World Digital Preservation Day 2022

World Digital Preservation Day, organised by Digital Preservation Coalition, is an international event to highlight the importance of digital preservation. This blogpost has been written by St George’s Archivist Juulia Ahvensalmi, Research Data Support Manager Michelle Harricharan, and Records Manager Kirsten Hylan. You can engage with the day and find out more about our work on the Museum and Archives Twitter account using the hashtags #WDPD2022 and #SGULWDPD2022. If you are interested in learning more about digital preservation at St George’s, or would like to get involved, please contact digpres@sgul.ac.uk.

‘Data for All, For Good, Forever’ is the theme of this year’s World Digital Preservation Day, demonstrating how digital preservation allows ‘digits to flourish’. What an apt theme for a university that has been transforming health and medical care since 1733! Whether it is developing the earlier practices of variolation into vaccination (introduced by Edward Jenner in 1798) that eventually eradicated smallpox or transforming health practice though our pioneering work in infection and immunity, population health and molecular and clinical research, for St George’s data has always been for good, for all and, with proper care, forever. This post will consider how by preserving records and data regardless of format that are held in the archives and currently being developed by our staff, we are not only ensuring we maintain our history, but that St George’s continues to contribute to ground-breaking medical research by allowing digits to flourish.

Postmortem Examinations and Case Books

St George’s, University of London (SGUL), is a specialist health and medical sciences university in South-West London. The Archivist, Research Data Support Manager, and Records Manager work together to advocate for digital preservation, winning funds for a digital preservation system, and identifying areas that hold records that require a long-term storage solution. As a medical school we have created many unique datasets that contribute to scientific knowledge and the teaching of medicine.

The Postmortem Examinations and Case Books were created by St George’s, University of London and St George’s Hospital between 1841 – 1946. The records contain case notes including medical histories and pathological findings, and detail social and cultural changes, medical advances, and historical events, including epidemics and the development of anaesthesia and antiseptics. The postmortem books were an integral teaching tool for students of surgery and anatomy at St George’s. Through a project funded by Wellcome, the casebooks were conserved, digitised and catalogued in 2018 – 2021. They now have a life beyond teaching; they are a genealogical, sociological, and historical resource freely accessible online, enabling researchers to broaden their and our knowledge of diseases and treatments that act as building blocks for current and future researchers’ work.

St George’s Post Mortem and Case Book 1846, and a catalogue entry for the case of Thomas Roles, PM/1880/236 displayed on the SGUL Archives catalogue.

The Cambridge Cohort of Open Spina Bifida

Our research data repository holds several valuable research datasets. One such dataset is The Cambridge Cohort of Open Spina Bifida which comprises of 9 reviews of 117 individuals born between 1963 – 1971 with open spina bifida. Spina bifida occurs when a baby’s spine and spinal cord does not develop properly in the womb, causing a gap in the spine (NHS, 2020). Most babies born with spina bifida can have surgery to close the opening in the spine, however, their nervous system will have already been damaged which can lead to a range of health problems. Some may also have learning disabilities.

The Cambridge Cohort of Open Spina Bifida is a unique spina bifida data resource that provides detailed data on the health and quality of life of individuals born with spina bifida. The resource is rare in that it includes a detailed neurological examination at birth, and follows up on participants throughout their lives, with 99% follow-up to the mean age of 50 years. The earlier reviews were conducted at home and school at the mean ages of 4 and 9 years and included clinical examination. Later reviews were based mainly on questionnaires (completed by patients and/or carers) and clinical records. The Office for National Statistics provided information on deaths to August 2017.

The data provide a full, comprehensive picture of the lives of people who received surgery for open spina bifida within 24 hours of birth until either they died (which a third did before the age of 5) or the end of the study in 2017. With a 99% follow-up, it represents a remarkable achievement in research and contribution to an area where not much had previously been known. For each of the participants, and their carers, participation in the research was a means of sharing their experience for good, for all those living with spina bifida – present and future, with the hope of improving understanding and treatment of their disease.

For the researchers, the study was an ongoing endeavour of love, started by a clinician, researcher and mother who passed the work on to her daughter on her retirement. Her daughter painstakingly continued her mother’s work, treasuring the study and the research as much as her mother before her. The dataset was passed to St George’s to share and preserve for the future – for all, for good, forever.

Oakeshott, P., Reid, F. (2021) The Cambridge cohort of open spina bifida. Figshare. DOI 10.24376/rd.sgul.14438780. Available at https://doi.org/10.24376/rd.sgul.14438780

A podcast with Prof Pippa Oakeshott, where she discusses her 2019 paper based on this data ‘Walking and living independently with spina bifida: a 50‐year prospective cohort study’, can be viewed on the Developmental Medicine and Child Neurology YouTube account.

Exploration of Disease Past and Present

What do these two resources, one containing information dating back to 1841, the other published in 2021, have in common? Both are maintained in a digital format, both add to our knowledge of a specific subject, and both have purposes that will evolve over time.

However, the everchanging technical landscape means that digital records essential for medical research are at risk. The importance of our digital records means there is a need for digital preservation to ensure these records remain accessible in order to protect our knowledge and investment, and ensure that future generations of researchers have the opportunity to access the knowledge contained within.

The historical records also provide a link between the past and present, and show the medical advances made over time. In 1865, a seven-month-old baby called Harriet (or Elizabeth) Garton was admitted to St George’s Hospital with a congenital meningocele, a type of spina bifida in which a sac of fluid protrudes through a gap in the spine. The only treatment available at the time was injection with iodine; it was not until 1895 that the first successful surgical operation was described. Although the iodine initially appeared to decrease the size of the tumour, little Harriet developed bronchiolitis and died five days after her third admission to the hospital: the doctor treating her blamed the disease on the ‘inclement’ weather when the child’s mother brought her to the hospital. Although the treatment was ultimately unsuccessful, the trial was seen as significant enough to discuss at length in an article published in 1866.

Illustration of the case, published in St George’s Hospital Reports, Vol 1 (1866) by Timothy Holmes, SGHMS/6/1/1; and the digitised post mortem case notes of Harriet Garton, infant, 10 Apr 1865, PM/1865/107.

Capturing and preserving our digital data allows us to place formal research datasets like the Cambridge Cohort of Open Spina Bifida alongside our understanding and treatment of the disease in 1865. It allows us to compare perceptions and innovative treatments over time. In 1865 surgery for spina bifida was not possible; now, it is part of standard care, with some surgeries even happening while babies are still in the womb. Our post-mortem examinations and casebooks include a number of cases of spina bifida and meningocele in infants aged between 3 days and 1 year, demonstrating how quickly babies’ health deteriorated without surgery in the past. Opportunities for future research includes exploring the genetic basis of neural tube defects like spina bifida and the use of stem cell technology as potential therapies.

Data for All, for Good, Forever

By actively managing our records and data and applying preservation tools and activities we can maintain the record and data’s ongoing viability. Key to achieving our goals is St George’s information management professionals including the Archivist, Research Data Support Manager, and Records Manager advocating for, and working with the owners of records and data to identify and actively manage their outputs.

The steps we take now to protect our digital records will ensure their longevity and the ability for researchers of the future to continue to access the knowledge held within. St George’s, University of London’s mission is to pursue excellence in academic medicine, healthcare and science, informed by a global outlook by creating and sharing knowledge. By identifying records for digital preservation, we ensure their availability for good, forever, and that the data contained within is available to all.

An Assassination in the Archive

‘Opening Up the Body’ is a Wellcome-funded 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 1841-1921. This post was written by Project Archivist Natasha Shillingford.

While cataloguing the 1909 volume of post mortem case books of St George’s Hospital, we came across the post mortem examination of Cawas Lalcaca, a Medico. The cause of death was listed as ‘Bullet wound in back perforating lung, diaphragm, liver, mesentery, intestines and ilium. 2^nd bullet wound in right chest.’  The medical case notes record that the ‘Patient was murdered on July 1 at the same time as Sir William Curzon Wyllie at the Imperial Institute by an Indian fanatic named Dhingra, who was subsequently executed at Pentonville.’

PM/1909/223. Archives and Special Collections, St George’s, University of London

What happened on that fateful night to result in the murder of two men?

A reception had been given at the Imperial Institute on behalf of the National Indian Association. It was attended by Lieutenant-Colonel Sir William Hutt Curzon Wyllie, K.C.I.E, C.V.O, Political Aide-de-Camp to Viscount Morley, Secretary of State for India and his wife, Lady Wyllie.

The Globe newspaper reported on the 2^nd July that “The occasion passed without incident until the close of proceedings. Sir Curzon was descending the staircase prior to leaving, Lady Wyllie having, in the meantime, descended to the cloakroom to fetch her wraps. Descending the staircase near Sir Curzon was Dr. Cawas Lalcaca.

Then suddenly, in the twinkling of an eye as it were, and to the stupefaction of those around, shots rang out, and Sir Curzon fell on his back on the stairs. An Indian student was standing in front holding a smoking revolver. One bullet had shattered Sir Curzon’s right eye; another bullet had pierced his face just below the other eye. Dr. Cawas Lalcaca fell with a bullet through his chest.”

There were a number of doctors among the guests, and they attended the victims, but “it was at once seen, however, that Sir Curzon’s fate was sealed and life was certified to be extinct. In the case of Dr. Cawas Lalcaca hopes were entertained of his ultimate recovery, and he was conveyed to St George’s Hospital, but died almost immediately.”

An eyewitness at the scene said that Dr. Lalcaca had previously been speaking to Sir Curzon Wyllie, and he was “of the opinion that he must have noticed the actions of the assassin just as he was about to fire, and thrust himself before Sir Curzon Wyllie, and thus received his death wound.”

PM/1909/223. Archives and Special Collections, St George’s, University of London

The morbid appearances in the post mortem examination at St George’s Hospital reveal the extent of Dr. Lalcaca’s injuries. The external description of the body describes the locations and entry of the bullets.

Meanwhile, the assassin was apprehended at the scene and escorted to Walton Street Police Station. The Globe newspaper reported that “the prisoner, stated to be a Parsee, is apparently about 25 years of age. Not of powerful physique, but mild-mannered, cool and self-possessed, his hair black, he was wearing gold spectacles, and a turban, which in the enactment of the tragedy fell off.” The motive of the crime was believed to be political, and in addition to the revolver which he fired, he had a further revolver, a long knife and a dagger on his person. His name was given as Madan Lal Dhingra, a student in Engineering at University College.

The Globe newspaper reported that when asked if he had anything to say, the prisoner replied, “The only thing I want to say is there was no wilful murder in the case of Dr. Lalcaca. I did not know him at all. When he advanced to take me I only fired in self-defence.”

An inquest on the body of Dr. Lalcaca was held at Westminster Coroner’s Court and was reported in the London and China Express, 9^th July 1909.

It stated that Dr. Lalcaca was a native of Allahabad but resided in Bombay, later at Shanghai. He was a doctor of medicine and had been in England since June 8^th. A friend described him as a “fine looking Indian, slightly over medium height, with a handsome bronze countenance, of a genial bearing, and refined appearance.”

The Coroner stated that it was a clear case of wilful murder by Dhingra or Dr. Lalcaca. He said that it was true that Dhingra stated that his intentions were not against Dr. Lalcaca and it was an act of self-defence, but that was not an excuse for murder. The Jury returned a verdict of ‘Wilful Murder’.

So, what was Dhingra’s motive for the attack on Curzon? The Christchurch Times reported on 10^th July 1909 that a brother of Dhingra had written to Sir Curzon Wyllie asking if he would offer Dhingra some advice, as “the family feared he was getting into a dangerous circle.” Sir Curzon apparently did write to Dhingra, and advised him in a tactful manner, but Dhingra resented this advice and clearly indicated this in a letter sent to Sir Curzon.

It was also said that Dhingra had attempted to kill George Curzon, Viceroy of India and had planned to assassinate the ex-Governor of Bengal. Wyllie’s presence at events with Indian students, made him an easier target for assassination.

Dinghra was tried at the Old Bailey on 23^rd July. He stated that “Whatever I did was an act of patriotism and justice which was justified. The only thing I have to say is in the statement which I believe you have got,” and he pleaded not guilty to the indictment. The Bicester Herald published Dhingra’s statement on 20^th August 1909. He wished it to be read at the trial, but permission was refused. “I admit the other day I attempted to shed English blood as an humble revenger for the inhuman hangings and deportations of patriotic youths. In this attempt I have consulted none but my own conscience. I have conspired with none but my own duty.” He continued, “I believe that a nation held down by foreign bayonet is in a perpetual state of war, since open battle is rendered impossible to a disarmed race. I attacked by surprise; since guns were denied me I drew forth my pistol and fired…The only lesson required in India at present is to learn how to die, and the only way to teach it is by dying ourselves. Therefore I died, and glory in my martyrdom.”

For the murder of Sir Curzon Wyllie and Dr. Lalcaca, Madan Lal Dhingra was hanged at Pentonville prison on 17^th August 1909.

The funeral of Dr. Cawas Lalcaca took place at Brookwood Cemetery, the only Parsee burial place within the metropolitan district. The London and China Express described the ceremony at the graveside as ‘short, simple and impressive. The coffin was covered with floral tributes. It was placed on a bier and drawn to the Fire Temple of the Parsees. When the coffin was taken into the building a fire of sandalwood and frankincense was lighted on the altar, on either side of which burned also a candle. The interment took place in a plain grace, and after the body had been taken from the temple, most of those present placed a small piece of sandalwood in the flames on the altar.”

The British Medical Journal reported that the floral tributes were particularly beautiful, and “conspicuous among them was a wreath from Lady Wyllie inscribed: ‘These flowers are sent by the wife of Sir Curzon Wyllie, in ever grateful remembrance of the brave and noble man who lost his life on the night of July 1^st in trying to save her beloved husband and others, with deepest sympathy.’”

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A Railway Mystery

‘Opening Up the Body’ is a Wellcome-funded 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 1841-1921. This post was written by Project Archivist Natasha Shillingford.

Following on from the discovery of a post mortem case of a monkey on the railway we decided to explore other cases of railway mysteries in the post mortem collection of St George’s Hospital. We soon came across a case worthy of the great Hercule Poirot.

On 23^rd September 1886 Moritz Fischer was admitted to St George’s Hospital with a compound depressed fracture of the skull, with laceration of the dura mater and brain with meningitis.

PM/1886/292. Archives and Special Collections, St George’s, University of London

The case notes said that ‘The man was found in a 1^st class compartment of the Metrop[olitan] Railway with a fractured skull.’ He was conscious but did not speak. There was a scalp wound about eight inches in length which extended from the centre of the forehead. The external table of the skull was fractured and the internal table was driven through the dura mater into the brain, with the brain substance protruding. The fragments of the bone were picked out with forceps and the scalp was brought together with sutures. He went on well without any special symptoms for nine days when he passed his urine into the bed and became drowsy. His temperature slowly rose from 99 degrees to 106 degrees on the evening of the 3^rd October and he died on the 4^th.

The post mortem examination states that there was a wound 3 ¼ inches long over the frontal region. It started from a point 1 inch to the right of the middle line and passed obliquely forwards and to the left. The angles of the wound were infiltrated. Beneath it, part of the temporal bone was absent. Some soft greyish substance protruded which was examined microscopically and found to consist almost entirely of nerve fibres, blood and granular matter.

PM/1886/292. Archives and Special Collections, St George’s, University of London

What happened to Mr Fischer in the first-class compartment to cause such brutal and deadly injuries?

Lloyds Weekly London Newspaper reported on September 26^th 1886 that on the arrival of the train at Bayswater, ‘the attention of the newspaper boy attached to the bookstall on the platform was attracted to the last compartment by one of the first-class carriage fourth from the engine, there being a stream of blood on the outside of the carriage door, the window of which was open. On looking through into the compartment the lad observed a gentleman lying prostate on the floor, alone, and with his feet towards the door, there being a small quantity of blood on the carpet, and a much larger quantity on the cushion of the seat nearest the engine.’ The acting-inspector on duty opened the door and ‘saw that the unfortunate man was quite insensible, and that blood was flowing from a terrible wound on the forehead.’ The gentleman was ‘attired in a grey overcoat, the coat underneath being of black diagonal cloth, and his trousers were light-striped. His gold watch and chain were safe, as were also his rings, but not much money was found in his possession. A few papers were discovered, and they were all in German. A visiting card was found bearing the inscription, “Mr. Moritz Fischer,” and the police, as the result of subsequent inquiries, ascertained on Friday that the injured gentleman was Mr. Moritz Fischer, head of the firm of Mr. A. Fischer and Co., general foreign agents of 35 Carter-lane, and having residence in Westbourne-terrace.’ Thus it appears that none of Mr Fischer’s belongings were stolen so theft was unlikely to be a motive for an attack. However, ‘It was reported that despite the carriage being empty, they could not be quite certain on the point, owing to the confusion which prevailed.’ Therefore it is entirely possible that another individual was in the carriage with Mr Fischer and escaped during the turmoil.

The police, however, were of the opinion that Mr Fischer sustained his injuries by accident, and the following anecdote appeared to confirm this hypothesis:

‘A friend of the injured man says that about twelve months ago Mr. Fischer met with a curiously similar but by no means so serious an accident while travelling on the railway. He had put his head out of the carriage window when he was struck by some projection in the tunnel. He was severely cut, and had to wear a bandage for some time. The injury then sustained was just over the forehead, as now, but the skull was not fractured. The old accident subsequently formed a standing joke among his friends, and he was often rallied about putting his head out of carriage window and advised not to be of so inquisitive a turn of mind. Only a few nights ago the old joke was repeated to him, along with the question whether he had lately been putting his head out of the window. This may be an explanation of the mystery, or it may be only a striking coincidence; but it is a singular fact that most of the known facts appear to lend themselves to such an explanation of what at first appeared to be a very tragic crime.’

The newspaper paper continues by saying that ‘It is conjectured that Mr. Fischer had a propensity for watching the people who occupied the adjoining compartments, and while indulging in this habit he must have placed his feet on the carriage seat, and in his endeavour to place his body as far outside the window as possible, his head must have come in contact with the projection in the spring of the arch.’

However, at the inquest into the death of Moritz Fischer (reported in the London Evening Standard 08 October 1886), a friend of the deceased, Fritz Mercier, said that despite being aware of Mr Fischer previously having injured his head during a journey from Manchester, he refuted the claim that he was well known to have put his head out a carriage window. Despite this, the inquest further confirmed that there was no sign of a struggle, there was no derangement of the carriage and ‘On the night of the accident when the traffic had ceased, Witness went in a carriage and found at the very spot where it was supposed the gentleman met with his injury, that it was quite possible by leaning about 18 to 20 inches out of the window, to meet with a similar accident. At the same spot there was a continuous trail of blood on the wall.’ Furthermore, a witness spoke to picking up a pair of spectacles about twenty yards from where the blood was found on the wall, and another witness testified that Mr Fischer had never been known to be without his spectacles.

Based on the evidence, and despite conflicting testimonies from the friends of Mr Fischer, the jury returned a verdict of Accidental Death. Foul play or a case of curiosity killed the cat, either way please refrain from putting your head outside a carriage window on a moving train.

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St George’s Archives – The Pastry Chef Murderer

‘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.

On 27^th July 1908 a patient called Ferdinand Alletrie was admitted to St George’s Hospital with a stab wound in the left chest which was penetrating the heart. The medical case notes say that ‘He was a waiter at the Bath Club. He had quarrelled with a colleague who waited for him outside and stabbed him in the chest.’ On admission he was observed to be in articulo mortis, or at the point of death. There was a stab wound in the third left intercostal space just to the left of the sternum. His clothes were noted to be soaked in blood. Ferdinand died five minutes after his admission.

Post Mortem Case Book 1908 (Ferdinand Alletrie, PM/1908/221)

The morbid appearances listed during the post mortem examination note that on the left side of the chest in the third interspace was a ‘punctured wound pointed at either end and gaping in the middle. It measured 1” long and ½” wide in the middle.’ The Post Mortem includes an illustration of the murder weapon as shown below.

Post Mortem Case Book 1908 (Ferdinand Alletrie, PM/1908/221)

But what led to the death of Ferdinand at St George’s Hospital? A search through historic newspapers uncovered an article called ‘Foreigners’ Fight at the Bath Club’ in the Leicester Daily Post dated 1^st August 1908. The article details the tragic events that took place at the Bath Club that evening as well as the resulting inquest at Westminster Coroner’s Court ‘on the body of a cook named Pierre Auguste Ferdinand Alletree, employed at the Bath Club, who died from the effects of a wound said to have been inflicted by another employee of the club, who was in consequences arrested.’ The accused man was named as Georges Backenstrass.

Pierre Souleyne, chef at the Bath Club, said that he had engaged Alletree as sauce cook at the beginning of June, and later employed Backenstrass as a pastry chef at the club. One evening Backenstrass approached the chef and said ‘Chef. I am very sorry. I want to leave at the end of the week.’ When asked why he wanted to leave, he said that he was not friendly with the sauce chef. Souleyne said to him, ‘You have nothing to do with the sauce cook, and he has nothing to do with you. You must work friendly together.’ The chef also spoke to the sauce cook, no doubt to diffuse the situation, and Alletree responded, ‘You know me. He is silly. Don’t take any notice of him.’ No doubt the chef thought the issue was resolved, but he soon received news that the two chefs were fighting.

Louis Ayrand, another sauce cook, gave evidence as to the relationship between the two chefs. He said that Backenstrass ‘was a quiet and reserved man. He had some malady, and for that reason he was avoided by the other men.’ He said that ‘we never ate any of his pastry’, because of this unnamed illness. Continuing, the witness said that Backenstrass and Alletree did not agree about their work, and they had previously quarrelled when Backenstrass would not send up the sauce. On the night of the murder Ayrand heard the two chefs quarrelling in the vegetable pantry, and they decided to settle matters outside in Berkeley Street. Soon another chef by the name of Griffin called out ‘The pastry cook has stabbed your chef.’ Soon after Alletree ran back to the club, his hand over his heart, pointed to the pastry chef and said ‘Arrest him, he has stabbed me with a knife.’

Griffin, a vegetable cook at the Bath Club, said that he had quarrelled with Backenstrass the same night, when he took a biscuit off the pastry chef’s plate and Backenstrass objected. Alletree then began arguing with Backenstrass, and the latter said ‘I will wait for you outside.’ Griffin followed the two men outside and saw Alletree put his hand to Backenstrass’ neck and push him back. Backenstrass retaliated by hitting Alletree in the chest with something, after which the sauce chef exclaimed ‘he has stabbed me.’

Another chef stated that he saw the cook with a knife after the quarrel and said to him ‘You ought not to use a knife when you have quarrelled.’ Backenstrass replied ‘Well, there are two waiting for me downstairs.’

When Backenstrass was taken to Marlborough Street Police Station he made a statement in which he said that the sauce cook had called him a sneak for talking to the chef about him, and that the sauce chef and Griffin had approached him in the pantry, the latter threatening to break his nose. Describing the affair in the street, Backenstrass said ‘I took my knife out of my right trousers pocket and struck him in the chest. The knife is very sharp. It is the one I used for pastry. I never carried it before that night. I took it because of the pastry cook and the vegetable cook. If they had left me alone this would not have happened. The sauce cook told me I had too many pans in the fire. He told me I ate too much and he would come and watch me out. I asked him several times to leave me alone, and he would not.’

Backenstrass was held at Brixton Prison prior to the inquest. However the Governor of the prison informed the Coroner that Backenstrass had committed suicide in prison by hanging himself in his cell. The Coroner pointed out to the Jury that although Alletree had started the quarrel, if Backenstrass was still alive they would have to commit him on the capital charge. The jury returned a verdict of wilful murder against Backenstrass.

A further search of the historic newspapers revealed the article ‘The Bath Club Tragedy. The Brixton Prison Suicide’ in the Faringdon Advertiser and Vale of the White Horse, 8^th August 1908. The article discusses the inquest into the death of Backenstrass. A medical officer testified that the prisoner, apparently a German, had suffered from a nervous affection. There were marks of two wounds of an operation in the abdomen, ‘but the man was in fairly good health, and behaved himself quite rationally, though he shewed that he was naturally worried about the crime.’ On the prisoner’s slate was found words written to the effect that ‘he had not been in good health, that he felt the disgrace, that his conscience was quite clear, and that he was guiltless of the offence with which he was charged.’ The jury returned a verdict of suicide whilst of unsound mind.

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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

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 14^th February 1897 after a short illness of pneumonia.

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 6^th 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 3^rd 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 23^rd 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 13^th 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 16^th March 1902 in Brighton.

Henry Minchin Noad

Henry Minchin Noad was born in 22^nd 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 23^rd July 1877, survived by his wife Charlotte Jane.

William Howship Dickinson

Image in public domain

William Howship Dickinson was born on 9^th 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 9^th 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/).

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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.

Post mortem examination book 1845 (Sarah Leigh, PM/1845/126) and Post mortem examination book 1920 (John Welburn, PM/1920/182). Archives and Special Collections, St George’s, University of London.

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’

Post mortem case notes for Elizabeth Burnett in PM/1849/20, signed by Henry Gray; and Alice McDonald, PM/1918/290, signed by H.I. (Helen Ingleby). Archives and Special Collections, St George’s, University of London.

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.

Medical case notes for James Cronin, PM/1864/233, signed by Octavius Sturges; and John Welburn, PM/1920/182, signed by Wathen Ernest Waller. Archives and Special Collections, St George’s, University of London

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 20^th 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.

Adjectives in the post mortem volumes. Archives and Special Collections, St George’s, University of London.

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 21^st 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’.

From the case notes made by Octavius Sturges in the Post mortem volumes. Archives and Special Collections, St George’s, University of London

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.

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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 Ahvensalmi, Project 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 19^th and early 20^th century central London. So let’s see what the collection can tell us about the patients of St George’s Hospital in the 19^th and early 20^th 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.

St George’s Hospital and the Constitution Arch, Hyde Park Corner. Engraving. Credit: Wellcome Collection. Attribution 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.

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 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 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 19^th 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 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 19^th 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 19^th 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 19^th 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!

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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.

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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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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…

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Image from St George’s Archives

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.

Henry Gray’s signature- Post Mortem case book 1855

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