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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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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International Women’s Day 2019

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Happy International Women’s Day!

There’s plenty of superb female writing talent in the Library, from our own St George’s academics, to classic and contemporary fiction writers. As we were celebrating reading for pleasure during World Book Day yesterday, we thought we’d mark #IWD2019 by pulling together a selection of female-authored fiction titles available in the Library.

You can find these and the rest of our fiction on the shelves at PN3353, but if you’d like to browse them online, click the image below. Each item is linked to its Hunter record, so you can check to see whether a copy is available to borrow. If it’s on loan, remember you can place a hold by signing in to Hunter:

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International Women’s Day is all about celebrating women’s achievements, so there’s no better day to mark the accomplishments of our first four female medical students. Admitted in 1915 due to a shortage of men during the First World War, two of them are pictured below. Helen Ingleby (L) & Hetty Ethelberta Claremont (R) went on to have successful careers in the medical profession.

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You can read more about ‘The First Women of St George’s’ in this interactive timeline. Click the image below for more details, or read our profile of pioneering female medics during the First World War.

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Gruesome and Ghostly: Tales from St George’s Archives

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To mark Halloween, our archivist Carly Manson, held two historical tours involving gruesome artefacts from our Archives and Special Collections.  Amongst the artefacts on display were a cloth used to wrap the dead body of King George II, and records relating to a scandal that provoked Charles Dickens to condemn post-mortem practices as “shocking”.

The history of each object on display was shared by the archivist, and the audience encouraged to ask questions. It was fantastic to learn about these fascinating artefacts and to see so many interested people in the audience.

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The artefacts from the events are also featured in this week’s Times Higher Education, in their article ‘The spooky secrets of London’s oldest medical school’:

https://www.timeshighereducation.com/blog/spooky-secrets-historic-uk-medical-school

 


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Women medics and the First World War.

Women medics and the first world war

By 1914, the long fight by women to gain entry to medical education had largely been won. However Oxbridge and the London teaching hospitals, including St George’s, still held out and refused to admit women for training. In 1915, in response to wartime staff shortages St George’s relented and admitted it’s first four female medical students. It was the first London teaching hospital to do so. The St Georges Hospital Gazette reported that:

‘Among the many sorrowful effects which the War has had upon us it is pleasant to record one joyful result which we would never have attained without a war. Variety and charm has been added to the Medical School and its works by the admission of ladies as students’ (St George’s Hospital Gazette, April, 1915).

Despite this initial enthusiasm, fears of controversy led to these places being rescinded.  The  female students were impelled to write and plead their cases. In 1916 the medical school acquiesced and allowed them to continue their studies. This indicates that medical training for women remained a contentious issue. By 1917 however, St George’s was prepared to even employ women, albeit temporarily, as house officers.

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Two of St George’s first female medical students (St George’s archive).

Irregardless of the medical school women graduated from, they were still confronted by a scarcity of available positions. Most found themselves limited to work in women’s hospitals, moving to obscure geographical locations or adopting specialities that did not generally appeal to men.  When the First World War broke out there was no official interest in involving qualified female doctors in the war effort. When Dr Elsie Inglis attempted to volunteer, the infamous War Office response was ‘My good lady, go home and sit still’. This was unlikely to ever happen; Dr Inglis like others had been involved in the suffrage movement. Women doctors simply approached their campaign to help the war effort in the same way they had fought for voting rights. They mobilised support, formed voluntary groups and raised money. In effect they simply circumvented  officialdom and offered their services elsewhere, even to foreign governments.

In 1914 the Women’s Hospital Corps was formed by Dr Louisa Garrett Anderson and Dr Flora Murray. The French government, unlike their British counterparts, promptly accepted their offer of help. Under the aegis of the French Red Cross the Women’s Medical Corp successfully ran military hospitals in Paris and Boulogne. In Paris they occupied the newly built Claridge’s Hotel on the Champs Elysee. The organisational skills required to raise funds, recruit staff, design uniforms and equip and manage the hospital were considerable. But both women were experienced doctors and had been active suffragettes, Dr Garrett Anderson herself had even been imprisoned in Holloway. They must have been formidable; the concierge told Dr Garratt Anderson that ‘he would have had an easier time fighting the Germans than facing so many active English Ladies!’ (Papers of Louisa Garrett Anderson,1914).

floramurrayFlora Murray supervising an operation at the Paris Red Cross Women’s Hospital (image courtesy of the Imperial War Museum).

In 1915, ostensibly to free men for service, the Corps was given control of the Endell Street Hospital in London which treated over 25,000 patients during the duration of the war (Murray, 1920). The Scottish Women’s Hospital, which had been formed by Dr Elsie Inglis after her War Office rebuff, distinguished itself in Serbia and France in 1916. In Serbia, the all female staff of the hospital found themselves in the midst of the conflict treating serious injuries in extremely difficult conditions. Moreover they had to fight major epidemics of disease and deal with a starving civilian population. The Hospital’s volunteers were forced to join the retreat during which thousands died. Some chose to take the even more risky option of  staying behind with patients who could not be moved.  Dr Inglis herself was taken prisoner of war.

In that same year, in the light of escalating need, the War Office reconsidered their positions and grudgingly allowed female doctors and surgeons to join the services. Despite the efficiency of the Women’s Medical Corps and the sheer toughness of the Scottish Women’s Hospitals the authorities continued to refuse to countenance the idea of women near the battlefield. Instead volunteer medics were sent  to locations like Malta. This was located far from the fighting and  most of the patients there were being treated for malaria and other infectious diseases.

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The Newnham and Girton units of the Scottish Women’s Hospitals about to leave for Serbia in 1915 (image courtesy of the Royal College of Physicians and Surgeons of Glasgow).

Nonetheless the war gave female medics, especially at the voluntary women’s hospitals, the chance to treat a wider range of cases. Like their male counterparts they dealt with gruesome wounds, amputations and fierce infections in great numbers. Dr Garrett Anderson described her routine in Paris:

‘I am in the theatre from 2 – 9 or 10 at night and eight or more [operations] The cases come to us very septic and the wounds are terrible. Today we are having an amput’ of thigh, two head cases perhaps trephine and five smaller ones’ (Papers of Louisa Garrett Anderson, 1914) .

Despite their efforts, women serving  their country were, unlike their male compatriots denied official military commission. In addition they were paid less, had one year contracts, were given no uniform and did not necessarily  receive any ration or billeting allowance. Furthermore they would not receive any pension if they were injured (Leneman, p.1593). Dr Jane Walker wrote to the Times in 1918 complaining that:

‘Although many of the medical women in the army not only have a high professional standing in civil practice, but now have a large experience in military hospitals, they rank below the latest joined R.A.M.C. subaltern, and are obliged to take their orders from him. When they travel, they travel not as officers but as soldiers wives’ (Times, 1918).

Whilst women’s’ suffrage had been put on hold for the duration of the war the Medical Women’s Federation decided to challenge this inequality robustly. A number of reasons for treating women in an inferior manner were put forward. Some feared it would be the thin edge of the wedge and that women serving elsewhere in the forces might also want commissions. The military were by nature conservative and some in it’s ranks had no sympathy for claims of sexual equality.

LouisaDr Louisa Garratt Anderson photographed in 1918 (image: Open I)

Perhaps the oddest objection was that the ordinary soldier would not bear examination by female medics or tolerate treatment of venereal disease. This, despite the fact that female nurses dealt with cases of venereal disease and had continual intimate contact with patients.  A doctor was traditionally a masculine authoritarian role and it was felt men might resent being told what to do by a woman. A famous Punch cartoon of 1915 shows a stern looking female doctor recognising a patient. The patient cheerfully points out that as a police constable before the war he had once arrested her in her guise as suffragette. There appear however to have been few examples of any complaints from patients at being treated by a female surgeon or medic. The women run hospitals were, in fact, considered to be far more pleasant places to be than many official alternatives.

endell wardWard round at Endell Street hospital (image courtesy of bbc. co).

Women doctors had some support, from both the British Medical Association and more enlightened officials within the War Office. The then Secretary of State for War Winston Churchill ultimately refused to allow women to hold commissioned rank commensurate to their skills and responsibilities. He concurred with the official line that a commissioned officer had to be able to undertake all kinds of military duties, including where necessary, fighting. The Medical Women’s Federation retort to this was that:

‘Commissions have been given to numbers of medical men who by reason of physical disability or age were not fit for service’ (Contemporary Medical Archives Centre).

The War Office however maintained that a man unfit for full service was still more able to serve than an able bodied woman. In 1919 the Medical Women’s Federation declared that in future it would advise it’s members never to volunteer for any emergency, unless they were treated in the same way as the men.

Despite finally being granted limited suffrage in 1918, many female army medics found themselves  rapidly demoted back the backwoods of hospital medicine, but not all. Some helped found famous hospitals and others became leading figures in their fields. Notably however, few were allowed to continue to practice as surgeons, where their greatest expertise and experience lay.

In the case of St George’s Blomfield wrote of its women students:

… they proved an enthusiastic and efficient body. Most of them became house officers in their turn. Some occupied the higher posts of assistant curator and pathologist with such signal success that their services were retained long after the war had ceased. No more women students were admitted, however, as soon as it became plain that we were getting enough men to fill all the necessary posts in due course. The school is not big enough to harbour women as long as it continues its present prosperity with men’ (Blomfield, p. 92).

The War Office in fact continued its stance until the Second World War became imminent when again a generation of female doctors and surgeons would be called upon. That generation however were even less inclined to tolerate the inequalities their predecessors had been but even then they were only granted ‘relative’ rank and often denied commissions.

Bibliography.

Blomfield, J. (1933) St George’s: 1733-1933. London: The Medici Society.

SA/MWF/C.163. Contemporary Medical Archives Centre, Wellcome Trust.

Leneman, L. (1933) ‘ Medical Women in the first world war-ranking nowhere’, British Medical Journal, 307 (December) pp.1592 – 1594.
Murray, F. (1920) Women as army surgeons. London: Hodder and Stoughton.
Papers of Louisa Garrett Anderson, The Women’s Library, London.

St George’s Hospital Gazette, 1915.
The Times Letters page, The Times, 4 July.

St George’s first four female medical students

To mark International Women’s Day the Library presented a display of archive material that documented the first admittance of women to study medicine at St George’s.

For anyone who was unable to make it on Monday to visit the display in the Library we have also produced a timeline exploring Women and Medicine and the first female medical students at St George’s. Click the image to open the timeline in Prezi.

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