Friday, 19 September 2014

Cheyne-Stokes respiration on display

Within LHSA’s collection are a number of display boards and captions, created for exhibitions over the years, which bring together images and stories from the history of medicine in the Lothian region. As such, they have become archive items themselves, a record of how the history of medicine has been displayed and many have been rarely viewed since their original display period. One of these items is a board illustrating Cheyne-Stokes respiration (ref. D P264 FM), probably dating from the 1970s or 1980s. The display shows on the left a portrait of John Cheyne and on the right is a portrait of William Stokes with a sample trace of Cheyne-Stokes respiration between them.

John Cheyne was born in Leith in 1777, the son of a general practitioner. Initially apprenticed by his father, he studied for an M.D. at the University of Edinburgh, graduating in 1805. Cheyne worked as an army surgeon, then at the Ordnance Hospital at Leith Fort. In 1809, he moved to practice in Dublin where he became the first Professor of Medicine at Royal College of Surgeons in Ireland in 1813. While there he published his description of a phenomenon of malfunctioning breathing in very sick patients. He noted that the patients’ breathing would stop entirely for a quarter of a minute then it would start again slowly, increase by degrees until it was heaving quickly then gradually cease again, with a total of approximately 30 breaths per minute. Some of the principle causes of this condition are brain haemorrhaging, advanced renal failure, heart failure and narcotic poisoning, therefore it is often thought of as a sign of imminent death.

William Stokes (1804 -1878) is regarded as one of the greatest teachers of clinical medicine. Stokes studied in Glasgow and Edinburgh and like Cheyne he relocated to Dublin. Twenty-eight years after Cheyne’s work, Stokes recorded another example of the respiration phenomenon for publication in the ‘Dublin Hospital Reports’ and quoted Cheyne, although he apparently added no new details. Perhaps because of his renown in the medical world, Stokes’ name has become inextricably linked to John Cheyne in the definition of Cheyne-Stokes Respiration.

What is also interesting on the display is that below the Cheyne-Stokes trace is another for comparison, where the patient has been injected with a drug, theophylline-ethylenediamine. In this case the respiration has gone back to normal, showing 20th century developments towards preventing the condition. According to the caption, this trace is from the first use of the drug in Great Britain for this treatment, in 1937 in Edinburgh.
Cheyne-Stokes respiration demonstration board (ref. D P264 FM)

Reference: Notable Names in Medicine & Surgery, Third Edition, Bailey, H and Bishop, W.J., 1959

Friday, 12 September 2014

A last blog from our intern Stephen

Here is the last account of my internship with LHSA - today I am going to talk about… money!

Archives often have to be very imaginative in order to find funding for important programmes such as conservation, cataloguing or educational projects. So I have been collecting information on possible external funders and have created a directory for future use.

With more than 8,500 funding organisations in the UK alone, a fundraiser should always stay clear-minded! What is the taxonomy of funders? 1. Firstly, the big funders. They generally fund a large spectrum of projects. We find public (or assimilated) bodies like the Heritage Lottery Fund or the Research Councils. Charities such as the Wolfson Foundation, the Gatsby Charitable Foundation and the Wellcome Trust (funder of LHSA's current projects) are extremely generous and award annual grants amounting to millions of pounds. 2. Family Trusts, professional bodies and London livery companies populate the second category. They generally give several dozens of thousands of pounds to charities operating in fields related to their main interests. 3. Finally, there are the small trusts distributing a few thousand pounds a year. Their scope of activity is often more restricted - one example is a bursary that is only available for descendants of French Protestant families from the Charente area (north of Bordeaux) who settled in Scotland in the 18th century, to study in Scottish universities! 

One other task I’ve been given is to prepare an application for the funding of a touring programme to several British universities to present and promote our case note cataloguing project. It has involved a good deal of costing (transport, meals, accommodation) and my skills have been branded as good as those of a travel agency! At least I have a plan B if not successful in the archive profession…

When not prospecting for external funding, I have visited other collections nearby. Firstly, a tour of the University's Anatomy Museum to admire skull casts of Burke and Hare. And then the archives of the Royal College of Surgeons of Edinburgh where I have been able to discover the surgical tools used by Norman Dott, a neurosurgeon, whose archives I’ve previously been cataloguing. The picture below shows my colleague Liz and I at the College of Surgeons - Liz wasn't too keen when I suggested we try out the instruments!


Friday, 5 September 2014

Conservator and Archivist, Working Together

This week Project Conservator, Emily, talks about the benefits of working with an archivist in the HIV/AIDS project….

The HIV/AIDS project consists of two parts; conservation of the entire collection and cataloguing four of the twelve collections which have not yet been reviewed. For the first five months of the project, I was working alone focused solely on the conservation of the material. In May, project archivist Karyn Williamson was recruited to catalogue the four uncatalogued collections. Difficulties arose, however, as the conservation of the catalogued material was completed by the time Karyn began. This meant that the cataloguing and the conservation had to be carried out in tandem to avoid the interruption of the work flow. Working together, we came up with a temporary numbering system that allowed me to record what conservation treatments had been carried out on which documents and also allowed Karyn to begin box listing the collections. This means that although the order and composition of the collection may change, any conservation work carried out is always recorded. 
Postcards and stickers from GD22, before conservation, items wrapped in acid free tissue and cotton tape.

Postcards and stickers from GD22, after conservation, rehoused in polyester album sleeves.
Through working with Karyn, I have learnt a great deal about the process of cataloguing and what archivists actually do! I had trained in the conservation of works of art on paper, so I had little idea of how an archivist would record and order the meters and meters of documents in the HIV/AIDS collections. The materials used to create a fine art print and paper office documents are similar, so my conservation skills could be transferred to archival items, but I had no idea how an archivist would make sense of seemingly random papers in the collections. I now understand how a well ordered collection with a clear catalogue can aid access to the material and encourage use of the archive. For me, the whole point of conservation is to ensure that the useable life of the collection is extended for as long as possible. I believe archives should be used for the benefit of all, and not just locked away in a store room. I want the items to be seen, used and enjoyed (safely!) and through good conservation practice and a concise catalogue, this is possible! Karyn’s ideas on outreach; creating educational resources, oral history programmes and exhibitions have also been inspirational and injected new life into the project. As a newly qualified conservator who is used to working in isolation, it is great to have a new set of eyes on the material and has also given me ideas to take on for future projects. 

I hope that working with a conservator has also been beneficial to Karyn. Many of the re-housing techniques I have used can easily be applied, by a non-conservator, to other collections. For example, using paper tabs rather than a plastic clips, which can cause planar distortion, to hold sheets of paper together and making bespoke boxes to house mixed material. As a conservator, I have also been able to offer advice on digitisation and re-housing to groups who are considering depositing HIV/AIDS related material into the LHSA collection, as well as being on hand to deal with tricky material, such as pages stuck together with ink or degraded sticky tape.

Sticky tape that has become discoloured and brittle over time.
Overall, I think the partnership between conservator and archivist working together rather than sequentially has been extremely valuable. Not just in terms of preservation and cataloguing of the material, but the chance to learn new skills from each other that can be taken on to new projects and the opportunity to collaborate on outreach activities.  Come down and find us for our #librarypop session on the 24th September (10am-12pm) on the first floor of the main library to find out more!

Friday, 29 August 2014

Internship update - our Wellcome Trust funded HIV/AIDS Project

In this week's blog post, current LHSA intern Stephen talks about his experiences while working on our Wellcome Trust funded project, 'Policies, Postcards and Prophylactics: a project to catalogue and conserve LHSA'S UNESCO-awarded HIV/AIDS Collections (1983-2010).

As an intern with LHSA I started to work with the HIV/AIDS collections two weeks ago. I have been involved in a variety of projects. Firstly, I attended a meeting on SCRAN, a Scottish image resource website where LHSA will soon be posting new photographs. SCRAN is a wonderful tool for teachers and pupils because of the breadth of subjects covered. Images can be used for teaching/studying purposes and institutions can create their own educational resources on specific topics, such as a lesson on the First World War. 

One of the "Take Care" Campaign images will will be used on the SCRAN website
Secondly, LHSA aims to use the rich and varied HIV/AIDS collections (particularly its images) to design an educational website, and I have taken part in that project. The resources will match the criteria set by the Scottish Curriculum of Excellence in the Health and Wellbeing or Expressive Arts areas so I have been involved in producing ideas and some draft resources.
Another of the images which will soon appear on SCRAN (GD22)
Thirdly, I have participated in several outreach projects, posting on Flickr and Facebook. On Flickr I have expanded our selection of albums of pictures of condoms, condom cases, posters, pins, badges, balloons, watches, t-shirts etc. Every item that could be printed on was used to inform the public on the dangers of HIV/AIDS. On Facebook and Twitter I have been posting images of the items I have found most interesting every day for a week.

To finish with I have been in charge of listing the items in a collection we have referenced as GD22, which corresponds to the Take Care Campaign collection. Box listing consists of a rapid listing of items in order to prepare the collection for arrangement and cataloguing. GD22 is an interesting collection to be working on because it contains many of the promotional objects designed for the campaign.

Friday, 22 August 2014

The History of a Charming Hospital

Among the NHS buildings around the site of Lauriston Building, a notable Victorian structure which still survives in use today, is that of Chalmers Hospital. The Edinburgh plumber and burgess George Chalmers (1773-1836) left the residue of his estate (worth £27,000) for the foundation of an infirmary in his will. At the time of his death, this money was not sufficient to build a hospital, therefore it was invested in government stock until 1854 when it had accrued enough for the hospital plans. Construction of the hospital began in 1860 and it opened on 22 February 1864 without ceremony. As originally designed, the Chalmers Sick and Hurt Hospital consisted of 48 beds in four wards, two of which were fee paying and two of which were for non-paying patients. Nurses’ quarters were only added in 1887. A programme of modernisation was carried out in the early 20th Century using money subscribed from the funds of the hospital faculty, in commemoration of Queen Victoria’s Diamond Jubilee in 1897. These included electric lighting, a new operating theatre, new surgical staff and an anaesthetist. The renowned surgeon Sir Harold Stiles was appointed during this period.

The hospital was not used for war patients during the First World War. However, in 1939 Chalmers Hospital was requisitioned by the government for civilian casualties of World War II, though in the event it was used for many service personnel also. In 1948, with the formation of the NHS, Chalmers Hospital came under its control and the practice of having fee paying patients ended. In 1951, the hospital became an annexe of the Hospital for Diseases of Women in the adjacent Archibald Place.

The hospital finally closed in 2008 and a major redevelopment of the site began. Much of the rear was demolished and replaced with a new structure designed to meet the needs of 21st century patients - however, the front and many original features have been renovated. It re-opened as a Sexual Health Centre in 2011 and continues to serve the community it was built for over 150 years ago, at the bequest of a plumber from the Canongate.

The images show a rear view of Chalmers Hospital and gardens from approximately the late 19th century (ref. LHB4/4/7/2) and a photograph of the front of the hospital from the late 1970s (ref. LHB4/4/7/15). In the later view, Lauriston Building and the Princess Alexandra Eye Pavilion are visible in the background.

Friday, 15 August 2014

A grand day out...

Last Friday, LHSA had the opportunity to take part in the annual Royal Edinburgh Hospital Fete. The event has been on our calendar now for a number of years, and it’s been a pleasure to take an ongoing part in the institution that has generated our most widely-used collection.

Along with the craft stalls, live music – yes, we did hear a piper making his way through the hospital corridors! – and home-baking, there’s also a historical element to the fete every year, and that’s where we come in. LHSA Manager Ruth put together a small display demonstrating how the history of the hospital is reflected in our collections in the fete’s History Room, from the first minute book of the hospital to photographs of its buildings in times gone by.   

LHSA display in the Royal Edinburgh Hospital History Room

Some of the items on display in the History Room were also used in last year’s 200 Years 200 Objects exhibition, celebrating the bicentenary of the Royal Edinburgh Hospital. My particular favourites were the editions of the Morningside Mirror on display. The Morningside Mirror was a magazine written by patients dating from 1845. It was printed on a specially purchased printing press (part of an early form of ‘occupational therapy’):

LHB7/13/23 - 1964 edition of the Morningside Mirror
By far the most popular items on the day were examples from our photograph collection. Not only did we represent the Royal Edinburgh Hospital, but also Bangour Village Hospital. Since many clinical and support staff who came to see us worked across both buildings, they could see the changes that had occurred across the sites. Perhaps some of the most arresting images we displayed in this centenary year came from the First World War, when both hospitals housed military patients, with Bangour Village Hospital being taken over by the War Office to treat physical casualties of war and the Royal Edinburgh Hospital treating soldiers suffering from the conflict's psychological effects.

Left: Unidentified First World War soldier from LHSA's Bangour Village Hospital collection (P/PL44).
Right: Red Cross ambulance at the Royal Edinburgh Hospital, First World War (P/PL7).

The image that intrigued most visitors was this one from 1966:

Celebrity visitor to the Royal Edinburgh Hospital (P/PL7)
We know that this lady was likely to have been a celebrity visitor, but we have had no luck in identifying who she is. As Blue Peter used to say, answers on a postcard, please….

Friday, 8 August 2014

An introduction to our latest intern

The blog this week comes from Stephen, our Archive (Projects) Intern:

Hi, I am Stephen Bournadet, a 26 year old intern with LHSA. I will be working for 10 weeks on various ongoing projects, involving cataloguing, conservation, outreach and fundraising. First a bit about myself: born between Bordeaux and Cognac in France, I graduated 3 years ago with a Master’s degree in Archives / Records Management from Aix-en-Provence. Then, after spending one year working in various places, I felt that I needed to travel while young and I came to Edinburgh where I secured a job as a language assistant. Falling in love with the city and my girlfriend (ah l’amour!) I want to stay here so I’ve started a MSc in Records Management and Digital Preservation at the University of Dundee (which I will complete by the end of 2015). Since arriving I have also been volunteering in various places, such as the National Library of Scotland and the Records Management Section (RMS) of the University of Edinburgh. The RMS is mainly involved in providing the university staff with guidance on record keeping and on handling Freedom of Information requests. From an archive point of view the RMS manages and prepares the records prior to their transfer to the University archives when they are no longer of business value. From a personal point of view, whilst I’ve really enjoyed my work there I must acknowledge that LHSA’s large windows on the 5th floor of the Main Library with views of the Pentland Hills are leading in the best office match!

Stephen hard at work with the Dott case notes

So far after two weeks working on the Norman Dott case note cataloguing project, I have to say that I haven’t been bored for a second. Luckily I haven’t been affected by some very detailed descriptions of patient’s conditions and I quite enjoyed trawling through poetic Latin and Greek medical terms (such as ataxia, hemiparesis or diplopia). Before working with LHSA I already had several forays into medical archives. Three years ago I classified and catalogued archives of a French local health board during WWII, discovering how life under German occupation was harsh (when Jewish doctors were banned from practice, even if hundreds of thousands of refugees had arrived). Last year, while on an internship at the University of Dundee archives, I worked with the Tayside asylums’ archives, carrying out research for relatives from as far away as Australia. 

My current work with LHSA is part of a wider project funded by the Wellcome Trust and involves cataloguing around 26,500 patient case files from collections relating to Norman Dott (1897-1973). Dott was a pioneering Edinburgh neurosurgeon and his records, spanning 40 years (1920-1960), are an invaluable source for history of medicine and genealogic research. The LHSA team and I (modestly) are gathering information on each case (for example patient age, profession and medical conditions) to create an online publically accessible catalogue.  We work with EAD-XML (Encoded Archive Description), an informatics language standard. EAD is widely used by the archive community and allows standardization of digital catalogues.

What has most struck me in this work is how developed surgery was in the 1950s and how efficient. In the case notes we find numerous examples of people who are severely incapacitated by conditions such as back pain or brain tumours. Patient care and surgical treatment could bring a huge relief and allow them to return to a normal life.

Overall a very good experience so far, see you in three weeks for an update on my job here!