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Continuity of Care Project Draws to an End

11 months, 3400 items, 7 blogs and 27 tweets later the Wellcome Trust funded project to catalogue and conserve the records of the Royal Scottish National Hospital comes to an end next week.

The collection provides a comprehensive record of the management and operation of the hospital from 1862 to its closure in 2002. But perhaps the most significant part of the collection is the admission applications.

The first application, 1865

The first application, 1865

Over 3,000 in total, these contain detailed information about the child’s condition, and are often accompanied by family correspondence, an assessment of the child’s abilities, and medical evaluations.

The applications create a research resource for a number of purposes: details of father’s occupation and income for the social historian; information on disability and the causes of death for the medical historian; and the opportunity to cross refer to other sources of data such as census records.

A lot of the applications include detailed case studies with temperature charts, records of physical and mental health and diagrams of the severity and frequency of seizures. Taken in conjunction with other parts of the collection, such as the administration and correspondence files, they present a comprehensive picture of treatment, research and social attitudes. Only used in depth by one academic researcher so far, they are a resource waiting to be exploited.

No final blog is complete without the obligatory before and after photographs of just what a difference funding like that provided by the Wellcome Trust can do.

The collection arrived in these boxes in 2012

The collection arrived in these boxes in 2012

The catalogued collection in the Archives Store

The catalogued collection in the Archives Store 2015










And as for my favourite items…I do like the drawings of santa that the children were asked to do as part of their assessment. Below is my favourite one from 1929.

Santa as drawn by 6 year old Albert in 1930

Santa as drawn by 6 year old Albert in 1930

This will be the last blog by the Project Archivist but by no means the last on the collection. Also, not only will there be an article on the hospital in the August edition of History Scotland but an exhibition in the display wall at Archives and Special Collections, University of Stirling Library from 6th August for two months.

Alison Scott, Project Archivist

Continuity of Care: new project to open up the archives of the Royal Scottish National Hospital

The University of Stirling Archives has received funding from the Wellcome Trust’s Research Resources grant scheme for a project to conserve and catalogue the archives of the Royal Scottish National Hospital, Larbert. Established in 1862 the RSNH (originally known as the Royal Scottish National Institution) was the foremost hospital providing custodial care for mentally impaired children in Scotland in the 19th and 20th centuries. The extensive archives of the institution that survive provide a comprehensive record of the management and operation of the hospital, and the treatment and care of its patients. The historical importance of the collection was recognised last year when it was added to the UNESCO UK Memory of the World Register.

Staff and patients in the grounds of the RSNH, Larbert.

Staff and patients in the grounds of the RSNH, Larbert.

The generous support of the Wellcome Trust will enable us to carry out a comprehensive programme of repair and rebinding of damaged material, along with the organization, arrangement and detailed cataloguing of the collection. We are currently advertising for a Project Archivist and Project Conservator (closing date for applications 15 June 2014). When the project is completed an online catalogue will provide a detailed record of the contents of the collection which can be accessed by researchers in our archives reading room. The archives of the RSN will provide new insights into the history of the treatment and care of children in Scotland and the wider society in which the hospital operated.

Many of the records of the RSNH require conservation and repair.

The project will include a programme of conservation, repair and rebinding.

Continuity of care #4

From Iowa to Alloa, a patient’s story…

Last week David, one of our project volunteers, came upon a particularly unusual entry in the earliest admission register for Stirling District Asylum. While transcribing the information recorded in the volume onto a database which will greatly improve access to the material he noted that the “Previous place of abode” given for James Dempster, a patient admitted to the hospital in August 1881 was Iowa.  The normal locations recorded for patients are the towns and villages of Central Scotland, not the American mid-west. The register recorded James’ occupation as “Farmer”, the Parish to which chargeable” as Alloa and gave his “Supposed cause of insanity” as “Sunstroke.” It also noted he remained in the hospital until February 1909 when he was briefly discharged before being re-admitted in March 1909.

Armed with the information contained in the admission register we were able to locate James’ case notes in the asylum’s case books, shedding further light on his case. Unusually for the Stirling Asylum James was recorded as being a private patient. His uncle provided an account of James’ unstable behaviour while staying at the family home in Clackmannan, where he threatened both his sister and a servant.  Described as suffering from “recurrent mania” James was admitted to the asylum on 20 August 1881. His case notes recorded that James “went to America at 24 years of age. Has been insane probably since the age of 32 as a result of sunstroke and has never recovered. Had been three years in a US asylum before return.” James’ farming skills were put to good use in the asylum and he was put to work on the hospital farm. The hard physical labour took its toll and by 1901 he had been moved to the less strenuous surroundings of the hospital garden.  Described as being a “good worker, very quiet and no trouble” James spent much of his time in the grounds of the hospital, a note written in September 1909 recording that he “takes a great interest in the small stream beyond the house and says that fairy children play there and gets wildly excited if a horse is driven through the stream as it may kill his fairy children.”

James’ story is one of thousands contained in the 50 volumes of case books for Stirling District Asylum which cover the years 1869-1918, many of which are brought to life by the evocative photographs of the patients which are pasted into the pages of the volumes.  The fantastic work being done by our team of volunteers who are cleaning and cataloguing the asylum records is making these stories accessible for the first time.

The 50 volumes of case books for Stirling District Asylum covering the years 1869-1918 contain thousands of stories.

The 50 volumes of case books for Stirling District Asylum covering the years 1869-1918 contain thousands of stories.

Continuity of care #3

As our project team continues to clean and prepare for use the case books of Stirling District Asylum we are discovering a wealth of additional information in the enclosures which are pinned, fastened or interleaved throughout the volumes. The case notes written in the pages of the case books record the initial personal and medical information collected at the time of admission and go on to provide regular updates on the treatment and condition of patients during their stay in the asylum. The enclosures, which are being carefully removed and catalogued, provide further medical and personal information relating to the patients.

Removing enclosures from a case book.

Removing enclosures from a case book.

Detailed accounts of the condition and behaviour of patients prior to admission are recorded in official correspondence from doctors, parish councils and other asylums from which patients have been transferred. Extracts from the medical certificates which were completed prior to admission are also sometimes included. Occasionally the incidents that triggered admission to the asylum were reported in the local press and press cuttings of such events were often placed alongside the case notes. Evidence of the care and treatment of the patients can be seen in the various hospital forms and records which are present including temperature charts, eye-test forms and additional loose case notes.

Alongside these official records the case books also include the personal correspondence of the patients themselves, an additional layer of evidence which brings their stories alive. The letters written by patients were intended for family and friends but these handwritten messages never left the asylum, instead being added by the hospital authorities to the case notes as evidence of the patient’s state of mind. Indeed some of these letters provide vivid first-hand accounts of the delusions and hallucinations suffered by patients. Many write of being kidnapped and held against their will, or ask for help to escape their incarceration. Other letters, however, are more measured and considered, apologizing to parents or spouses for their recent behaviour and asking loved ones to come and visit.

It is heartening to note that not all patient correspondence was confined within the walls of the asylum. The enclosures also include the occasional letter written by a recovered patient to the doctors in the asylum thanking them for their treatment and providing an account of life since their return home.

Continuity of care #2

This week we transferred the first of the Stirling District Asylum case books which have been cleaned and catalogued by our project team to the archives store. Another element of the project to prepare the archives of the Asylum for public use is the creation of a database of patients who were admitted to the hospital. The asylum’s patient registers record details of the admission and discharge of those treated in the hospital and this information is being carefully recorded and transcribed by our project team.

The registers provide fascinating information relating to the lives of the patients recording their age, marital status, previous occupation and place of abode. Medical details such as bodily condition, form of mental disorder and ‘supposed cause of insanity’ are also recorded. Alongside the standard medical reasons given some of the more unusual ‘supposed causes’ noted in the hospital’s first register, beginning in 1869, include ‘loneliness and religious contemplation’, ‘excessive use of ardent spirits’, ‘disappointment in love’ and ‘severe blow on temple from a golf ball.’ Another reason given is ‘Sunstroke’ – this however, was for a former soldier who suffered it while stationed in India. The registers also note if patients were previously admitted to the hospital and/or transferred to other institutions, which provides valuable information when trying to trace the movement of patients through the network of Scottish asylums. 

The patients registers are a source of detailed social and medical information.

The patient registers are a source of detailed social and medical information.

The creation of this database of asylum patients will be of great benefit in a number of ways. It will provide a quick and efficient way of searching the records for individuals, assisting us in responding to genealogical enquiries. It will also reduce the actual handling of these old and damaged volumes, contributing to their long-term preservation. And for academic researchers it also allows the possibility of re-using the large amount of tabular / statistical information recorded in their research allowing, for example, breakdowns of the patient population by occupation or ‘place of abode.’

Continuity of care #1

A gap in the Scottish archival record has been filled with the transfer of the archives of Stirling District Asylum to the University of Stirling. Part of a larger transfer of historical records to the University Archives by NHS Forth Valley, the records of Stirling District Asylum (later known as Bellsdyke Hospital) provide a detailed account of the care and treatment of mental health patients in Central Scotland in the late nineteenth and early twentieth centuries. This semester we have begun work on a project with a team of student volunteers (thanks Catherine, David, Ian and Jennifer!) to prepare these records for public consultation in our archives reading room.

The case books contain enclosures such as letters relating to the treatment of patients.

The case books contain enclosures such as letters relating to the treatment of patients.

The project team will be working on a set of 50 volumes of case books which provide detailed records of the care and condition of patients in the hospital beginning in 1869. These volumes were working documents, regularly updated by medical staff. They include many enclosures relating to the treatment of patients – both medical records such as temperature charts and personal material such as correspondence. From the 1890s onwards the case books also include photographs of the patients which are pasted onto the pages of the volumes, a common practice also seen in contemporary case books from other Scottish asylums.

From the 1890s onwards photographs of patients were pasted into the pages of the volumes.

From the 1890s onwards photographs of patients were pasted into the pages of the volumes.

Basic cleaning of the volumes is being carried out, with dust and surface dirt being removed using conservation-quality natural hair brushes. The enclosures, many of which are secured to the pages of the volumes with metal clips and pins are being carefully removed to be stored alongside the volumes. Further cleaning of the pages of the volumes is then carried out where required using chemical sponges – conservation-quality cleaners which carefully remove the dust and grime which has accumulated over more than a century of use and storage.

Surface dust being removed from the pages of a case book with a brush.

Surface dust being removed from the pages of a case book with a brush.

Once cleaned and catalogued these volumes will be made available for use in our archives reading room. Academic researchers across a range of disciplines will find a wealth of social, historical and medical material in the records. Comparative studies with other Scottish Asylums will also be possible for the first time. The collection will also be of interest to family historians, opening up a new source of genealogical information.

2015: End-of-year review

As 2015 draws to a close its time to review another busy year for the University Archives and look at how our collections were used by researchers. As in previous years we’ve put together an end-of-year chart of our most popular collections by combining the information recorded in our enquiries database with the records of material consulted by visitors to our archives reading room.

The collection which topped this year’s chart has been incredibly popular since its transfer to the University Archives in 2012. No. 1 in 2013 and no. 2 in 2014 the NHS Forth Valley Archive has retaken the top spot in 2015. The bulk of the collection relates to two local hospitals, the Stirling District Asylum (Bellsdyke Hospital) and the Royal Scottish National Hospital, Larbert. There continues to be huge genealogical interest in the information contained in the records of the hospitals, alongside increasing academic interest in the research value of the material.

Stirling District Asylum Case Books

Stirling District Asylum Case Books

This summer the completion of the Wellcome Trust funded Continuity of Care project improved access to the collection through a programme of conservation and cataloguing of the Royal Scottish National Hospital Archive, with full details of the collection now available on our online archive catalogue.

Our No. 2 is a former chart topper (in 2012) its place in this year’s list showing the growing research interest in the collection. The Musicians’ Union Archive provides a comprehensive record of the organisation’s activity since it was founded as the Amalgamated Musicians’ Union in Manchester in 1893. Recent enquiries related to the collection have included topics as varied as female musicians in London during World War One, the working practices of cinema musicians in the silent era, international union relations, The Beatles, the impact of the synthesizer and miming on Top of the Pops. The collection also provides a rich resource for family historians researching their musical ancestors.

Cover of issue 22 of The Musician, December 1957

Cover of issue 22 of The Musician, December 1957

The Musicians’ Union Archive is also a key resource for two major AHRC funded projects, British Silent Cinema and the Transition to Sound (De Montfort University / University of Stirling) and The Musicians’ Union: A Social History (University of Glasgow). Some of the research carried out by these projects will be presented at the conference ‘Working in Music: The Musicians’ Union, musical labour and employment’, which will be held in Glasgow in January 2016.

As the University of Stirling heads toward its 50th anniversary in 2017 we find our own institutional archives at No. 3 in this year’s list. 2015 saw an increased interest in our own archival resources both within the university and from external researchers. The University Archive holds the official history of the institution in its minute books, reports and publications. It also preserves the unofficial story of life on campus through student newspapers, memorabilia and oral history interviews with retired staff and alumni.

Our film collections continue to be popular with researchers.

Our film collections continue to be popular with researchers.

Before we end our review of 2015 an honourable mention should go to our film-related collections. The personal and working papers of three Scottish filmmakers took fourth, fifth and sixth places on our chart (Lindsay Anderson, John Grierson and Norman McLaren). If combined these film archives would have topped the list, their continued popularity showing the wealth of material relating to the history of cinema held in our collections.

Outside the archives reading room our most seen collection was undoubtedly our Commonwealth Games Scotland Archive. Our touring Hosts & Champions exhibition, which celebrates over 80 years of Scottish participation and achievement in the Commonwealth Games, has visited a variety of venues across Scotland this year, starting its tour in Irvine in March and ending the year at Dumfries Museum. The exhibition will continue its tour in the new year visiting Stranraer in January and Kirkintilloch in March. We’ll provide further information about the Hosts & Champions touring programme and other exciting projects and events taking place in 2016 in the new year.

Those results in full:


1. NHS Forth Valley

2. Musicians’ Union

3. University of Stirling


1. Norman McLaren

2. NHS Forth Valley

3. Commonwealth Games Scotland


1. NHS Forth Valley

2. Musicians’ Union

3. Norman McLaren

Further details of previous end of year reviews can be found here.

‘A backward lad’ – records of the children at the Royal Scottish National Institution

The cataloguing work on the Continuity of Care project is still going on, with work well under way on the 3000+ applications. The database to the collection now holds over 1000 items. But the number of items that show the abilities of the children themselves can be counted on the fingers of one hand.

Opposite is a rare example of the literacy and numeracy skills of one applicant. His name

Handwriting and long division by George Aitken, 1886

Handwriting and long division by George Aitken, 1886

was George Aitken as he was fully able to write himself, along with his date of birth. To include an example of his numeracy skills is even more unusual. In his note accompanying these samples, A J Fitch, secretary to the Institution writes:

‘I have seen this lad and have difficulty in discovering his imbecility. The boy reads fairly well – writes and does sums. He is a backward lad consequent upon elipeptic [sic] attacks which prevents his attendance at an ordinary school.’

The Institution had a policy of refusing admission to epileptics. At the bottom of the medical certificate that accompanies most of the applications is the declaration:

‘Cases of Insanity, of confirmed Epilepsy, of the Deaf and Dumb, and of the Blind, are ineligible for admission, except upon payment’.

In reality this policy was readily overlooked. As Fitch himself commented in a note to an 1889 application:

‘ you have however somewhat relaxed your rule as to epilepsy and may be disposed to look favourably’.

Although easy to dismiss this change of heart as motivated by the payments anticpated from the parents, one application from 1891  shows an other side of the Institution. Subject to fits and ‘unable to make any payment’, she was still admitted.

Schoolroom at the Scottish National Institution, c1915

Schoolroom at the Scottish National Institution, c1915


Theories on Down syndrome in the 1930s

This blog is the third from Continuity of Care – the project to catalogue and conserve the records of the Royal Scottish National Hospital. Thanks to a grant from the Wellcome Trust, this project started in the middle of August and will be completed by July 2015.

Although very short the featured letter is of significance to scientific debate of the time. As it is out-going correspondence it is not signed but was written by Dr Robert Durward Clarkson, the Medical Superintendent. It comes from one of the correspondence files.mongols RS-2-8-2

The Dr Crookshank mentioned in the letter was Dr Francis Crookshank, author of ‘The Mongol in our Midst’. This book established the theory that ‘mongoloid’ children were a throw back to an ‘inferior race’. The evidence he provided were examples of physical characteristics shared by ‘Mongolian imbeciles’ and those of the Mongoloid race such as small earlobes and a propensity for sitting cross-legged. These features resulted from the shared distant racial history of the parents and were caused by under-development in the womb.

The book was very popular in its day and the third edition was published in 1931, the year before this letter was written. It is interesting that both Dr Clarkson and his correspondent, Dr Lionel Penrose, clearly rejected the hypothesis.  Indeed Penrose went on to do considerable research on the genetic causes of mental retardation, further discrediting Crookshank’s theory. The paper that Penrose is sharing with Clarkson was ‘The Blood Grouping of Mongolian Imbeciles’ published in The Lancet in February 1932. Unfortunately his covering letter has not survived. A later letter from Penrose to Clarkson in June 1932 thanks Clarkson for allowing him to visit the Royal Scottish National Institution and asks for Clarkson’s help in gathering data on epiloia or tuberous sclerosis.

Crookshank committed suicide in 1933.

Wheat starch paste vs polyester sleeves

This blog is brought to you by Explore Your Archives week and is the second on Continuity of Care – the project to catalogue and conserve the records of the Royal Scottish National Hospital. Thanks to a grant from the Wellcome Trust, this project started in the middle of August and will be completed by July 2015.

The project includes funding for a conservator and Liz Yamada started in the post in September. She has already surveyed the collection and identified items which need conservation work. Of particular interest are the first two Registers of Discharges and Removals.

Page from the Register RS/1/4/1

Page from the Register RS/1/4/1

The volumes record where children were sent after leaving the Institution. They record information on the length of stay in asylum and more interestingly the condition of the child – whether recovered, relieved, not improved or incurable. As the photograph shows although all the children are discharged as ‘not improved’ the observations tell a different story.


But this blog entry is about the conservation of the items rather than their archival content.

discharges and removals conservation 1

Covers of the registers RS/1/4/1-2

discharges and removals conservation 2

Pages of the registers

They look very similar from the outside but could be conserved in very different ways. It is likely that the first volume, covering 1864-81, will be conserved in a conventional way: the pages will be cleaned with a latex sponge; the edges and spine folds repaired with Japanese paper and wheat starch paste; the binding re-sewn; and the old cover re-attached and consolidated so that it continues to be used as a book. The second volume, covering 1881-1915, on the other hand, is likely to be disbound, the pages put in polyester sleeves and stored in a folder with the detached cover.

discharges and removals conservation 3

Register showing edge tears

Why the difference in approach? The second volume could be repaired in the same way as the first but it would be more difficult, hence more time consuming and as a result, much more costly. One of the crucial differences between the two volumes is that the paper used for volume 13 is more brittle and as a result, many of the folds have cracked, so most of the pages are now single sheets. Another key difference is that the text is very close to the page edges and there are lots of edge tears in those areas. Very light Japanese paper would need to be used for repair so that the text is visible through it. This would not be very strong and would necessitate repairing both sides which doubles the repair time. The Japanese paper used for conservation is generally cream in colour so it will always stand out on blue paper originals. Although this is not detrimental to the preservation of the item, it is not very attractive. The repair papers could be toned blue with acrylic paints before they are applied but again, this adds to the repair time. Placing the pages in polyester sleeves will ensure that the pages can be handled without losing further information and can be preserved without the need for repair. Should it be necessary or desirable to carry out full repairs on the volume in the future, this will still be entirely possible.

Polyester sleeves are completely inert and a useful tool for the long-term preservation of many paper-based items. They protect items physically from being torn or creased and in some cases protect them chemically from items that give off damaging fumes. However, they cannot be used for everything in an archive collection. The cost of sleeves can add up quite quickly as can the weight which can impact on boxing, shelving floor loadings and archive staff who have to carry the boxes. They also add bulk, taking up valuable storage space. Polyester also carries static so it is not suitable for friable (powdery) media such as pastel, charcoal and soft pencil because it can lift the image off the paper. Sleeving items also changes the feel of the item, the smell and the overall appearance which is not necessarily desirable.