by Sarah Chaney

In 1935, Dr Isaac Lloyd Johnstone decided to publish a “case of unusual surgical and psychological interest” in the British Medical Journal. This concerned a patient he had encountered over a decade before, while he was a surgical dresser at the Middlesex Hospital. This man was operated on for the removal of several nails and, as Lloyd Johnstone took the patient’s medical history, he discovered that his abdomen was “a mass of scars”; the patient described having had more than a dozen similar operations in the past. Before leaving the hospital, the patient had handed the dresser his memoirs, intriguingly titled “Things I have swallowed since 1905”.[1]

Foreign bodies removed from the stomach of a 26-year-old woman in 1915, The Museums at the Royal College of Surgeons.

The patient’s account described around a dozen operations for the removal of items, predominantly nails, screws and cutlery, but also hairpins, safety pins and, once, a tin whistle. According to Lloyd Johnstone, his informant would make money from his ability to swallow unusual items, by showing a group of objects to his companions in various public houses, and taking wagers against his ability to swallow them. The patient stated that he had always been able to pass objects up to two and a half inches in length, and Johnstone considered that larger objects found their way into the patient’s abdomen when “a drink or two and an intimate knowledge of the hospitals of London made him reckless”.

Indeed, the wagers did not necessarily end with the initial swallowing. In 1912, the patient reported having wound up in Guy’s Hospital after swallowing a 6 ½ inch nail, which took three operations to remove. In his own words:

Before being operated on there was a bet between the Night Nurse and the Student as were the 6 ½ inch lied, one said it was in the transfered Coln, and the Night Nurse said it layed in the Coln, to make sure Mr. John Dunn had me X Rayed and Skiagraphed and the Skiagraph showed that it was in the Coln, and then I was operated on straightaway. The Night Nurse won the Bet which was £5 0, 0 which my Dresser Mr. Taylor had to pay up. [sic]

In Mr XYZ’s account (as Lloyd Johnstone called him), the bet is emphasised over and above his own recovery, indicating the importance he laid on this aspect of his swallowing. The patient remained proud of his abilities, despite the painful and dangerous nature of his career. On at least one occasion, his actions had been thought fatal by hospital staff (after “6 Larg Safty Pins and 5 Ladies Hair Pins … they gave me up for Dead”), yet his account ends proudly with the words “I defy contradiction”. His composure and purpose, as Lloyd Johnstone noted, made XYZ very different from the “usual” hysterical or suicidal cases of foreign body ingestion.

Yet swallowing objects for money or notoriety has a lengthy history, bound up in the notions of performance and risk covered in a previous blog post on sword swallowing. Historian Emma Spary has researched the connections between the medical profession and the swallowers often referred to as “extraordinary eaters”. Her recent book – Eating the Enlightenment – includes a chapter on the involvement of the medical profession in cases of the consumption of non-nutritive items in 18th century Paris.[2]

The contents of the stomach of a knife eater, Gordon Museum (King’s College London)

One such case which features in a London museum is the “contents of the stomach of a knife eater”, housed in the Gordon Museum. This collection of rusty blades, buttons and medallions was removed by surgeons at Guy’s Hospital from the stomach of an American seaman named Cummings, known to the British medical profession from 1799. This unfortunate individual (much like the sword swallower in the UCL collections) ended up being dissected by surgeons a decade later. Like Mr XYZ, Cummings reminds us that the swallowing of foreign items is not necessarily an irrational pursuit, and might be carried out for a wide variety of reasons.

You can watch a video of Dr Spary discussing “extraordinary eaters” on the Damaging the Body website here.

by Sarah Chaney

One of the most important diagnostic tools to assist in foreign body removal was the development of the x-ray. In 1895, Wilhelm Röntgen, a German physics professor, developed the x-ray photograph, which enabled the interior of the body to be made visible using electromagnetic radiation.[1]  In the late 1890s and early 1900s, medical reports on foreign bodies frequently focused on the use of the “Röntgen Rays” or “skiagraphs” (as x-rays were then widely called) to locate such objects. A few weeks after Röntgen published the first X-ray photograph, Norman Collie at UCL made his own x-ray tube in order to locate a broken needle in the thumb of a female patient.

World’s first diagnostic x-ray, by Norman Collie at UCL.
UCL Special Collections, on display in the Octagon Gallery
until 30 April: http://www.ucl.ac.uk/museums/whats-on

Many of the foreign bodies case histories in hospital records of the period focus on the use of this new diagnostic technique. However, x-rays could also lead to tension between patients and clinicians, when the photographs contradicted stories told by patients. One German publication of 1899 reported a soldier’s claim to have been bitten by a horse as “malingering” (a serious military crime) when broken needles were found in the wound, suggesting that the injury was self-inflicted.[2]

Image showing self-inflicted burns in a
“hysterical” patient, from John Collie’s
Malingering and Feigned Sickness (1913)

Yet, surprisingly (given the widespread publicity given to so-called malingering in civilian populations in the decades preceding the National Insurance Act of 1911), these stories seem to have been of less interest to many surgeons than the diagnostic procedure itself. At the Royal London Hospital in 1898, for example, little interest was shown in the fact that the x-ray photographs of 38-year-old domestic servant Elizabeth Quaife did not tally with the history she gave.[3] Elizabeth claimed that she had suffered pain in the knee joint ever since a long hat pin ran into her leg while she was sweeping under a bed: in hospital, however, five separate needles were discovered in the joint. Unlike in published cases, the surgeon made no reference to the potential use of x-ray imagery to detect fraud, but instead used the case to evaluate the usefulness of the technique itself. This, it was thought, had been successful in locating and removing four needles but “the fifth needle shewed by the skiagraph was … not found. It is probable that the figure shewed in the skiagraph was due to a shadow of the other needles. This, once more, shews that the skiagraph may be deceptive.”

This emphasis on diagnosis and removal certainly tallies with the lack of interest surgeons tended to show in the cause of foreign bodies. Foreign Body in this period was a diagnosis, not an exploration of a patient’s state of mind. When Rachel Taylor was admitted to the Royal London in 1900 – after swallowing a pin and a tin tack – and again in 1906 having swallowed two nails “the night before last”, it was not noted whether either instance was accidental or intentional.[4] Despite published concern over the potential abuse of charitable treatment, in practice this does not seem to have been a significant issue for either surgeons or physicians at the Royal London Hospital: cases of “artefact injury” were treated without question whether or not the patient paid for their treatment.

by Sarah Chaney

We know sadly little about the sword swallower’s sword that resides in the UCL Pathology Collection: not even how long it has been here. What we do know is that this performer was very unlucky. Perhaps he (or, indeed, she) didn’t tilt his head back far enough. Perhaps he moved during the process of insertion. Whatever the case, the sword pierced the flexible tube of the oesophagus, leading to the performer’s death. The heart and oesophagus were preserved – perhaps as a warning of the dangers of such feats – alongside the weapon that led to his demise.

Fatally ruptured oesophagus, caused by the sword swallower’s sword. Photograph Gemma Angel, UCL Pathology Collections.

Sword swallowing seemingly originated in India some 4,000 years ago, but reached the western world of Ancient Greece and Rome in the first century AD. The performer tilts his or her head back, extending the neck, and learning to relax muscles that usually move involuntarily. A rigid weapon can then be passed down as far as the stomach, usually for just a few seconds, before removal. It is dangerous, certainly, but few performers suffer the fate of the individual preserved in the UCL collections. According to one recent article in the British Medical Journal, most serious incidents occur owing to distraction or attempts at exceedingly complex feats:

For example, one swallower lacerated his pharynx when trying to swallow a curved sabre, a second lacerated his oesophagus and developed pleurisy after being distracted by a misbehaving macaw on his shoulder, and a belly dancer suffered a major haemorrhage when a bystander pushed dollar bills into her belt causing three blades in her oesophagus to scissor. [1]

In many ways, sword swallowing is the opposite of the ingestion of other foreign bodies: rather than swallowing, the performer maintains absolute control over the process of consumption, taming the body’s reflexes and realigning the organs. As Mary Cappello notes in her fascinating literary biography of surgeon Chevalier Jackson (1865 – 1968), who was an expert in foreign body removal, sword swallowing was recognised by doctors as inspirational to their own techniques. Jackson took his lead from German professors Alfred Kirstein and Gustav Killian, who lectured that sword swallowing proved the possibility of passing a rigid tube into the oesophagus, in order to remove lodged objects. Jackson, who developed his own oesophagoscope in 1890, admitted that the abilities of circus performers had opened his eyes to the opportunity of removing foreign objects without dangerous surgery. He even taught his children how to “scope” themselves.[2]

In an intriguing parallel, the insertion of some foreign objects into the human body thus assisted with the removal of others. At the turn of the 20th century, the removal of foreign bodies lodged in the throat and airways frequently required an incision to be made into the trachea or oesophagus, an operation which could prove fatal. In the records of the Royal London Hospital, from 1890 to 1910, we find no mention of oesophagoscopy or bronchoscopy: instead, surgery or the probang or “coin-catcher” was the norm. This latter instrument was generally a simple hook, inserted without any kind of viewing device or illumination. The practitioner would feel blindly for the object, and either attempt to hook it out, or push it into the stomach. This might lead to numerous complications. In 1903, surgeons at the Royal London attempted to remove a halfpenny from the throat of a five-year-old boy by pushing it into the stomach. However, it was subsequently reported that the coin catcher broke off in the boy’s throat, necessitating a major operation from which the child did not survive.[3] Small wonder that, less than a decade later, Jackson declared such objects “rough, unjustifiable, brutal”.[4]

UCL Pathology Collections contains many examples of foreign objects removed from the
human body: this purpose built display showcases many such objects, some with
small x-rays of the objects prior to removal.

X-ray imaging techniques aided the removal of foreign objects by instruments, and foreign body specimens are often accompanied by photographs showing the item’s location in the human body. The above set of items is found in the UCL Pathology Collection, the objects having been gathered by several surgeons in the 1920s – ‘50s. At some point, the individual boxes made for each specimen were mounted together, in a specially designed plastic surround. Fittings on the back indicate that the case was made to hang on a wall. But why? To decorate the office of a surgeon, showing off his achievements? To offer a warning to others to take care (particularly parents, for all these objects were removed from children and infants)?

Chevalier Jackson claimed that his collection of more than two thousand foreign bodies (now housed in Philadelphia’s Mutter Museum) was not a curiosity, but indicative of the everyday nature of foreign body ingestion and inspiration. Yet many of these specimens are not everyday. The two boxes of multiple objects in the bottom right, for example, were removed from the vaginas of young girls (six and eight years old respectively). The case notes do not indicate how these objects arrived in their location. Did the girls insert them themselves, or might it be a sign of sexual abuse? In her research into the medical histories of Jewish immigrants to the East End of London in the late nineteenth and early twentieth centuries, Carole Reeves came across a case of multiple foreign body insertion in a young woman, whose vagina was found to be tightly packed with pins. Reeves speculated that Leah G. might have inserted these items in an effort to ward off potential (and actual) abusers.[5]

In most instances, we can uncover little about the motivations of those in the late 19th and early 20th centuries whose foreign bodies are recorded in medical records: surgeons were often little interested in how the object came to be in its current location, but only in its removal. Yet this may often make such displays still more intriguing than otherwise. As Mary Cappello put it, in a video discussion of the UCL artefact pictured above for the Damaging the Body website: “What is the border or boundary between human flesh, between human life and the object world?”

References:

  by Sarah Chaney

A visit to the current Museum of London exhibition, Doctors, Dissection and Resurrection Men (on until 14 April 2013), brought to mind the recent Buried on Campus exhibition in the Grant Museum. Several of us have previously blogged about reinstating the stories of the forgotten dead, as well as the issues around the display and interpretation of human remains in a museum context. As I myself wrote, the disinterrment of human remains is not unusual during building work: the Museum of London exhibition focuses on the excavation of the former Royal London Hospital burial site, during recent improvement works. The bones found showed traces of a variety of practices, including dissection for autopsy, as well as marks made during surgical practice and articulation for the creation of teaching specimens.

Dissection, particularly in the case of medical teaching, was often linked to artistic practice. Doctors, Dissection and Resurrection Men opens with the grisly plaster cast of James Legg, hanged for murder in 1801. Legg was subsequently flayed and posed as if crucified: a collaborative project between artists Benjamin West and Richard Crossway, and sculptor Thomas Banks, who believed that most depictions of Christ’s crucifixion were anatomically incorrect (for more on the Anatomical Crucifixion see Gemma Angel’s post). Rather less theatrically, anatomical drawings and textbooks were also created directly from dissection practice. During a recent session in the Art Museum, I discussed with visitors the way in which anatomy textbooks create stylised images, removing certain body parts in order to emphasise others. Students re-created these images for themselves: first with the corpse, then in their own sketches, re-interpreting the body in a way that made sense for their practice.

Joseph Lister – Side of the Neck and Floor of the Mouth (1850), UCL Art Museum #4801

Amongst the UCL Art Collections are a number of student sketches of the famous surgeon Joseph Lister (1827 – 1912), well-known for his introduction of antiseptic techniques into surgical practice. Born in Essex, Lister came to UCL in 1844, initially as a student of the arts. After graduating, however, he subsequently turned his attention to medical studies, continuing at UCL until he gained his M.B. in 1852. The sketches in the collection mainly date from 1849-50, produced as part of Lister’s studies. The techniques used indicate some of the interesting artistic choices available to anatomical illustrators: perhaps also the influence of Lister’s varied education and interests. The sketch above, for example, was made on tinted paper, which enabled the young Lister to highlight structures using white chalk. This emphasis, along with the effective use of colour (in this instance, major blood vessels are depicted in red, standing out clearly in an otherwise monochrome drawing), enables quick and easy recognition of bodily structures, adding depth to the sketch. For an un-trained eye, the mass of tissues within the human body could not be read in such a manner. The ability to render the three-dimensional body in a series of recognisable images – and then understand the physical body through such images – was as important as surgical skill.

Box Viewer from the UCL
Physiology Collections (080:RFH)

The huge variety of techniques for anatomically representing the human body is also evident elsewhere in the UCL Collections. The Physiology Collection includes a volume of the Edinburgh Stereoscopic Atlas of Anatomy, published in 1905. Stereoscopy became a popular technique of representing three-dimensional structures from its inception in the 1840s. Two offset photographs or other images are presented to the viewer which, when viewed through the stereoscope, are seen separately by the left and right eye. As occurs in ordinary vision, the brain combines the images perceived by both eyes; in the case of stereoscopy, giving the illusion of three-dimensional depth. The Edinburgh Atlas aimed to use this technique to represent photographs of dissections in a manner closer to that seen in the three-dimensional human body than simple sketches. Bulky and expensive, the success of the Atlas was relatively limited. It still serves, however, as an unusual reminder of the way in which the human body has continued to require anatomical translation.

  by Sarah Chaney

Recently, I was lucky enough to be able to borrow a replica strait-jacket, which visitors to the Grant Museum were only too eager to try on, offering an interesting point of departure for conversations on freedom and constraint within a mental health context. The backdrop of the Grant Museum itself offered a striking way of representing a comparison often made in histories of psychiatry: as Andrew Scull puts it, “the madman in confinement was treated no better than a beast; for that was precisely what, according to the prevailing paradigm of insanity, he was.”[1] Scull was talking about the 17th and 18th centuries in particular – for him, the introduction of moral treatment (an approach focused on providing a restful environment and work and occupational opportunities for asylum inmates) around 1800 encouraged a shift in understandings of the mentally afflicted. From being viewed as animals, requiring control and confinement, they were re-classified as children, who might be educated.

This idea of a clear shift is overly simplistic, failing to take into account, for example, changing ideas of education, child-rearing or cruelty to animals. Indeed, Patricia Allderidge has criticised the use of cases of restraint to support this argument. The dehumanising nature of restraint is often supported by reference to cases like that of James Norris, an American marine who was admitted to Bethlem in 1800. From 1804, Norris lived in an iron harness which had been specially made for him, and is pictured below. The effects of a severe head injury made Norris violent and dangerous, and all other methods of controlling his behaviour had apparently failed, resulting in serious injuries to staff and other patients. This type of restraint was thus extremely unusual, and cannot be used to make general points about contemporary ideas of insanity. What’s more, there are other suggestions that Norris was not necessarily confined because he was considered to be “a beast”: as Allderidge notes, the least-quoted aspect of Norris’ life at Bethlem is that “he occupied himself … by reading the books and newspapers which were given to him, and amusing himself with his pet cat”.[2]

James Norris, 1815
(incorrectly identified as William Norris
by newspapers).

In popular lore, the history of asylums is frequently presented as closely associated with mechanical restraint. Few people, for example, are aware of the “non-restraint” movement in England and Wales, which saw all restraining garments, straps or chains disappear from the vast majority of asylums for a half-century, from 1840. This rather complicates the widespread assumption that social or medical change must necessarily be progressive: if one encounters a strait-jacket in a museum collection, for example, it is much more likely to be a twentieth century garment than a Victorian one. This idea can be disturbing for those who like to imagine a humane present contrasted with a brutal past. The arguments used during the non-restraint debates indicate that this topic was also much more complex than ideas of progress allow for. Those who were wary of adopting a blanket policy of non-restraint argued that other measures of coercion were simply being substituted, including physical handling by staff, the use of locked rooms and padded cells, and “chemical restraint” by drugs (all issues, along with legal constraints, which remain concerns in psychiatry today).

Indeed, one of the most disturbing cases that I came across in my asylum research was well within the non-restraint period. In 1865, Henry Wright, a middle-aged clerk, was admitted to Bethlem after severely wounding himself by cutting his own throat. While in hospital, Henry made repeated efforts to tear open his wound, so that, a month after admission, it was noted that “[i]t is not safe to leave hold of his hands for an instant. He is looking ill and sedatives have very little effect on him.” For much of his time at Bethlem, Henry was accompanied everywhere by two attendants, who ceaselessly kept hold of his hands, severely limiting his movements. This was not considered to be restraint: nor did it help Henry, who made his last recorded suicide attempt a year after admission, following which he was discharged uncured.

Replica Strait-Jacket.

Sad cases like Henry’s remind us that the assumption that restraints are necessarily dehumanising can actually perpetuate the associations between madman and beast suggested by Andrew Scull. While strait-jackets are often assumed to be cruel, they also tend to be judged as evidence of the wearer’s problematic nature. When restraints appear in film or TV, they tend to be used to signify potential danger to others: as Henry’s case indicates, most people who wore such clothing were considered dangerous only to themselves. Even those who were thought to be a danger to others, like James Norris, do not necessarily fit the stereotype of the “raving lunatic”, and were able to carry out intellectual pursuits while confined. An excellent exhibition at Guy’s Hospital by artist Jane Fradgley (Held, on until 8 March 2013), offers a much more nuanced perspective on so-called “strong clothing”, suggesting that it can in some cases be protective, as well as restrictive. For people like Henry and James, restraint of some kind was inevitable: whether this was in the extreme form suffered by the latter, or the sedatives and physical holding used to try and prevent the former from severely injuring himself.

by Sarah Chaney

During the recent One Day in the City exhibition in the Art Museum, I had an interesting conversation with a couple of visitors who had popped in during the Marxism 2012 conference held elsewhere onsite. The exhibition took a variety of images depicting certain aspects of London over time, often raising questions about the relationship between representation and reality: for example, an etching showing the city as if viewed from a non-existent hill. Prior to aeroplanes, helicopters and even hot air balloons, the artist could not possibly have seen the city from such an angle. Yet they imagined what such a view might have looked like, and faithfully drew their idea of the reality.

Wenceslaus Hollar (1607-1677) – London Panorama. UCL Art Museum.

By situating such images in the past, we often assume that we are seeing uncomplicated depictions of reality: what life was really like in London a hundred, two hundred, or three hundred years ago. Yet representations of London life are just that: representative of a particular individual – and, most often, social or political – point of view. When we look at historical prints as objects, stripped of their context – and even their creators – we run the risk of misinterpreting them altogether.

“Do you think?” one of the visitors mentioned above asked, “that time often causes us to dilute, or even lose altogether, the political message of historical images?” This conversation encouraged all of us to view the exhibition in a slightly different manner, looking beyond what we could recognise of “our” London (buildings, geographical landmarks or institutions) to see London as a place teeming with people who were, genuinely, historical actors: people who held diverse beliefs, opinions and ideas just as we do.

In particular, we discussed some of the etchings by William Hogarth displayed in the exhibition. It is well known today, of course, that Hogarth (1697-1764) was a satirist and social critic. His works often run in a series, charting the course of particular ways of life that he wished to critique: on display in the museum was Industry and Idleness: other examples included Marriage à la Mode and A Rake’s Progress. Despite acknowledging the critical nature of Hogarth’s work, and the strong use of symbolism within his images, scenes of London life are nonetheless often assumed to be just that: a clear representation of what life was actually like in the city during Hogarth’s life. Nowhere does this occur more frequently than in relation to the final scene in A Rake’s Progress, in which Tom Rakewell’s profligate life has seen him admitted to the “madhouse”: the Bethlem Royal Hospital (or Bedlam, as it was commonly known).

Hogarth: A Rake’s Progress (1735). Wellcome Library, London.

Hogarth’s image of “Bedlam” is often used in histories as an illustration of the eighteenth-century asylum, suggesting that various elements of the work indicate what the asylum was “really” like at the time. In particular, the well-dressed lady visitors are used to highlight the existence of public visiting in this period, a regular practice until 1770. Like most hospitals in this period, Bethlem was a charitable institution and thus was maintained by donations, which were requested from all visitors. Yet Hogarth’s image is a satire: while Rakewell’s fellow patients can be viewed in relation to diagnoses of the day (such as religious delusion, love melancholy and delusions of grandeur), they can equally be seen to satirise the state of contemporary institutions – the Church, the monarchy, and scientific endeavour. By viewing Hogarth’s image merely as a representation of the Hospital itself, we risk missing the fact that he also has plenty to say about society outside the Hospital. As in drama, literature and poetry, representations of Bethlem in art frequently aim to hold a mirror up to society, rather than to represent the realities of mental health experience and treatment.

by Sarah Chaney

Henry Scott Tuke was a student at the Slade School of Fine Art in the 1870s, winning a three-year-scholarship in 1877: sadly, this was twenty years too early for his prize-winning work to have made it into the UCL Art Museum. The Tuke family had a number of connections with UCL, however: Henry’s elder brother was a medical student at University College Hospital.

Although biographies of the Newlyn painter often mention his doctor father, little is made of this connection – Henry remains a figure of interest for art and cultural historians, and his father for historians of medicine. Yet parallels between art and psychiatry were often emphasised in the late nineteenth century. Daniel Hack Tuke, Henry’s father, was a governor at Bethlem Royal Hospital from the 1870s until his death in 1897, and art was an important topic at the asylum, for patients and staff alike. Daniel’s obituary in the Hospital Magazine, Under the Dome, concentrated on his well-known son, noting that:

The early death of his eldest son, who was a brilliant student of University College Hospital, was a painful blow to Dr. Tuke, but no doubt he found some amount of solace under this loss in the successful career as a painter of his other son, Mr. H.S. Tuke. The latter has been a foremost member of the Newlyn School, and like most of his brother artists of that school of painters, has lived a good deal on his boat on the coast of Cornwall, and, we remember, that about three seasons since, Dr. Tuke, upon his first visit to the Hospital, after his autumn holiday, said to the present writer that he had much enjoyed it, having in good part spent it with his son upon the latter’s studio-boat. [1]

From this remark, it would seem that Henry and his father were close. It may be interesting to pay closer attention to the fact that Henry Scott Tuke is best remembered today for his Impressionist style paintings of male nudes, becoming a cult figure in gay cultural circles. Was this connection also made in his life? Certainly, homosexuality (or ‘sexual inversion’ as it was more commonly known at this time) was a topic of interest for many psychiatrists, among whom Daniel Hack Tuke was extremely prominent. In Austria, for example, forensic psychiatrist Richard von Krafft-Ebing devoted much of his magnum opus, Psychopathia Sexualis (first published in 1886) to the topic, later becoming a fervent opponent of Paragraph 26, which outlawed homosexual acts in German and Austrian law.

English sexologist, Havelock Ellis, meanwhile, had been mentored by Hack Tuke during his own days as a medical student. In the early 1890s Ellis and writer (and self-confessed ‘invert’) John Addington Symonds corresponded about a book they wished to write together on the topic. Ellis complained about the lack of interest from his medical colleagues, in particular that Daniel Hack Tuke himself “wrap[ped] a wet blanket around it [the topic], with averted eyes”. Symonds had similarly been annoyed in a letter to his friend, Edmund Gosse, that when he tried to ‘draw’ Tuke on the topic of ‘sexual inversion’ he “found that he preferred to discourse on ‘hypnotism’.”[2]

Symonds and Gosse were both certain of the ‘character’ of Henry Scott Tuke’s art (i.e. homosexual). Perhaps this was also why Symonds felt that Daniel would be a natural ally, in addition to the doctor being an old friend of his father’s. In 1891, he sent the psychiatrist his philosophical text on homosexuality, A Problem in Modern Ethics, but informed Havelock Ellis that Tuke “shrinks from entertaining the question in any practical way.”[3] A year later, Symonds was made ‘angry’ by Daniel’s attitude, seeing it as evidence of the refusal of English Medical Psychologists to discuss the topic at all. Tuke, Symonds claimed, was “unscientifically prejudiced to the last degree.”[4] Today, we may well feel that Symonds’ anger was justified, and that Daniel Hack Tuke should have lent his well-known name to a project, in support of his son. Or we may feel that the “sentimental” psychiatrist (as his colleagues described him) was the very worst person for Symonds and Ellis to approach, and that the topic of sexual inversion might, to him, have appeared personally painful. He may have worried that his involvement might reflect badly on his son’s career or, alternatively, he might not have regarded the topic as falling into the field of pathology at all. We can conclude, however, that Ellis and Symonds felt that Daniel Hack Tuke’s personal connections should encourage a commitment to exploring homosexuality both medically and politically, and that the quiet, serious doctor did not.

He did, however, keenly support his son’s career, attending exhibitions at the Royal Academy of Art – and, perhaps, at the Slade before that. While there is no work by Henry Scott Tuke himself in the UCL Collection, the Art Museum includes work by his teachers. The artist studied under Sir Edward Poynter, depicted here in a portrait by Alphonse Legros, another of Henry’s teachers.

Sir Edward Poynter by Alphonse Legros (1837 – 1911) from the UCL Art Museum

by Sarah Chaney

The current exhibition in the Petrie Museum, Fit Bodies, often gives me a chance to reflect, with visitors, on what a “fit body” actually is. When we describe a body as being fit, we are often saying as much about what it is not, as describing what it is: the fit body always implies the existence of its opposite, the unfit body. Such concerns have often served social and political ends – the recent Petrie exhibition, Typecast, on late nineteenth-century eugenics, being a case in point – making it vitally important for us to acknowledge the ways in which the judgment of “fitness” acts as a process of normalisation.

Historically, we often view past cultures through their art or religious iconography, extrapolating from this what life was “really” like in the past: I’ll return to this idea in more detail in a future post. An example related to Fit Bodies would be the associations we make between Ancient Greece and athleticism. However, as one of the Petrie staff recently pointed out to me, the prevalence of war and the large number of youths who did military service in Ancient Greece meant that physical disability or scarring was not uncommon. Indeed, he notes, depictions of disability are relatively common in Greek imagery. Perhaps we often miss this because we assume that Greek culture idealised the “perfect” body and, in that sense, the depiction of Ancient Greece as a society obsessed with athleticism may say as much about our own culture as theirs.

In my own research, I am particularly interested in “damaged” bodies. Like the fit body, the damaged body is not a fixed and obvious entity, but a concept that changes depending on cultural mores and political concerns. I run a seminar series, which encourages debate around various incarnations of the damaged body in various eras: http://damagingthebody.org. Some of the ideas raised may be very familiar to us today’ others are completely alien to our own concepts of damage and fitness, which I hope serves to remind us of how fragile these concepts often are. My thesis focuses on the idea of self-inflicted injury in the late 1800s, an even more complicated concept than damage in general. When and how do we decide that damage has been self-inflicted? Is a feat of endurance to be understood as self-inflicted injury? Or taking part in a reckless endeavour? Neglect of health? Or even attempts at self-treatment?

The last of these is particularly interesting from a nineteenth-century perspective. Ideas of “self-harm” (particularly associated with self-inflicted cut wounds) are widespread today: so much so, that one teenage museum visitor referred to the mechanical leech as “self-harm in a box”. However, for the most of the population in the 1800s, bloodletting was an important means of restoring physical health. This makes it very difficult to judge the words of nineteenth-century actors by our own standards. Today, self-harm tends to be described as a means of externalising emotional pain, or replacing it with physical pain that is considered easier to manage; the relation of self-injury to emotional or mental suffering is thus invariably emphasised. If we choose to, we can read the words of nineteenth-century individuals in this way. When asylum patients are reported as having bled themselves to relieve distress, or pressure in their heads, we assume that they are describing self-harm as we know it, proving this to have universal meaning. In my view, this would be erroneous. The ideas behind bloodletting as a practice – and nineteenth-century concepts of mental illness itself – make it much more likely that this bleeding was intended as a physical remedy, intended to cure a physical illness (believed to be located in lesions of the brain or nerves). Self-inflicted wounds were not understood to “damage” these people’s bodies, but were instead a legitimate therapeutic practice, intended to restore fitness. Recognising a “fit” or “damaged” body, then, depends greatly on our own cultural and political perspectives, which are invariably shaped by our historical and geographical contexts.

by Sarah Chaney

Katie’s recent post on the ethics of displaying human remains in museums, along with the recent Grant Museum exhibition on the topic, raised some important questions about collection and display. Unsurprisingly, this is a frequent topic of concern in medical museums – particularly in hospital museums, teaching collections tend to focus around anatomy and pathology, a large part of which consists of specimens of human remains. But what exactly constitutes “human remains”? This is, on occasion, a surprisingly difficult question to answer.

Many medical collections were created in the eighteenth and nineteenth centuries, as anatomy schools grew and increasingly began to offer practical training for medical students, alongside lectures. One such fascinating collection can be found at Benjamin Franklin House, in Craven Street near Charing Cross. An ordinary Georgian townhouse, which was home to American Founding Father Benjamin Franklin for nearly sixteen years, the building also housed a private anatomy school. The school was run by the landlady’s son-in-law, William Hewson; who had previously worked with the well known anatomist William Hunter. Hewson sadly died young, of septicaemia contracted during a dissection, but the remains of his school were uncovered during the restoration of the house in recent years, in a pit where the back yard would have been.

It is not unusual for bones to be unearthed when foundations are laid for new buildings in London, something explored not so long ago in an exhibition at the Wellcome Collection, London’s Dead. These skeletal remains are what first springs to mind when we think about human tissue. It is skeletons that we often expect to see in museums; the absence of flesh suggests age and the process of decay. How long, though, do we continue to regard these skeletons as the remains of our loved ones? Cemeteries, for example, tend to offer burial plots for periods of only around fifty or sixty years. By this time, the body will have decomposed, and the land can legally be re-used. In Sheffield, part of the former city cemetery has been turned into a park. In London, memorial grounds are built over all the time. Once people have faded from memory, it seems that their remains do too.

But what other human remains do we find in medical collections? Many of the specimens are dissections of various sizes and complexity. It seems obvious which of these are tissue and which not, but even here the recent Human Tissue Act has struggled to define humanity. We might assume that any part of our physical form constitutes human tissue but, legally speaking, this is not the case. Body parts that regularly grow and are removed, for example, are something of a grey area; for example, locks of hair, often kept as mementos of a loved one, can legally be kept or displayed by any museum. But what about blood? The status here is uncertain. On the other hand, a tumour which has been surgically removed is considered human tissue, despite the fact that the person operated on may well have considered it to be alien to their own person.

Stained Brain Specimens in the UCL Pathology Collection. Courtesy of Bethlam Heritage.

One of the things that intrigues me most, however, is the place of foreign bodies in medical collections. Foreign bodies are objects that have been swallowed, inhaled or otherwise inserted into the human body. Often, particularly when these items end up in the bladder, the body creates deposits around these objects, protecting organs from sharp edges or corrosive material. When removed, the foreign body may be invisible within layers of mineral coating. These objects are faintly mysterious: created by the human body, they are nonetheless not considered to be human at all. They lie beyond the regulations on human tissue, but could not have come into existence in the first place without having had a relationship with that tissue.

by Sarah Chaney

“A room without pictures is as bad as a room without windows.”

So wrote a newspaper reporter in the Dumfries Herald in 1881, when commenting approvingly on the therapeutic environment of the Crichton Royal Institution and Southern Counties Asylum in Dumfries. Like many other psychiatric hospitals of the period, the galleries of this institution were indeed heavily decorated. Domestic furnishings, pictures, birdcages, plants and drapes were all intended to contribute to a domestic appearance, thought to be both comforting and morally and spiritually uplifting. Indeed, the domestic environment of the asylum was often interpreted as directly curative. The annual reports of many asylum medical superintendents frequently focused on improvements to facilities, with very little information that we might regard as directly medical, such as physical and pharmaceutical intervention.

But what pictures were displayed? Art was often donated by benefactors, meaning there was little choice as to what could actually be shown in the Hospital. Sometimes this might lead to what seem, today, to be surprising displays. Art historian Nicholas Tromans has identified one of the pictures in images of wards at the Bethlem Royal Hospital as an engraving after Landseer’s Otter Hunt. As he points out, today the work is considered too distressing to exhibit, making it seem a picture that we might not imagine to have had a particularly calming or uplifting influence on patients! Another hunting image in Landseer’s work, from the collections of the UCL Art Museum, is shown below. On other occasions, art might be commissioned by the governors of a Hospital. The theatre at the exclusive Normansfield Hospital, set up by John Langdon Down in 1868 for young people with learning disabilities, was partially painted by Marianne North. The walls are also adorned with sets from Gilbert and Sullivan’s Ruddigore at the Savoy Theatre, presumably bought at auction in the early 1890s.

Edwin Landseer (1802-1873) – His Master’s Dog (UCL Art Museum)

 Doctors also often regarded themselves as artists. Medical obituaries of the late nineteenth century regularly highlighted the various creative pursuits of psychiatrists, seen as an important indication of their intellectual status as Victorian gentlemen. Participation in musical and dramatic performances was expected of all asylum staff, including the low-paid ward attendants. Indeed, when one attendant walked out of a band practice session at the Crichton Royal Institution in Dumfries in December 1880, he was told by the superintendent to “choose whether to be obedient, contented and loyal or leave the place”. He selected the latter, and left that same evening. Theo Hyslop, superintendent of Bethlem Royal Hospital from 1898 to 1911, was a keen artist, who exhibited at the Royal Academy and later became a controversial art critic.

Hyslop also seems to have encouraged his patients to paint, and organised a public exhibition of some of this art at Bethlem in 1900. Indeed, in many asylums, some of the art on display was certainly created by patients. Sometimes, artists happened to be resident within the institution. Richard Dadd, for example, created most of his famous works while an inmate of Bethlem and, later, Broadmoor. The un-schooled James Henry Pullen, known as the “genius of Earlswood Asylum”, apparently caught the interest of Edwin Landseer, who sent the young man some of his paintings to copy: another connection between Landseer’s work and the asylum. Other patients may have practised decorative work. In 1883, the superintendent of Bethlem reported that “during the past year we have been engaged in painting artistically one of the male infirmaries, and although it has been somewhat difficult to get a sufficient number of the patients occupied, yet, on the whole the result has been satisfactory, we have had not only kindly assistance from ladies, who have no connection with Bethlem, but we have had several patients among the ladies who have developed quite a taste for the work, and next year I hope to carry this decorative work into several of the other wards.” The following year it was recorded that female patients had been engaged in the painting of a dormitory: such decorative work can be seen in the photograph below.

Dormitory at Bethlem in early twentieth century (Bethlem Royal Hospital Archives & Museum)

As Savage’s words indicate, painting was considered an occupational pursuit: something that would relieve the tedium of asylum life and distract patients from the “morbid introspection” that many doctors blamed for the onset and prolongation of insanity. Imagination and creativity, however, were also considered to be important elements of the human psyche by many asylum practitioners of the period, traits which separated humans from animals and thus aided the “degraded” asylum patient towards mental health. Art in the asylum thus served multiple functions, something that continues to this day through such organisations as the Bethlem Gallery and Museum and the Langdon Down Museum.