St George’s Archives – View of the Dissecting Room of St George’s Hospital

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 Natasha Shillingford, Project Archivist.

View of the Dissecting Room of St George’s Hospital, Archives and Special Collections, St George’s, University of London

“At the time of which I am writing, between the years 1858 and 1860, Mr Pollock and Mr Gray were Lecturers on Anatomy, Mr Athol Johnstone was Lecturer on Physiology, and Dr Noad, Lecturer on Chemistry; whilst Dr Dickinson and Dr Hastings were Demonstrators of Anatomy. All these appear in the photograph.”

‘The Men of my Time’, St George’s Hospital and Medical School Gazette, No. 3, Vol 1

George Pollock

Painting of George Pollock
Photo credit: St George’s, University of London

George David Pollock was born in India in 1817, the son of Field-Marshall Sir George Pollock and his wife Frances Webbe. Pollock was sent to England as a child and later apprenticed to a country practitioner. He then entered St George’s Hospital and became House Surgeon to Sir Benjamin Brodie. Due to Brodie’s influence, Pollock in 1843 gained the post of Resident Physician to Lord Metcalfe, Governor-General of Canada. Following Lord Metcalfe’s death, Pollock returned to England and in 1846 he was elected Assistant Surgeon to St George’s Hospital, where he served for thirty four years until his retirement in 1880

In 1869, the Swiss surgeon Jacques-Louis Reverdin developed a successful method for the allograft of human skin. Based upon Reverdin’s work, Pollock performed the first such successful operation in England in May 1870. This technique was known as the Pollock Graft and was adopted by many surgeons.

Pollock took over the care of ophthalmic cases at St George’s. He was also Demonstrator of Anatomy under Prescott Gardner Hewett, and succeeded him as Lecturer on Anatomy. In the Ophthalmic Department at St George’s Hospital, he was known for his cataract operations which led to his private practice in eye diseases. He was also appointed Surgeon on the founding of the Hospital for Sick Children in Great Ormond Street and took great interest in cleft palate operations.

Pollock also served as Examiner in Surgery to the Indian Medical Service where he was said to be a popular member of the teaching staff. He was also President of the Association of Fellows and headed a reform party at the Royal College of Surgeons. He was President of the Royal Medico-Chirurgical Society in 1886, and of the Pathological Society in 1875, and also Surgeon in Ordinary to the Prince of Wales.

He practiced at 36 Grosvenor Street until the last year of his life, when he moved to 35 Chester Square. He married Marianne, daughter of Robert Saunders, in 1850 by whom he had five children, three surviving him. He died on 14th February 1897 after a short illness of pneumonia.

Henry Gray

Image of Henry Gray
Copyright expired. CC BY 4.0

Henry Gray was born in 1827, the son of a Private Messenger to George IV and William IV. He entered St George’s Hospital on 6th May 1845 and he soon focussed his attention on the study of anatomy. In 1848, at the age of 21, he was awarded the Triennial Prize of the Royal College of Surgeons for his essay on ‘The Origin, Connection and Distribution of the Nerves of the Human Eye and its Appendages, illustrated by Comparative Dissections of the Eye in other Vertebrate Animals’. As a student he was described as a painstaking and methodical worker who learned anatomy by undertaking dissections himself.

In 1850 Gray was appointed House Surgeon under Robert Keate, Caesar Hawkins, Edward Cutler and Thomas Turner. On 3rd June 1852 he was elected a Fellow of the Royal Society, a rare distinction at the age of 25. Gray devoted himself to the study of anatomy and the first edition of his ‘Anatomy, Descriptive and Surgical’ was published in 1858, with engravings by Dr Henry Vandyke Carter. The book, known as ‘Gray’s Anatomy’, had reached the 23rd edition by 1928.

In 1861, Gray became a candidate for the post of Assistant Surgeon at St George’s Hospital. His election was viewed to be certain, but he contracted smallpox while looking after a nephew with the disease, and died after a short illness on 13th June 1861. Upon his death, Sir Benjamin Brodie wrote ‘I am most grieved about poor Gray. His death, just as he was on the point of realizing the reward of his labours, is a sad event indeed…Gray is a great loss to the Hospital and the School. Who is there to take his place?’

Athol Archibald Wood Johnstone

Post Mortem examination book 1844 (Anne Thompson, PM/1844/64) Archive and Special Collections, St George’s, University of London

Athol Archibald Wood Johnstone was born in 1820, the youngest son of Dr James Johnson, Physician to King William IV, whose name was accidentally spelt Johnson instead of Johnstone. Athol Johnstone reverted to the original family name on the death of his father.

He studied at St George’s Hospital, where he became House Surgeon, Demonstrator of Anatomy and Lecturer on Physiology. He later succeeded George Pollock as Surgeon to the Hospital for Sick Children, Great Ormond Street. Johnstone was also Surgeon to the Royal Alexandra Hospital for Children with Hip Disease, and to St George’s and St James’s Dispensary. In 1861 he declined to stand for the vacancy of Assistant Surgeon to St George’s Hospital following the death of Henry Gray. In 1862 he moved to Brighton where he practiced as Surgeon to the Brighton and Sussex Throat and Ear Hospital, the Invalid Gentlewomen’s Home, and the Brighton Battery of the old Royal Naval Artillery.

He was twice married, his second wife surviving him. Johnstone died on 16th March 1902 in Brighton.

Henry Minchin Noad

Henry Minchin Noad was born in 22nd June 1815 at Shawford, Somerset, the son of Humprey Noad. He was educated at Frome Grammar School. He began the study of chemistry and electricity, and about 1836 he delivered lectures on both subjects at the literary and scientific institutions of Bath and Bristol. He joined the London Electrical Society in 1837.

In 1845 he began his studies under August Wilhelm Hofmann at the Royal College of Chemistry. He joined the medical school of St George’s Hospital in 1847 when he was appointed to the chair of Chemistry. He remained in this role until his death.

In 1849 Noad obtained his degree of doctor of Physics from the University of Giessen. In 1850-51 he conducted an inquiry into the composition and functions of the spleen with Henry Gray. In 1856 he was elected a Fellow of the Royal Society. He was appointed Consulting Chemist to the Ebbw Vale Iron Company, the Cwm Celyn, and Blaenau, the Aberdar and Plymouth, and other iron works in South Wales. In 1866 he became an examiner of malt liquors at the India Office. In 1872 he became an examiner in Chemistry and Physics at the Royal Military Academy in Woolwich.

Noad died at his home in Lower Norwood, London on 23rd July 1877, survived by his wife Charlotte Jane.

William Howship Dickinson

Image of William Howship Dickinson
Image in public domain

William Howship Dickinson was born on 9th June 1832 in Brighton, the son of William Dickinson of Brockenhurst. He was educated at Caius College, Cambridge and at St George’s Hospital. After graduating in 1859, he became Curator of the Museum, Assistant Physician in 1866 and Physician in 1874. He was also Assistant Physician from 1861 to 1869 at the Hospital for Sick Children, and later physician from 1869 to 1874. He held the offices of Censor and Curator of the Museum at the Royal College of Physicians, delivered the Croonian Lectures in 1883 and the Harveian Oration in 1891. Dickinson was Examiner in medicine to the Royal College of Surgeons and to the Universities of Cambridge, London and Durham.

Thomas Pickering Pick recalled attending an anatomy demonstration by William Howship Dickinson. He said that ‘The first of these which I attended was on the kidney, and a specimen from the dead-house was exhibited. I ventured to ask, no doubt with all diffidence as a beginner, whether it was not a very large one, and was met by the remark: “By no means; perhaps you are thinking of the kidneys you have eaten for breakfast this morning.” At this there was a universal titter, and I felt extremely small. But undoubtedly the suggestion was a perfectly true one. It was the first time I had seen a human kidney, and my knowledge of that particular organ was entirely derived from the sheep’s kidney on the breakfast table.’ (‘The Men of my Time’, St George’s Hospital and Medical School Gazette, No. 3, Vol 1)

Dickinson was a general physician but he was known as an authority on diseases of the kidney and children’s diseases. He was known to be a meticulously careful observer who visited the wards of St George’s Hospital every day to observe his patients and take their medical histories. Dickinson was said to have ‘worshipped St George’s Hospital almost to the point of idolatry and received in return, during his long life, no small measure of its homage.’

In 1861 he married Laura, daughter of James Arthur Wilson, physician to St George’s Hospital. They had four daughters and two sons. Dickinson died on 9th January 1913.

Cecil Hastings

Unfortunately not much is known about Dr Cecil William Hastings, Demonstrator of Anatomy at St George’s Hospital. The student registers of the medical school reveal that he was educated at the University of Oxford and became a Member of the Royal College of Physicians. He took the post of House Surgeon in 1853 and was also Physician at the Royal Pimlico Dispensary.

Search the Authority Records on the Archives and Special Collections catalogue to find out more about the Surgeons and Physicians of St. George’s Hospital (https://archives.sgul.ac.uk/).

Screenshot of a search in the Authority Records on the Archives and Special Collection catalogue.

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The Founder of Post Mortem Examinations at St George’s, University of London

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 Natasha ShillingfordProject Archivist.

Photograph of portrait of Sir Prescott Gardner Hewitt, Archives & Special Collections, St George’s, University of London
Photograph of portrait of Sir Prescott Gardner Hewitt, Archives & Special Collections, St George’s, University of London

‘It is not the oil-painting which adorns the walls our board-rooms…which will cause him so vividly to abide in our memories as, perhaps the unrivalled collection of pathological experience which this Hospital possesses, and which we owe to the initiation of Sir Prescott Hewett. For it is to him we are indebted for the inauguration of the system of recording the post-mortem records of the Hospital, which had now remained in force for over fifty years, and which has endowed us with a collection of pathological experience perhaps unrivalled in the medical world. This is a monument which will ever remain and will be ever associated with the name of Hewett.’ (‘Distinguished St George’s Men’, St George’s Hospital and Medical School Gazette, Vol III, Issue 25)

Post mortem examination signed by Prescott Hewett, PM/1842/104. Post Mortem Casebooks, Archives and Special Collections, St George’s, University of London
Post mortem examination signed by Prescott Hewett, PM/1842/104. Post Mortem Casebooks, Archives and Special Collections, St George’s, University of London

Prescott Gardner Hewett was born on 3rd July 1812, the son of William N W Hewett of Bilham House, near Doncaster, by his second wife. His father was a country gentleman whose fortune was said to have suffered from his love of horse racing. Hewett received a good education and spent some years in Paris where he trained in the studios, having first decided to become a professional artist. However he became acquainted with the son of an eminent French surgeon and he became inspired to joint the surgical profession himself. He studied anatomy in Paris before returning to England.

Upon his return he entered St George’s Hospital where his half-brother Dr Cornwallis Hewett had been Physician to the hospital from 1825-1833. The excellence of his dissections caught the attention of Sir Benjamin Brodie, and he was appointed Demonstrator of Anatomy and Curator of the St George’s Hospital Museum around 1840. The first record in his handwriting was dated 2st January 1841. It was said that his ‘lucidity of expression, his clear and graphic exposition of his subject, his apt illustrations, and above all his facile and ready pencil, which served to demonstrate the most complicated anatomical point, soon gained him recognition and esteem of his class.’ (‘Distinguished St George’s Men’, St George’s Hospital and Medical School Gazette, Vol III, Issue 25)

It was during his time as Curator of the Museum that the post mortem records that are currently being catalogued as part of the Opening up the Body project were first commenced by Hewett. Also, many of Sir Benjamin Brodie’s preparation in the Museum were put up by Hewett.

He was appointed Lecturer on Anatomy in 1845 and Assistant Surgeon on 4th February 1848. He became full surgeon on 21st June 1861, in succession to Caesar Hawkins, and Consulting Surgeon on 12th February 1875.

He was also elected President of the Pathological Society of London in 1863, and ten years later he occupied the Presidential Chair of the Clinical Society. Amongst his other positions, he was appointed Surgeon Extraordinary to Queen Victoria in 1867, Sergeant-Surgeon Extraordinary in 1877, and Sergeant-Surgeon in 1884 in succession to Caesar Hawkins. From 1867 he also held the appointment of Surgeon to the Prince of Wales, and afterwards King Edward VII. On August 6th 1883 he was created a baronet.

Hewett was also Arris and Gale Professor of Human Anatomy and Physiology at the Royal College of Surgeons from 1854 to 1859, a Member of the Council from 1867 to 1883, Chairman of the Board of Examiners in Midwifery in 1875, Vice-President in 1874 and 1875, and President in 1876.

On 13th September 1849 Prescott Hewett married Sarah Todmorden, eldest daughter of the Rev. Joseph Cowell, of Todmorden, Lancashire, by whom he had one son and two daughters. He died on 19th June 1891 at Horsham, where he had retired after being created a baronet.

Few men have ever left the world with a more stainless record of duty honestly done and of success won by no ignoble means.

(‘Distinguished St George’s Men’, St George’s Hospital and Medical School Gazette, Vol III, Issue 25)


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From servants to soldiers, from agriculture to administration: occupations in St George’s Hospital Post Mortem casebooks, 1841-1918

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 Dr Juulia AhvensalmiProject Archivist.

Post mortems? Surely they’re all about death and misery? In this blog post I hope to show that is not the (only!) truth. I want to examine what else historical post mortems can tell us, and illustrate how they contain a wealth of information about not just the deaths, but also the lives of the patients. The post mortem volumes held in the archives of St George’s, University of London provide a fascinating glimpse to the social structures of 19th and early 20th century central London. So let’s see what the collection can tell us about the patients of St George’s Hospital in the 19th and early 20th centuries. What did they do for living? How did big changes in the society such as the industrial revolution and the First World War show in the lives of Londoners at this time? I’ll use visualisations to give an overall picture, and zoom in to look at the people behind the statistics, so sit back – get your cup of tea ready – let’s go to Hyde Park Corner.

Engraving of St George's Hospital and Constitution Arch
St George’s Hospital and the Constitution Arch, Hyde Park Corner. Engraving. Credit: Wellcome CollectionAttribution 4.0 International (CC BY 4.0)

Most of the post mortem cases record the occupation of the patient, and this is one of the details we have been keeping a track on whilst cataloguing the volumes. The image below shows an overview of occupations from the volumes finished so far, ranging from 1841 to 1918; the data has been visualised using Flourish, and you can explore the graph in more detail by zooming in, and filtering the data by year to take a closer look.

Flourish data visualisation
Source: Post Mortem Casebooks, Archives and Special Collections, St George’s, University of London. By Juulia Ahvensalmi

The largest categories are in the building and construction trade (general labourers, painters, carpenters), and in domestic service (servants, cooks, housemaids). Other categories include food and accommodation services (people working in public houses, hotels and restaurants), food industries and sellers of food (grocers, bakers, butchers), people working in occupations relating to agriculture (largely stablemen, grooms as well as gardeners and farm labourers) and industries and manufacture (from smiths to window blind makers) and transport (drivers, railway workers and so on). The classification is a simplified version of ‘The occupational structure of Britain 1379-1911’ by the Cambridge Group for the History of Population and Social Structure.

It’s not always clear what category is most appropriate – unless the record explicitly states that someone works for instance as a servant at a hotel, rather than at a private house, it is impossible to know. ‘Servant’ has therefore been classified as ‘domestic service’, with the caveat that this might not exclusively be the case. The category ‘miscellaneous services and occupations’ include what it says on the tin – a selection of occupations that do not fit neatly the other categories, often because they were rare within the data, or because it is not clear which category they should belong in. The latter category includes things like apprentices (who were they apprenticed to?) and collectors (what exactly were they collecting?). Amongst them there is a wonderful array of occupations: there’s a mosaic worker from 1870, an assistant secretary of the Conservative Club from 1918, a piano forte maker from 1877, a keeper of urinal from 1858, a sword polisher from 1888 and a cats’ meat man from 1858. The latter would have sold meat for cats, probably walking around the streets with a cart (one can only imagine the cats trailing after him!). Rosa Blacker in 1858 is ‘Clergyman’s daughter’, and Louisa Lee in 1887 is just described as ‘gypsey’ (there would also be a lot to say about the use of language in the records, often startling and offensive to the modern reader).

The hospital at this period was located at Hyde Park Corner: the site was not closed until 1980. The building still stands, but instead of a hospital it now houses a luxury hotel. Knightsbridge, Kensington, Chelsea, St James’s, Mayfair, Soho – these days that part of London doesn’t suggest the working class population that the occupational data highlights here. But although Hyde Park Corner, then as now, had an abundance of large, wealthy households, these houses required servants, as well as people working in the local shops and factories. Some of the areas which we may now connect with wealth and opulence were not always like that; the notorious slum around Westminster, for instance, was dubbed the ‘Devil’s Acre’ by Charles Dickens. The so-called poverty map by Charles Booth, a businessman and social reformer, published 1886-1903, shows the area around Hyde Park to be largely wealthy and middle class, but towards Westminster and Chelsea there are areas in which the population is classed from ‘poor’ to ‘very poor, casual. Chronic want’ and ‘lowest class. Vicious, semi-criminal’.

Charles Booth's Poverty Map
Charles Booth’s poverty map of the area around Hyde Park Corner. Source: Charles Booth, © 2016 London School of Economics and Political Science. Map data © OpenStreetMap contributors

Accidents and diseases are frequently a direct consequence of people’s occupations, and the post mortems enable the tracking of occupational diseases. Painters often suffered from colic, or lead poisoning, and paper stainers also frequently dealt with toxic substances: John Hyland, 48, is noted as having handled during his working life ‘much lead, arsenic, copper & mercury’ – a paper stainer would have worked with wallpaper, which, due to its vivid colours, was notoriously deadly in the Victorian era. Falling off scaffolding or ladders is a frequent cause of death for builders, and in 1888 we find the case of Aaron Gatheridge, 53, who, as a carpet layer, had ‘swallowed many nails and tacks’ (he died of cancer of the pylorus).

Preconceptions and prejudices about certain occupations as well as classes can also be seen in the post mortems. Those working in the hospitality industry in particular were often assumed to be heavy drinkers, and the doctor treating David Ferguson, 45, in 1888 notes that ‘He was a butler but claimed to be considered temperate’, whilst George Carter’s, 45, medical record in 1860 states that ‘This man was an omnibus driver of drunken habits, like most of his class’. Some positions also came with certain benefits, as we learn from the case of George Courtenay, 38, in 1860: ‘He was a very sober man, though he partook freely of the beer which was allowed in unlimited quantity to the servants’ (sobriety is also a relative concept).

Post Mortem record of Mary Fitzgerald 2 Mar 1905 PM/1905/57
Post Mortem record of Mary Fitzgerald, 2 Mar 1905 PM/1905/57. Post Mortem Casebooks, Archives and Special Collections, St George’s, University of London

Of Mary Fitzgerald, aged 35 in 1905 it is noted that ‘Her life had always been sedentary – that of a needlewoman’. Another aspect of 19th century life the post mortems reveal is social and geographical mobility. Sarah Black was only 15 years old when she died of tuberculosis. She is described as being a kitchen maid, and her medical case notes tell us that she had come to London from Argyleshire two years previously, presumably to find work in the city. The doctor notes that ‘She was a dark-haired Highland girl with a fair skin’.

Not everyone was, however employed: unemployment was also a problem, and with no social security available apart from poor houses and charity hospitals, unemployment often meant destitution. The case notes of Samuel Brooks, 24, tell us that at the time of his admission to the hospital suffering from tuberculosis, ‘he had been out of work a long time, & starving, that he had recently found employment, and it was supposed he had been unequal to his task. He had been ailing for a fortnight, and had been entirely laid up for a week’. William Chant committed suicide in 1887, aged 57, after a period of unemployment; his notes tell us that ‘in consequence [he] had got very depressed’.

The class divide

The class divisions were stark: if you were wealthy enough, you would pay for a doctor to visit you at home, or attend their private practices. Only those who could not afford it went to the hospitals, which were often filthy and unhygienic.

Post Mortem record of Agneta Le Strange, 3 Oct 1918, PM/1918/207
Post Mortem record of Agneta Le Strange, 3 Oct 1918, PM/1918/207. Post Mortem Casebooks, Archives and Special Collections, St George’s, University of London

There are occasional exceptions to this rule in the post mortem records: among the occupations of the hospital patients we find some gentlemen, a couple of ladies, an admiral and a naval commander, for instance. But looking further into these cases, they all turn out to be accidents or a sudden disease. The evocatively named Agneta le Strange was brought to the hospital unconscious by the police in 1918 after suffering a sudden brain haemorrhage; not a heroine in a gothic novel or a wizard as her name might suggest, Agneta was presumably visiting the family’s London townhouse in Eaton Square (the family also had a mansion in Norfolk). In the majority cases, the bodies, though recorded in the post mortem volumes, were not autopsied, as that was another marker of social status: the choice to not have a post mortem. H.J. Blagrove, a ‘gentleman’, was ‘flung from his horse near the hospital’ in 1854, but his relatives asked that his body would not be examined, apart from his skull, which had been injured in the accident.

Occupations in SGUL post mortem examination books, 1858. Source: Post Mortem Casebooks, Archives and Special Collections, St George’s, University of London. By Juulia Ahvensalmi

The earliest of the post mortems from the 1840s only record patients’ occupations sporadically, often when it has some bearing to their disease. As we proceed further in time, the registrars start recording the occupations more methodically. Decades before cars filled the streets of London, horses were an important feature in everyday life, as the presence of grooms and stablemen shows; cab drivers, carmen and coachmen were employed in driving the horse-driven carts or cars around the capital. A gardener might have worked somewhere like the Vauxhall Pleasure Gardens, Chiswick Garden or Hyde Park, for instance, or in any number of plant nurseries providing plants to aspiring gardeners in the capital – there are even occasional farm labourers among the patients. Many people are employed in the building and construction: London was rapidly growing and these skills were in demand. There are fruiterers, bakers, butchers, distillers; people work in hotels, restaurants,  coffee houses, pubs (‘potman’ collected and washed dirty pots and glasses in a public house); they cook and serve; sew dresses, make cabinets and wigs and saddles; the charwomen and street sweepers clean and take care of public places as well as private houses.

The gender divide

Women’s occupations in SGUL post mortem examination books, 1841-1918. Source: Post Mortem Casebooks, Archives and Special Collections, St George’s, University of London. By Juulia Ahvensalmi

Women did not have many occupations open to them on their own right. When in employment, they were, by and large, working with textiles as dressmakers, needlewomen and milliners, and in domestic service, as servants, housemaids, cooks, laundresses and cleaners. Towards the late 19th century industrialisation means some other occupations become available for women, such as working in factories, and in particular during the First World War we start seeing clerks, secretaries and typists among the women. Lilly Grundy, 19, is recorded as having been a ‘machinist’, probably in a shoe factory. For unmarried women with children, the options were even fewer, and for most of the 19th century limited to dressmaking and cleaning. The post mortem records usually note the occupation of the father for the children; recording the occupation of the mother instead signals to the reader that the mother was unmarried. The mother of Edwin Cannon, aged 4 in 1887, was a charwoman (or cleaner), and the mother of Pat Gurney, aged 5 in 1917, was a flower seller, indicated in the post mortem records by ‘M’ for ‘mother’.

Index to the post mortem volume 1887, showing the entry for Edwin Cannon, PM/1887/120, and index to the post mortem volume 1917, showing the entry for Pat Gurney, PM/1917/266. Post Mortem Casebooks, Archives and Special Collections, St George’s, University of London

This was also the time when St George’s Medical School allowed its first female students, several of whom went on to work at the hospitals, including on the post mortems. Mostly, however, women’s status was defined by that of their husband or father; they are designated as ‘wife of labourer’, ‘wife of coachman’, or simply ‘married’, ‘wife’ or ‘widow’. And looking more closely into the cases it is soon obvious why this would be. Lack of (knowledge of) contraception as well as the social unacceptability of it meant that many women spent much of their lives pregnant, breastfeeding and caring for their children – they simply did not have the chance to even consider working outside the home. Emma Rickets, 50, is recorded as having had 22 children in 1888 – and having been one of 22 herself. That is of course an extreme example – but 10 children is not uncommon, and surely much fewer would have been stressful enough. Maria Cooper was 27 when she died in 1860; she is noted to have been married at 15 and borne nine children before her untimely death.

War and bureaucracy

Soldiers and sailors make occasional appearances in the records, often in the form of men who had perhaps gone ‘to sea’, often in East India Company’s employ, and latterly returned to Britain from the colonies. James Scott, for instance, died aged 44 in 1881. His occupation is listed as a confectioner, but his medical case notes tell us that he had gone to sea aged 17 in East India Company’s service, and had suffered from dysentery whilst in India. Life at sea is laid bare in the description of Scott as ‘a very heavy drinker of spirits, especially 1858-1870 when he had much morning vomiting & depression’. Far fewer are references to people who made the journey in the other direction: John Lusila was only 23 when he died in 1854 of tuberculosis. His medical record notes that ‘This poor black, who was a native of Angola, and had been in the West Indies, had been 10 years in England, & was a waiter in an eating house’.

Post mortem record of John Lusila, 17 Dec 1854, PM/1854/384. Post Mortem Casebooks, Archives and Special Collections, St George’s, University of London

From the Napoleonic wars in the early 19th century to the First World War, the post mortems record soldiers, their wives and their children. In the visualisation of the occupations in 1918, the armed forces has become the largest category: there are soldiers, privates, riflemen, sergeants, a captain, a naval commander and an admiral – and in particular their wives and children, who of course were the ones remaining in London.

Occupations in SGUL post mortem examination books, 1917. Source: Post Mortem Casebooks, Archives and Special Collections, St George’s, University of London. By Juulia Ahvensalmi

The visualisation also shows a huge increase in the types of occupations, compared to the earlier chart of 1858. In addition to the categories seen earlier – domestic service, occupations relating to the food industries and hospitality, building and construction – the industrial revolution, as well as the war, is apparent in all the jobs in factories: machinists, munition workers, aeroplane makers, electric fitters. There are also more white-collar type jobs in administration (clerks, secretaries, typists); there are engineers, a barrister, an architect, a bank manager and so on. The biggest change, however, is in the ‘other’ category, which earlier was filled with married women; in 1918, this category only includes two widows and one housewife.

Hélène Crosmond-Turner in Various musical celebrities by and after Elliott & Fry bromide print, 1890s. NPG Ax139913 © National Portrait Gallery, London

One of the interesting categories are those working in arts and entertainment. There are not many, but they include Percy Vaughan, a comedian, who died of tuberculosis aged 29 in 1887. His medical case records laconically that ‘he had been a pantomimic actor & had lived hard and fast’. Another tragic story is that of an opera singer, Hélène Crosmond-Turner. Born Rosa Levison or Leverson, she shot herself in a cab on Piccadilly in 1888 after failing to renew her contract as a lead in Aïda. She had for some time been worried about her financial situation and her career, and had tried some days previously to overdose on painkillers. The papers made much of this dramatic suicide, including describing her dress in detail – red and brown stripes, with a black and brown checked ulster, trimmed with imitation beaver (‘not one of her best outfits, as her landlady Mrs Godbold later observed’). Part of the attention lavished at poor Hélène following her death was due to her famous mother, Madame Rachel, whose tagline was ‘beautiful forever’. From selling rabbit skins and used clothes in London’s East End, Rachel proceeded to be the owner of a very profitable beauty salon in Mayfair. Her famous cosmetics, however, contained a multitude of toxic chemicals, including prussic acid, lead and arsenic. This, alongside with allegations of blackmailing her clients, led her to being prosecuted for fraud. She died in Woking jail in 1880, aged 60, eight years before her daughter.

What other stories would you like to hear from the post mortem project? We’re lucky in that we have all the volumes digitised, so we’re able to continue cataloguing the cases, and are eager to hear your views!

A Case of Leprosy in the Archives

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 Natasha Shillingford, Project Archivist.

The post mortem record of Amy Bradshaw, Archives & Special Collections, St George’s, University of London, PM/1884/9

Amy Bradshaw, a seven-year-old girl, was admitted to St George’s Hospital on 24th July 1883 and she later died on 10th January 1884. She was suffering from Leprosy.

The medical case notes record that ‘Her mother was a native of Oxfordshire, her father of Barbados, where his family had lived for three generations since leaving Scotland.’ Amy was one of six children, one of whom died in infancy of dysentery, and two had Leprosy. The sister next above her in age was four and a half years older, and she developed symptoms of Leprosy in 1875. Amy was said to have first developed symptoms herself in 1879, when her mother noticed raised spots ‘like blind boils’ on her back and thighs, which after a time turned brown and were succeeded by a fresh crop.

On admission she was described as ‘a dark intelligent child of characteristically leprous aspect. Over the face and hand the flattened tubercles, in parts red, in parts brown, are abundantly scattered: the nose enlarged, flattened at the tip, red and pigmented; the lower lip the same.’ On her arms, legs and feet were depressed cicatrices and scattered dark brown pigment.

On examination the larynx and epiglottis were found to be thickened and unnaturally white and a lumpy deposit was found. ‘The timbre of the voice is somewhat nasal and the vowel sounds slightly continental.’

Amy was treated with Chaulmoogra Oil in the form of an emulsion which was seen as a success and the child was happy as a rule, although she occasionally complained of soreness and aching in the leprous tubercles. On 17th December her temperature rose rapidly ‘when an acute invasion of the new growth set in with much pain and suppuration.’ The medical case notes report that Amy’s elder sister who was suffering from the same symptoms, was allowed to leave the hospital on 23rd December to spend Christmas at home. However, she developed pneumonia shortly after and died on 6th January. Amy also gradually developed pneumonia in the hospital and ‘sank with great pain, and high fever, dying in Jan 10 1884.’ The post mortem report states ‘Face disfigured by leprosy cicatrices.’

Leprosy affects the nerves, respiratory tract, skin and eyes. It can cause loss of fingers and toes, gangrene, ulcerations, skin lesions and weakening of the skeleton. If left untreated, it can lead to a loss of sensation in the hands and feet. This lack of ability to feel pain can lead to the loss of extremities from repeated injuries or infection due to unnoticed wounds. Leprosy can also damage the nerves in the face which causes problems with blinking and eventual blindness. Other symptoms, which can be seen in the case of Amy Bradshaw, include flattening of the nose due to destruction of nasal cartilage, and phonation and resonation of sound during speech.

Credit: Elephantiasis graecorum, True Leprosy. Chromolithograph.
Credit: Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

The disease takes its name from the Greek word λέπρᾱ (léprā), from λεπῐ́ς (lepís; “scale”). Leprosy has a long and complicated history and for centuries has been associated with social stigma, which even in the modern day continues to be a barrier to self-reporting and early treatment.

The earliest possible account of a disease which is believed to be Leprosy appears in an Egyptian papyrus document written around 1500 BC. Indian texts from 600 BC also describe a disease that resembles Leprosy. The first account of the disease in Europe occurs in the records of Ancient Greece after the army of Alexander the Great came back from India, and then in Rome in 62BC which coincided with the return of troops from Asia Minor.

Leprosy had entered England by the 4th century AD and was a common feature of life by 1050, although throughout its history it has been feared and misunderstood. It was often believed to be a hereditary disease, or some believed that it was a punishment or curse from God. Pope Gregory the Great (540-604) considered people with Leprosy to be heretics.

Others thought that the suffering of lepers echoed the suffering of Christ and they were enduring purgatory on earth and would go straight to heaven when they died. Therefore, they were considered closer to God than other people.

Leprosy patients were often stigmatised and shunned by the rest of society. During the middle ages people suffering from Leprosy were made to wear special clothing, ring bells to warn others of their presence, and walk on a different side of the road.

Credit: Manuscript showing leper. Credit: Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

A passage from Leviticus 13: 44-46 shows the biblical perception that people with leprosy were unclean and should be ostracised from society:

the man is diseased and is unclean. The priest shall pronounce him unclean because of the sore on his head.

Anyone with such a defiling disease must wear torn clothes, let their hair be unkempt, cover the lower part of their face and cry out, ‘Unclean! Unclean!’ As long as they have the disease they remain unclean. They must live alone; they must live outside the camp.

Credit: Two lepers receiving food through a wall. Etching by Gaitt after A. Decamps. Credit: Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

Even in more modern times, patients with Leprosy were often confined to colonies called Leprosariums because of the stigma of the disease. Some of these colonies were situated in remote lands or islands, such as the island of Spinalonga off the coast of Crete which was used as a leper colony from 1903 to 1957. The novel ‘The Island’ by Victoria Hislop tells the story of the leper colony on Spinalonga and its inhabitants.

In 1873 Dr Gerhard Henrik Armauer from Norway identified the germ that causes Leprosy. The discovery of Mycobacterium Leprae proved that leprosy was not a hereditary disease, or a punishment by God, but an infection caused by bacteria.

Patients with Leprosy were often treated, as can be seen in the case of Amy Bradshaw, with oil from the chaulmoogra nut. The treatment was said to be painful and its success was questionable, although some patients appeared to benefit. Leprosy is now curable with multidrug therapy (MDT) which was developed in the early 1980s

The last case of indigenous leprosy in the UK was diagnosed in 1798. Leprosy can no longer be contracted in this country, but there are around 12 new cases diagnosed each year. The World Health Organisation (WHO) (https://www.who.int/news-room/fact-sheets/detail/leprosy) figures state that in 2018 there were 208,619 new cases of leprosy diagnosed. This is approximately one every two minutes.


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Hysteria in the archives

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, Project Archivist.


Elizabeth Greed was 51 years old in 1888 when she was admitted to St George’s Hospital. Her medical case history, which survives in her post mortem record in the archives, tells us that she was married and had had five children; one of them had died. Another one was said to have tuberculosis, and one was said to be a ‘cripple’. When she was young she was said to have suffered from hysteria and scarlet fever.

Elizabeth herself said that about five years before, whilst walking in her garden, she had suddenly lost power in her legs. Although she recovered from this incident, she had been knocked down in the street the previous summer, and had struggled walking ever since. She also complained of various other ‘abnormal sensations’, including tingling in her limbs and a constricted feeling in her chest. She felt like she was floating in water when sat down, and when she walked, she could not feel the ground. She was also annoyed by a constant smell of sulphur.

She went to ask for treatment at Guy’s Hospital, but, feeling ill-treated there, took a cab to come to St George’s Hospital instead, then located at Hyde Park Corner. She was received by a young doctor called Richard Sisley, who in his notes describes her as ‘olive-skinned’ and her manner as ‘hysterical’. He says she only appeared to be able to walk supported, describing her movements resembling those of a marionette. He thought many of her symptoms pointed to hysteria, although the loss of power and the involuntary movements of her legs were suggestive of ataxic paraplegia – a condition that can be hereditary, or caused by damage to brain or the spinal cord, and is characterised by loss of motor function in the lower extremities.

The post mortem record of Elizabeth Greed, Archives & Special Collections, St George’s, University of London, PM/1888/132

Elizabeth was admitted as an in-patient to the hospital on 7 March 1888. Further examinations found no abnormalities in her heart or lungs, but she was becoming increasingly paranoid and delirious. She thought she was being poisoned by turpentine mixed in her food. She was worried she would be sent out of the hospital, but she also thought that the ward she was in was filled with paraffin and would be set on fire. She lost weight, becoming increasingly weak, until she was unable to stand. On 11 April 1888, ‘she died without first symptoms, quietly’. The cause of death was recorded as possible mania and dementia, and ataxic paraplegia.

The case notes in the post mortem record of Elizabeth Greed do not elaborate more on her alleged hysteria, but her case gives us a glimpse of how women’s health was approached: despite her symptoms pointing to a physical condition, her behaviour is labelled as hysteric. Life in the 1880s London was not easy, and this was particularly the case for the poorer part of the population. We can assume that Elizabeth was poor, as those able to pay would not have attended a charitable hospital such as St George’s – they would have had the doctors come to them, or visited them at their private practices instead. The census records reveal that Elizabeth was from Clapton, and her husband Robert had moved to London from Taunton in Somerset. They lived in Bermondsey, which in the 19th century was a buzzing industrial hub, specialising in tanning, leather working, cotton work and food processing. All this industry meant that the population in Bermondsey was largely poor: the factories offered employment, but it was not particularly secure or well paid. Elizabeth is described as a ‘needlewoman’ (other related occupational terms include ‘dressmaker’ and ‘seamstress’). This was often work that could be done from home: sewing and mending clothes, making it easier for the women to care for their families. It was also, however, work that was very much underpaid, and the working conditions were likely to have been dire, with insufficient light and long hours, whether the work was done at home or in a factory.

But why was she labelled hysteric? Hysteria is no longer part of the medical vocabulary, but in the 19th century it was a common way to describe and diagnose what was perceived as emotional excess, primarily of women (this usage of course still continues outside medical diagnoses). It was seen to affect women from all social classes. The term encompassed a variety of symptoms, including anxiety, nervousness, agitation and demonstrations of sexual desire. Sexuality was at the heart of the condition; the word hysteria comes to English via Latin hystericus, from Greek ὑστερικός (husterikós, “suffering in the uterus, hysterical”), from ὑστέρα (hustéra, “womb”). Hysterical symptoms were thought to originate in the womb, and a commonly cited method of treatment was said to involve using a vibrator in order to gain release in the form of orgasm – this, however, is a myth rather than a commonly employed treatment.

Brodie, Benjamin. 1837. Lectures Illustrative of Certain Local Nervous Affections. St George’s, University of London Archives. Credit: Juulia Ahvensalmi

St George’s also plays a part in the history of hysteria. Benjamin Brodie, one of the most eminent doctors of his time and physician to the royal family, examined cases of ‘nervous affections’ in 1837. In these cases, patients had suffered from articular pain and swelling, but there had been no deterioration of bone or cartilage in the post mortem examination. In Brodie’s view these cases were neurological disorders, perhaps following a minor injury or a strong emotional experience, which could lead to a ‘hysterical knee’, for instance.

Another St George’s doctor writing about hysteria was Robert Brudenell Carter, who worked as an ophthalmologist at St George’s in 1870-1883. In his 1853 book ‘On the Pathology and Treatment of Hysteria’, he (unlike most of his contemporaries) emphasized the effect of emotions on the nervous system, arguing that a strong emotion might lead to a hysteric attack even in otherwise healthy women, as well as men. The prevalence of hysteria among women could, in his view, be explained by women’s heightened emotions, but also due to their having to suppress their emotions more than men, who were allowed to be physically and sexually more active.

The association of hysteria with the nervous system rather than the uterus, and with psychological, rather than physical, causes became more widely accepted during the 19th century. Jean-Martin Charcot was instrumental in re-defining hysteria in terms of neurological disorders, and his use of photography at the Salpêtrière asylum in Paris created controversial imagery of female hysteria.

Jean-Martin Charcot demonstrating hysteria in a patient at the Salpetriere. Lithograph after P.A.A. Brouillet, 1887. Credit: Wellcome Collection. CC BY

The American neurologist Silas Weir Mitchell advocated the so-called ‘rest-cure’ to calm the overstimulation of mind, which he believed was the cause of hysteria. This treatment was made infamous by Charlotte Perkins Gilman in her short story ‘The Yellow Wallpaper’ in 1891:

“John is a physician, and perhaps—(I would not say it to a living soul, of course, but this is dead paper and a great relief to my mind)—perhaps that is one reason I do not get well faster.

You see, he does not believe I am sick!

And what can one do?

If a physician of high standing, and one’s own husband, assures friends and relatives that there is really nothing the matter with one but temporary nervous depression—a slight hysterical tendency—what is one to do?

My brother is also a physician, and also of high standing, and he says the same thing.

So I take phosphates or phosphites—whichever it is, and tonics, and journeys, and air, and exercise, and am absolutely forbidden to “work” until I am well again.”

John W. Ogle, a physician at St George’s, discusses the case of Sarah G., 20, who was admitted to St George’s Hospital in 1869. She stated that she had been coughing and vomiting for about a year, and she had never menstruated until three weeks before her admission to the hospital. She had been treated previously at other hospitals for pain in the abdomen and vomiting. Ogle describes her as ‘rather delicate and interesting-looking’, and her manner as ‘somewhat sly and hysterical’.

Caption: John William Ogle (1824-1905), physician at St George’s Hospital. Credit: US National Library of Medicine

She was fed beef-tea and milk with limewater: beef broth was standard hospital fare, and the limewater was intended to relieve indigestion. Her constipation was treated with a ‘blue pill’ and the herbal remedies colocynth, senna draught and calumba; she was also given spirit of ammonia and bicarbonate of potassium. The so-called blue pill was (rather than Viagra!) a mercury-based medicine commonly used for this purpose, but also for treating a wide variety of other complaints, including syphilis, toothache and tuberculosis. Later various other medical concoctions were attempted, including calomel (mercury chloride), edemas made of castor oil and rue, belladonna (‘beautiful woman’ in Italian, from its cosmetic use for dilating pupils, the plant is also known as the deadly nightshade, and was used by the Roman empress Livia Drusilla to poison her husband emperor Augustus), brandy, prussic acid and morphine – it’s a wonder she was still alive at this stage, one might think!

Although her condition did not appear to be improving, she was seen to get up from her bed to watch Queen Victoria pass by the hospital on her way to open Blackfriars Bridge. This convinced Ogle that she must have been faking her illness. Despite her continued refusal to eat, she vomited and evacuated her bowels. Ogle quotes in his article a letter allegedly written by her to another patient, asking her to bring her a ‘nice peice [sic] of bread’ and to take care that she should not be seen to do so. She was further treated with faradisation (muscle stimulation by electric currents), and she was given daily baths until she got her period; she was also forced to do some exercise by walking her to the middle of the ward and then ‘leaving her to scramble back to her bed’. She appears to have got into disagreements both with the ward nurse and with Ogle, her doctor, until one day she suddenly walked out of the hospital.

Ogle diagnoses this case as ‘temper-disease’, suggesting that the original symptoms relating to her lungs may have been real enough to begin with, but that the attention received from exhibiting these symptoms had led the patient to feign further, imaginary, symptoms. He describes his patient as ‘by nature self-willed, with a ‘naughty’ disposition, badly trained, too well pleased to attract and receive attention, of an hysterical temperament’. Quoting Benjamin Brodie, he suggests that it is possible that even the cough was a hysterical symptom – a hysterical lung, if you will.


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Libraries Week 2019: Celebrating Archives

Libraries Week takes place between 7th – 12th October 2019. This year’s campaign is focused on celebrating the role of libraries in the digital world. Over the course of the week we’ll be introducing you to different teams within the Library and explore how they use technology to support our community.


Today’s post comes from our Archives team, who have been involved in a large-scale digitisation project – so this year’s Libraries Week theme offered a perfect opportunity to provide an update! Click here for previous posts from our Archives.

Opening Up the Body: Digitising, cataloguing and visualising post mortem case books

Opening Up the Body is a project to conserve the Post Mortem Examinations and Case Books of St George’s Hospital, 1841-1946, and to catalogue and digitise those dating from 1841-1917 – that’s about 27,132 cases across 76 volumes. The catalogue data and digitised images will be made available on the St George’s, University of London website.

Post mortem of Caroline Parker, 42, from 1865.

The volumes contain manuscript case notes and detailed reports of the patients’ medical history, including details of treatments and medicines administered to patients. They also contain comprehensive reports of the pathological findings made during the detailed examination of the body after death. These rich and detailed post mortem records are a unique resource, which will contribute to our understanding of medical education, death practices, and the history of London’s hospitals and infectious diseases, amongst other things. Moreover, the volumes feature notable physicians and surgeons, including Henry Gray, who compiled his influential ‘Gray’s Anatomy’ whilst performing post mortems at St George’s.

Meet the team

Two Project Archivists have now started to catalogue the post mortem volumes and the project team consists of the University Archivist, Carly Manson, and two Project Archivists, Juulia Ahvensalmi and Natasha Shillingford.

How do we use technology to support our users?

AtoM (Access to Memory)

AtoM (Access to Memory) is a web-based, open source, standards-based application for archival description and access. AtoM was originally built with support from the International Council on Archives to encourage broader adoption of international standards for archival description across institutions. AtoM is a dynamic open source application with a broad user base who work together to continually improve and enhance the software to the benefit of the whole community.

Our catalogue is made available via the St George’s Archives & Special Collections website: https://archives.sgul.ac.uk/. AtoM allows users to type keywords into the search box located at the top of the banner, or they can explore the collections by browsing via collection, people and organisations, archival institutions, functions, subjects, places or digital objects. The catalogue homepage also displays the most popular items that have been searched for that week, which provides a glimpse into the interests of our researchers.

Each individual post mortem is being catalogued according to international standards and a summary of each will be produced, providing searchable keyword access. The information being captured in the catalogue includes the name of the patient, occupation, gender, date of admission, date of death, the physicians and surgeons who attended the case, a transcription of the diseases affecting the patient, and notes from the medical and post mortem examinations.

Example post mortem catalogue record

The catalogue data from the Opening Up the Body project will be imported from spreadsheets into AtoM.  The digitised images will be linked to the individual catalogue entry, allowing researchers to access the collection remotely and therefore increase access to the collection and also preserve the physical volumes.

Subject access points are being identified using the Medical Subject Headings (MeSH) database (https://meshb.nlm.nih.gov/search), which will allow researchers to search and identify cases by disease and anatomy group. For example, at the click of a button a researcher will be able to identify post mortems that were related to diseases of the respiratory system, or patients that were admitted to the hospital following an injury.

Name access points are also being created for every surgeon and physician of St George’s Hospital who treated the patients or undertook the post mortem examinations, and will be linked to their authority record in the catalogue. The authority record will list information such as dates of existence and a biographical history of the key figures in the history of St George’s.

Visualising the post-mortems

Word cloud of commonly found words in a post-mortem volume from 1887 using Wordclouds.com (https://www.wordclouds.com/)

As we catalogue the material, we are collecting a large amount of data. In order to be able to get the most out of this incredibly rich source, we’ve modified our cataloguing templates to structure the data so that we can both export it into AtoM in the required and easily readable format, and to make it easier to properly explore that data and gain new insights into the material.

This also requires standardising the data, especially when it comes to the names of diseases. These can change over time: tuberculosis, for instance, may be called tuberculosis or phthisis, and we want to make sure we can track these conditions, regardless of what they’re called (this of course is not always that simple, but that may be a subject for another blog post!).

Packed circles showing groups of diseases in 1864, using Flourish (https://app.flourish.studio/templates)

There are plenty of free, open-source tools available, many developed specifically for digital humanities. Visualisation tools are great for immediate visual effect, for telling stories and for drawing attention to details that might otherwise be missed, or might be worth more in-depth exploration – why does the word ‘India’ appear so frequently in the word cloud above, for instance? Why did so many people die of cardiovascular and respiratory diseases? Visualisations are nothing new, of course – John Snow (who at one time worked at St George’s) managed to figure out the cause of the 1854 cholera outbreak by mapping the cases.

Line graph showing instances of death from cholera during the 1854 cholera epidemic in London, using Flourish
Sankey diagram illustrating distribution of diseases by gender in 1864, using Flourish

As we continue cataloguing and collecting more data, we can begin to explore changes over time and ask more questions – did people live longer? How do their occupations change? How do medical advances affect the kind of diseases featured in the post mortems? How do the post mortems themselves change? Presenting the material like this not only allows our readers insights into the contents of the post mortem records, but it also gives us a chance to reflect on the details of our work, and on the ways in which we are dealing with the data as we go along. More importantly, though, we can use these visualisations to bring the material to life – so to say!

We are only just starting, so look out for more exciting visualisations as we delve deeper into the post mortems! And feel free to get in touch with us at archives@sgul.ac.uk – we’ll be happy to answer any questions you may have about the project and accessing the material.


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