From the archives: International students at St George’s

In this blogpost, written by Archivist Juulia Ahvensalmi, we will be looking at the international history of St George’s students.

St George’s Medical School was formally established in 1834, but the hospital, which was opened in 1733, took pupils long before that. There were also several anatomical schools closely associated with the St George’s, including John Hunter’s Great Windmill Street school (established by John’s brother William Hunter in 1745), and Samuel Lane’s School of Anatomy and Medicine adjoining St George’s Hospital; John Hunter was a surgeon at St George’s, and Lane had also studied at St George’s.

There were fees to pay, and students could study for various lengths of time. The early student records show that some students only enrolled for a three-month period, others for six or 12 months. Initially pupils were assigned to a particular surgeon or physician. To become a perpetual pupil, there was an additional fee (which in 1870 was 100 guineas), and allowed the student admission to the practice of the physicians and surgeons of the hospital and all the lectures, allowing them to compete for any prizes and to become clinical clerks and dressers. The high fees then (as now) meant that education was not available for everyone, and the majority of the students were from the upper middle classes; many had gone to public schools and Cambridge or Oxford before attending St George’s.

Photo of 1805 student register.
Student register 1805, showing students enrolled for various lengths of time under different surgeons. Register of Pupils and House Officers 1756-1837, SGHMS/4/1/16, Archives & Special Collections, St George’s, University of London; and Extract from student register, 1945, showing the schools and colleges attended by student prior to their enrolment at St George’s. Register of Pupils 1837-1946, SGHMS/4/1/18, Archives & Special Collections, St George’s, University of London.

International connections

The student records held in the archives reveal a steady trickle of international students, based on their names (which in these early records is often the only information recorded). Names, of course, can only be used as a starting point, but the records also occasionally explicitly refer to visiting students, as in the case of Michal Astrashapovitch and Stephen Koniwetsky, who paid £20 to study under Everard Home and attend the lectures ‘for an uncertain time, to be settled at their leaving England’. There is no more information about them, but they may have been Russian – there are several other Russian names which suggests some regular contact or connection.

Photo of 1808 student register, showing enrolment of Michal Astrashapovitch and Stephen Koniwetsky.
Student register 1808, showing enrolment of Michal Astrashapovitch and Stephen Koniwetsky. SGHMS/4/1/16, Archives & Special Collections, St George’s, University of London.

Another early student was Philip Syng Physick, who had graduated from the University of Pennsylvania, and travelled to England to study under John Hunter in 1785. Known as the ‘father of American surgery’, he is said to have performed the first human blood transfusion, and was particularly interested in using autopsy as a method for observation and discovery – a practice that we can time and again see in our post mortem records.

Swedish names also appear in the registers with some regularity, especially in the 1890s when it appears to have been somewhat of a trend to travel to London to study medicine. These students include Henning Grenander, who later gained fame as a figure skater, winning the world title at the National Skating Palace in London in 1898.

Image of Henning Grenander ice skating.
Henning Grenander. Image: skateguard1.blogspot.com

Henrik Kellgren’s ‘Swedish Institution for the Cure of Diseases by Manual Treatment’in Eton Square, London appears to have further encouraged Swedish students to study in London: Axel Wolter Louis Stackelberg, who was a pupil at Kellgren’s institute, for instance, is enrolled for 6 months as a student of anatomy in 1897, while both Kellgren’s sons Ernst and Jonas also studied at St George’s for a period; Jonas went on to study rheumatism, was a pioneer in the study of physiology of pain, and became a professor of rheumatology in Manchester in 1953.

The adventures of Hajji Baba of Ispahan

Hajee Baba may have been the first Muslim student at St George’s, and one of the first Iranian medical practitioners to study in Europe in this period. He came to England to study medicine alongside another young Iranian, Muhammad Kazim or Mohammed Cassim, in 1811 with the British ambassador to Iran, Sir Harford Jones. Hajee Baba was the son of an officer in the Shah’s army, and the sending of students to study in Britain was seen as a way of strengthening the diplomatic ties and connections between the countries; his brother trained as a mining engineer in Russia. Kazim was to study arts, but died shortly after their arrival in England.

Hajee Baba stayed in England for eight years. Following his studies, he returned to Iran to work as a physician in the court in Teheran, and in 1835 he is described as ‘a respectable elderly looking man’. He also worked as an interpreter for Persian missions abroad. Eventually he became the chief physician to the shah. He died in 1842 or 1843.

Composite image. From left to right: photo of 1817 student register, Cover of ‘The Adventures of Hajji Baba of Ispahan’ (1824-28) by James Justinian Morier; Poster for ‘The Adventures of Hajji Baba’ (1954).
Student register 1817, Register of Pupils and House Officers 1756-1837, SGHMS/4/1/16, Archives & Special Collections, St George’s, University of London; Cover of ‘The Adventures of Hajji Baba of Ispahan’ (1824-28) by James Justinian Morier; Poster for ‘The Adventures of Hajji Baba’ (1954), Wikipedia, ©20th Century Studios.

He may have been the inspiration for a series of best-selling novels, ‘The Adventures of Hajji Baba of Ispahan’ (1824-28) by James Justinian Morier, secretary to Sir Harford Jones; Hajee Baba was reportedly annoyed at Morier’s use of his name for this purpose (and would have been, we can imagine, even more annoyed by the American adventure film of the same name of 1954!).  Nile Green’s book ‘The Love of Strangers: What Six Muslim Students Learned in Jane Austen’s England’ (2016) recounts the story of a group of six students who travelled to Britain in 1815, based on contemporary diaries and letters of the students, in which he also mentions Hajee Baba and his unfortunate companion.

The problem of sources…

Often, the spelling of names varies considerably in different sources (this is of course particularly true when the original is in a different script), which can make tracking people difficult (but we do enjoy a bit of detective work!); there is a Wikipedia entry for Hajee Baba, for instance, but in that his name is spelled Hadji Baba Ashfar, whilst the Encyclopaedia Iranica uses the form Ḥājjī Bābā Afšār; in Persian his name is افشار، حاجی بابا.

Many students are also entered in the registers only by their first initial and surname, making identification even more problematic. A ‘foreign-sounding’ name, moreover, is of course not solid evidence either way – the somewhat exotic-sounding Peregrine Fernandez in 1799, for instance, ‘gentleman of Widcombe, Somerset’, may have had family roots elsewhere, but was born and bred in London. Where the student records are simply lists of names, as the earlier ones are, we have to turn to other sources to find out more about the people behind the names.

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

One student we do know more about is Assaad Kayat, who enrolled as a student at St George’s in 1843, studying alongside Henry Gray (of Gray’s Anatomy). His fascinating story is recounted in more detail in an earlier blogpost, and his autobiography tells us a lot about his childhood in Beirut, as well as his and his wife’s experiences as immigrants in London.

The archives also reveal the story of Boghos Baghdasan Tahmisian, who, according to an appeal launched in 1892 by the Turkish Mission’s Aid Society, was a ‘native of Cilicia’, in present-day Turkey; his name may suggest Armenian origins. He is in the appeal described as a diligent student, who had arrived in London in 1889 and enrolled as a medical student at St George’s. He had, however, found himself lacking adequate funds to be able to finish his studies, which is why the society decided to appeal to the public on his behalf.

Composite image. Left-hand side: ‘An appeal on behalf of Mr B.B. Tahmisian’ (1892). Right-hand side: a letter signed by Tahmisian.
‘An appeal on behalf of Mr B.B. Tahmisian’ (1892) and a letter signed by Tahmisian. Archives and Special Collections, St George’s, University of London.

Pictorial propaganda

Following the end of the First World War, the Universities Bureau of the British Empire (now Association of Commonwealth Universities), established in 1913, encouraged British universities to admit students, and the Foreign Office was eager to distribute what they called ‘pictorial propaganda’:

‘The idea is to endeavour to impress the peoples of Russia and of the East with the greatness of the educational system of the British Empire’

Photo of letters to the Medical School, preserved in the minute books of the Medical School Committee XII-XIII.
Letters to the Medical School, preserved in the minute books. Minutes of the Medical School Committee XII-XIII, SGHMS/1/1/1/15. Archives and Special Collections, St George’s, University of London.

‘This medical school is unable to admit any Ceylonese students’

(Medical School minute books, 1920)

The minute books of the medical school from that time contain frequent references to the admission (or not, as it were) of international students; the minutes refer to students by their nationalities: ‘a Pole’, ‘the Siamese doctor’, ‘a native of India’.

At times, certain nationalities were the subject of intense conversations. Following the end of the First World War and demobilisation, many ‘American and colonial’ soldiers found themselves with some time to spare, and willing to use that time to study. A letter from the Royal Society of Medicine in 1918 warns that if plans to offer brief post-graduate courses for such students are not soon put in place, ‘the chances are that the majority of them will go to Paris, where […] post-graduate courses have been arranged for all Allied Officers and are already in full swing!’. The response from St George’s was not enthusiastic due to staff shortages and bureaucratic burden on the school. In the end, however, it was decided that up to 10 American students could be admitted for a three-month course, with a fee of ten guineas.

Appeals from the Egyptian Educational Mission received an even less favourable response: despite admitting two Egyptian students for a clinical course, ‘it was decided that this School cannot bind itself to admit any definite number of Egyptians’, the dean at this time wrote, suggesting that the school is too small to admit ‘foreign students […] although I am doubtful whether they ever really amalgamate or attempt to settle down with their fellow-students’.

At the moment we’re looking forward to delving into our nursing records and learning more about the student nurses at St George’s. Our initial research suggests that in the 1950s-1960s for instance up to 70% of the nursing students were immigrants to the UK; among these are many from the Windrush generation, and students came from all over the world, including the Caribbean, Ireland, India, Nigeria, Sweden and Bermuda.

Photo showing nursing students' nationality in 1970s student records.
Records of nursing students at St George’s in the 1970s. Archives and Special Collections, St George’s, University of London.

Want to know more, or see and study the records for yourself? Just get in touch with us at archives@sgul.ac.uk – we’d be very happy to hear from you!


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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.


If you are interested receiving updates from the Library and the St George’s Archives project, you can subscribe to the Library Blog using the Follow button or click here for further posts from the Archives.

St George’s Library Then & Now: 1998

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Libraries Week takes place between the 8th – 13th October 2018. Over the course of the week we’ll be exploring our Archives to look at how the library has – and hasn’t! – changed over time.


In this final retrospective look at the Library, we’ve delved into a really interesting commemorative brochure produced by library staff to celebrate 21 years of being based in Tooting.

Back in the early 1990s staff were singing the praises of their “several CD-ROM machines, word processing facilities and a scanner” which warranted instating an enquiries desk where library staff could be on hand to answer IT related questions.

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It’s interesting to note that even with the differences and improvements in technology over the past 20 years, many of the enquiries that helpdesk staff answered back in 1998 will be very familiar to users and helpdesk staff today!

Needless to say the type of enquiries facing the library staff are mainly computer related. The most common ones are

‘My Printer is not working’
‘The printer has stopped printing half way through’
I can’t open my file on the computer’

The rest of the commemorative brochure makes for an interesting read: it captures a pivotal point in the development of modern academic libraries as the way we access information began to rapidly change. Technology has streamlined many library services whilst also generating new challenges – especially over the two decades that have passed since the publication of this brochure.

For example, the move from print to electronic journals has had a fairly dramatic impact on the physical layout of the library. With most journal subscriptions now online, we no longer require the rows and rows of shelving to accommodate print copies and can offer far more study spaces, which is of real benefit to our users.

 

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The Library now manages access to thousands of journal titles, far in excess of what we ever could have accommodated physically in print, giving staff and students at St George’s access to far more content than before, with the added convenience that in most cases it can be accessed from anywhere and at any time.

However, with online journals the Library typically licenses the content for a specific period of time, whereas with print journals we owned the volumes and issues of the journals we purchased. Our Journals team must negotiate the terms and conditions of these licences with our suppliers each year, making these transactions far more complex.

Supporting access to online subscriptions also requires maintaining a number of key systems, such as our link resolver, which generates the links through to the full text of articles we have access to; either from search results in Hunter or our other healthcare databases.

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The Library also needs to manage the process of authentication: whereby journal sites identify a user is from St George’s and entitled to access that particular resource. The Journals team work hard to make this process as smooth as possible and provide the necessary support for users where difficulties arise. Responding to the pace of change as technologies develop is a real challenge for library staff and will undoubtedly continue to shape the academic library of the future.

On a final note, the brochure also offers interesting snippets of social history too. Present day staff thankfully have much more input over their own sartorial choices!

1977-98 Library Brochure trousers

…and female staff are now permitted to wear trousers for the task.

 


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If you are interested receiving updates from the Library and the St George’s Archives project, you can subscribe to the Library Blog using the Follow button or click here for further posts from the Archives.

 

 

St George’s Library Then & Now: 1977

LibWeekRGB
Libraries Week takes place between the 8th – 13th October 2018. Over the course of the week we’ll be exploring our Archives to look at how the library has – and hasn’t! – changed over time.


In this exploration of the Archives, we’re looking at some of the physical incarnations of the Library throughout St George’s illustrious history. Today the hospital and medical school are located in Tooting, but until the 1970s were situated in central London at Hyde Park Corner.

The Library at Hyde Park had many traditional features: lots of dark wooden furniture, high shelving, and books behind glass cabinets. There also appear to be desks perched very precariously on the balcony below the lovely domed ceiling, which today might cause all manner of health and safety headaches.

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As St George’s moved to Tooting in 1976, the Library settled into a more modern looking space. These photos, from 1977, give us a sepia-toned glimpse into the Library as it was then: slightly more accessible shelving, hundreds of print journals, much lower ceilings and a slightly sterile looking staff office. That said, the black and white image in the slideshow below shows a much brighter, wider study space that isn’t that dissimilar to the library back in 2012, before our last refurbishment.

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Do you have any pictures taken in or around the library from your time studying at St George’s? Whether it was last year or 20 years ago, we’d love it if you could share them with us!

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If you are interested receiving updates from the Library and the St George’s Archives project, you can subscribe to the Library Blog using the Follow button or click here for further posts from the Archives.

 

 

The Dissection of an Egyptian Mummy at St George’s Hospital Medical School

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Our Archivist Carly Manson has been looking more in depth into the history of St George’s. One of the interesting stories that you may not know about, is that the med school once dissected a mummy!


 

egyptian mummy

1835 saw the opening ceremony of St George’s Hospital Medical School. It also saw the opening of an ancient Egyptian mummy, in the hopes of impressing an expectant crowd.

Physicians and surgeons were permitted to have a limited number of pupils in the early days of St George’s Hospital, but there was no established medical school. Students would travel to various places for the different studies needed in their professional education.  A medical school was eventually formed in 1831, and established on Kinnerton Street in 1834, a few minutes walk from the hospital at Hyde Park Corner in central London.

According to The Lancet, one of the world’s oldest general medical journals, there was an official opening of the St George’s Hospital Medical School at Kinnerton Street in July 1835. To attract visitors to the opening, it was advertised that an Egyptian mummy was to be dissected in front of the audience in the new Anatomical Theatre.

The mummy was said to have been a high ranking lady who belonged to the Temple of Ammon in Thebes.  Its exterior casing was ornate and varnished black, while the inner casing was made of sycamore wood covered with hieroglyphics which acknowledged the Egyptian deities.

It was announced that the mummy had been gifted to the school by the high ranking Lord Frederick Fitzclarence. But according to the ‘intercepted letters’ section of The Lancet article, a Mr Turner stated that the mummy was actually an old present to Mr Robert Keate, the hospital Surgeon:

“You would notice in your card of invitation, that the mummy was presented to the school by no less than Sir Frederick Fitzclarence, but on inquiring I found that, like Brodie’s other trickeries, it had not been presented to the school at all, but that Lord Fitz had given it to Bobby Keate ages ago.” (Wakley, 1835)

Unfortunately, The Lancet goes on to state that “the mummy gave more than the usual trouble to Mr P. and his assistants, and, after all, presented nothing singular to gratify the eye or the curiosity…. All appearance of flesh was destroyed, and the corpse looked like a skeleton dipped in pitch.” (Wakley, 1835)

Not everyone was disappointed by the event, The Lancet cites Mr Turner as stating “I do not regret going, as it turned out to be a fine intellectual comedy” (Wakley, 1835).  Despite the Lancet’s somewhat negative article, news spread of the opening, and the American Railroad Journal acclaimed that “much curiosity has been excited in the scientific world by the opening of a mummy”. (Minor, 1835)

First programme for medical school
Prospectus for a course of lectures on anatomy at the St George’s Hospital Medical School at Kinnerton Street for 1837-1838

For further information relating to the history of St George’s Hospital and the medical school, please contact the Archivist at archives@sgul.ac.uk or go to the following webpage: http://library.sgul.ac.uk/using-the-library/archives

Did you know…

The word ‘dissection’ originates from the Latin ‘dissecare’, meaning ‘to cut to pieces’. Dissection, also known as ‘anatomisation’, has been used for centuries to explore the body of a deceased animal or plant to study its internal structures and functions. Dissection is still practised in medical schools worldwide, although computer models are also increasingly used to teach anatomy. One resource that St George’s Library currently subscribes to is Acland’s Anatomy, an accessible online tool with realistic 3D visuals.


Reference list

Wakley, T. (ed.) (July 1835), ‘Kinnerton Street School’, The Lancet, vol. II, pp.457-463

Minor, D.K. (ed.) (August 1835) The American Railroad Journal, and Advocate of Internal Improvements, Vol 4. no 33, pp.526