to reflect back on some of our achievements of 2015: projects completed – cataloguing and conserving our HIV/AIDS collections, and a website full of educational resources based on them ( – and a brand new Wellcome Trust-funded TB case note cataloguing project began. We started converting our catalogues to make our collections available in ArchivesSpace (the University’s new online archive discovery tool), hosted a John Lewis Golden Jubilee Trust secondee, worked to preserve our regularly used bound volumes and architectural plans, and answered a wide range of your enquiries relating to the material we look after. All of this and more has featured in the blogs of the last 12 months…
But we’ve got 2016 to look forward to now, and lots in store for us already. As well as our usual work helping others to access the LHSA collections, we’ll be collaborating with our NHS archivist colleagues across Scotland to organise a one-day symposium looking at the benefits of using archive material in art projects (and taking part in a couple of art projects ourselves for the redevelopment of the Royal Edinburgh Hospital and the new buildings at the Little France Royal Infirmary of Edinburgh site). We’ll also be showcasing a couple of our recent Wellcome Trust projects in an exhibition in the Main Library display wall later in the year, which will coincide with the completion of our Wellcome project to catalogue Norman Dott’s case notes that started back in 2012.
We’re delighted to be taking part in the University’s Innovative Learning Week (ILW) in February where we have secured some funding from the ILW programme to create resources from archive material to entertain and educate 11 to 14 year olds in the Royal Edinburgh Hospital for Sick Children. And we’ll be working with colleagues from the Hospital to make sure those resources are just right!
The rest of January is a particularly exciting time for us as we welcome two new members of staff. The first is a maternity cover post, to continue (and complete) the Dott case note cataloguing and the second is our Access Officer, who will focus on LHSA's user services work. More from both of them once they join us later this month, so watch this space!

Tuesday, 15 December 2015

Christmas comes off the shelf!

In the final LHSA blog of 2015, Archivist Louise has been finding out how the festive season was celebrated in Edinburgh’s hospitals…

This week, I’ve been searching through our catalogues and going through archive boxes to find out how Christmas was marked in hospitals in our region. In the first three days of next week, I’ll be introducing what I found on Twitter – so don’t forget to join us on @lhsaeul…

When I was first asked to look out some festive-themed items, I must admit to being a bit stuck – after all, Christmas and hospitals are not exactly linked in people’s imaginations. However, simply by searching for the word ‘Christmas’ in our online catalogues, I found a surprising number of items reflecting the importance of the holiday in the hospital year.

Christmas was a time when staff went out of their way to make a normally family-centred time happy for their patients, and we’ve more than a few pictures of celebrations on the wards, as this image of Charles Falconer carving the turkey at the Western General Hospital in the 1970s shows:

Charles Falconer carves the turkey (GD28/8/3/73)

However, as early as 1826, it was recognised that medical staff needed to mark Christmas too, as James Hamilton Junior reminds us:

Letter from James Hamilton Junior (GD1/75/36) - I had to go into the Treasures' Room for this one!

Because the handwriting is a bit difficult, I thought I’d transcribe it:

‘It will save the very unpleasant task of examining Dr Hope as a witness if he will admit that in the beginning of Decr. 1815 and before the annual meeting of the Senatus Academicus he announced to his audience in his classroom that he and his colleagues of the Medical Faculty had agreed that in future the medical students should have Christmas holydays.’

Christmas is also traditionally a time for giving and, in a time before the NHS when many hospitals relied on donations for their livelihoods, institutions put out special Christmas appeals in order to boost their coffers:

A Christmas calendar, sold in aid of the Royal Edinburgh Hospital for Sick Children (LHB5/20/3/7)

After 1948, hospitals carried on fundraising at Christmas, as shown by this card sold in order to raise funds for the Edinburgh Royal Hospital for Sick Children’s TASK appeal to build a new wing for the hospital:

Christmas card sold in aid of the TASK appeal LHB5A/6/4/9

So don’t forget to join us on Twitter next week to see what other items I’ve unearthed from Christmases past and present. There’ll be some familiar-looking items and some festive surprises... For example, can you guess who this is?

This is GD1/15/12 - that's all I'm saying... for now!

In the meantime, Merry Christmas and all good wishes for 2016 from the LHSA team - Ruth, Becky, Paul and Louise!

Friday, 11 December 2015

Coughing, kissing, and the spread of tuberculosis

As winter draws in and coughs start spreading, our Project Cataloguing Archivist Rebecca looks at how a cough could be both a symptom and a cause of tuberculosis.

Just as nowadays we are told to seek medical advice if we have a cough for more than 3 weeks, patients would often report to the Royal Victoria Dispensary with a troubling cough. A productive cough could often be a symptom of tuberculosis along with haemoptysis, or coughing up blood. Patients would be tested for exposure to tuberculosis bacteria and have their chest x-rayed to see if any of the characteristic signs of tuberculosis were present in the lungs. For many patients, no signs of disease were found and they were sent home with instructions to return in a few months to check for changes in the lungs.

A cough was a characteristic sign of tuberculosis (think of the ominous cough developed by many a period drama character), but it was also a key vector in the transmission of the disease. The bacteria could be present in any phlegm coughed up, and therefore be spread through airborne transmission the same as any other infectious chest disease. Studies in the 1920s showed that tuberculosis bacteria could live outside the body and intermingled with dust for several days. This is why patients were encouraged to sparsely decorate their homes, and why twentieth century sanatoriums were built with far less decorative flourishes than their nineteenth century predecessors.

A WWII-era poster informing the British public of the dangers of coughs and sneezes. © IWM (Art.IWM PST 14154)

Coughing into a handkerchief could prevent the bacteria spreading in the air, but the handkerchief would need to be fully sterilised after each use in order to stop the tuberculosis bacteria from lingering, difficult to achieve in a domestic setting. It was widely acknowledged that the best solution in a domestic setting was to kill the bacteria with fire. Patients at home were told either to cough into disposable paper handkerchiefs or into disposable paper flasks, which could be burnt in a closed stove. Patients would also have been given sterile 'sputum flasks' to cough into. These could have disposable liners, or in hospitals they could be collected and sterilised on site.
The Royal Victoria Dispensary handed out informational leaflets to patients including this and other advice. The images below are some examples, and they really convey the strict rules which patients were expected to follow in order to prevent the spread of tuberculosis. Instructions to keep windows open, avoid kissing, and for the patient to sleep alone in a large, airy room all seem unfeasible in different ways, particularly in a cold Edinburgh winter, so it is likely that they weren't always followed; they do, however, represent the ideal behaviour of the tuberculous patient to do their part in not spreading the disease.

A card handed out to patients at the Royal Victoria Dispensary, with strict rules on hygienic living. (LHSA slide collection)

Advice for Royal Victoria Dispensary patients on living well. (LHSA Slide Collection)