How should the History of Medicine be studied?

The teaching of Medical History in Medical Schools has largely been a token gesture and with increasing pressure on the curriculum many have given up any attempt at formal teaching. Considering the scope of the subject and the practicality of producing a comprehensive teaching course, this is not surprising, And yet, most doctors feel that a knowledge of our medical past is important in our practice of medicine today. So how can we continue to enthuse and impart details of our medical heritage to our successors when it is more essential that they are exposed to the clinical skills of practising medicine.

It will perhaps be of interest to hear how we are approaching this problem in Sheffield University Medical School. At the very beginning of the MB ChB programme students undertake a 6-week ‘Student Selected Component on the History of Medicine’ in which they choose one essay title from a list of 270 that span the history of medicine from Ancient Egypt to the present day. The primary purpose of this assignment is to encourage students to develop their generic skills in information searching and synthesis, critical analysis, academic writing, the use of referencing systems and the avoidance of plagiarism. The history of medicine was chosen as the focus for this assignment as a topic that is hopefully of interest to all medical students at the very start of their careers, giving them a chance to consider medicine’s roots as they embark on their journey to become its future.

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Over the past three years, history of medicine exhibitions have also been displayed in the medical school foyer. This started with ‘Sheffield Cares for the Wounded’ in 2014, commemorating the role of Sheffield doctors in a field ambulance on the Western Front in World War One as well as those caring for the wounded returning to Sheffield. Apart from the history of their own medical school, students learnt about the evacuation techniques developed then and refined today. This was followed by more focussed exhibitions on ‘Blood Letting’ dealing with leaches, cupping and scarification and more recently with ‘Inoculation and Vaccination’. Such exhibitions require a secure, alarmed, display cabinet which was obtained with financial support from the Medical School and Sheffield’s Charitable Trusts and which, although initially expensive, now enables us to borrow documents and precious artefacts from private and public collections as well as facilitating display of items from our own Medical School’s past history.

We think this dual approach is one way of keeping alive the study of the History of Medicine in our medical schools. Although requiring enthusiastic volunteers and financial support, it is, we think, more likely that attractive exhibitions such as these will more easily capture the interest of the average medical student than didactic teaching.

Derek R. Cullen , Consultant Physician Emeritus
Julian L. Burton, Senior Teaching Fellow, Academic Unit of Medical Education.

The UK Medical Heritage Library – a free on-line resource of 19C published work

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The UK Medical Heritage Library (UKMHL) is now available as an open access collection via the Historical Texts service: https://ukmhl.historicaltexts.jisc.ac.uk

The collection has been produced through a three year project funded by Jisc and Wellcome Library to digitise over 15 million pages of 19th century published works. Encompassing over 65,000 publications, the subject areas covered are broad and include topics such as consumer health, sport and fitness, food and nutrition as well as medicine and medical practices, providing a valuable resource for study in the medical humanities and beyond.

A range of visualisations have also been created to help researchers explore the data in various ways.

  • Image wall: displays all of the images extracted from publications in your search results
  • Hospital map: enables you to identify and explore content related to specific hospitals
  • Timeline: displays events that occurred in the time period of your search results
  • Ngram: compare word frequencies
  • Dendrograms: for body parts and medical conditions
  • Sunburst diagrams: for body parts and medical conditions

The UKMHL collection is currently in a separate Labs area of the Historical Texts service, but it will also be added to the main service (http://historicaltexts.jisc.ac.uk ) in 2017. So, for institutions that subscribe to Historical Texts, it will be cross-searchable alongside the existing Early English Books Online (EEBO), Eighteenth Century Collections Online (ECCO) and 65,000 texts from the British Library 19th Century collections. The collection will continue to be freely available to the general public as well though.

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Image link: https://data.ukmhl.historicaltexts.jisc.ac.uk/view?pubId=ukmhl-b21273832&index=ukmhl&pageId=ukmhl-b21273832-117  (publication is in the Public Domain)

Susan Anderton
Service Manager (Historical Texts and Journal Archives, JISC)

Pills, prescriptions and pharmacists: creating a new pharmacy history course

©Royal College of Physicians, photography by Mike Fear ©Royal College of Physicians, photography by Mike Fear

When I was asked by the Faculty of History and Philosophy of Medicine and Pharmacy at the Society of Apothecaries whether I would consider programming an entirely new 3 day course in pharmacy history, I jumped at the chance.  Working with my co-course director, Dr Stuart Anderson, we had the opportunity to shape a mini course from scratch.  But what to include from an enormous history with a very broad reach?  And would anybody be interested in attending?

We decided firstly to focus on British pharmacy history, although the course began with a very brief overview of the global story up to 1500.  We were keen to include various strands in the programme including the pharmaceutical industry, the growth of the pharmacy profession and (as I’m a museum curator) plenty of access to original sources.  We also decided on a multi-venue approach to appeal to delegates and make the most of the wonderful resources in London.

Day 1 at the Wellcome Trust and Library included sessions on alchemy, business history, and law and ethics, but also a very popular session from Peter Homan demonstrating various dispensing techiques and introducing us to prescription registers from the Library collection as historical sources. Day 2 was at the Royal College of Physicians with lectures on the pharmacopoeia, pharmacognosy in the 19th century, and delftware drug jars.  Delegates were then treated to a tour of the RCP’s medicinal garden, and a chance to get up close to a selection of their rare books.  The day ended with a tour of the new Royal Pharmaceutical Society Museum.  The final day was at Apothecaries’ Hall with an account of their history, an exploration of their manufacturing operations, and a tour of the current building.  The final afternoon comprised a lecture on the development of the pharmacy profession in the 19th and 20th centuries, and two sessions on the growth of the pharmaceutical industry.

It was an incredibly rich and packed 3 days with some excellent speakers, all of whom had written their lectures especially for the course, and some fantastic visits and source-based sessions.  And the 37 delegates were, thankfully, suitably inspired and impressed.  Typical feedback has been “the combination of talks, visits and displays was well balanced, refreshing and stimulating” and “the event was excellent and covered such an interesting range of material and locations.” Maria Ferran, Faculty Coordinator, has already received enquiries about running the course again, which is extremely pleasing.  If you might be interested in attending a future course, contact Maria facultyhp@apothecaries.org

Briony Hudson

Records of Medical Professionals

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Records digitised by the Wellcome Library, which cover more than a million medical professionals, are now available for searching online. The data collections include:

UK & Ireland

Medical Directories 1845-1942
Queen’s Nursing Institute Roll of Nurses 1891-1931

UK

Dentist Registers 1879-1942
Medical and Dental Students Registers 1882-1937
Physiotherapy and Masseuse Registers 1895-1980
Roll of the Indian Medical Service 1615-1930
The Midwives Roll 1904-1959

More information can be found at: ancestry.co.uk.

Edward Wawrzynczak

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Poynter Lecture 2016

Dr Sam Alberti - Poynter Lecturer 2016

Dr Sam Alberti – Poynter Lecturer 2016

We are grateful to Dr John Firth for this summary of the 2016 Poynter Lecture.

The evening began with  a plug for the 2017 BSHM 27th Congress at Surgeon’s Hall, Edinburgh 13th – 16th September. The four themes of the Congress are “Women in Medicine” , “Scotland’s contribution and influence”, “Apothecaries and their successors”, “Art and photography in medicine”. Full details www.bshm.org.uk/congress

The Poynter Lecture is the annual lecture organised by the British Society for the History of Medicine which this year was delivered on 12th October at the Wellcome Collection. Dr Frederick Noel Lawrence Poynter (1908-1979) was Librarian then Director of the Wellcome Institute for the History of Medicine.   He was a medical historian and wrote several books and articles specialising in Tudor Medicine.  He was also active in professional societies, being President of the British Society for the History of Medicine in 1972 and Secretary-General of the International Academy of the History of Medicine.

Dr Sam Alberti
The auditorium takes over 150 people and I estimated there were over 90 attending. The talk “Finding patients in the Medical Museum” was given by Sam Alberti whom I met when he organised a series of lectures at the Royal College of Surgeons where he was the Curator of the Hunterian Museum. Six months ago he became Keeper of Science and Technology in the National Museums of Scotland. Iain Macintyre, President of BSHM introduced Dr Alberti.

The patient objectified but the doctor remembered
The lecture  began by discussing the trends in medical museums, giving a historical perspective richly illustrated by historical examples such as Barts, the Wellcome Museum and the Berlin Museum of Medical History at the Charité (founded by Rudolph Virchow) amongst many others. Medical museums were at their peak in the late 18th and early 19th centuries. Dividing Museums into “Wet or Dry” he suggested that each had a different trajectory. Museums in that era showed anonymised specimens as examples of disease, often with the patient’s story removed. He showed examples of the Hunterian Museum area devoted to Lister with instruments he designed and some given as gift that he would have been too critical of to use. Patients became objectified. Medical Museums commemorated the Doctor, not the patient (eg Lister, Jenner, Fleming). Dr Alberti pointed out that Henry Wellcome collected massively to represent the patient experience. Over 100,000 of the items he amassed  went to the Science Museum and patients were well represented.

Finding the patient
The Science Museum Galleries are being renovated and new medical galleries will open in 2019. Dr Alberti  used the example of the  Dittrick Museum in Ohio as a museum with a  more narrative approach and heritage function.(http://artsci.case.edu/Dittrick/). The Charité in Berlin is his favourite museum. Situated in  the old hospital wing each museum bay contains a  “bed” each showing the case of a patient.

Having been in his position in the National Museums of Scotland for just six months he recognises that it exhibits  “Science and technology with some medicine”. But the museum has incorporated examples of patient experience of bio medicine and the impact of technological change. He showed a small case study of asthma which focused on the experience of having asthma. Illustrated by a rugby player who lives with asthma Dr Alberti reflected that it is all very well what you can do with disability but there is a fine line exemplified by a patient who said “just because I have prosthetic leg  I don’t want to use it to run a marathon”

Disability explored
He showed some older prosthetic arms that were offered to those affected by Thalidomide but they were too clumsy and some individuals chose  not to  wear them. “Better without” they reckoned. Returning to some historical examples in museums he pointed out that some are not anonymised, like the Irish Giant Charles Byrne whose skeleton is in the Royal College of Surgeons.  He showed an embroidery from 1848 by Charlotte Waite who was one of the first children to be operated on using chloroform. Also in the Hunterian is a severe scoliotic spine now accompanied by an audio by the historian Ruth Richardson who suffers from the same condition. Dr Alberti says there is need “to reunite human remains with patients”. Incorporating art and photography in this endeavour, he showed an example of a laryngeal specimen taken from an opera singer and photoshopped to lie over her  neck. The exhibition Re-Framing Disability at the Royal College of Physicians consists of portraits which depict disabled men and women of all ages and walks of life, many of whom earned a living exhibiting themselves to the public. The hidden histories behind the portraits are examined.  (see https://www.rcplondon.ac.uk/news/re-framing-disability-portraits-royal-college-physicians )

“Disability in a box”
Dr Alberti referred to “Cabinet of curiosities” . Rather than term for the precursor of museums (see https://en.wikipedia.org/wiki/Cabinet_of_curiosities) he was referring to “Cabinet of curiosities how disability was kept in a box” which was in 2014. Full details can be found at http://www2.le.ac.uk/departments/museumstudies/rcmg/projects/cabinet-of-curiosities. A more recent  series where art merged with museum was “Exceptional and Extraordinary” . This project invited four artists to explore behind the scenes of eight of the UK’s most renowned medical museums and, in collaboration with experts in medical history, disability and museums, produced a series of thought-provoking new commissions that examine our attitudes towards difference and aim to stimulate debate around the implications of a society that values some lives more than others. (see http://www2.le.ac.uk/departments/museumstudies/rcmg/projects/exceptional-an  and http://www2.le.ac.uk/departments/museumstudies/documents/e-e-all-performances-final).
In “Transplant” there is collaboration between artists  Tim Wainwright and John Wynne and the transplant surgery unit at Harefield Hospital. It began in 2006 with a year-long residency at Harefield Hospital where the artists recorded and photographed patients, staff and the hospital environment. The project eventually developed into a series of photographic and sonic works, exhibitions and publications.
See http://www.transplantproject.com/ for full details.

War, Art and Surgery
“War Art & Surgery” exhibited at the RCSEng which was a contemporary response by the Artist Julia Midgley  to surgeon artist Henry Tonks’ WW1 pastel portraits of facial reconstruction. A YouTube video is available. https://www.youtube.com/watch?v=VyFV67kthnk.

The lecturer  reflected on comments by soldiers that soldiers’ deaths make news more than the rehabilitation of the injured. One contrast between war injuries 100 years ago and the present is the rising proportion of limb losses from IED’s. He pointed out that capturing narrative is easier historically. The exhibition “Life Support” (see http://www.nms.ac.uk/national-war-museum/whats-on/life-support/) is about the support systems and the medical treatment. Curators worked with the soldiers words on the labels. The voices of the personal are there, but Dr Alberti pointed out co-curation can be risky. He asked if we are making the soldier a victim …. the hero versus the cripple.  A clinical support network had to be in place. He finished by saying that the perspective of clinicians,  nurses and ancillary staff need to be incorporated but the role is in the patient. The Science Museum currently has the exhibition “Wounded” which he recommended.

The lecture finished with the words “it is an exciting time to be visiting medical museums”.

All in all it was a thought provoking evening.

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