Object of the month: Drilling the head

Posted on 9 April, 2013 by Danny Birchall
Bronze Age skull from Jericho. Wellcome Images.

Bronze Age skull from Jericho. Wellcome Images.

Why do so many surviving skulls from the stone age bear the marks of early brain surgery? Muriel Bailly digs deeper into the history of one particular skull in our collection.

While studying archaeology I had always been fascinated by the impressive scientific knowledge of our ancestors, especially in medical sciences. As there is no better place than Wellcome Collection to study the history of medicine, I was very pleased when I first started working here and discovered that there is a trepanned skull from Jericho dated from 2200 BCE on display in the Medicine Man gallery.  This trepanned skull shows that our ancestors were already capable of practicing successful craniotomy 4000 years ago, and with access to neither anaesthetic nor antiseptic!

The word ‘trepanation’, or ‘trephination’ is derived from the Greek typaron meaning to bore, and it literally means to drill a hole into the skull. It is the earliest form of surgery known to us: the first evidence of trepanation has been dated from 6500 BCE for a specimen found in the French necropolis of Ensisheim (Alsace). All around the globe, archaeologists have found specimens dated from the Neolithic period (10 000 BCE/4000–2500 BCE) presenting evidence of trepanation. The hole would have been made by scraping the bone with sharp stones such as flint or obsidian while the patient was still conscious, although they would potentially pass out from the pain.

A large number of trepanned skulls have been found in Europe, Africa and Southern America, proving that this was a common technique. But why would our ancestors want to put themselves through this much pain?

Meticulous studies have shown that trepanation was essentially carried out on young men and that most specimens presented evidence of head injury. The percentage of those who recovered from the operation (including our specimen at Wellcome Collection, who survived repeated trepanations) shows the astonishing degree of technical skill of people from the Neolithic era, but leaves the question of motive open. Researchers today still have different interpretations of this practice. Indeed, since science and magic were – at that time – of the same nature, it is difficult to differentiate the ritual or magical motives of trepanation from the therapeutic or medical ones.

Because a large number of trepanned skulls also show evidence of head injury, some researchers see a therapeutic motive to this practice. This procedure was carried out to relieve the blood pressure underneath the surface of the skull, as well as to remove bone fragments from the wound. In that case, what about the other percentage of the population who underwent trepanation and do not have evidence of head trauma? It is strongly believed that trepanation may have been used to cure various diseases that are believed to have their seat in the head, such as headache, epilepsy and even depression.

Our specimen at Wellcome Collection suffered four trepanations and managed to survive all of them. There is evidence of regrowth of the bone, indicating that the individual lived on for many years after the operations. In addition to the trepanned holes, we can see evidence of head injury on the top of the skull, supporting the idea that this person had trepanations as a medical treatment following an intracranial trauma.

During the Neolithic period, Jericho was a very important settlement. Various city-states were established on the land, and the presence of large defensive walls suggest that the city-state kings were frequently attacking each other. Between 2400 and 2000 BC, the size of the settlements diminished under the pressure of Bedouin attacks. Could our specimen – dated 2200 BCE – have gained this injury during one of these battles? It is possible, although we will never be sure.

After the Neolithic period trepanation became much less common, to such a point that during the 18th and 19th centuries surgeons would reject the procedure outright, owing to its almost one hundred per cent chance of mortality! However, you’d be mistaken if you thought the procedure had died out altogether. It’s still practiced today in its early form – as opposed to our modern craniotomy – by medicine men in Kenya and Algeria.

Muriel Bailly is a Visitor Service Assistant at Wellcome Collection.

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Object of the month: canopic jars

Posted on 28 May, 2012 by Danny Birchall
Limestone, jackal headed canopic jar, Egyptian. Wellcome Images

Limestone, jackal-headed canopic jar, Egyptian. Wellcome Images

What could a jackal-headed jar of organs have to do with a Spartan sailor? William Birnie lifts the lid on how ancient Egyptians preserved the life force of the dead.

Housed in our End of Life display in the Medicine Man gallery are two very beautiful jars, made from limestone, so simple, elegant and beautifully sculpted that they could be mere decorative objects. Their lids reveal their true purpose, as ancient Egyptian canopic jars, and they played a major role in the process and rituals of mummification.

Ancient Egyptian funerary customs were complex, elaborate, and crucial in allowing the deceased to travel through the Underworld, ensuring a smooth transition from earthly existence to immortality. Mummification could last up to 70 days and was designed to preserve, protect, and establish the body as a life-like presence for the afterlife. The process was intricate and rituals took precedence. Initially the body would be dried, cleaned and rubbed with good smelling oils. Embalmers would place amulets, designed to defend the body, between the layers of linen which wrapped it. Priests dressed as Anubis (the Egyptian god associated with the afterlife and mummification) would read spells aloud to ward off evil spirits, while every layer of bandage was painted with a liquid resin in order to glue and strengthen the whole. Once a body had been wrapped, complete with a picture of the god Osiris painted on to its surface, it would be arranged in the tomb; afterlife paraphernalia, to ensure preparation, would also be entrusted including clothing, valuable objects, furniture, food, and drink.

The ancient Egyptians believed each person to be made up of a variety of physical and non-physical elements, which included Ib (heart), Sheut (shadow), Ren (name), Ba (soul) and Ka (life force). Mummification was intended to provide a place to house these parts. The Ka was a life force sustained by the food and drink left at the tomb by living relatives; depictions of food offerings on a tomb wall could also foster this nourishing function. The Ba could leave the body, enabling the dead to participate in the worlds of the living and the dead. Attention was paid to the appearance of the mummy itself so that the Ba would recognise its own body and return safely. A full and happy afterlife could only be enjoyed if the different parts survived.

Canopic jars contained the large human organs or viscera (liver, lungs, stomach, and intestine). Each of Horus’ sons were assigned a different organ to protect, represented in the forms of a hawk, an ape, a man and a jackal, thus allowing us to identify which organs are stored in each jar. Fascinatingly, the jars themselves are also represented in a mummified fashion, all having the same wrapped body. The jars in our collection have lids depicting the human and jackal; Imsety (liver) and Duamutef (stomach), respectively.

The viscera were wrapped individually in linen and once placed inside the jar had resinous consecrated oil poured over them. The jars were then ritually closed and conserved for eternity inside the tomb. They could be placed at the corners of a sarcophagus or in a false wall in its base. Sometimes they were stored together in a canopic chest or box. These boxes started out simply enough but soon became more elaborate. The brain, regarded as unimportant, was pulled out of the skull using a hook inserted through one nostril, then thrown away. The heart was left in place, as it was considered to be the organ that held the spirit, along with the understanding and the senses of an individual. It would be needed on the Day of Judgement in the Underworld, when the God Anubis would weigh it to ensure the worthiness of the deceased to enter the underworld.

Fourth Dynasty Queen Hetepheres is believed to be the first royal Egyptian to have had her organs dried out and preserved. After the Eighteenth Dynasty (c.1550–1292 BC) canopic jar lids were no longer adorned with the face of the deceased. Instead, they were identified with the four different gods who were the sons of Horus. Horus, son of Isis and Osiris, was portrayed with the head of a hawk and the body of a man. He was God of the sky and in one version of his myth, during the battle for control of Egypt, Horus had his left eye gouged out by the god Set. For the ancient Egyptians, Horus’ left eye represented the moon and explained why the moon was so much weaker, dimmer than the sun. Horus retaliated by castrating Set, hence the infertility of the desert. It was understood that his four sons, emerging out of a water lily that rose from the waters of Nun, were given funerary duties by Anubis.

Why are these jars – which can be made from limestone, pottery or gilded wood – called canopic jars? The ancient Egyptians themselves did not refer to them in such a manner, calling them Qebu en wet (jars of embalming). Rather, it was modern Egyptologists that named them canopic. The British Museum states they were  mistakenly linked to Greek mythology as Canopus, the captain of the fleet of ships of Menelaus, King of Sparta, was buried in Egypt after the fall of Troy and worshipped in the form of human-headed jar. Early Egyptologists noticed a connection between this object and the visceral jars in the tombs, hence the name.

During the first millennium BC when the viscera began to be returned to the body due to improved embalming techniques, the practice of storing the viscera in canopic jars gradually declined with dummy unhollow canopic jars placed in the tomb instead. For a short period during the Twenty-First Dynasty  (c. 1069–945 BC), amulets in the form of the four sons were placed alongside the viscera inside the body. Throughout their history, canopic jars were limited to the upper social strata and with cheaper  and more accessible mummification methods during the Ptolemaic period (305–30 BC), there was simply no need for them any longer, with the last royal canopic jar belonging to Apries (reign 589 BC–570 BC).

William Birnie is a Visitor Services Assistant at Wellcome Collection. You can contact him at w.birnie@wellcome.ac.uk.

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Object of the month: Letting blood

Posted on 25 April, 2012 by Danny Birchall
Jan Baptist Lambrechts: A surgeon preparing to let blood by cupping, his apprentice. Wellcome Images

Jan Baptist Lambrechts: A surgeon preparing to let blood by cupping. Wellcome Images

Feeling unwell? Perhaps you’re suffering from a surfeit of blood? William Birnie investigates the curiously long history of a cure that usually left the patient feeling worse.

Molière’s dictum that ‘nearly all men die of their remedies, and not of their illnesses’ seems a deadly accurate one for the procedure of bloodletting. Although perplexing for us in 2012 to consider it was ever felt to be advantageous, there are compelling reasons why accomplished men felt bloodletting beneficial to human health.

Bloodletting, a type of ancient therapy based upon a specific concept of disease, began with the ancient Egyptians around 1000 BCE. Spanning antiquity, the custom continued throughout the Middle Ages and ultimately reached its apex at the beginning of the 19th century. Nevertheless, by the end of that century its use as a therapeutic tool had virtually died out.

Previous to the time of Greek physician Hippocrates (460–377 BCE) it was felt that all illness was due to one disease, with varying symptoms. Observations by Hippocrates led to recognition of specific disease states and to the development of the body humours theory. The practice was thought to purge the body and restore balance to these humours, which were linked to the classical Greek elements and comprised of blood, phlegm, black bile and yellow bile.

The health of the body (the microcosm) was determined by the balance of these humours, just as the state of the world (the macrocosm) was determined by the four elements of earth, air, water and fire. This perhaps somewhat simplistic view of body humours was later formalized into four qualities (warm, cold, moist, and dry) and also the four seasons. For example, black bile was cold and dry, phlegm was associated with winter, and yellow bile was coupled with fire: too much fire made your temperament choleric.

Of all these humours, blood (air, spring, warm and moist) was the principal one that needed the most management. It was believed blood could stagnate in the body’s extremities and as a consequence, bloodletting was used to prevent and treat many illnesses. The seeds of Galen’s ideas can be found in the Hippocratic Corpus, but they had grown into something far more cogent by the time of Galen. His discovery that veins and arteries are full of blood, and not air as was previously supposed, meant a complex system developed regarding the best time to blood let. How much blood was to be removed depended on a number of things: proximity to the affected area, geographical location, weather, and, reassuringly, the patient’s age and constitution. Sessions of bloodletting would often not stop until the patient began to swoon, with fainting seen as the natural conclusion of the treatment.

In discussing the followers of Greek philosopher Chrysippus and physician Erasistratus and their reasons for opposing bloodletting, Galen expressed their dissatisfaction in terms of bloodletting’s harmful side-effects rather than the practice itself. Interestingly, the principle of bloodletting itself was not seen as wrong by these followers; it just had to be administered correctly, with excessive bloodletting deemed murder. Other practical objections included cutting an artery instead of a vein, an inability to stop the bleeding and the occurrence of cases where the patient never woke up. As mentioned earlier, bloodletting was a certain type of therapy, one based on the patient as a being very distinct from the disease.

A number of techniques and devices were used during its practical application. One early technique required a vein to be cut (venesection) with either a knife or a lancet. In our Medicine Man gallery we have a number of these devices including a scarificator (not to be confused with the body modification technique), a bleeding bowl and a cupping set. One of the scarificators in Medicine Man is multi-bladed and contained within a box. A spring mechanism releases the blades, which would rapidly disappear after an incision had been made. Cupping was a later approach that required the use of heated cups, with the heated air inside creating a vacuum and thus encouraging blood to flow. This appliance was often used in association with the concealed scarificator previously mentioned (those in Medicine Man are part of a set).

The leech was also established as a reliable means of venesection, and is particularly revealing in how its uses were phrased. Using the leech to bleed a patient was markedly advantageous for those considered to have ‘delicate constitutions’. Read into that what you will.

The idea of the Greek humours in relation to bloodletting fell out of use as more was discovered and understood about the body. In a clear demarcation of their roles, physicians would recommend the treatment of bloodletting, while barbers would perform it. English physician William Harvey (1578–1657) disproved many of the theories underpinning the practice of bleeding with his publications on the circulatory system, yet he was resolute that bleeding had a salutary effect:  ‘vitiated states and plethora of the blood, are causes of a whole host of diseases; and the timely evacuation of a certain quantity of the fluid frequently delivers patients from, very dangerous diseases, and even from imminent death. In the same measure as blood is detracted, therefore, under certain circumstances, it may be said that life and health are added’.

Although many of his contemporaries ignored the consequences of such findings, and continued to bleed patients, doubts began to creep in to the hypothesis of blood acting as the vital force of the body, seat of the soul, with all weakness and insanity attributed to a defect in this fluid. By the 19th century, doubts were quite vocal, with Scottish physician Dr John Bennett writing in 1855 that he doubted whether bleeding a patient from the arm would do anything except reduce their strength and impede their recovery.

Although falling in and out of favour throughout the ages, with bloodletting virtually dismissed as quackery with the beginning of the 20th century, attachment to the practice persisted by some. For example, Sir William Osler recommended it in his 1923 publication Principles and Practice of Medicine. Now that the practice is no longer used as the therapeutic tool it once was, parallels can still be drawn, and it is intriguing to note that the amount taken during blood donation today (just under 500ml) was the amount usually removed during bloodletting’s heyday.

In writing about the practice, which she described as killing in two fashions, in the court of Louis XIV, Nancy Mitford was explicit when she stated: ‘After being bled the patient always felt much worse, and this was considered an excellent sign. The Comte de Toulouse, having bravely endured the operation for stone, was bled four times in twenty-four hours. Strong and young, he recovered. Twenty-six years later he received the same treatment for the same complaint, and died.’

Need I say more?

William Birnie is a Visitor Services Assistant at Wellcome Collection. You can contact him at w.birnie@wellcome.ac.uk.

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Object of the month: the scold’s bridle

Posted on 26 March, 2012 by Danny Birchall
Scold's bridle. Wellcome Images

Scold's bridle. Wellcome Images

Although much of Henry Wellcome’s collection was devoted to instruments and materials of healing, some of the objects found in it have a more sinister purpose. Elizabeth Baddeley looks at a tradition of punishment rooted in the fear of female autonomy.

When visitors peer into our cabinet of masks in Medicine Man they are, almost without fail, drawn first to the bright, colourful disease masks from Sri Lanka; to the exaggerated features of the ritual mask from Bhutan; to the almost eerily realistic grinning false face Iroquois mask from North America. It seems almost as an afterthought that they turn to our object here: the matt grey, iron mask of the scold’s bridle. It seems clunky and dull next to the lively features of the more geographically exotic specimens it is displayed alongside. Surprisingly, the history, use and legacy of this and similar objects are a much underexplored subject.

This object is between 200 and 450 years old and is from Belgium, but could be from any part of Northern Europe from the late medieval or early modern period. It is made from heavy iron, and has the caricatured ears of an ass, exaggerated facial features and twisted, cruel-looking horns. It is a scold’s bridle.

The offence of scolding means little to nothing to us today, but in the 16th and 17th centuries, it was an acute insult. It was a uniquely female misdemeanour, and as such it is often compared to that other contemporary, and uniquely female, crime of being a whore. Both were often punished with a round on the ‘cucking stool’ – a mechanism where the accused was dunked into a river or pond while secured to a seat – and both are often viewed as female crime in a male-dominated legal system. A scold was, after all, ‘a troublesome and angry woman, who by her brawling and wrangling amongst her Neighbours, doth break the publick Peace, and beget, cherish and increase publick Discord’ according to William Sheppard in 1675.

The gendered nature of this crime has led to historians discussing whether it was a male way of limiting women’s powers of expression and activity. Indeed, the prevalence of accusations against scolds seems to have peaked between the mid-16th and 17th centuries, and in Britain has been linked to the wider social upheaval surrounding the English Civil War. Punishment with a bridle like this one, or ‘branks’ as they were also known, is less well recorded, but we know that it was done, as with the cucking stool, to ridicule and expose the women in front of her neighbours. It could also be painful. The woman would be made to wear the device for a stated time, and it would be heavy, the iron would be very cold (especially in winter), and the strut of metal that went into her mouth to hold down her tongue from further nagging (which has unfortunately broken off this example) would become increasingly uncomfortable. Indeed, on some bridles this was not just a piece of metal but a spike, designed to cause pain.

The idea of punishing a woman for stepping out of her place is not uniquely British: as mentioned above, scold’s bridles have been found across Europe. This crime of being a scold is represented in the mocking ‘world turned upside down’ rituals of French charivari and Italian carnivals. Men dressed as women, children played bishops and bishops dressed as paupers during the festival; this reversal and ridiculing of traditional norms was used to reinforce the correctness and normality of those norms in everyday life. This was true especially in relation to gender roles: alongside the punishing of scolds was the ridiculing of what cultural historian Natalie Davies calls the ‘woman on top’: domineering wives, especially young brides of elderly husbands or women who abused their husbands. Also linked is the enduring idea that witches were female, often wise old spinsters or midwives. Statistically, we know that a huge number of men were also accused and punished for witchcraft, but the concept of witches and the description of them in contemporary sources is usually purely female and contributes to the general fear of women stepping out of their place. The contemporary fear of powerful women has in the past been linked to a high number of young, unmarried but wage-earning women living away from home as servants and the measure of power and freedom this gave them.

One idea that connects the scold’s bridle, accusations of witchcraft and the ‘woman on top’ is the belief that women were particularly prone to bouts of irrational behaviour, prone to communicating with the devil as they did not have the rational power to stay away, and inclined to scold and nag about unimportant matters. According to early modern medical ideas of the four humours, a theory about the body existent since ancient Greece and changed little by the 16th century, women were cold and damp with little blood. Indeed, this small amount of blood would linger around their uterus, instead of spreading throughout the body  and into the brain. The Greeks even wrote of how the uterus would ‘wander around’ the body if it had too little blood. As such, women were often seen as being ‘led’ by their uterus, a dangerous organ, making them prone to irrational behaviour. Nor was this idea soon forgotten, for the very Victorian illness of hysteria takes its name from the Greek ‘hystera’, meaning uterus. This may seem odd to a modern audience, more used to hearing of men being led by their nether regions than women.

Elizabeth Baddeley is a Visitor Services Assistant at Wellcome Collection.

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Object of the Month: First World War Amputees

Posted on 16 December, 2011 by Danny Birchall
Appliances from from 'Mechanical Substitute for The Arms'. Wellcome Images

Appliances from 'Mechanical Substitute for The Arms'. Wellcome Images

The development of weapons of war and the development of treatments for those damaged by them often go hand in hand. William Birnie looks at some curious appliances designed to improve the lives of those who lost limbs in the First World War.

It is easier to destroy than to repair, with the resources for destruction provided by society often greater, yet the years during and following the First War World saw significant and exceptional attempts to help those who had returned home permanently injured by destruction on an industrial scale.

Horrific wounds from new technological advances such as machine guns, shell fragments and poison gas meant that over 41,000 men lost at least one limb as a result of their injuries gained during the war (and this was in the British Armed Forces alone). The modern mechanised nature of warfare led one man to write home and comment on the carnage: ‘this is not war; it is the ending of the world’.

The conditions on the front line meant a lower standard of medical care, unhygienic equipment, lack of water, inadequate lighting and poor supplies of operating instruments, including ligatures, needles and supports. When this is considered against the remarkable fact that it took, on average, between eight and twelve hours to evacuate a wounded soldier from the front to a Casualty Clearing Station (CCS), it is not surprising that so many men returned home without a limb. The even starker situation at Gallipoli, where a soldier had to face a voyage of two to three days, led Major Stanley Argyle to despair at the number of limbs that were amputated and lives lost that would otherwise have been saved.

Motorised transport made it possible to establish the clearing stations on the Western Front, which were staffed by surgeons, nurses and anaesthetists, yet these were far from satisfactory themselves and the sheer length of the front often meant they were six to nine miles behind. Trying to operate on filthy war wounds instead of clean unbroken flesh meant the neat techniques in which an ‘aesthetic result’ was paramount had to be abandoned in favour of ‘crude unfinished ways’, much to the chagrin of surgeons working amidst the bloodshed.

Servicemen were entitled to free artificial limbs (until 1948 artificial limbs were provided free of charge only to those who had lost limbs as a result of war service), but by 1915 the existing system could not keep pace. Throughout the war, limb provision remained a problem, combined with a lack of hospital space for men awaiting limbs.

Two American firms, Rowley and Hanger, were invited by the government to set up subsidiaries in Roehampton, London, in the grounds of a former mansion commandeered by the Imperial War Office. This site became Queen Mary’s Hospital and opened its doors to its first 25 patients in 1915. During the war it became known as one of the world’s leading limb fitting and amputee rehabilitation centres, providing treatment and training opportunities so that patients could later find employment. Demand was high and often men left hospital with artificial arms without the proper training in their use. Artificial limbs were made on-site, yet, despite this, limb provision remained a struggle and it was only after the armistice that the situation was brought under control. New mechanisms were patented and lucrative government contracts enabled new research and developments to take place.

The appliances shown above, part of our ‘Treating Yourself’ section in our Medicine Man gallery, fitted to a mechanical substitute for the arms made for an amputee who had lost both arms at the shoulders (a rare injury even during the First World War). They are components of a much larger prototype developed by an Edinburgh gas fitter, George Thompson. The tools clipped onto the mechanical arm, which was then fastened onto a table. The tools and arm would be operated using foot pedals situated under the table and driven by a series of levers.

The idea of this amateur invention was to enable amputees, with practice, to eventually be able to accomplish everyday tasks independently. There is a conventional set of a knife, a fork and a spoon that has been slightly modified, along with weighted scissors, a round metal object designed to carry a cup, a ‘rubber thumb’ to turn the pages of a book, a cigarette lighter, and a fountain pen, the nib of which has been specially angled in order to fit into the ceramic ink bottle.

Moreover, there was a need to provide help not only for the physical, visible injuries connected with the loss of a limb, but also the invisible, mental ones, and a story of consummate resourcefulness can be found in the years after the war in Germany. Physically disabled from birth, Carl Hermann Unthan (1848–1929), helped the physically disabled soldiers when they returned home to Germany by publishing Ohne Arme durchs leben (Surviving Life Without Arms, 1916), an illustrated handbook for disabled veterans. He worked quickly, writing seventy-eight pages of it in twenty days. It was a step-by-step guide how to master life’s challenges and adapt. It seems incredible to believe but Unthan had trained himself to fasten a necktie, use a knife and fork, even play the violin, using only his feet. He travelled around Germany hoping to be a motivator and lead by example.

It is an interesting idea to think that medical treatment is constantly refined to keep pace with the improvements in weapon technology and the damage it inflicts, with doctors and surgeons forced to rethink their interventions in order to give patients the best possible chances of survival. The First World War was the last war where amputations, on otherwise healthy young men, were at such a high level, and consequently provisions had to be made at home for those returning injured.

William Birnie is a Visitor Services Assistant at Wellcome Collection. You can contact him at w.birnie@wellcome.ac.uk.

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Object of the Month: Hair today, gone tomorrow?

Posted on 10 October, 2011 by Danny Birchall
Mourning brooches containing the hair of a deceased relative. Wellcome Images

Mourning brooches containing the hair of a deceased relative. Wellcome Images

A lock of hair is a traditional lovers’ token. But this most everyday and intimate part of the human body can also be used in a more sorrowful context. Sarah Bond tells us more…

It is easy to miss these four little brooches, tucked away as they are in the far corner of Medicine Man alongside Egyptian canopic jars, mortuary crosses and even a shrunken head. But these examples of European mourning jewellery demonstrate an ambiguity at the heart of Henry Wellcome’s collection – the potential for the human subject to become material object after death.

Medicine Man is full of curios serving as literal or metaphorical extensions of the human body, and, like most medical collections, also features artefacts formerly part of the body itself. These brooches are no exception, each containing samples of human hair, neatly arranged and set behind glass.

Hair is certainly a material that occupies the narrow ground between person and thing – in life as much as death. Although it is ‘dead’ matter (as only the follicle contains living cells), once separated from the body, our hair is capable of outlasting us. These qualities of durability, alongside the fact that it is easily removed from the body and can be manipulated into almost any shape, led to the widespread use of hair in the 18th and 19th centuries as a tangible way to remember an absent loved one. Encased in a locket, ring or brooch, a lock of hair stood in for the recently departed, whose memory, it was hoped, would endure for as long as the jewellery itself.

But detached hair, alienated from its natural location on the body, can also provoke disgust – a reaction any of us who have found a stray hair in our food can identify with. The anthropologist Mary Douglas proposed that any ‘matter out of place’, including hair, becomes dirt, posing the threat of chaos and disorder unless carefully gathered and contained (1966).

As loose hair clippings might otherwise prove disturbing (especially those taken from a dead body), a process of transformation was necessary in order for them to become effective memory objects. ‘Working’ the hair into jewellery achieved this in various ways. Hair was coaxed into beautiful forms; fixed permanently into neat loops, curls, or weave, it was presented as a controlled and manageable substance, as it would have been on the body in life. It was then often mounted within gold or silver casings, and embellished with pearls – enduring materials that again acted to disguise the body’s frailty. Such opulent surroundings helped to showcase the hair (and, by extension, the person it represented) as precious and sacred.

Along with much of Wellcome’s collection, accurate catalogue entries for these particular items were never recorded. We can’t even be sure if they are all mourning pieces, despite their inclusion in the ‘End of Life’ case. Oblong brooches or ‘pins’ were very popular in the early 19th century, often set with gemstones, which coded for sentiments such as ‘love’ or ‘dearest’. Unless set with jet or black enamel, or engraved with an inscription honoring the deceased, they may well have been love tokens. The garnets used in one piece (centre foreground) indicate truth and virtue, and on close inspection the hair panel appears to have been plaited from two distinctly differently coloured strands of hair – possibly those of lovers?

The largest brooch, by contrast, is typically Victorian in style and probably dates from the second half of the 19th century. Featuring a graveyard scene, and the dedication ‘In Memory of A.G.’, the hair – presumably that of ‘A.G.’ – has been glued to form the branches of a weeping willow, a common analogy for the grief-stricken mourner. A third brooch, from a similar period, comprises two individual locks of hair, teased into waves. A larger, darker lock encloses a tiny, platinum blonde curl, the fine strands of which may well have been cut from the head of a child or infant. The hair is secured with gold thread and seed pearls, often used to represent tears.

But the smallest piece of jewellery overtly demonstrates another crucial function of hairwork – to act as memento mori, a reminder of the inevitability of death. By far the earliest example of the four, the reverse of the oval slide is engraved with the initials ‘W.H., 1689’. This locket incorporates a miniature skeleton, holding a scythe and an hourglass, alongside a bed of woven hair. In contemplating the remains of another – once person, now object – the wearer is prompted to consider his or her own similar fate.

During the 17th century mourning jewellery was largely confined to the European elite. Usually rings, these were produced to commemorate the death of influential individuals and served as status symbols, being distributed at funerals to secure the memory of the deceased. Samuel Pepys (1633–1703) willed that 129 mourning rings be given away at his funeral, in three grades of different quality. The most valuable rings were reserved for those with the closest relationship to the deceased, or the highest social status.

In contrast to the earlier pieces, the value of 18th and 19th century mourning jewellery was attributed to the unique sentimental worth of the hair itself, rather than the materials surrounding it. New techniques for working hair had contributed to its rising use, but it was the death of Prince Albert in 1861 which led to a real explosion in its popularity. Queen Victoria commissioned jewellery in Albert’s honour almost immediately, and continued to observe mourning for the rest of her life, a decision that was to have considerable influence on the wider population. Books of stylish patterns in hairwork were published, and machinery was developed to weave unprecedented quantities of the material.  Soon the jewellery became so fashionable it became possible to buy ready-made pieces reasonably cheaply – ironically losing the intimate personal connection that had popularised the use of hair in the first place.

Hair jewellery was increasingly produced in the home in an effort to re-personalise the trend, by individual women following patterns in manuals and popular magazines. Creating the pieces oneself also guarded against the substitution of ready-worked hair by unscrupulous jewellers.

Although we are of course distanced from an era that considered the wearing of hair to be acceptable and tasteful, some of the original power of these objects does comes across. Despite the anonymity of these few strands, we can speculate on the stories surrounding them – the lives of those they once belonged to, those who wore them, and how they went on to become part of Wellcome’s collection.

Sarah Bond is a Visitor Services Assistant at Wellcome Collection.

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Wellcome goes graphic

Posted on 30 September, 2011 by Danny Birchall

As Wellcome Collection regulars will know, the Medicine Man gallery is full of intriguing objects collected by Henry Wellcome during his lifetime, each with their own story to tell. Both Henry and his objects proved inspirational to a group of Camden Summer University students who spent a week at Wellcome Collection learning how to create graphic novels and producing their own artwork.

The students studied contemporary graphic novels and historic comic books in the Wellcome Library’s collections to get them started, but soon developed their own stories and began drawing these into life.

The resulting artwork was displayed in an exhibition of work produced by students attending various Camden Summer University courses this year, hosted by The Swiss Cottage Gallery in Swiss Cottage Central Library from September 8-17.

See if you can spot the Medicine Man objects and themes in the students’ work, which have been photographed and included in the Wellcome Images collection. You can examine them all in greater detail in our set on Flickr.

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Object of the Month: Goya and the Medical Profession

Posted on 8 September, 2011 by Danny Birchall
Francisco José de Goya, 'Of What Ill Will He Die?'. Wellcome Images

Francisco José de Goya, 'Of What Ill Will He Die?'. Wellcome Images

What kind of doctor would be portrayed as a donkey? William Birnie investigates a curiously satirical Goya etching on display in our Medicine Man gallery.

Throughout his career Francisco José de Goya y Lucientes (1746-1828), who is regarded as the most important Spanish romantic painter and printmaker of his time, moved from the insouciant to the deeply pessimistic in his paintings, drawings, etchings and frescoes. The Goya etching housed in our Medicine Man gallery, entitled De Que Mal Morira? (Of What Ill Will He Die?) is part of a set of eighty such prints which attacks human vanity. They were first published in 1799.

This series of graphic images, entitled Los Caprichos, meaning whim, caprice or fancy, is extremely influential in the history of Western art and was itself influenced by Enlightenment thought, created during a time of social repression and economic crisis in Spain. In order for progress to be made and for humanity to advance, Goya believed the chains of backwardness had to be broken, and Los Caprichos encapsulates his attempts to analyse the human condition and his ambivalence toward authority and the church. In the words of the artist himself, Los Caprichos displays “the innumerable foibles and follies to be found in any civilized society … the common prejudices and deceitful practices which custom, ignorance and self interest have made usual”.

Themes dealt with in the etchings include the corruption of the nobility, witchcraft, child rearing and avarice, with a varied cast of characters comprising goblins, monks, aristocrats, prostitutes and animals acting like human fools. The donkey, acting the roles of wicked, pompous or foolish human beings, is particularly prevalent and appears in six etchings.

A prominent belief during the Enlightenment was the faith in the progress and perfectibility of society with the help of science and technology. Happiness would be promoted if physical health was protected and restored, and with this came a general ‘medicalized society’ reliant on the employment of professionals who could deal expertly with health related problems. This meant all others in the popular sector claiming healing roles were to be dismissed as quacks, an obstacle to progress.

Los Caprichos takes place in a world on the margins of reason, heading towards fantasy and it is a discerning statement of man’s bad habits, eccentricities and madness. In De Que Mal Morira? (Of What Illness Will He Die?) the recumbent man is attended by two shadowed figures and his physician who is characterised as a fashionably attired ass. The ass is searching for his patient’s pulse, while displaying a garishly large gem on his hoof. Goya denounces vice using satire, yet denied all intention of personalities in his work; subjects were chosen which best highlighted the hypocrisies of the day and exposed them to ridicule. Goya himself said in an advertisement from 1799: “In none of the compositions which form part of this collection has the author proposed to ridicule the particular defects of any one individual…”

This particular etching is satirising the maladroitness and self-posturing of the medical profession, as the patient is clearly dead, yet the ass physician continues to check for a pulse. Goya is suggesting that the treatment given by ignorant doctors may be just as dangerous, if not more so, than the illness from which the patient is suffering, and that perhaps the patient knows his own constitution best. This was a view shared by Arnulfe d’Aumont, a French physician who wrote an article on the subject for Diderot’s Encyclopédie, and stated: ‘There does not exist a definition of health applicable to everyone, each has his own state of wellbeing.’

Anxiety and nightmares are depicted in the series, showing a society going to ruin. One print shows donkeys riding on the backs of the hard-working poor, while another shows a donkey teacher reading from a book to a donkey pupil; the implication being that the pantomime will persist if we continue to believe in the fallacies of earlier generations. In Enlightenment ideology, self-sufficiency in treatment based on superstition or lack of knowledge was displaced by a new dependency on qualified physicians and surgeons. It was this medical elite, with superior knowledge about bodily processes in health and sickness, that took on an increasingly prominent role in European society.

The world of unreason in which Los Caprichos takes place runs counter to the ordered reality which thinkers in the 18th century believed to contain an underlying pattern, giving rational knowledge as to how the body worked. The physicians, under considerable pressure to apply all known measures for the benefit of their patients, often wealthy patrons, had to rationalise the causes and manifestations of disease in line with contemporary thought shared by the educated elite. This in turn helped to firm up the bonds between healers and patients.

Goya is deriding these physicians who employed traditional remedies by linking them rationally to their new theories, giving an old therapy new logic and authority: treatments, as evident in this etching, that were often of dubious efficacy. The lack of sound knowledge, augmented by physicians dependent on house calls, rather than hospitals, in order to further understand illness, led many physicians to focus purely on their patient’s most obvious symptoms and the need to impress their  patients with heroic measures such as bleeding. It is perhaps this over eagerness on the behalf of the ass physician that Goya is so scathing of in his work.

Willian Birnie is a Visitor Service Assistant at Wellcome Collection. You can contact him at W.Birnie@wellcome.ac.uk.

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Object of the Month: Blade Runner

Posted on 4 April, 2011 by Christopher Sirrs
Guillotine blade used in execution of Jean-Baptise Carrier. French, 1790-94

Guillotine blade used in execution of Jean-Baptise Carrier. French, 1790-94. Science Museum/SSPL

For a man so interested in the history of health and wellbeing, it is remarkable just how many torture devices, weapons and instruments of execution found their way into Henry Wellcome’s vast collection of between 1 and 2 million medical and anthropological curios. From African spears to amputation saws and from trepanned skulls to torture chairs, Wellcome’s collection served not only as a grizzly catalogue of medicine’s past attempts to heal and cure but as an unsettling reminder of how knowledge of the human body can be used to cause just as much harm as good. By placing these gruesome offerings alongside more traditional symbols of ‘good medicine’ – the stethoscope, the medicine chest – Wellcome’s collection quietly challenged the ethical authority of Western medicine, with its famous claim, enshrined in the Hippocratic Oath, to ‘do no harm.’

The truth is, as Henry Wellcome surely realised, medicine has never been solely about the preservation of health and life. In various political and religious circumstances, medical knowledge can be co-opted to deliberately cause harm or take life away, from the horrific Nazi concentration camp experiments to the cool clinical practice of Death Row in America. Medicine’s ethical integrity in regard to the taking of life continues to be questioned in the 21st century: recent controversy erupted when it was discovered a British pharmaceutical company was selling a drug to be used as part of the lethal injection in the United States, and the place of medicine in euthanasia or abortion is still fiercely debated.

All these issues buzz around this month’s item, a guillotine blade used during the French Revolution, on display in Medicine Man. Surprisingly small (nowhere near the size of the contraptions usually seen in magic tricks or in films) the reason it found a home among Wellcome’s more overtly medical artefacts was as simple as the device itself: its use was suggested as a more swift, clinical, medical way of executing people during the Revolution by the eminent physician, Joseph-Ignace Guillotin (1738–1814).

The circumstances of Guillotin’s birth couldn’t have been more grimly prophetic. Prior to the Revolution, a variety of methods of execution were used in France, and one of the most feared was the breaking wheel, which cudgelled its victims to death. According to Guillotin family legend, it was the shock of hearing the blood-curdling cries of a man being broken upon the wheel that led to Guillotin’s premature birth. Guillotin grew to be a wealthy and respected physician, renowned for his rationalism and reformist attitudes. Along with Benjamin Franklin, in 1784 he was a member of the inquiry that investigated Franz Anton Mesmer’s theory of animal magnetism, and he dallied with ideas of political reform before turning his attention to the reform of capital punishment in 1789. It was Guillotin’s belief that, as a first step towards abolishing capital punishment altogether, a more humane and egalitarian form of execution was required in France to replace the torturous and class-based punishments handed out in the ancien régime: in general, the aristocracy was afforded the dubious honour of decapitation by sword, while commoners were usually hanged. To this end he proposed a ‘simple mechanism’: ‘The device strikes like lightning, the head flies, blood spouts, the man has ceased to live,’ he argued.

It is a myth that Guillotin designed and built the blade before later falling victim to it (he died quite peacefully in 1814, although he did narrowly escape his own death by it). The French guillotine blade was designed by a surgeon, Antoine Louis, and built to specification by a German maker of musical instruments. In fact, if it wasn’t for a popular Royalist satirical song of the day, Guillotine’s name would probably have never become attached to the device; instead, it probably would be known to this day as the Louisette or Petite Louison, after the surgeon who designed it. The ‘Guillotine’ wasn’t even the first decapitation machine. Forms of the guillotine had been in use in Europe for centuries before the French Revolution: the Maiden in Scotland and the Gibbet in Halifax were two methods used in Britain (if someone was caught stealing a sheep in Halifax, a sheep would be brought in as the executioner, releasing the rope that unleashed the blade).

The guillotine blade on display in Medicine Man was used to execute an infamous revolutionary, Jean-Baptise Carrier. Carrier was renowned for the sadistic ways he despatched his enemies, such as the drowning of political prisoners in the River Loire. It often isn’t realised just how recently execution by guillotine was practised in France: the last guillotining (in private) took place in 1977, to execute a Tunisian murderer called Hamida Djandoubi. The last public guillotining took place in the 1930s; it was only in 1981 that France withdrew the death sentence altogether.

Some historians have argued that Guillotin was a humanitarian, since he suggested the use of an instrument that did away with forms of execution that were crueller and more protracted by comparison. In this sense, perhaps the guillotine can be considered a ‘medical’ object of sorts, and more at home with its surrounding objects than it may appear. On the other hand, the guillotine allowed people to be unthinkingly executed on a terrifying scale – 40,000 people during the French Revolution alone. Can a device which led to so many deaths in any way be considered ‘medical’?

Chris Sirrs is a Visitor Services Assistant at Wellcome Collection.

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Object of the Month: Out of Touch

Posted on 28 October, 2010 by Danny Birchall
Copy of Queen Anne's lodestone. Wellcome Images

Copy of Queen Anne's lodestone. Wellcome Images

If you’ve attended one of our free themed tours, you’ll know that the objects in our collection have a myriad of wonderful stories to tell. From the history of nursing to evolution and cultural responses to life and death, every one of our objects can be seen in a new and different light and has its own unique history and significance. With over 500 objects in Medicine Man alone, we have lots of objects vying for your attention. Every month, therefore, we’ll be bringing you an interesting object from our vast collection, and finally giving it its well-deserved place in the limelight! Chris Sirrs starts us off with a curious ‘touch piece’…

The silver touch piece shown above (the object pictured is actually a replica of the object on display) was reputedly used by Queen Anne of Great Britain (1665-1714). Containing a magnetic stone called a lodestone, it was used in the ritual of the ‘royal touch’, a spectacular display of seemingly miraculous healing performed by a long line of English monarchs, allegedly dating back to the reign of Edward the Confessor.

The touch piece was used to cure scrofula, or the ‘King’s Evil,’ a type of tuberculosis that affected the lymph nodes in the neck. Eminent physicians and surgeons would recommend sufferers seek the royal touch as a last resort for their cure, and local parishes would often finance the long and arduous pilgrimage to London.

Touch pieces were often given to pilgrims as a memento of their experience, and were thought to be invested with magical curative properties of their own. They were often pierced so they could be suspended from a ribbon and worn around the neck. Among the pilgrims to have received the touch from Queen Anne was the infant Samuel Johnson, who later became a celebrated essayist and writer of the famous English Dictionary.

The monarch was allowed to achieve a medical monopoly, of sorts, over healing by touch alone. Although a range of folk healers performed touch-healing in local communities across England, those who achieved a significant following could be imprisoned or even tried for witchcraft. In 1637, a self-proclaimed ‘seventh son’ named James Leverett was investigated by the London College of Physicians for allegedly imitating the royal ritual, and was sentenced to whipping and imprisonment in the notorious Bridewell jail.

After the upheaval of the Civil War and Interregnum, the royal touch ceremony experienced a surge in popularity. Charles II, keen to re-establish the Stuarts’ divine authority to rule, is said to have touched over 90 000 of his subjects in just nineteen years of his reign. This huge number was swelled by subjects, many from abroad, who returned to receive the cure for a second or even third time.

Queen Anne was the last English monarch to perform the rite. Her Protestant brother-in-law, William III, famously saw it as superstitious nonsense, and is reputed to have said to his subjects, ‘May God grant you better health and commonsense’ (in a parody of the liturgy). The newly-emerged Tory party, supporters of the monarchy, encouraged Queen Anne to briefly renew it, but her death in 1714 marked the official end of the practice. The Hanoverians, strict Calvinists, associated the rite with the worst excesses of Catholicism, and made no attempt to continue the tradition.

However, the rite had a lasting appeal in the popular mind. Some physicians continued to recommend the touch to their desperate patients, and folk healers continued to be sought after. Yet as mechanical explanations for the ‘miraculous’ cure became more accepted among the medical community, the touch became increasingly the subject of humour. In 1721, the surgeon James Handley joked, ‘You might have a Cure as well, by rubbing the Part with a Broomstick.’

Chris Sirrs is a Visitor Services Assistant at Wellcome Collection.

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