Outpatients at St George’s Hospital, 1733-1948

This blogpost was written by Alexandra Foulds, Project Archivist at St George’s, University of London.

How did you become an outpatient at St George’s Hospital before the creation of the NHS? What was it like to be an outpatient at St George’s Hospital at this time? Well, from its establishment in 1733 until the creation of the NHS in 1948, St George’s Hospital was what was called a voluntary hospital, which meant that it was reliant on receiving donations from ‘subscribers’ for funding. The board of governors at St George’s Hospital was made up of those who made large financial contributions to the hospital and medical staff who, unlike at most voluntary hospitals, were eligible to make subscriptions to the hospital.

In order to support themselves, voluntary hospitals ‘ran continuous appeals and publicity campaigns’, and voluntary hospitals competed with each other for funding. They would organise dinners and fundraisers which played an important part in the social calendar for donors. The expanding middle class would donate to the hospitals out of philanthropy and because of the social status it brought them. Becoming a subscriber to a voluntary hospital also meant that you could refer people to the hospital to become an outpatient or inpatient, and the amount donated equated to a certain number of referrals that were allowed per year.

Voluntary hospitals were created in the eighteenth century to give free medical treatment to the ‘sick poor’, or those who could not afford to be treated by private physicians. A distinction was made between the ‘poor’ who were considered to be self-reliant and therefore believed to be deserving of charity and the ‘destitute’ who were not. As Henry Burdett, the hospital administrator who helped to establish the British Hospitals Association in 1884, stated:

‘The people who are entitled to free relief are those who are able to maintain themselves independently of all extraneous assistant until the hour of sickness, when the breadwinner, for instance, is  struck down, or the added expense of sickness in the home renders it necessary that the hospital of dispensary should step in’.

This meant that initially to be treated as an outpatient or an inpatient at a voluntary hospital like St George’s, patients needed a letter from one of the hospital governors or a hospital subscriber that said that they were ‘proper objects of charity’, and even once patients had been accepted they were subject to suspicion that they may be abusing the system.

The outpatient department functioned alongside dispensaries to provide out of hospital medical care to poor patients on a charitable basis, and it was where the majority of what we now refer to as primary care was conducted.

Patients at St George’s mostly came from Westminster and Pimlico, both of which were largely poor, working class areas and some parts of which were slums. In 1910 St George’s Hospital reported that the majority of patients came from Westminster (Pimlico), Chelsea, Fulham and Battersea, with a few coming from further South in Clapham, and Lavender Hill (King Edward). 6% of these patients were trained servants, however, only 2 1/4% were currently employed as servants, and their average annual wage was between £21 and £22.

Photo of a newspaper clipping showing a photo of people attending the unveiling of the bust of John Hunter at the St George's Hospital Medical School, Hyde Park Corner. Not Dated.

After receiving a letter from a subscriber to the hospital, outpatients would visit St George’s Hospital. They would first be seen by a Medical Officer who would decide whether a patient was an acceptable hospital case, should be an outpatient or an inpatient, or should be treated as a casualty in which case they would be seen by a doctor immediately. The term casualty could apply to anything from ‘a small cut’ to a ‘bad toothache’, as well as those who had been in an accident. Once a patient had been accepted as an outpatient an Inquiry Officer would ask for their name, age, occupation, address, their marital status, their wages, and if they were married then their number of children that were dependent on them. In the case of patients who were children they would also be asked for information about the father, and in the case of married women they would be asked for information about their husbands.

Upon their second attendance at the hospital they would be seen by a Casualty Officer and an Almoner. The almoner could then investigate to advise on whether free treatment should be ceased and patients should be referred to workhouse infirmaries, private practitioners, dispensaries, or other hospitals. In 1910, of the 48,583 outpatients 6,768 cases were investigated, with 432 considered not suitable for treatment. The almoner could also decide along with the doctor whether home visits from volunteer ‘lady health visitors’ should be organised, or whether instruments (such as trusses for hernias) or meals should be provided, generally paid for out of the Hospital’s Samaritan Fund which was principally made up of subscriptions from hospital governors. The almoner was also responsible for coordinating with charitable societies to ensure that patients would continue to receive the care they needed outside of the hospital.

At the beginning of the nineteenth century, outpatient treatment numbers were small, however, from 1835 they began to rise and continued to rise until the beginning of the twentieth century. In the years 1833-1842, St George’s Hospital treated 70,000 cases of which 44,000 were outpatients. By 1910, St George’s treated 48,583 outpatients in that year alone, of which 67% were casualties.

As a result, doctors had to treat patients incredibly quickly, with Dr Robert Bridges, a casualty physician at St Bartholomew’s Hospital and later the Poet Laureate, writing in 1878 that he had to treat over 30,000 outpatients a year at a rate of 88 seconds per patient. By 1900, St George’s Hospital introduced a limit on how many new outpatients would be treated each day with the rest being turned away. In 1910 average outpatient attendances were approximately 160 a day, with new cases limited to 15 per hospital department per day, with all patients being seen first by a superintendent who imposed the limit when they arrived at the hospital. If a patient was not one of the 15 but was considered to require treatment he was brought back the next day.

Photo of the outpatient department at St George's Hospital at Hyde Park Corner.

As outpatient departments provided free access to health care, they were viewed as being in competition with private physicians and were therefore seen as a threat to the physician’s income. This meant that in medical journals outpatient departments, and voluntary hospitals more generally, were frequently described as locations in which patients abused the medical system by getting free care when they could afford to be treated by a private doctor.

By the end of the nineteenth century several voluntary hospitals, St George’s among them, was choosing not to require a letter from a hospital subscriber for outpatients (Louden), and so physicians tried to introduce the requirement for patients to be referred to the hospital by private practitioners in order to prevent this perceived abuse of the system. A letter to the British Medical Journal in 1894 stated that:

‘The abuse of the hospitals’ outpatient departments is an evil so gigantic that the tendency is to regard it […] as necessary in the sense of being unavoidable […] The remedy lies in the hands of those who suffer most from the unfair competition of the hospitals, and it is idle to appeal to the public or to the hospital authorities. […] The remedy I would suggest (though I claim no originality) would be to admit to the outpatient department only patients whose cases are certified by some medical authority or medical man to require special consideration’.

In 1910, however, only 3-6% of outpatients at St George’s Hospital were referred by physicians.

These perceived abuses led in 1910 to an investigation into the admission of outpatients in hospitals in London by the King Edward’s Hospital Fund for London, who from 1897 gave funding to voluntary hospitals. They called on people from various medical charities and representatives from each of the voluntary hospitals to testify, asking about the suitability of the letter system, hospital procedures for dealing with outpatients, the numbers of outpatients and the kinds of cases hospitals treated, and whether they believed the system was being abused by patients. William West, the treasurer at St George’s at the time, testified, arguing that he did not believe that the system was abused at St George’s, but that there were times it was misused by patients who had paid to be treated by a physician and upon seeing no improvement wanted a second opinion and so visited the hospital.

In 1948 the NHS Acts brought voluntary hospitals under public ownership, however, researchers have argued that it is these nineteenth and early twentieth century arguments about the relationship between hospitals and private physicians that led to our current NHS health system in which patients are required to be referred to specialists in hospitals by their GP.


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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 23rd 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 1st 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 3rd October and he died on the 4th.

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 26th 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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The Post Mortem Examinations and Case Books as a Source for Genealogical Research

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.

Previous blog posts have highlighted the value of the Post Mortem collection for contributing to our understanding of medical education, death practices, and the history of London’s hospitals and infectious diseases. However, it is also a valuable and rich resource for genealogy and tracing your family history. The collection consists of 76 volumes, and an estimated total of 36,000 cases which is a lot of names! The majority of the patients admitted to St George’s Hospital were from the lower classes as wealthier individuals were able to pay physicians to attend to them in their homes. Therefore, the Post Mortem Examinations and Case Books provide information about working class patients who may not be represented in many other records and can provide additional or missing information about your ancestors.

PM/1890/349. Archives and Special Collections, St George’s, University of London

The right-hand page is reserved for details of the medical case before the patient’s death. It records the patient’s medical history, current symptoms which caused them to attend the hospital, a description of the patient on admission and details of the treatments prescribed and changes in condition prior to their death. On first glance the medical case history appears to be rather formulaic but on closer inspection they provide fascinating insights into the patients and provide a glimpse into their life before death.

From 1st July 1837 all births and deaths had to be reported to a local registrar, who in turn reported them to the superintendent registrar of the registration district where the birth or death occurred. Since 1874 doctors’ certificates were also required by a registrar before a death certificate could be issued. A death certificate records where and when the individual died, name and surname, sex, age, occupation, cause of death, the signature, description and residence of the informant, when the death was registered and the signature of the registrar.

The death certificate of George Danbury will undoubtedly list his death simply as Tetanus. However, the medical notes expand on this diagnosis and tell us that ‘A fortnight before his admission George Danbury ran a nail into the ball of his right great toe. He felt no pain but later felt stiffness of the jaw and pain in the back. On admission he could not open his jaw and there was stiffness and pain in the back of the neck. He began to experience spasms, had a good deal of sweating and the head became retracted and fixed.’ (PM/1870/258)

The case notes often include the medical history of other family members to determine if the patient could be suffering from an inheritable disease. This is invaluable for tracing other family members of the deceased.  Fifty-three-year-old Henry Moon died in 1889 from ‘Carcinomatous stricture of Oesophagus’. The case notes begin ‘The patient was a clerk. He gave a family history of carcinoma. One aunt had died of cancer of the throat, another of cancer of the stomach, a cousin of cancer of the eye.’ (PM/1889/285). The medical case notes will also record if they came from a phthisical (tuberculous) family, and if their parents lived to an old age. If the patient is female, it will often be noted how long they had been married, how many children they had given birth to, how many children were living at the time of her admission, and how many miscarriages the woman had suffered. The case notes for Sarah Harris records ‘Pregnancies = 9. Children = 8. Miscarriage = 1, in Dec last at 5 months. Says that during this last pregnancy had ‘fits’ when about 4 ½ months gone, from which time till she aborted she did not feel the child. A doubtful abortion in Feb last.’ (PM/1881/388). Ellen Pointon, a thirty-nine-year-old Widow ‘had been married for 9 years. She had had 1 miscarriage and four children, 3 of whom were alive when she came into the hospital.’ (PM/1888/301)

The case notes often track a patient’s travel both within the UK and abroad to determine the origin of the disease, particularly if the disease is highly infectious. 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 (PM/1884/9). Charles Dilloway was a footman who had just returned from a foreign tour. Twenty days before his admission he was in Rome. He returned via San Remo, Cannes and Boulogne. ‘He was back in England a fortnight before he came to the hospital. After his return he lived at 35 Chesham Place Belgrave Square’ where he slept below ground. Not only is each city he travelled through recorded in the case notes, the physician has also recorded the name of each hotel that he stayed at during his travel back to England.

Furthermore, the physicians often record the address of the patient along with living conditions if they believe it is relevant to the disease, such as in the case of a four-year-old boy called Albert Pratt. His ‘Parents lived at Brighton but the child had been staying at 1A Bulmer Place Notting Hill Gate. In this house the floor of the W.C. [Water Closet] was in a very bad state, having all crumbled away. The Landlord refusing to do anything. Within the last 6 weeks 6 persons living in the house, 4 children and 2 young women had had sore throats but all recovered.’ Young Albert, was diagnosed with Diphtheria and ultimately succumbed to the illness. (PM/1889/22)

Diet is often commented on in the medical case notes, such as in this case of 15 year old John Landeg who died of Scurvy in 1882.  ‘When admitted the boy stated that he had been feeling weak and ill for four or five months previously. That he had a dislike to [non] salt meat and consequently had for the last four or five weeks been eating only salted meat. He was an office boy, in the habit of taking away from home meat for the whole day, and consequently rarely eat vegetables. Got potatoes on Sundays only.’ (PM/1882/366)

Alcohol consumption is also often recorded, such as in the case of 25 year old Alfred Balcombe who was described as ‘A coachman of intemperate habits, a beer drinker, reported to be generally in a fuddled state, refusing his food and supplying its place with beer, ’ (PM/1866/18) or Frederick Osborne, a forty five year old labourer, who had ‘always been accustomed to drink beer, avoiding the weaker kinds and drinking chiefly ‘six ale,’ and some spirits. The average quantity of beer was five or six pints daily.’ (PM/1888/95)

Occupations are listed where known, and the medical case notes often expand on simple terms such as ‘Groom’ or ‘Soldier’. Elbra Appleby died in 1881, aged fifty-one. In his work as a painter he had been exposed to so much lead that, despite precautions, he developed colic and wrist drop, losing strength in both hands and becoming irritable and depressed (PM/1881/392). John Lewicki was ‘An old soldier, formerly on Napoleon’s Polish lancers. He had fought in nearly all the wars of the empire. He had been frost-bitten at Beresina, and again at Moscow. He was wounded at Austerlitz, recovered a sabre cut at Vittoria. Altogether he shewed seven scars. He escaped from Waterloo unhurt. Latterly he enjoyed a pension for a few years, but lost it on account of his republican views. He was expelled from Paris and contrived to get his living by selling pencils about the streets of London. He attributed his illness to eating sprats.’ (PM/1860/36)

Sometimes the comments of the physicians can be extremely evocative and paint a picture of the patient on their admission. For example, the doctor Octavius Sturges (1883-1894) describes various patients 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 case notes sometimes include anatomical sketches and drawings, and occasionally portraits of the patient, such as in the case of Thomas Roles, a 49-year-old Shopkeeper, who was admitted to St George’s with a tumour of the face which was removed by operation.

PM/1880/236. Archives and Special Collections, St George’s, University of London

The left-hand page, labelled ‘Morbid appearances’, is used to record the details in the post mortem examination, with each part of the body examined in depth. The morbid appearances also include a general description of the body, recording information such as height, weight and hair colour. At a time when photography was unusual for many working-class Londoners such as those attending St George’s Hospital, the general description at least provides a hint as to their appearance. Thomas Roles was described as ‘Well nourished. Obese. 5’6” high. Hair dark.’

In conclusion, the Post Mortem Examinations and Case Books are a unique and fantastic resource for tracing the lives of working-class individuals in London, and the information provided in the volumes almost serves to bring the patients back to life.


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#MorbidAdvent: What Did We Learn?

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 Alexandra Foulds, with contributions from Project Archivist Natasha Shillingford and Archivist Juulia Ahvensalmi.

St George’s University of London Museum and Archives Instagram post on smallpox as part of #MorbidAdvent
St George’s University of London Museum and Archives Instagram post on smallpox as part of #MorbidAdvent

In December 2020 we decided to do an advent calendar on social media in which we would use every day to highlight a disease or condition that could be found in our post mortem casebooks. Calling it #MorbidAdvent, throughout the month we covered:

When we started, we assumed that these were conditions that had been relegated to history but the morbid nature of all these diseases was brought into stark relief with the realisation that none of the diseases apart from smallpox (thanks to the efforts of Edward Jenner) have actually been eradicated.

Vaccinations are, of course, of particular interest and relevance at the moment, and there are vaccines for many of the diseases we examined, including tuberculosis, rabies, influenza, whooping cough, tetanus, diphtheria, measles and smallpox. Others, such as malaria or leprosy can be treated with various medications.

Despite this, many of the diseases remain common outside of the Western world. 10 million people were diagnosed with tuberculosis in 2019, predominantly in South-East Asia, Africa, and the Western Pacific, resulting in 1.5 million deaths. There were an estimated 229 million cases of malaria in 2019, the majority of them in sub-Saharan Africa: children are particularly vulnerable to the disease. Diphtheria, despite mass immunisations in the UK in the 1940s, is still common in Africa, India and Indonesia, with a 5-10% death rate affecting mainly children. Measles, which has an alarmingly high R number of 12 to 18, similarly caused over 140,000 deaths in 2018, mostly in children under 5 years old. Cholera outbreaks remain common in Africa, South America and Asia. In 2008-2009 an outbreak in Zimbabwe killed 4200 people and in 2010-2011 another in Haiti caused 6631 deaths. In all of these places, a lack of access to health care, poor water quality and poor sanitation allow for contagious diseases to take hold and spread.

As these diseases have not been eradicated they frequently resurface in the United Kingdom. There are still around 12 new cases of leprosy diagnosed each year in the UK and the World Health Organisation states that in 2018 there were 208, with 619 new cases of leprosy diagnosed worldwide. This is approximately one every two minutes. In 2019 the notification rate for TB in the UK was 8.4 per 100,000 of the population. Even smallpox has the potential to return, as it did in 1978, as it is retained in laboratories.

It is not only contagious diseases that can have resurgences. Rickets, for example, which is caused by a vitamin D deficiency, despite mostly disappearing in the UK in the 1950s with mass programs of cod liver oil for children, has recently experienced a comeback that has been attributed to children spending more time indoors and the use of sun creams whenever they are outside.

Photo of the post mortem record of Ethel Almond who had rickets and then contracted tubercular meningitis (PM/1888/314). Archives and Special Collections, St George’s, University of London.

The post mortem record of Ethel Almond who had rickets and then contracted tubercular meningitis (PM/1888/314). Archives and Special Collections, St George’s, University of London

Patients at St George’s Hospital

Visualisation of the causes of death found in the post mortem casebooks of St George’s Hospital 1841-1887 created using Flourish. Archives and Special Collections, St George’s, University of London.
Visualisation of the causes of death found in the post mortem casebooks of St George’s Hospital 1841-1887 created using Flourish. Archives and Special Collections, St George’s, University of London.

When we started the advent calendar we knew that the period covered by our post mortem casebooks (1841-1946) was punctuated by numerous outbreaks, epidemics and global pandemics of various contagious diseases. The most notable of these that affected the UK included:

Cholera: 1831-1832, 1838-1839, 1848-1849, 1853-1854, 1866-1867

Influenza: 1830-1831, 1833, 1836-1837, 1847-1848, 1857-1858, 1889-1890 (Russian/Asiatic Flu), 1918-1920 (Spanish Flu)

Smallpox: Large epidemics in 1837-1838 and 1870-1874 (after the Franco-Prussian War). 1901-1902 was the last outbreak in London. (England was declared rid of smallpox in 1939).

Scarlet fever: 1892-1893. Particularly common at the beginning and ends of the nineteenth century.

Diphtheria: 1850-1860

While trying to find cases of these diseases in the post mortem casebooks, however, we were struck by the fact that there were far fewer cases than we had expected, even in years when there were epidemics. This was despite many contagious diseases being more easily caught by people with malnourishment, a condition from which it is likely that many of the patients at St George’s would have suffered. St George’s Hospital’s nineteenth-century position at Hyde Park Corner meant that many of its patients came from Westminster and Pimlico, both of which were very impoverished, working-class areas of London at this time. Wealthier patients in nearby St James’s, Belgravia and Mayfair would have been more likely to have been treated by visiting physicians (some of whom would have also worked at St George’s) in their own homes. Hospitals had been created in the UK in the eighteenth century to serve the ‘deserving’ working class poor and were considered, at least until the late nineteenth century, to be dirty and sources of contagion, so people tended to stay away if they could. The extremely poor who were unable to support themselves, considered to be ‘undeserving’, would have been treated in workhouse hospitals.

Fever hospitals

Trying to account for this low number of contagious diseases in our post mortem casebooks led us to find out about fever hospitals, or hospitals set up in the nineteenth century specifically to treat contagious diseases. Prior to this only a small amount of hospitals were willing to take contagious patients. A smallpox hospital had been created in Windmill Street off Tottenham Court Road in 1746, and patients with other contagious diseases could be sent to one of the Royal Hospitals or to Guy’s Hospital. As part of the nineteenth-century public health movement, 12 fever hospitals were created in London, starting with the Institution for the Care and Prevention of Contagious Fevers (later called the London Fever Hospital) at Grays Inn Lane in 1801. While the majority of these were on land, between 1883 and the end of the nineteenth century three of them were converted ships (the wooden warships the Atlas and the Endymion, and the iron paddle steamer Castalia), which were moored on the River Thames and used to treat smallpox patients. Patients who needed to be treated in a hospital were sent to one of these fever hospitals after being referred by a doctor, and were only treated in hospitals such as St George’s if their condition was not apparent when they were admitted. Once their condition was diagnosed, we can see from the medical notes in our post mortem casebooks that they were moved to separate wards. One of the fever hospitals, however, the Grove Fever Hospital which opened in 1899, was sited where St George’s Hospital is now in Tooting. Two of the ward blocks survive to this day.

Photograph of Grove Fever Hospital. Archives and Special Collections, St George’s, University of London.
Photograph of Grove Fever Hospital. Archives and Special Collections, St George’s, University of London.

Highlights of the advent calendar

A few of the conditions covered in the advent calendar proved to be particularly interesting and unusual, such as glanders, leprosy, and malaria.

Glanders

Glanders is an unusual disease in the Morbid Advent Calendar as it is a zoonotic disease. In other words, Glanders primarily occurs in horses, mules and donkeys but can be transmitted to humans by direct contact with an infected animal’s body fluid and tissues, and can enter the body through skin abrasions. The majority of patient’s in the post mortem volumes who contracted Glanders, were stablemen, horse keepers and grooms.

Despite the fact that the last confirmed case in Great Britain was in 1928, it still remains a very real threat, particularly as a biological weapon during war and has long been a threat to armies. It is believed that Glanders may have affected the horses of Marshall Tallard’s cavalry prior to the Battle of Blenheim in 1704 which helped the Duke of Marlborough to win the battle. It is also believed that during World War I, Russian horses on the Eastern Front were deliberately infected with Glanders by German agents. More recently, the Soviet Union allegedly used the germ that causes Glanders during the Soviet-Afghan War.

Unlike many of the diseases featured in the calendar, there is currently no vaccine for Glanders. The lack of a vaccine, the fact that the disease is not widely known and is therefore difficult to diagnose, the ability for the germs to be released into the air, water or food supply, and the germ’s resistance to common antibiotics makes the bacteria a significant bioterrorism threat.

Leprosy

Photo of manuscript showing a leper. Wellcome Collection. Attribution 4.0 International (CC BY 4.0)
Manuscript showing a leper. Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

The earliest possible account of a disease which is believed to be leprosy appears in an Egyptian papyrus document written around 1500 BC. The first account of the disease in Europe occurs in the records of Ancient Greece after the army of Alexander the Great returned from India.

Leprosy had entered England by the 4th century AD and was a common feature of life by 1050. However, it seemed unusual to find a case of leprosy in London in 1884, particularly as the last case of indigenous leprosy in the United Kingdom was diagnosed in 1798.

Further research uncovered that it wasn’t until 1873 that Dr Gerhard Henrik Armauer from Norway identified the germ that causes leprosy and proved that it was not a hereditary disease or a punishment by God, but an infection caused by bacteria. It is now curable with a multidrug therapy which was developed in the early 1980s.

Malaria

The post mortem record of John Lee who is described as having ‘lived in an aguish district near Eastbourne’ (PM/1891/87). Archives and Special Collections, St George’s, University of London.
The post mortem record of John Lee who is described as having ‘lived in an aguish district near Eastbourne’ (PM/1891/87). Archives and Special Collections, St George’s, University of London.

From ‘mal’aria’, or bad air, malaria was so named as it was thought to be caused by miasma. The connection between mosquitoes and malaria was not established until the 1890s; Patrick Manson, the first lecturer in tropical diseases at St George’s Hospital Medical School and the founder of the London School of Hygiene and Tropical Medicine, was instrumental in developing the so-called mosquito-malaria theory.

Far from being confined to hot, faraway countries (though the postmortems show that the majority of the cases were contracted by soldiers, seamen and colonial officers in India, the West Indies, China or the United States), the postmortem books reveal cases in places like Deptford, Hampshire and Eastbourne: it turns out that malaria was, in fact, a significant cause of death in Britain. In these cases, the diagnosis is often given as ‘ague’ or ‘marsh fever’. Decrease of marsh wetlands and increase in cattle as well as improvements in housing, drainage and ventilation (factors which affect also many other causes of death during this period) and water chlorination led to malaria gradually disappearing as an endemic disease in Britain (the last cases occurred in Stockwell in 1953).

Quinine, derived from the bark of cinchona tree, has been used to treat malaria since the 1600s, and the origins of gin & tonic is often said to be as an anti-malarial drug, though this is not strictly true. Quinine is still used to treat malaria, although there are now various other medications too.

What did we take away?

Finding out more about these diseases put the current Covid-19 pandemic in a new light. While it is easy to think of our current situation as exceptional, what our advent calendar made clear was that it is something that humans have experienced many times before and continue to endure in many parts of the world. While it might be easy to find this thought quite bleak, it helped us to feel more positive. Like all outbreaks of contagious disease, this too shall pass, and as our history and our experience over the last year shows, we have the ability to band together to make great medical advancements when we have the drive to do so. Current technology has enabled us to experience this pandemic in a global way that has never been seen before and hopefully this unity will continue as we try to vaccinate the world’s population. Perhaps this will carry forward and enable us tackle other diseases together, giving new impetus to strategies such as the World Health Organisation’s plan to cut new cases of TB by 90% and reduce deaths by 95% by 2035.


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#ExploreYourArchive: St George’s Archives

This week we’re celebrating Explore Your Archives, an initiative designed to showcase archives around the UK. You can follow the day using the hashtag #ExploreYourArchive as well as on St George’s archives and museum social media on Twitter, Instagram or Facebook. This blogpost was written by St George’s Archivist Juulia Ahvensalmi.

The history of St George’s reaches all the way back to the early 18th century. With a history tightly interwoven with that of St George’s Hospital, it is impossible to talk about the history of St George’s without talking both of the medical school (what is now the university) and the hospital.

St George’s Hospital, Hyde Park Corner in the 18th century and in the early 20th century. Archives and Special Collections, St George’s, University of London.
St George’s Hospital, Hyde Park Corner in the 18th century and in the early 20th century. Archives and Special Collections, St George’s, University of London.

The hospital was established at Hyde Park Corner in 1733, and it wasn’t until the 1970s that both the medical school and the hospital were relocated to Tooting. Initially located in the seemingly idyllic countryside setting of the Hyde Park, the hospital was built as a charity hospital, to serve the poorer part of the population. Difficult as it may be to imagine now, the patients came primarily from the slums of Westminster (what is sometimes known as the ‘Devil’s Acre’) and the surrounding area, and our post mortem records show for instance how the 1854 cholera epidemic in Soho resulted in a spike of deaths at the hospital.

Post mortem records, 1854 (PM/1854) showing deaths caused by cholera and a visualisation of the death rate during the epidemic, created from the data in the records using Flourish. Archives and Special Collections, St George’s, University of London.
Post mortem records, 1854 (PM/1854) showing deaths caused by cholera and a visualisation of the death rate during the epidemic, created from the data in the records using Flourish. Archives and Special Collections, St George’s, University of London.

Our student records are a veritable treasure trove for the history of St George’s and its alumni. From the early days, surgeons and physicians were permitted to take on pupils. The first student records date from 1752, although the medical school itself wasn’t formally established until 1834. These volumes record the attendance of medical luminaries such as Edward Jenner, who was a pupil at St George’s in the 1770s under John Hunter. Besides other well-known names, such as Henry Gray, the records continue to be a valuable source for learning more about the history of St George’s and its alumni.

‘Register of pupils and house officers, 1756-1837’ (SGHMS/4/1/18), and Edward Jenner’s entry in the pupil register, 1770. Archives and Special Collections, St George’s, University of London.
‘Register of pupils and house officers, 1756-1837’ (SGHMS/4/1/18), and Edward Jenner’s entry in the pupil register, 1770. Archives and Special Collections, St George’s, University of London.

Much of the history of St George’s appears to be very white, very male, and very elite – medical education was not for everyone. Sometimes we get asked who, for instance, was the first BAME student at St George’s, which is a question we cannot, unfortunately  answer with any degree of certainty – the early student records consist mainly of only names, and although we hold some student photographs from as early as the 1860s (such as this photograph depicting the dissecting room), the records in the archives do not tell us of the ethnic origins of the students in any systematic way.

The archives can, however, reveal less well-known, but important and fascinating aspects of this history. We have highlighted, and will continue to highlight, these stories in our social media posts, from Hajee Baba, who may have been the first Muslim student at the Medical School in 1807; to Assaad Y. Kayat, a Lebanese student at St George’s in the 1840s, who studied alongside Henry Gray, and wrote a book about his life and his medical studies in England; to Henning Grenander, a Swedish figure skater and masseuse, who was a student at St George’s in 1896; to Helen Ingleby, one of the first female students at St George’s in 1915; to Kathryn Hamill Cohen, a psychoanalyst and one of the first female students at St George’s after the Second World War.

Assaad Y. Kayat, a student at St George’s in the 1840s, and Kathryn Hamill Cohen, a student at St George’s in the 1940s. Archives and Special Collections, St George’s, University of London.
Assaad Y. Kayat, a student at St George’s in the 1840s, and Kathryn Hamill Cohen, a student at St George’s in the 1940s. Archives and Special Collections, St George’s, University of London.

Even more importantly, we continue to collect student records so future users of the archives will perhaps look with the same awe at the records of the cohort of 2020 as we now regard the early student records – and that history will look very different from the early history of the institution.

Many and varied collections

The archives are also a home to a variety of other items that tell the story of St George’s. We have a sizeable collection of rare books, including Edward Jenner’s ‘Causes and Effects of Variolae Vaccinae’ (1798) and John Snow’s ‘On Chloroform and Other Anaesthetics’ (1858). From the 16th to the 20th century, this collection has been accumulated by the library over the years at both Hyde Park Corner and Tooting, and is now held in the archive.

Edward Jenner, 'Causes and Effects of Variolae Vaccinae' (1798), showing the hand of Sarah Nelmes, a dairymaid whose cowpox pustule Jenner used to vaccinate the son of his gardener, 8-year old James Phipps, demonstrating that cowpox could provide immunity from the more dangerous smallpox. Blossom, the cow in question, is still at the SGUL Library. Archives and Special Collections, St George’s, University of London.
Edward Jenner, ‘Causes and Effects of Variolae Vaccinae’ (1798), showing the hand of Sarah Nelmes, a dairymaid whose cowpox pustule Jenner used to vaccinate the son of his gardener, 8-year old James Phipps, demonstrating that cowpox could provide immunity from the more dangerous smallpox. Blossom, the cow in question, is still at the SGUL Library. Archives and Special Collections, St George’s, University of London.

There are various artworks (some of the busts and paintings are featured at Art UK website) and a large photograph collection, which includes photographs relating to the school and the hospital as well as other hospitals and institutions closely associated with St George’s. These include Atkinson Morley’s, which was originally built as a convalescent home for St George’s patients (who were initially transported to Wimbledon by horse-drawn carriages). Latterly it was known for its neurological centre, with neurosurgeon Wylie McKissock at its helm. The archives also holds oral history recordings, including an interview of McKissock talking about his career and experiences at St George’s and at Atkinson Morley’s.

Staff and patients at Atkinson Morley’s, 1934; and the bust and surgical kit of Benjamin Brodie held in the archives. Archives and Special Collections, St George’s, University of London.
Staff and patients at Atkinson Morley’s, 1934; and the bust and surgical kit of Benjamin Brodie held in the archives. Archives and Special Collections, St George’s, University of London.

Another fascinating collection is our artefacts: from anatomical models to surgery kits, the collection tells of the fascinating history of medicine. The surgery kit displayed below, awarded to a St George’s student called Edward Walker in 1856, includes amputation knives, a trephine and bone forceps, among other items. It can be regarded with a new level of trepidation when we realise that antiseptics and anaesthesia were still being developed, which made surgery of any kind a horrifying prospect for the patient; John Snow was one of the early adopters of ether and chloroform in surgical anaesthetics at St George’s. And to demonstrate that medical advances often take their time, despite Jenner’s smallpox vaccination, smallpox was not eradicated until 1976 – and one of the items held in the archive is Professor Harold Lambert’s smallpox testing kit from the 1950s.

Surgical kit, 1856 and smallpox testing kit, 1950s. Archives and Special Collections, St George’s, University of London.

Online and digital

We recently explored our digital futures in this blog and the links we can make to the past and to our heritage through the archives (in this case, connections between records relating to COVID-19 and influenza epidemics of 1918 and 1889).

We continue to catalogue our collections, and to make them available online via our online catalogue. Our flagship project on St George’s historical post mortem records (which you may have heard of if you’re following us at all, as we do like to talk about it!) is in full swing, with Project Archivists Natasha Shillingford and Alexandra Foulds cataloguing and making available online new volumes of post mortem cases.

Perhaps paradoxically, they give us a glimpse to the lives of those who rarely get a voice, and whether you’re interested in anatomical illustrations (some executed with some artistic flair), medical treatments (such as champagne, gin and ether or belladonna and arsenic), 19th century occupations, casual racism and prejudices exhibited by the doctors, colonial patterns of travel and immigration, mental health in the 19th century or pastry chef murderers, follow us on social media and get in touch – we’re always happy to hear from you!

Is there anything else you’d like to see or find out? Get in touch with us at archives@sgul.ac.uk or via our social media channels, and we will do our very best to answer any questions you may have.

‘Digits: For Good’: Vaccinating Harrods and Selfridges, or, (Digital) preservation of COVID-19 and influenza records

Digital Preservation Day 2020 celebrates the positive impact of digital preservation. The theme ‘Digits: For Good’ focuses this year on the creation and preservation of research and development data used in finding a vaccine for COVID-19. In this post we’ll look into the work we’ve been doing to preserve these records, and also what the archives can tell us of past pandemics. This blogpost has been written by St George’s Archivist Juulia Ahvensalmi, Records Manager Kirsten Hylan and Research Data Support Manager Michelle Harricharan. You can engage with the day and find out more about our work on Twitter at @CollectionsSgul and @sgullibrary and using the hashtags #WDPD2020 and #SGULWDPD2020.

Our COVID-19 story 

At St George’s, University of London (SGUL), a specialist health and medical sciences university in South-West London, the Archivist, Research Data Support Manager, and Records Manager have joined forces to advocate for digital preservation.   

When it comes to meeting the challenge of preserving our digital materials, we have found that by bringing together staff members from different areas of the University we can utilise different skills and internal networks to achieve our goals.   

As part of the work we are undertaking around digital preservation, the team aims to collect all Covid-19 related material produced by SGUL. This includes a variety of documents in a variety of formats, produced by different parts of the university, including 

  • Communications, such as emails, web pages, FAQs, video recordings and social media. These provide evidence of our response to the crisis and our management of it – something that will be both interesting and important to keep for the future. Communications sent out to students, staff, alumni as well as those externally available will tell the story of how St George’s reacted to the pandemic 
  • Governance records, including minutes of meetings. These provide evidence of the conversations and decision-making about the responses and management of the pandemic 
  • Research, including recording the range of Covid-19 research St George’s researchers have been involved in throughout the pandemic as well as our researchers’ incredible work in the national and international media. Research data from these studies are also important to collect and preserve for the long term.

To date we are curating and preserving the items that we aware of, and we have started conversations with departments such as External Relations, Communications and Marketing to identify material we may have missed.   

We are conscious of the need to collect the full complement of Covid-19 material as ultimately this material will be an important part of our Archive in years to come and support future research.   

Looking back 

The majority of the material related to COVID-19 is digital, but that is not the case for most of the material held in the archives (although in the future that is of course likely to change!). The one pandemic most often compared to COVID-19 is the 1918-1919 influenza pandemic, known most commonly (and misleadingly) as the ‘Spanish’ flu, or ‘the Grippe’. Estimates of the number of deaths caused by it vary anywhere from 17 to 100 million people worldwide

In order to understand more about the current pandemic, and our responses to it, and to learn from our past mistakes, we need to look into the past. How did St George’s, then, respond to this pandemic? Well – the answer is that we don’t really know. The minutes of the Medical School (later SGUL) committee and council make no reference to the pandemic. St George’s Hospital and Medical School Gazette, journal produced by St George’s staff and students between 1892 and 1974, notes in February 1919 that the out-patient department and many wards at the hospital had to be closed as so many nurses were off sick, but the medical school records don’t reveal much more (although St George’s Hospital records, which are held at the London Metropolitan Archives, may hold more information). 

A photo of a paragraph in the St George’s Hospital and Medical School Gazette, Feb 1919. Archives and Special Collections, St George’s, University of London.
St George’s Hospital and Medical School Gazette, Feb 1919. Archives and Special Collections, St George’s, University of London.

What we do have is historical post mortem examination records, which we are currently cataloguing and making available online. These records provide an incredible source for studying death and disease in 19th and early 20th century London. They chart, among other things, the 1854 cholera epidemic, show how prevalent tuberculosis was, and contain numerous fascinating and illuminating cases, such as that of the pastry chef murderer in 1908. 

Photo of book cover: Post mortem and case book 1846, PM/1846. Archives and Special Collections, St George’s, University of London.
Post mortem and case book 1846, PM/1846. Archives and Special Collections, St George’s, University of London.

When we started cataloguing the volumes for 1918 and 1919, we were expecting to find plenty of examples of influenza, and were surprised when, well, there just weren’t that many.  

There were, of course, some cases, and many that sound troubling, such as the case of Ada Bell, a soldier’s wife aged 32, who died at St George’s 31 Oct 1918. Her illness was initially diagnosed as pneumonia, but she was brought to the hospital delirious, coughing and suffering from diarrhoea, deafness and shortness of breath. Her cause of death was deemed to be typhoid fever and influenzal bronchopneumonia. 

Scan of Post mortem case of Ada Bell, [Wife of] Soldier, 32, PM/1918/240. Archives and Special Collections, St George’s, University of London.
Post mortem case of Ada Bell, [Wife of] Soldier, 32, PM/1918/240. Archives and Special Collections, St George’s, University of London.

As the symptoms were varied, cases were sometimes misdiagnosed as dengue, cholera or typhoid, for instance. Of the overall deaths in those two years at St George’s, influenza cases account for 5.5% of all the cases: the yellow line in the graph below shows cases where influenza was reported to be the cause of death (or, to be more specific, cases in which influenza is mentioned in the post mortem report). We don’t, however, have the admissions registers for the hospitals, so we cannot tell the number of cases overall, only the number of deaths. 

There is a relatively large number of ‘unknown’ causes of death during these years as well (shown in turquoise in the graph below) – these are cases for which the records enter no cause of death and no details on the medical case, and they may or may not include some further influenza cases. The graph also shows other respiratory tract diseases (in green) and digestive system diseases (in purple).  

Graph showing deaths at St George's hospital 1918-1919. Showing overall deaths, influenza, other respiratory tract diseases, digestive system diseases and unknown causes deaths.
Deaths at St George’s Hospital 1918-1919. Source: Post mortem examinations and casebooks, PM, Archives and Special Collections, St George’s, University of London.

The 1889 influenza 

Influenza was of course not confined to these years only. Every so often influenza cases would flare up, and the previous time this happened on a large scale in 1889-90. With our propensity for blaming single countries for viruses, this pandemic is sometimes referred to as Russian flu and, according to some theories, it may have played a part in immunising those who had it against the 1918 flu, which appeared to disproportionately strike the younger population. 

There were attempts at finding medicines to cure the disease, and there was a minor scandal when the name of the teacher of materia medica (the study of drugs to treat diseases) at St George’s was found printed on an advertisement for an influenza cure: despite denying his involvement, he had to resign. The advertisement does not actually tell us what the medication consisted of, but we can only assume it did not work. 

‘Woodland affaire’, 1890. Archives and Special Collections, St George’s, University of London.

Influenza also continued to be a concern even after the 1918-1919 pandemic had abated, and in the 1926 St George’s decided to get involved in researching vaccines for influenza. There was a public funding campaign for the project, and in February 1927, St George’s published a letter in The Times

‘following on the traditions established here by Jenner and Hunter in their historical work, we are […] engaged in special research with the object of ascertaining what causes influenza, how it can be controlled, how it can be prevented from spreading and, finally, whether a really effective treatment can be found for it’. 

Scan of article in newspaper about influenza epidemic, research at St George's Hospital. ‘Influenza epidemic: Research at St George’s Hospital’. The Times, 15 Feb 1927.
‘Influenza epidemic: Research at St George’s Hospital’. The Times, 15 Feb 1927.

The arguments found in the plea for funding sound familiar: the ‘heavy burden which this scourge places on the community by the dislocation of business and loss of working power’. Because the project was widely publicised, the public was eager to take part, and we have some wonderful letters from people writing in and suggesting their own cures and theories of the causes of influenza: we will be tweeting these, so look out for them on our Twitter feed! 

Records relating to influenza research. Archives and Special Collections, St George’s, University of London.

The money for the research was found, and the subject of the vaccinations was chosen to be the staff of Harrods and Selfridges on Oxford Street, as well as the staff at Quin & Axtens and Bon Marché in Brixton, department stores which had recently been acquired by Selfridges. Altogether 345 people were vaccinated.  

Photo of table 1, ‘Report on anti-catarrh inoculations (catarrh of respiratory mucous membranes)’, 1928. Archives and Special Collections, St George’s, University of London.
Table 1, ‘Report on anti-catarrh inoculations (catarrh of respiratory mucous membranes)’, 1928. Archives and Special Collections, St George’s, University of London.

The various reports, meetings minutes and correspondence held in the archives tell us how the research subject was decided on, issues to do with the research, space and equipment (including the building of a spiral staircase in the laboratory – obviously an essential architectural refinement) and, most importantly, how the research was conducted and what the results were. 

The report of the findings in 1928 shows the research was conducted using attenuated vaccine ‘obtained from pathological fluids or secretions or from a mucous surface of persons who exhibited clinical evidence of disease’, with the assumption that the disease was called by a bacterium called Pfeiffer’s bacillus, or Haemophilus influenzae (also known as h-flu). It was not until a few years later, in 1933, that it was definitely established that influenza was actually viral, and not bacterial.  

And the results? Well, it appears that 1927 was a disappointing year when it comes to influenza, at least from the researchers’ point of view. The vaccination campaign was, however, declared a success, and there were plans to repeat it the following winter (although if that did happen, the records have not survived). 

Photo of response to ‘Report on the work carried out in the Research Laboratory’, 11 Jul 1928. Archives and Special Collections, St George’s, University of London.
Response to ‘Report on the work carried out in the Research Laboratory’, 11 Jul 1928. Archives and Special Collections, St George’s, University of London.

The preserved documents reveal an on-going preoccupation with and interest in influenza, even though (given what we are currently going through) there does not appear to be much sense of urgency, certainly not at the time of the 1918 influenza. 

Although the research was not successful in finding a vaccine that worked, it was an important step on the way: you won’t know what works until you try it. Our knowledge is cumulative, and dead-ends are part of research – not everything can work out, but it all adds up. The first influenza vaccine was developed in the 1940s, and (soon, hopefully) we will see a COVID-19 vaccine. 

Looking forward

What does this all have to do with digital preservation, then? Compared to the 1918 and 1889 flu pandemics the records we are creating today are largely digital. The technology supporting these records change rapidly and may one day become obsolete. If this happens, we could lose access to valuable records, including our covid-19 records. St George’s has recognised this and is actively engaged in looking after our digital information for the long term. We’ve recently purchased a digital preservation system, Preservica, to help us to preserve our digital records. We are working to develop methods and processes that will allow us to preserve the records that are currently being created, and to do so in a meaningful way that will work for colleagues across the organisation. 

Rather than thinking of digital and physical something entirely separate, we should consider them as part of a continuum, as it were. Preserving digital material can be challenging, and we can’t always replicate the processes used for paper with digital material, but the gaps in the past records show the need to preserve evidence of the current pandemic, not only for historical interest but to provide evidence of what happened and how we dealt with it. 

If you are interested in learning more about digital preservation at St George’s, or would like to get involved, please contact archives@sgul.ac.uk.

Former students of St George’s: Kathryn Hamill Cohen (1905-1960)

To welcome new and old students to St George’s, our Archive team will be exploring the stories of some of our alumni. Today’s post comes from Archivist Juulia Ahvensalmi.

‘Death of a Ziegfeld girl’, The Daily Mail, 5 Jan 1960. Source: Patricia Highsmith Papers, Swiss Literary Archives.
‘Death of a Ziegfeld girl’, The Daily Mail, 5 Jan 1960. Source: Patricia Highsmith Papers, Swiss Literary Archives.

Newspaper headlines in 1960 made much of the death of Kathryn Hamill Cohen. Portrayed looking elegant and glamorous, newspaper reports could hardly contain themselves – the story, after all, seemed to have it all: suicide of a Chelsea doctor, psychoanalyst and a Broadway dancer. She was also a lover of Patricia Highsmith. But who was she, and what was her connection to St George’s?

Kathryn Hamill Cohen was one of the first female students to enter the Medical School when St George’s again admitted women in 1945, for the first time since the First World War. There had been considerable resistance to the idea of female students, and it was only in 1915 that first female students were admitted to St George’s. Even then, their time was limited, and after the war the doors of the medical school were again closed to women.

University of London, Report of Special Committee on Medical Education of Women, 1944. Medical School Committee Minutes, Vol 26, SGHMS/1/1/1/29, Archives and Special Collections, St George’s, University of London.
University of London, Report of Special Committee on Medical Education of Women, 1944. Medical School Committee Minutes, Vol 26, SGHMS/1/1/1/29, Archives and Special Collections, St George’s, University of London.

The minutes of the Medical School show that co-education (that is, women and men studying together) was a hotly debated subject between the wars, and St George’s also received petitions and requests to allow women to continue studying alongside men. Progress was, however, slow, and so it was not until 1944 that a report by the London universities found that, in fact, patients (astonishingly) did not mind being examined by female students, and since opposition to co-education appeared to be diminishing and many universities were already admitting women, the remaining argument against allowing female students appeared to be that ‘the Schools for men are loath to lose their traditions which have been built up by generations of male students’.

Student register 1945 showing the first female students at St George’s since the First World War. SGHMS/4/1/18, Archives and Special Collections, St George’s, University of London.
Student register 1945 showing the first female students at St George’s since the First World War. SGHMS/4/1/18, Archives and Special Collections, St George’s, University of London.

And so Cohen was admitted to study at St George’s alongside with four other women in 1945: Ruth Clare Cornford (Chapman), Patience Proby, Adrien Patricia Dunlop and Zaïda Megrah (Hall / Ramsbotham). Being one of so few women must have been hard – even the student records had everything printed as ‘Mr’ as default, as Cohen’s attendance card for anaesthetics shows below. Furthermore, while the other women were in their early 20s, Cohen was 40 when she began her studies at St George’s. Her outlook on life and on her studies must have differed considerably from that of her fellow students.

Attendance card from the Department of Anaesthetics. Student index cards A-C, Archives and Special Collections, St George’s, University of London.
Attendance card from the Department of Anaesthetics. Student index cards A-C, Archives and Special Collections, St George’s, University of London.

Prior to her medical studies, she had led an eventful life. Born in New York in 1905, she had worked as a dancer at Broadway with the Ziegfeld Follies, who were hugely successful, glitzy revue performers with elaborate choreographies.

In 1930 she moved to the UK; her arrival is recorded on a passenger list from New York to Plymouth on 30 Dec 1930. She was 25 years old, and her occupation on this list is given as actress. Later that year she married Dennis Cohen, a publisher at the Cresset Press, who may have been an MI6 officer, and who was also involved in organising Kindertransport from Germany during the war. They eventually moved to Chelsea, where they had commissioned an avant-garde house still known as the ‘Cohen house’.

Image of the so-called Cohen House at 64 Church Street, Chelsea. ©Gillfoto [aka Kenneth John Gill] CC BY-SA 3.0.
Image of the so-called Cohen House at 64 Church Street, Chelsea. ©Gillfoto [aka Kenneth John Gill] CC BY-SA 3.0.

At some point prior to 1945 Cohen worked as a secretary to Nye Bevan, who in 1948 went on to establish the NHS: perhaps this work prompted her to consider medical studies, rather than politics. Between 1941 and 1944 she was a student at Newnham College, Cambridge, where she studied anatomy, physiology and biochemistry. She enrolled as a student at St George’s in September 1945, a week after the official end of Second World War 2 September 1945.

Student photograph of Cohen, Kathryn Hamill, 1945. Student index cards A-C, Archives and Special Collections, St George’s, University of London.
Student photograph of Cohen, Kathryn Hamill, 1945. Student index cards A-C, Archives and Special Collections, St George’s, University of London.

After graduating from the medical school in 1948, her student records show that she worked as house officer and registrar at St George’s Hospital for several years (and even in her student photograph she looks glamorous). Later she was employed as psychoanalyst at the hospital and appears to have practiced psychiatry from her home office. She was also interested in genetics, and published on the use of hypnosis in treating skin diseases. Although psychoanalysis may now have a dubitable reputation, it was a respected field of study at the time. 

During this time she met the author Patricia Highsmith at a party in New York. The two had an affair in 1949: “Kathryn was beautiful, intelligent, melancholy, monied, and married: a combination Pat always found irresistible”. Highsmith asked Cohen to accompany her on a trip to Italy, although the affair does not appear to have continued after that.

It was this connection to Highsmith that made Cohen famous, as she was a partial inspiration for Highsmith’s novel ‘The Price of Salt’ (later republished as ‘Carol’ and made into a film in 2015), a departure from her usual psychological thrillers in that it was a romance – and a lesbian romance at that, which in the 1950s was somewhat scandalous. Dennis Cohen’s publishing house (for which Cohen worked for as a co-director) published several of Highsmith’s books, including ‘Strangers on a Train’, which Alfred Hitchcock made into a film.

Cate Blanchett as Carol in the 2015 film. Source: The Playlist.
Cate Blanchett as Carol in the 2015 film. Source: The Playlist.

Her life, however, had a tragic end: in 1960 Cohen took her own life by taking an overdose of barbiturates. In a further (if morbid) connection to St George’s, her post mortem was performed by Donald Teare, pathologist at St George’s, and also a former student of St George’s.


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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 27th 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 1st 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, 8th 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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Former students of St George’s: Assaad Y. Kayat (1843-1846)

To welcome new and old students to St George’s, our Archive team will be exploring the stories of some of our alumni. Today’s post comes from Archivist Juulia Ahvensalmi.

Image of Assaad Y. Kayat
Image of Assaad Y. Kayat. Source: ‘A Voice from Lebanon with the Life and Travels of Assaad Y. Kayat’ (1847).

Going through student records recently in the archives, I came across the name Assaad y Kayat in the list of students enrolled at St George’s in 1843. There was not much information in this list: his student number was 4093, he had attended the medical school for three seasons and he ‘appears not to have paid his fees’. His name stood out from the list of predominantly British names (the students at St George’s were until relatively recently primarily white, middle or upper class and male – you can read about our first female students in 1915 here), but the brief description was also intriguing. Who was Assaad, where did he come from and what happened to him?

As luck would have it, it turns out that Assaad, helpfully for us, published a book with his life story. He spelled his name As’ad Yakub Khayyat or Assaad Y. Kayat, and the book he wrote was called ‘A Voice from Lebanon, with the Life and Travels of Assaad Y. Kayat’. It was originally published by Madden & Co on Leadenhall Street, London, in 1847, and the front page includes a (rather dashing) portrait of him (see above).

The book appears to have been written specifically for a British audience. He had spent time in England on three occasions: it was on his third trip that he became a student at St George’s. At the age of 32 when he began his studies, he would have been considerably older than most of his fellow students – Henry Gray, for instance, was only 16 when he began his studies the previous year. Assaad was also married and had two small children, and had to earn money to cover his studies, so he presumably did not have much time for student activities. In his book, however, he only has words of praise for his time as a student:

‘I … entered as a medical student at St George’s Hospital … I shall be for ever indebted to them for the instruction I have received from their high skill. It is indeed a glorious hospital, an exalted medical school; it is an honour to be taught at it’

Signature of Assaad Y. Kayat in the St George’s Hospital Medical School Register 1836-1902.
Signature of Assaad Y. Kayat in the St George’s Hospital Medical School Register 1836-1902. Archives and Special Collections of St George’s, University of London

Life and travels of Assaad Y. Kayat

Born in 1811 in Beirut, Assaad describes in vivid detail his childhood and upbringing, through epidemics, wars and revolutions. He learns to read and write at the age of four, first in Arabic, his mother tongue, as his father wants to give him a good education (‘from the fear of my growing to manhood in a state of wretchedness and oppression’). Showing great promise and inclination for learning languages (he subsequently learns both ancient and modern Greek, Italian, English and Persian) as well as an astute business sense, Assaad soon progresses from selling rag papers to interpreting for sailors and merchants and is eventually employed as an interpreter by the British consul and representative of the East India Company in Syria. He travels widely around Middle East and Europe. Keeping in mind his audience, there is a lot of name-dropping of British dignitaries, officials and other people he meets on the way – his skills at networking are clearly second to none.

Although his focus is on Christian missionary activities, his account comes across as strikingly liberal for its time: he talks of ‘native agency’ and the importance of having native teachers and preachers, as well as of learning local languages and customs. He is a keen advocate of education, and in particular women’s education and equality.

Medical education

Throughout the account, he emphasises his journey to become a doctor ‘in order to benefit my fellow creatures’. On his second visit to England in the later 1830s, he attends some medical lectures at Cambridge, as well as at St George’s, where his first connection appears to have been the hospital chaplain, Rev William Niven. He regards medical education as an essential:

‘It requires no miracle to heal, but only to attend a medical course for a diploma or degree. A dose or two of sulphate of quinine often cures your patient of ague; vaccination prevents his taking the small-pox; the use of certain precautions prevents your catching the plague.’

In 1843 he returns to England, accompanied by his wife and toddler, as well as a group of young men with the view of obtaining an education for them, and to study medicine at St George’s. It is not all plain sailing, however, His wife Martha struggles to settle in; she has a toddler and a small baby to care for, she is sick herself, cannot get used to the miserable weather and the famous London fogs (or smogs caused by pollution in the dirty and overcrowded city), she doesn’t speak English and is largely confined to their small rented rooms, instead of their lovely house and garden and the company of her family and friends in Beirut (so despite his advocacy for women’s education, his own wife is stuck with a very traditional role at home). They are struggling with money; the committee (‘Committee of the Syrian Society’) Assaad had set up to enable the education for his ‘Syrian youths’ is slow to help, and Assaad attempts to raise money by giving public lectures on Syria and Christianity and by setting up a small importing and exporting business.

He is also keenly aware of his status as an immigrant in Britain and encounters prejudices and racism. He cites a journalist, who ‘came to my lectures twice, and all she could observe was my handsome appearance – her ears tickled by my foreign accent’ and talks at length about the difficulties in trying to expel these prejudices:

‘Some take me for a prince, or at least a chief; others, for a Chinese ambassador, a merchant, or an interpreter. Some think I am a Jew; others, a Turk, a missionary, a philosopher, or a lecturer; Christians of every denomination appointing to me a station or an office according to their own preconceived notions.’

Entry for Assaad Y Kayat (student number 4093). St George’s student records Vol 5. SGHMS/4/1/7.
Entry for Assaad Y Kayat (student number 4093). St George’s student records Vol 5. SGHMS/4/1/7. Archives and Special Collections of St George’s, University of London.

The student records show that Assaad studied for three seasons. One of the records notes that he ‘appears not to have paid his fees’, but according to his own account he finishes his studies in 1846, obtains his diploma and is admitted as a member of the Royal College of Surgeons, before returning to Beirut. It is unclear which account is true; maybe some more research in the archives will shed more light on the matter.


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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

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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