The First Bone Atlas—A Success or Failure?

William Cheselden completed a surgical apprenticeship in 1709. Remaining in London, he was unable to immediately develop a practice and instead taught anatomy. He eventually turned his class notes into a book, The Anatomy of the Humane Body. It was wildly successful, partially because it was in English rather than Latin. The book proceeded through 13 editions and was the go-to source for surgical anatomy for a hundred years.

Based on his deep understanding of anatomy, Cheselden became an adept surgeon—setting fractures, removing cataracts, and extracting bladder stones. His surgical reputation rapidly spread far and wide.

Cheselden is best remembered, however, for what might be considered a failure. Understanding that skill in surgery requires a thorough understanding of anatomy, in 1733 he published Osteographia, or the Anatomy of the Bones. The book took several years and £17,000 to complete. It was the first book devoted solely to bone anatomy. It sold only 97 copies, yet Osteographia is a treasure of anatomy and artistry.

Cheselden recognized that techniques of perspective and shading were critical to rendering three-dimensional objects accurately onto paper. Just a slight shift of the artist’s head or an urge to highlight a shadowed surface distorted the results. These were outcomes that Cheselden wanted to avoid. Surgeons needed absolutely accurate representations of the skeleton. The subtleties of each contour had to be perfect.

Under Cheselden’s guidance, two artists accomplished his aim. Unique at the time for medical illustration, they suspended the bones from a tripod placed in front of a large box. A tiny hole in one end allowed light and an image of the bones to enter. One of the artists sat at the open end and traced every detail onto a glass plate, which Cheselden then converted to an engraving. At the time, the technique of using a camera obscura was unique for medical illustration. Today we recognize the device as a pinhole camera.


Osteographia ranks as one of the all-time great anatomy atlases in scope and elegance. The camera obscura, depicted on the book’s title page, signals the work’s accuracy. Osteographia’s sensitivity and elegance become quickly evident when noting the exquisite detail of the drawings, their arrangement on each page, and the lack of overlying labels or lines. The text is sparse. Cheselden knew that the images could tell their own story. They continue to do so.

Roy A. Meals, MD blogs regularly at www.aboutbone.com

New collection of medical photographs

Thanks to a grant from the Wellcome Trust, the Historic England Archive has completed a 12 month project to conserve, digitise, and catalogue a collection of photographic prints showing health and social care in Britain between 1938 and 1943.

The Mozelle Sasson High Voltage X-Ray Therapy Department at St Bartholomew’s Hospital, 20th January 1939. (MED01/01/0123)  Source: Historic England Archive

The 4,071 black and white photographs were taken by Norman Kingsley Harrison for the Topical Press Agency, and were only recently rediscovered in the Historic England Archive. The Topical Press Agency, established in 1903, supplied newsworthy photographs to the Fleet Street press and specialist journals. While it is not clear why all of the photographs in the collection were taken, it is possible that some were produced for journals such as Nursing Times. Each photograph is accompanied by a detailed caption written by the photographer, which has been transcribed and supplemented by further research.

A broad range of subjects is covered by the Medical Collection, including medical procedures, child welfare, blood transfusion, and nurses’ training. Wartime healthcare and nursing feature heavily, including auxiliary and military hospitals, improvised wards, and bomb damage.

The collection reveals a snapshot of 1930s and 1940s Britain, and shows a health service responding to the demands of a country at war. Significantly, many of the sites shown in the photographs have changed dramatically or have been destroyed or transformed, giving added significance to the collection as a photographic record.

Captivating oral history interviews with nurses who trained and worked in the 1940s and 1950s also form part of the Medical Collection, and a short film featuring the interviews and photographs has been published on YouTube.

The collection offers insights into the history of nursing, rehabilitation, specific procedures, and healthcare in the years prior to the founding of the NHS. It also provides a fascinating record of the development of social care, and documents ground-breaking medical developments during the Second World War, the beginnings of the National Blood Service, and the nursing of military casualties.

More information can be found at www.historicengland.org.uk/medical, and the digitised photographs can be viewed at archive.historicengland.org.uk by searching “MED01”. Low resolution images are available for free, and high resolution images for personal non-commercial use can be ordered free of charge. For more information about ordering, please contact archive@historicengland.org.uk

Abigail Coats, Cataloguing Officer, Historic England Archive

Archibald Watson Lecture 2018

Photograph of Archibald Watson (taken around 1890)

Archibald Watson FRCS (1849 – 1940) was an Australian surgeon and professor of anatomy at the University of Adelaide. He is commemorated in the prestigious Archibald Watson Lecture of the Royal Australasian College of Surgeons and the Royal Australasian College of Physicians.

The 2018 lecture was given by Peter Burke a member of the BSHM. Peter’s lecture graphically illustrates the colourful career of this brilliant but mercurial man.

Watson’s medical education included study in England, France, and Germany. He entered and passed the ‘College and Hall’ in London (MRCS and LSA) and was later awarded 2 MDs and FRCS. During his life, Watson served in the Boer War and World War 1 and travelled widely. He taught anatomy, pathology and operative surgery in Adelaide and achieved an unrivalled reputation as a teacher and consultant.

Peter Burke’s lecture can be viewed at
https://drive.google.com/file/d/1lPm7NtIbUceNwGKDJCMd8GnHC1lg8oSJ/view?usp=sharing

Chris Derrett

Jenner, Fewster and Jesty

Jenner vaccinating (Gillray) – Courtesy Wellcome Images

On the 14th May 1796 Edward Jenner carried out the first stage of his now famous vaccination experiment and inoculated a young boy named James Phipps with cowpox. To this day Jenner’s name is associated with the discovery of vaccination as a concept, and the worldwide eradication of smallpox. However, there were others who helped light the path to Jenner’s discovery, and even carried out that same experiment decades before Jenner.

Vaccination could not have happened without the development of variolation; the process of inoculating healthy individuals with smallpox matter in order to confer immunity against the disease. It was based on the observations that a primary attack of smallpox often provided a degree of immunity against contracting the disease again in the future. It was introduced to Britain in the early eighteenth century by Lady Mary Wortley-Montagu, who had come across the concept of ‘smallpox parties’ whilst living in Turkey. Following the successful variolation of her own son, she also had her daughter inoculated with smallpox matter in 1721 by the surgeon Charles Maitland. Others soon followed suit, including a royal variolation when George II had his two daughters inoculated with smallpox, at the request of his wife Caroline, Princess of Wales.

The concept gradually spread across the country, but it was not until it reached the county of Suffolk and the ears of a young surgeon named Robert Sutton, that it truly took off. Sutton advertised variolation as a service, including bed and board with the added incentive of ‘tea, wine, fish and fowl’ all for a monthly fee. Gradually inoculation houses started to appear across the country, inspired by the likes of Sutton and his business enterprise.

It was at one of these inoculation houses that in 1768 John Fewster, a Gloucestershire surgeon and apothecary, recognised that a great number of patients could not be infected with smallpox. On enquiry he discovered that they had all previously been infected with cowpox. He made note of this and communicated it to a small medical society of which he as a member at the time. It just so happened that Edward Jenner was also present at this society meeting, as a young apprentice to another local surgeon named Daniel Ludlow. Fewster was a strong supporter of the Suttonian method of variolation and he did not recognise the importance or see the need at the time for the development of inoculation with cowpox.

It would be wrong to talk about the history of vaccination without mentioning Benjamin Jesty (1736-1816), a dairy farmer from Yetminster, in Dorset. Not only did he recognise the protective effect that cowpox had over smallpox, but he also went so far as to vaccinate his wife and children with cowpox in 1774, at least twenty years prior to Jenner’s famous experiment. Furthermore he tested his vaccination trial in 1789 when his two sons were variolated by their local doctor and they did not go on to exhibit any signs of a reaction. Jesty unfortunately did not go on to publish his results, and perhaps due to the public outrage that ensued when the locals discovered that he had inoculated his family with animal matter, did not go out of his way to publicise them either. However, his experiment did not go unrecognised, and he was invited to attend George Pearson’s Original Vaccine Pock Institute in 1805. The physicians at that institute decided that Jesty’s experiment had pre-empted Jenner’s, and they awarded him with a testimonial scroll stating just this.

It is evident that the history of vaccination is more complex than the well-known story of Jenner, the milkmaid and the cow. The concept of cowpox being protective against smallpox was reportedly widely known throughout the dairy country in England and across the continent in Germany. However, it cannot be disputed that Jenner was the only one to make this fact publicly known and to recognise the importance that this discovery could have in the fight against smallpox. It was his determination and dedication to the subject which subsequently led to the World Health Organisation declaring the eradication of smallpox on 8th May 1980.

More can be discovered about this fascinating subject by paying a visit to Dr Jenner’s House, Museum and Garden in Berkeley, Gloucestershire. https://jennermuseum.com/

Roy Porter, ‘The Prevention of Smallpox’, in The Greatest Benefit to Mankind. A Medical History from Antiquity to the Present.(London: HarperCollins, 1999) 275-6

S.L. Kotar and J.E. Gessler, Smallpox: A History (North Carolina: McFarland & Company, 2013),18

Robert Jesty and Gareth Williams, ‘Who invented vaccination’, Malta Medical Journal, 23, 2 (2011) 29-32

Lydia Thurston and Gareth Williams, ‘An examination of John Fewster’s role in the discovery of smallpox vaccination’, J R Coll Physicians Edinb,45 (2015) 173-179

Lydia Thurston

Arnica Pharmaceutical Jar

 

Can you help the Archivists at Boots Nottingham to identify the figure on the lid of this beautiful pharmaceutical jar?

Some officers of the British Society for the History of Medicine recently visited the Boots Archives in association with the Annual meeting of the British Society for the History of Pharmacy. We were shown this beautiful Arnica pharmaceutical jar. Discussion ensued regarding the figure on the lid of the jar. Several suggestions were made. We agreed to ask members for the British Society for the History of Medicine for their opinions.

Mike Collins