Edinburgh Mystery Object

(from Surgeons’ Hall Museum, Edinburgh)

One of the earliest published descriptions of this instrument (possibly the earliest),  was by a famous Scottish surgeon-anatomist who collected examples from other surgeons and made modifications.

What is the instrument called, what was it used for and who was the surgeon ?

Clue – his portrait hangs in  Surgeons’ Hall, Edinburgh, venue of the BSHM September Congress

submitted by Iain Macintyre

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The Mesmerist: John Elliotson (1791-1868)

In 1837, when 19-year-old Queen Victoria ascended the British throne, medicine was a bleak and brutal business. Operations were performed without pain relief while the standard medical therapies were bloodletting, purging and dosing with toxic potions. But that summer a promising medical innovation crossed the Channel from Paris: mesmerism. Most of the British medical establishment scorned this new-fangled French idea but one doctor, the highly esteemed physician John Elliotson, embraced mesmerism with zeal. For 18 months in 1837 and 1838 Elliotson staged dramatic demonstrations on his patients at University College Hospital which drew fascinated audiences, provoked sensational headlines and – ultimately – split the medical profession.

The Mesmerist: John Elliotson (1791-1868) is an exhibition at the Library of the Royal Society of Medicine.
1 Wimpole Street, LONDON  W1G 0AE

This exhibition tells the story of John Elliotson and his battle to promote mesmerism – hypnotism as it was later renamed – in the face of furious opposition from the medical establishment and medical press.  Elliotson was President of the Medical and Chirurgical Society of London in 1833, and it was during his term of office that the Society was granted a Royal Charter to become, in 1834, the Royal Medical and Chirurgical Society.

Robert Greenwood, Heritage Officer, The Royal Society of Medicine Library

BSHM Wikipedia Editathon

Although it often seems like everything is on Wikipedia (the main page currently features articles on the oldest living Pole, the feathers of birds, and 1894 flash floods in Austria, for example!) there are many areas that could benefit from some substantial improvements, and  the history of medicine is one such field. So on 11th April, the British Society for the History of Medicine brought people together at the Wellcome Library to celebrate some of the medics, places, and events that deserve a more prominent place in the online historical record.

The Viewing Room was packed with a mixture of historians, medics, students and local wiki-editors. We began the day with inspirational talks from Iain Macintyre and Emily Mayhew, who took historic images as their focus. As we listened to them speak, topics for improvement were rapidly added to the event page – the history section of the medical illustration page needs work, and the moribund wards which Mayhew mentioned seem like a topic deserving of a page.

Most of those attending had done little or no editing of Wikipedia before, but nowadays it’s very straightforward to get started. Everyone logged in and the Wiki-editing part of the day began with new editors introducing themselves on Wikipedia and exploring some of the page-features they’d never used before, such as Talk pages where editors discuss articles and History pages where you can see every single change ever made to a page. By lunchtime, the room was buzzing with conversations about the talks and about which pages people were planning to tackle!

After lunch, Ross MacFarlane provided a quick tour of the online resources of the Wellcome Library that can be used as sources and inspiration for editing, such as the Digital Collections that are available to all users and Databases and Journals that can be accessed free with a Library card. Nusa Faric talked about her research into why people contribute to medical pages on Wikipedia, and inspired us by showing how many people can benefit from improved articles and introducing us to Wikipedia Zero (a project to provide Wikipedia free of charge on mobile phones, particularly in developing markets). Fired up and ready to go, the group dived in to editing! Some began creating pages from scratch in their Sandbox, whilst others launched into making improvements or corrections on existing pages.

New pages have already been created for leprosy doctor Isabel Kerr; Beryl Corner, who halved newborn mortality rates; cancer researcher Henry Wade; Mary Sturge, who conducted pioneering work on alcoholism; a tool for dental extraction called Coupland’s elevators; and Gilbert Primrose, surgeon to King James I. Pages for Edward Berdoe and Florence Barrett have been improved, the date of publication of De Humani Corporis Fabrica Libri Septum by Vesalius has been corrected on the History section of the Medical illustration page, and a fascinating snippet about the re-enactment of surgery has been added to the Historical accuracy section of the page on the television series The Crown. Other pages in the works include a draft on psychiatrist and mental health campaigner Doris Odlum. Impressive work for such a short time!

Readers are already enjoying this work too – just counting the brand new pages created as part of the editathon, they have been viewed 498 times already (in just a single week!).

There is still more to be done though. A list of the Presidents of the Royal College of Surgeons of Edinburgh shows that many of these eminent figures are yet to have articles, and many of the women doctors listed on the event page still need pages creating or improving. These themes tie in perfectly with two of the themes of the BSHM Congress this year: Women in Medicine and Scotland’s Contribution and Influence. So if you find yourself inspired by a paper in Edinburgh this September, and want to share fascinating stories from the history of medicine with a wider audience, consider joining the Wiki-editing! There are lots of BSHM members who can give you pointers on getting started, and you’re very welcome to contact me at the Wellcome Library too.

Alice White

Wikimedian in Residence at the Wellcome Library
Email: a.white@wellcome.ac.uk
Tweet: @HistorianAlice

Celebrating Dr. Caroline Nompozolo on International Women’s Day

To mark International Women’s Day (8th March)  the archives of the Royal College of Surgeons of Edinburgh has published an interesting blog  on the little-known story of a pioneering female doctor, Caroline Nompozolo, “the first woman of colour from the Union of South Africa to qualify in medicine”. (Children’s Newspaper, Oct 1943)

The blog can be read at https://rcsedlibraryandarchive.wordpress.com/2017/03/08/celebrating-dr-caroline-nompozolo-on-international-womens-day/

Iain Macintyre

 

Robert Fludd MD. FRCP. (1574-1673)

Robert Fludd. Line engraving by T. de Bry, 1645, after Matthäus Merianafter
Credit: Wellcome Library, London. Wellcome Images

A respected physician, Censor four times of the Royal College of Physicians, Robert Fludd was also an anatomist, a friend of William Harvey whose experiments he witnessed, and well-respected by both James I, and by Charles I who awarded him the income from Crown land in Suffolk. All this was perhaps nothing unusual among those who stood well in the senior world of that hierarchical society, a society to which he belonged by birth and by his own medical reputation, and his father’s reputation as an honest and well-rewarded public servant of the redoubtable Queen Elizabeth I.

It was less usual that he was also a distinguished and well known neo-platonist, hermetic philosopher and alchemist, who summed up in himself and in his numerous and large-scale publications the pre-scientific synthesis of cosmic harmony; that is, the intimate and harmonic relationship of the sentient platonic universe with the sentient human being. This was the world before the Cartesian ‘cogito, ergo sum’, which divides the observing ego from its observed subject, a definitive change in perception which has revolutionised human culture since the mid-17th century.

Fludd’s philosophy is epitomised in his magnificent if uncompleted Utriusque Cosmi … Historia 1617-1626 (‘The History of the Macrocosm and Microcosm’), and in his Medicina Catholica 1629-1631 (‘Universal Medicine’) whose lavish, graphic and cogent illustrations illuminate for us the rich world-picture of the Renaissance multi-layered mind, of the prescientific magus, which perceived by metaphor and symbol rather than by our logic. It is not surprising that his illustrations are increasingly used in works on Renaissance literature, philosophy, art and culture. His images speak louder than words. And they are some of the finest and most detailed illustrations, published during that period.

Caught between the old world of symbol and metaphor and the new world of rigorous investigation and scientific experiment (which he also exercised in practical demonstrations of anatomy), Fludd provides for us a passage back to an integrated and sentient universe. Though few of us could support the analogical base on which his system is founded, his symbolism may still speak validly to us today. It is no bad thing to understand the past from within. Our forebears deserve respect, understanding, and even empathy. In history, as in anthropology (of which history is a part) it is possible to maintain participant / observer status. History then ceases to be entirely an account of the past.

Further reading: Godwin J. Robert Fludd: hermetic philosopher and surveyor of two worlds. London: Thomas & Hudson, 1979.

Robin Price – British Society for the History of Medicine

“I am a refugee of Nazi oppression”: The Scottish Royal Medical Colleges and Medical Refugees

The Triple Qualification (TQ) examination of the three Scottish medical colleges, established in 1884. provided a medical qualification recognised by the GMC. It was used by individuals and groups who were unable, for a variety of reasons, to gain entry to university medical schools. Prominent among these groups were women in the 1880s and 90s and refugees from the Nazis in 1930s and 40s. To mark Holocaust Memorial Day on the 27th of January, the archive of the Royal College of Surgeons of Edinburgh has published this account of the stories of some of these refugees.
https://rcsedlibraryandarchive.wordpress.com/2017/01/27/i-am-a-refugee-of-nazi-oppression-the-scottish-royal-medical-colleges-and-medical-refugees/

Iain Macintyre

Neurology and Psychiatry in Babylon

How rapidly does medical knowledge advance?  Very quickly if you read modern newspapers, but rather slowly if you study history.  Nowhere is this more true than in the fields of neurology and psychiatry.

It was believed that studies of common disorders of the nervous system began with Greco-Roman Medicine, for example, epilepsy, “The sacred disease” (Hippocrates) or “melancholia”, now called depression.  Our studies have now revealed remarkable Babylonian descriptions of common neuropsychiatric disorders a millennium earlier.

Figure 1. A well preserved Babylonian cuneiform Tablet on Epilepsy.
Number 26 in a series of 40 medical “diagnostic” Tablets.
Reproduced by kind permission of the British Museum.

There were several Babylonian Dynasties with their capital at Babylon on the River Euphrates.  Best known is the Neo-Babylonian Dynasty (626-539 BC) associated with King Nebuchadnezzar II (604-562 BC) and the capture of Jerusalem (586 BC).  But the neuropsychiatric sources we have studied nearly all derive from the Old Babylonian Dynasty of the first half of the second millennium BC, united under King Hammurabi (1792-1750 BC).

The Babylonians made important contributions to mathematics, astronomy, law and medicine conveyed in the cuneiform script, impressed into clay tablets with reeds, the earliest form of writing which began in Mesopotamia in the late 4th millennium BC.  When Babylon was absorbed into the Persian Empire cuneiform writing was replaced by Aramaic and simpler alphabetic scripts and was only revived (translated) by European scholars in the 19th century AD.

Figure 2. A bas-relief of a wounded lioness from the Palace of Ashurbanipal at Nineveh.
An arrow in the centre of the spine was observed to lead to paralysis of the hind legs,
but knowledge of the spinal cord and its functions did not exist.
Reproduced by kind permission of the British Museum.

The Babylonians were remarkably acute and objective observers of medical disorders and human behaviour.  In texts located in museums in London, Paris, Berlin and Istanbul we have studied surprisingly detailed accounts of what we recognise today as epilepsy, stroke, psychoses, obsessive compulsive disorder (OCD), psychopathic behaviour, depression and anxiety.  For example, they described most of the common seizure types we know today e.g. tonic clonic, absence, focal motor, etc, as well as auras, post-ictal phenomena, provocative factors (such as sleep or emotion) and even a comprehensive account of schizophrenia-like psychoses of epilepsy.  Early attempts at prognosis included a recognition that numerous seizures in one day (i.e. status epilepticus) could lead to death.  They recognised the unilateral nature of stroke involving limbs, face, speech and consciousness, and distinguished the facial weakness of stroke from the isolated facial paralysis we call Bell’s palsy.  The modern psychiatrist will recognise an accurate description of an agitated depression, with biological features including insomnia, anorexia, weakness, impaired concentration and memory.  The obsessive behaviour described by the Babylonians included such modern categories as contamination, orderliness of objects, aggression, sex and religion.  Accounts of psychopathic behaviour include the liar, the thief, the troublemaker, the sexual offender, the immature delinquent and social misfit, the violent and the murderer.

The Babylonians had only a superficial knowledge of anatomy and no knowledge of brain, spinal cord or psychological function.  They had no systematic classifications of their own and would not have understood our modern diagnostic categories.  Some neuropsychiatric disorders e.g. stroke or facial palsy had a physical basis requiring the attention of the physician or asû, using a plant and mineral based pharmacology.  Most disorders, such as epilepsy, psychoses and depression were regarded as supernatural due to evil demons and spirits, or the anger of personal gods, and thus required the intervention of the priest or ašipu.  Other disorders, such as OCD, phobias and psychopathic behaviour were viewed as a mystery, yet to be resolved, revealing a surprisingly open-minded approach.

From the perspective of a modern neurologist or psychiatrist these ancient descriptions of neuropsychiatric phenomenology suggest that the Babylonians were observing many of the common neurological and psychiatric disorders that we recognise today.  There is nothing comparable in the ancient Egyptian medical writings and the Babylonians therefore were the first to describe the clinical foundations of modern neurology and psychiatry.

A major and intriguing omission from these entirely objective Babylonian descriptions of neuropsychiatric disorders is the absence of any account of subjective thoughts or feelings, such as obsessional thoughts or ruminations in OCD, or suicidal thoughts or sadness in depression.  The latter subjective phenomena only became a relatively modern field of description and enquiry in the 17th and 18th centuries AD.  This raises interesting questions about the possibly slow evolution of human self awareness, which is central to the concept of “mental illness”, which only became the province of a professional medical discipline, i.e. psychiatry, in the last 200 years.

Reference
Reynolds EH, Kinnier Wilson J. Neurology and Psychiatry in Babylon. Brain 2014; 137: 2611-2619.

Dr. Edward H Reynolds MD FRCP FRCpsych
Department of Clinical Neurosciences, King’s College, London