What a year 2022 has been!
We are so pleased to show you something that every librarian loves… STATISTICS! Please enjoy St George’s Library in 2022 – in Numbers!
St George’s Library in 2022
archives
St George’s Archives – Morbid appearances
‘Opening Up the Body’ is a project to conserve the Post Mortem Examinations and Case Books of St George’s Hospital, 1841-1946. Our Archive team have been cataloguing and digitising records dating from 1841-1917 – that’s about 27,132 cases across 76 volumes. The comprehensive reports contained within these volumes reveal some fascinating stories, which we’ll be sharing with you via the Library blog. Today’s post comes from Juulia Ahvensalmi, Archivist.
We have now catalogued a good chunk of St George’s historical post mortem records, and are preparing to make them available on our catalogue soon. In our blog posts, we’ve been exploring various themes and aspects emerging from the records, from examining cases of leprosy and hysteria, to delving into the social backgrounds and occupations of the patients.
But let’s take a closer look at the records themselves. Do they always contain the same information? How are they structured? What do they actually say? The format doesn’t vary very much: the records we are now cataloguing stretch from 1841 to 1920, and tend to follow the same template, as shown in these images from 1845 and from 1920.
Apart from the two earliest volumes, in which each case occupies only a single page, all the volumes reserve a two-page spread for each individual patient. The labelled boxes across the top of the pages record the patient’s case number, name (sometimes also occupation is noted here), age, date of their admission to the hospital, date of death, the name of the doctor admitting them, the length of time between death and the post mortem examination, references in medical and surgical registers and the ‘Nature of disease’.
This last box details the cause of death, based on the examination. Sometimes the cause is determined to be straightforward, and the box only lists a single ailment (‘Fracture of skull’, ‘Pneumonia’), but more often multiple diseases or other ailments are listed – there is not always a single cause of death, but multiple contributing factors. In the catalogue we are including a transcription of this field, as well as a standardised form of the disease(s), using Medical Subject Headings (MeSH). Treatments (in particular operations) as well as post-mortem changes and features of the body sometimes also appear in this list, and can vary from brief and vague (‘Disease of the heart’) to very long and specific:
‘Renal sarcoma (removed by operation). Accidental inclusion of small gut in abdominal saturation. Volvulus of small gut. Small gut obstruction. Commencing peritonitis’, or
‘Phthisis. Old adhesions of the pleurae. Lymph in pericardium. Atheroma in aorta & mitral valve. Tubercular spots in various parts of the intestines with ulceration of the mucous membrane. Mesenteric glands enlarged’
The left-hand page, labelled ‘Morbid appearances’, is reserved for the details of the post mortem examination in which, following a general description of the appearance of the body (‘Body well-formed and in good condition…’), each examined part of the body is listed. This is sometimes presented as larger wholes (cranium, thorax, abdomen) or simply as list of organs and body parts that were examined (left hip, skull, lungs, heart, uterus and so on). The bottom of the page is usually signed by the doctor who performed the examination; this tended to be a fairly junior doctor. Sometimes there is more than one name.
Any preparations or samples taken are also listed here, with references to the catalogues of the Pathology Museum of St George’s – as a part of the Post Mortem Project, we are listing these references and attempting to locate them in the museum – the referencing systems have, however, been changed multiple times over the years, so the task is not always that easy.
The right-hand page is for details of the medical case before the patient’s death. This, too, is usually signed by the doctor examining the patient, and is similarly formulaic: first, the history of the case is rehearsed, detailing symptoms and other details, followed by a description of the patient on their admission and details of the treatment(s) received prior to their death. If there is no post mortem examination, no medical notes are included either.
There are of course some differences in the way the case notes are presented during this time – we are, after all, talking of a period of 79 years. Some, although by means not all, of the 20th century volumes contain a carbon copy of typewritten medical notes instead of the more usual handwritten ones (a blessing for the cataloguers, who have to decipher the often rushed handwriting – the later volumes also tend to be more difficult to read!). These notes were copied from the medical and surgical registers recording all admissions to the hospital. Unfortunately, however, we no longer have these registers, so it is impossible to tell whether the notes were copied exactly or changed in the transmission.
Perhaps, however, typing your notes rather than writing them down by hand affected the way the cases were recorded: the later volumes certainly tend to be briefer, focusing on the medical facts only, where many of the earlier case notes contain more colourful descriptions and often personal observations by the doctors: the patients are often described in terms which strike the modern reader as distinctly subjective in a medical context, even unprofessional and offensive. Some of the language used in the descriptions can come as quite a shock to the 21st century reader, such as descriptions of patients as ‘idiot’ (which remained as part of the medical vocabulary until the 1970s), ‘stupid’ or ‘half-witted’:
‘[He] was never more than half-witted and could follow no occupation. The [epileptic] fits increased in frequency and the man became more nearly idiotic’ [Alfred Dolman, PM/1891/376]
Racial and ethnic prejudices similarly appear in the medical case notes. John Lusila (PM/1854/384), a waiter who died of tuberculosis, is described as ‘this poor black’. Of Michael Fitzgibbon (PM/1864/127), a cooper who died aged 32, it is simply noted: ‘Of this illness no accurate account could be obtained (the patient was Irish)’; it is unclear whether the reason for the trouble in communication was linguistic (perhaps Michael did not speak English?) or something else. Jane Caldecourt (PM/1887/283), a kitchen maid who died aged only 17, is described as ‘a well-nourished, healthy-looking girl of very dark complexion, mother was a coloured woman’.
One of the doctors, Octavius Sturges (1833-1894), who was a medical registrar at St George’s Hospital in the 1860s, was particularly fond of sketching evocative and occasionally even poetic images of the patients with his words. One patient is described as ‘an anxious, delicate girl with an anxious, sad expression’, another as ‘a dark, spare person of melancholy aspect, a needlewoman’; another as ‘stout and well-built with the countenance of a drunkard’ or ‘a miserable, emaciated old man having the withered and wrinkled face of a mummy’. The reader gets a very immediate sense of the people in front of Sturges (and of Sturges himself in the process): perhaps he had unrealised ambitions as a novelist? A rather disparaging description of Sturges by a colleague after his death describes Sturges as ‘A man of ordinary size with his head rather sunk down between his shoulders. The colour of his face was high and purplish, for he was a victim of nitral stenosis. Not one of our great physicians, he was a thoroughly practical children’s doctor’ – the truthfulness or kindness of the statement can be debated, but it does seem like a description Sturges might have approved of.
If you are interested receiving updates from the Library and the St George’s Archives project, you can subscribe to the Library Blog using the Follow button or click here for further posts from the Archives.
Gruesome and Ghostly: Tales from St George’s Archives
To mark Halloween, our archivist Carly Manson, held two historical tours involving gruesome artefacts from our Archives and Special Collections. Amongst the artefacts on display were a cloth used to wrap the dead body of King George II, and records relating to a scandal that provoked Charles Dickens to condemn post-mortem practices as “shocking”.
The history of each object on display was shared by the archivist, and the audience encouraged to ask questions. It was fantastic to learn about these fascinating artefacts and to see so many interested people in the audience.
The artefacts from the events are also featured in this week’s Times Higher Education, in their article ‘The spooky secrets of London’s oldest medical school’:
https://www.timeshighereducation.com/blog/spooky-secrets-historic-uk-medical-school
If you are interested receiving updates from the Library and the St George’s Archives project, you can subscribe to the Library Blog using the Follow button or click here for further posts from the Archives.
Gruesome and Ghostly: Tales from St George’s Archives
Come along to a spooky special event with exhibits from the archive. Archivist Carly Manson will delve into St George’s weird and wicked past in two afternoon sessions on Halloween. Expect tales of body snatching and ghosts that haunt St George’s, letters and lectures from the past with bloody intent, and images showing the fascinating history of St George’s.
Halloween Tuesday 31st of October – 2 sessions available
First session: 1.30pm – 2.15pm
Second session: 2.45pm – 3.30pm
Students and staff of St George’s University of London and St George’s Hospital are welcome to attend this free event. To book your place, or for more information, email archives@sgul.ac.uk.
Body Snatchers and Red Rot: The Post Mortem Records of St George’s Hospital
Archivist Carly Manson has recently been giving talks about St George’s Archives (look out for the Halloween special!) and looking more in depth into our collections and how best to preserve them. One collection that deserves a special mention is our post mortem examinations and case books…
In the bowels of the medical school at St George’s, there lies a series of post mortem examinations and case books from St George’s Hospital, spanning the mid-19th and 20th centuries.
Pioneering physician Sir William Osler once described the post mortem records of St George’s Hospital as the “finest collection of its kind”. Osler stressed the importance of the post mortem in medical education and it has played an important role in the history of the medical school, today St George’s, University of London.
Today the hospital and medical school are located in Tooting, but until the 1970s were situated in central London at Hyde Park. The deaths and diseases recorded within the case books therefore offer an insight into shifts in the population health of central London. They feature detailed autopsy reports written by noted surgeons including Henry Gray, Caesar Hawkins and Timothy Holmes, and later eminent figures such as Claude Frankau and William Duke-Elder.
Today, post mortems are more commonly associated with forensics and criminal investigations. In the 19th century, the purpose of the post mortem was for physicians to support their diagnosis made when the patient was alive, and to identify any other unrecognised factors that contributed to the cause of death. Bodies were also examined in order to identify the internal functions and structures of the body and the relationships between these.
As well as the post mortem examinations undertaken, the case books chart the bodies which went unexamined, many of which were transported to the medical school for the teaching of anatomy. At a time when ‘body snatching’ was still fresh in the public consciousness, the case books reveal issues around consent and the changing way in how we see the body after death.
Dissection was prohibited in England until the 16th century. At that time, limited rights were given allowing around ten bodies a year for dissection. In 1752 the Murder Act was passed, allowing medical schools more access to bodies by providing the corpses of executed murderers. This meant there was still a great shortage of bodies for the pursuit of medical knowledge. This shortage resulted in the growth of the illegal body trade and those known as the ‘body snatchers’, or ‘Resurrection Men’, as they were commonly known at the time.
In 1832, the Anatomy Act was passed, allowing the lawful possession of a body for anatomical examination provided that relatives of the deceased did not object. Until this point, it was extremely difficult for physicians and surgeons to contribute advancements in medical science. The practice of dissection was still mostly condemned on moral and religious grounds at this time, and protests against the Act continued into the 1840s. Many protesters believed that the Act still failed to stop the sale of paupers’ bodies for medical research without their consent.
Rosie Bolton, Conservator from the Leather Conservation Centre, recently visited the St George’s Archives and Special Collections to examine the red rot found on the leather covers of the post mortem case books. ‘Red rot’ is a typical deterioration where the leather becomes degraded and turns into thin powder. Rosie inspected the condition of the covers and took PH tests to check the acidity levels of the leather. It is hoped that the medical school will be awarded funding from the Wellcome Trust to fully conserve these fascinating case books and their histories.
Conservator Rosie Bolton, examining our post mortem case books.
Did you know…
Red rot (or redrot) is a degradation process found in vegetable-tanned leather. Red rot is caused by prolonged storage or exposure to high temperatures, high relative humidity, and environmental pollution. Red rot commonly appears as a red dust or powder on the surface of the leather. Unfortunately, the deterioration processes associated with this also affect the fibrous structure of the leather, and if left untreated, leather suffering from red rot can disintegrate completely into a red powder.
For further information relating to the history of St George’s Hospital and the medical school, please contact the Archivist at archives@sgul.ac.uk or go to the following webpage: http://library.sgul.ac.uk/using-the-library/archives
Library ♥ Archives: Explore Archives
As well as taking centre stage during November for our Library Loves Archives promotion, this month the St George’s Archives will be taking part in a campaign to encourage everyone to explore archives. Explore Archives runs from 19th-27th November and last year over 300 archives from across the UK and Ireland took part.
This is the first time St George’s will be taking part in the archives campaign, which aims to show the potential of archives to excite and bring people together, and tell amazing stories.
Last month we introduced you to the St George’s Archive Project, and now we are holding an archives handling session inviting staff and students to get hands on with history with a selection of treasures from our archives.
The Explore Archives handling session will be held on Monday 21st November from 12.30pm-1.30pm and staff and students are invited to attend to see what is held in our archives and hear what stories they can tell us about the history of St George’s.
Booking is required and places are limited, so please contact archives@sgul.ac.uk to reserve your place. We’ll also have exclusive postcards featuring some of our archive treasures for attendees to take home.
During Explore Archives week we will be tweeting throughout with interesting facts and items from our historical collections. Follow @SGULlibrary and the hashtags #stgeorgesarchives and #explorearchives
Find out more about Explore Archives (http://www.exploreyourarchive.org/)
View a timeline of the history of St George’s, University of London
Introducing the St George’s Archive Project
We’re pleased to introduce to you the St George’s Archive Project, which aims to preserve our archives and make them accessible for research.
St George’s has a long and rich history, dating back to the early 18th century. The Hospital was first founded in 1733 and even before the Medical School was formally established at the Hospital in the 19th century, St George’s already had a long history of training pupils. The pupil registers held in the archives date back to 1756, and John Hunter, one of our most well-known alumnus, is the first name listed on his entry to the Hospital as House Surgeon.
What are Archives?
Archives are a collection of records or objects created or gathered by a person or institution and selected for long-term preservation as evidence of their activities. Our archives tell us about our history, preserving the past and allowing others to discover it.
As well as papers, books and photographs, our collections contain over 300 artefacts, consisting mainly of historic surgical instruments.
Why are they important?
Many of our archives are unique, and if lost, are irreplaceable. They represent our documented heritage, telling the story of St George’s.
The collections provide a rich source for research, not only about the history of the Hospital and Medical School, but also the wider transformation in the teaching and practice of medicine and health since the 18th century.
In support of this project, the University’s first professional archivist started earlier this year.
What is an Archivist?
It is the job of the archivist to preserve and widen access to archives and the information contained within them. This might include assisting users and answering enquiries, promoting the collections through exhibitions and talks, and using curatorial skills to select, arrange and catalogue archives.
An archivist does not carry out detailed research themselves, but instead they facilitate access to collections in support of research.
Before joining St George’s, University of London, Archivist Elisabeth previously worked in the archives at the University of the Arts London, the Guardian newspaper and the Royal Botanic Gardens, Kew.
Until now the majority of the collections were inaccessible. Elisabeth is currently listing and repackaging the archives prior to cataloguing. This will allow the collections to be searched more easily, helping interested researchers find the information they need for their research.
Project progress so far has included introducing suitable access arrangements to help to protect the archives for use by current students and future generations.
Looking forward
A lot of the work of the Archive Project so far has taken place behind the scenes but in November 2016 we will be celebrating our archives during Explore Archives week, encouraging everyone to explore archives.
Look out for future blog posts updating you on the progress of the St George’s Archive Project.
We will also be posting interesting things from our archives on Twitter, so be sure to check out hashtag #stgeorgesarchives
Cambridge University Press Journals Digital Archive – now available
We now have access to the Cambridge University Press journals digital archive.
Coverage starts from 1827 to 1997 and includes 93 titles within science, technology and medicine. Some of our popular Cambridge titles include:
- Behavioural and Cognitive Psychotherapy – now available from 1975
- British Journal of Nutrition – now available from 1947
- Cambridge Quarterly of Healthcare Ethics – now available from 1992
- Development and Psychopathology – now available from 1989
- Prehospital and Disaster Medicine – now available from 1985
- Proceedings of the Nutrition Society – now available from 1944
- Psychological Medicine – now available from 1970
- Public Health Nutrition – now available from 1998
All of the above content is now available via our e-journals A-Z list and Hunter
For further help with journals please email: journals@sgul.ac.uk
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