Dott the draughtsman...

This week, our Project Archivist, Louise, talks about Norman Dott’s skill in draughtsmanship…
As I look through Norman Dott’s neurosurgical case notes, the many different ways of conveying information, diagnoses and treatment methods never fail to amaze me. From the typed case summaries and charts that you might expect from loose-leaf case notes in this period, folders can contain photographs, x-rays, greetings cards, slides, off-prints and press cuttings.

Some of my favourite things to find in the case notes are surgical sketches, uncovering Dott’s methods in visual form. Some sketches were made by professional artists for use in publication or clinical demonstration, and you may recognise some of the examples below from the LHSA website:

LHB1 CC/20/PRI.682 – artist sketch showing operation for removal of cyst


Artist sketch showing ligature of intracranial aneurysm (from LHSA Norman Dott clinical drawing collection)

The visual communication of his specialism for learning and teaching purposes was obviously very important to Dott: he planned Ward 20 in the Royal Infirmary of Edinburgh (which was to become Scotland’s first dedicated neurosurgery ward, opening in 1938) with artist and photographic studios. However, behind many of the surgical sketches made by artists were drawings made by Dott himself, both as templates for artists to make more detailed representations and for consultation in their own right. Before a motorcycle accident led him to pursue a medical career, Dott was to begin an apprenticeship as an engineer, and perhaps this led to his fondness for using sketches in clinical notes. This drawing demonstrates a procedure for which Dott was a pioneer, in the treatment of intracranial aneurysm by the application of a ligature:

LHB1 CC/24/PR2.3601 (patient details have been redacted)

Whereas this sketch portrays the approach to removing a brain tumour from a young patient:

LHB1 CC/20/PR1.289

Dott was an assiduous record-keeper, not only keeping meticulous clinical notes that were frequently complimented by his peers, but preserving information related to his patients in many forms, from cards sent in thanks from grateful patients to handwriting samples and articles clipped from newspapers. Dott’s own sketches are an essential part of his substantial clinical archive, explaining in visual form the progression of his thoughts and his perception of the life-threatening illnesses which he so often encountered.

Audience engagement

How we communicate the importance of our collections, their relevance to a worldwide audience, and promote access to them is a key part of our work. This month has seen lots of activity on that front with exhibitions, talks and filming all taking place and helping to bring LHSA into contact with people from many walks of life. Keep a look out for us over the coming weeks!

Patient artwork from the Royal Edinburgh Hospital (REH) is featuring in two exhibitions – one at the Djanogly Art Gallery in Nottingham, the other at Halle St Pierre in Paris, and reproductions of this artwork are due to feature at the Scottish Mental Health Art and Film Festival at Summerhall, Edinburgh, from 5 to 19 October.

‘Melancholia’ by John Willis Mason, copy on show at Summerhall in October

The Wellcome Trust (WT) has interviewed researcher Dr Gayle Davis about her work on infertility case notes held at LHSA, conserved with WT funding. The film will be available on their website. Next week, items from the REH will be the subject of a three-part series of BBC Radio Scotland interviews, to be broadcast in November, to commemorate the Hospital’s bicentenary.

Archivist Laura has been talking about the history of the Royal Infirmary of Edinburgh’s finances from its beginnings in the 1720s, until the introduction of the NHS in 1948, to former employees of the Bank of Scotland. Today she is talking about the Archive’s use of social media in engaging audiences to an Archives and Records Association Training Day in Aberdeen, ensuring that we share best practice with colleagues in the archive sector, and learn from them too.

Dispensing hope

Following on from a number of blogs on the treatment of Tuberculosis (TB), this week we look at the formation of the Royal Victoria Dispensary and the start of preventative measures for the disease.
A scourge of Scottish Society in the 1880s, TB infected 1.9 out of every thousand persons in Edinburgh at that time. In 1882 however, German physician Robert Koch made an important breakthrough by identifying that tubercle bacillus was the cause of all of the various forms of the disease in the humans and livestock.
In the years following this, Edinburgh clinician Robert W Philip (1857-1939) was at the forefront of finding a holistic solution to the problem. Using Koch’s discovery as a starting point, Philip decided that the best way to eradicate the disease was to prevent and treat it at all points of transmission. He thought that since TB had been introduced to society through ignorance and neglect, it could equally be removed by methodical reasoned actions. In 1887, from just 3 rooms in Bank Street, Edinburgh, he set up the Royal Victoria Dispensary with the idea that TB patients must be sought out by the physician, along with their whole families for examination. This was the first dispensary of its kind in the world and these combined actions became known as the Edinburgh Scheme.
An early 20th Century slide of Bank Street with a cross marked at the door of the Royal Victoria Dispensary
Following on from the Dispensary, the Royal Victoria Hospital was founded in 1894 and Polton Farm Colony in 1910, keeping ill and recuperating TB patients away from the community. In 1914, the Dispensary, Hospital and Colony were given to the City of Edinburgh and the Royal Victoria Tuberculosis Trust was founded to manage them. 

By 1910 in Edinburgh, infection rates had reduced to 1.07 per thousand and 0.8 per thousand by 1920, vindicating Philip’s actions. Philip tirelessly lectured around the world to see his ‘Edinburgh Scheme’ put into practice around the world wherever TB was found and the results were the same – a steady decrease in infections was to be found.
Dr, later Sir, RW Philip taken from the Summer 1883 Royal Infirmary of Edinburgh Residents photograph
LHSA related records include Royal Victoria Dispensary minutes back to 1891 and case notes back to the 1920s. 
Reference: National Association for the Prevention of Tuberculosis, Sir Robert W. Philip 1857-1939: Memories of his Friends and Pupils, 1957

Back by popular demand

Today saw the second instalment of the ‘History Room’ – a pop-up museum in the Royal Edinburgh Hospital to celebrate its 200thbirthday.

Laura, our Archivist, and Artlink intern Emma setting up the History Room

We took part in the History Room in July, on the anniversary of the first patient admitted all those years ago, and it was such a success that we were asked to come back again. This time the History Room coincided with the Hospital’s summer fete, so as well as items from our collection illustrating aspects of Royal Edinburgh history, there was a pipe band, a barbeque and cake on offer (not in the same room as the archive material of course!).
The LHSA display
Despite the absence of summer weather, there was a good turnout and it was another great opportunity to talk to patients, staff and members of the local community about the LHSA collections and the services that we have on offer.
Laura talking to History Room visitors
Detail of the LHSA display: four drawings of the Hospital by a patient
Objects held by the Hospital displayed in another part of the History Room 

A table set with Hospital crockery and cutlery; objects held by the Royal Edinburgh
Not content to restrict such a great event to the Hospital's bicentenary year, we're already signed up to come back for next year's fete!