The difficulties of diagnosis

Today we have a story about a girl called Annie, which I shared at the Child Care History Network Conference earlier this year. Hers is a sad story, but at the same time it can teach us a lot about the complexities of diagnosis in the early-20th Century.

Annie was born in 1894 in a small village near Dorking in Surrey. It wasn’t an easy childhood for her: when Annie was 10 years old her father died of pneumonia, and to make matters worse, one year later her mother died of congenital heart disease.

We don’t know what happened to Annie immediately after she was orphaned, but about a year later she went into the workhouse in Dorking. Her two older brothers were working as farm labourers in a nearby village, and her older sister was married and living on another nearby farm, but none of them could afford to help Annie. This meant that the workhouse was the only option.

Annie remained in the workhouse in Dorking for a year until 1907, when she was 13. At this point, the Dorking Guardians of the Poor filled in an application for Annie to enter the care of The Children’s Society (then known as the Waifs and Strays Society). Why the application was made at this point, we don’t know; but it’s understandable that they thought it would be good to get Annie out of the workhouse.

See the first page of Annie’s application form below (click the image to see a larger version).

The front page of Annie's application form, giving information about her family, 1907, from case file 12767

Annie’s application was successful and in June 1907 she entered St Margaret’s Home in Penkridge, Staffordshire. Just before entering the home, a medical form notes that Annie is in good health.

Unfortunately, when Annie had been in St Margaret’s Home for two years, her health began to falter. She was sent to Stafford Infirmary, where the doctor who saw her diagnosed her with a weak heart. At this point Annie was 15 (the school leaving age at the time was 12), an age at which the girls in St Margaret’s Home often left care to start work. The doctor at the infirmary advised that Annie shouldn’t start work for at least a few months and that even then it should only be light work. With this advice, Annie was sent back to St Margaret’s Home to recuperate.

Time passed and yet Annie didn’t seem to be getting better. The local doctor at St Margaret’s Home saw her and diagnosed her as having pneumonia along with the heart disease. The doctor’s prognosis, however, was good: he said that with medicine, care and sea air, Annie might get better in a month.

If you’re a regular reader of this blog, you will have noticed that sea air is a treatment that was very popular in the late-19th and early-20th Centuries. The doctor at the home said that Annie should be sent to the East Coast of England because its sea air was known to be bracing. Presumably, when it comes to pneumonia, bracing sea air was thought to be best.

Following the doctor’s orders, The Waifs and Strays Society tried to find Annie a place in their home in Lowestoft in Suffolk. This home, however, didn’t have any special facilities for sick children and so couldn’t take Annie on. With the East Coast not feasible, Annie was instead sent to the South Coast. On this coast, at Hurstpierpoint in Sussex, The Waifs and Strays Society had a dedicated convalescent home, Nayworth Convalescent Home, where Annie could get specialist medical treatment.

We next hear of Annie in July 1909, when she had been at Nayworth Convalescent Home for a month. Her illness had grown worse, leaving her bedridden and eating nothing but milk and barley water. By this point, all talk of Annie going out to work had ended. It was thought that she might never be well enough to start work, and might have to rely, once more, on the workhouse in Dorking.

Very shortly, the discussion about Annie’s future had taken a back-seat to her current state of health. See the letter below, sent by the matron of Nayworth Convalescent Home (click the image for a larger version):

Letter from the matron of Nayworth Convalescent Home, discussing Annie's admission to the children's hospital in Brighton, 1909, from case file 12767

August 1rst. 1909

Re Annie [surname]

Dear Sir. –

As I have been nursing night
& day Dr. Parry recommended
this child’s admission to the
Children’s Hospital at Brighton.
I took her there on Friday
afternoon. She was very ill
when I left her & so I went down
yesterday to see her. She had
brightened up a little but the
doctor at the Hospital considers
it a very bad case.

Her heart is weak but Kidney

disease is the primary cause
of the trouble.

I am. yours faithfully

Elsie P. Smith

Annie stayed in hospital for a month, with her condition sometimes getting better and sometimes growing worse. The matron from Nayworth Convalescent Home kept in frequent contact with the hospital during this time.

Sadly, in late August 1909, Annie lost the battle she had been fighting and passed away, aged 15. Her death certificate states that she had died of pancreatitis followed by heart failure. Correspondence in Annie’s file describes just how much she would be missed by the people who had looked after her during her time in care. She was said to have been very patient in the face of her illness and grateful for all that was done for her.

When it comes to Annie’s story, I’m particularly intrigued by the variety of diagnoses that she was given. Her first diagnoses were heart disease and pneumonia and, if you remember, these are the diseases that Annie’s parents had died of. You have to wonder if the doctors were thinking that Annie’s illness might be hereditary or linked to her parents in some way.

Then, when Annie went to hospital in Brighton, she was given a diagnosis of kidney disease, suggesting that the doctors there saw she was having abdominal trouble. Finally, on the death certificate, it states that Annie died of pancreatitis and heart failure.

We will never know which diseases Annie actually suffered from. It seems likely that she had either kidney disease or pancreatitis, and that she also had a hereditary heart condition. She may even have had pneumonia as well, although it’s hard to tell from this distance of time. This lack of clarity shows us just how difficult it was for doctors to reach a diagnosis, and how difficult it was to treat cases like Annie’s, with only the medical knowledge available at the time.

Exploring the history of disabled children in care

It’s UK Disability History Month, which is a good time to reflect on disability history and what it means for today. The Children’s Society has helped disabled children ever since it was founded in 1881; this means that our collections here at The Children’s Society Archive can tell a lot about the history of disabilities and attitudes to them over the past 130 years.

Leaflet celebrating 50 years of the Children's Union, a body which raised funds for The Children's Society's homes for disabled children, leaflet dated 1938

Two years ago we finished a project called Including the Excluded, which catalogued and preserved our archival collections relating to The Children’s Society’s work with disabled children.

Click here to visit the project’s webpages and find out more about The Children’s Society’s work with disabled children (and to see catalogues of the documents we hold that can be used to study disability history).

We blogged about the Including the Excluded project as we went along, so check out the Including the Excluded category to see the stories and insights that we came across.

The end is nigh! Find out about the final stages of our project at a seminar in London on 8 December 2014

Want to hear what we’ve discovered in our Unexplored Riches in Medical History project? Now you can!

I’m happy to announce that I will be giving one of the Voluntary Action History Society’s seminars on 8 December where I will be discussing the results of the Unexplored Riches in Medical History project. Want to come along? The seminar will be held at Senate House in London on 8 December, starting at 5:30pm. Attendance is free.

Click here for more details.

Children undergoing hydrotherapy treatment at St Nicholas' and St Martin's Orthopaedic Hospital and Special School, Pyrford, Surrey, c1930s

We’re drawing ever closer to the end of the Unexplored Riches in Medical History project, and I’ll be using this seminar to discuss just how far we’ve come in the two and a half years since the project began. In particular I’ll be highlighting the historical trends in children’s health and healthcare that we’ve discovered during the project. And, for those of you wanting to take on a challenge, I’m going to talk about the parts of our archive collection that could really benefit from further medical history research. (As with any project like this, we’ve uncovered more questions than we have answers.)

Please come along to hear what we’ve found. It would be great to see you there.

Visit the Voluntary Action History Society website for further information.

Volunteering: embracing diversity and inclusion

How can we improve our volunteering programme at The Children’s Society? A couple of weeks ago myself and two of our volunteers, Hilary and Rod, went to find some answers to that very question when we attended a volunteering forum at the St Alban’s Centre in London.

St Alban's Centre in London on a bright October morning

I’d been to a previous volunteering forum in Birmingham in March. These events are a chance for volunteers and volunteer managers from across The Children’s Society to get together and share ideas on how to make our volunteering programme better.

The theme for October’s volunteering forum was “Embracing Diversity and Inclusion”. We spent the day discussing how we can embed diversity and inclusion into our volunteer programme here at The Children’s Society. This means working out what barriers there might be that prevent people from volunteering with us and finding ways to remove those barriers.

What we’re striving for is to have a diverse range of people volunteering for The Children’s Society, with all the skills, experiences and insights that they can bring with them. Not only that, we want our organisation to reflect society as a whole and the children we work with so that we’re able to do the best we can to help those children.

A break for tea after some interesting discussions

It was a packed day. First we heard from The Children’s Society’s Volunteering Team who explained what we’re doing now, how diverse our volunteer base is and where we need to improve. Then we heard from a panel of guest speakers from different charities and organisations across the country, who talked to us about what they are all doing to improve diversity and inclusion. We picked up lots of ideas from the panel, ranging from making it as easy as possible for volunteers to get their expenses reimbursed, to providing different ways for people to apply to volunteer roles so that they can choose the way that is easiest for them.

After lunch we heard a talk about unconscious bias: the ways in which we can be biased for or against certain things without even knowing it. We learnt about the different ways we can be biased, whether that’s by our own expectations and stereotypes or through being influenced by the opinions of others. It was sobering and thought-provoking stuff, but really fascinating as well.

Thankfully we were shown how to avoid being swayed by our biases. One way is to avoid making important decisions when there’s little time or when you’re tired and stressed, as these situations are when you can be most influenced by your biases. Another way is to find out what biases you have; that way you can make an extra effort to not be swayed by them. To help with this last one, we were told about the Harvard bias tests which you can take to discover what unconscious biases you may have. Warning: the results of these tests can be surprising, as you may be more biased than you think!

Finally, the last part of the day was a group session where we discussed the different things we could do to embed diversity and inclusion within volunteering at The Children’s Society. This was a really productive session and there were lots of ideas and actions to take away.

Overall, it was a really interesting day. There was a lot of food for thought, and I certainly have some ideas for how we can improve the volunteer experience here at The Children’s Society Archive.

They also had some copies of our snazzy new volunteer handbook at the volunteering forum, so I brought a few back with me

Want to get involved? If you’re thinking about volunteering with us at The Children’s Society, take a look at our volunteering pages to see our current volunteer opportunities.

Discovering medical history and childcare at the Child Care History Network Conference 2014

“Healing the Wounds of Childhood” That was the name of the conference we attended two weeks ago. It was the annual Child Care History Network conference and this year the focus was on children’s medical history.

You can listen to the talks from the conference, including my own, on the Child Care History Network website.

The conference venue, Buckerell Lodge Hotel in Exeter

The conference was held at the Buckerell Lodge Hotel in Exeter, and as we were still in the last throes of summer (despite the fact that it was October!) the day was warm and sunny. What better time to go to Devon?

There was a whole day full of speakers talking about medical history. First up, though, was myself!

Janine speaking about the Unexplored Riches in Medical History project at the conference

I gave the delegates an overview of what we’re doing in the Unexplored Riches in Medical History project, explaining how we’re cataloguing and conserving our records relating to medical history so that they can be used for medical history research. It was also a great excuse to show off some of the fascinating records we have here at The Children’s Society Archive, including a medical book listing the day-to-day medical care given to children at St Cuthbert’s Nursery in Darlington, County Durham, in 1966; and the case file of Annie, a girl who came into care in 1907 aged thirteen, and the struggle of medical professionals to diagnose the condition that left her seriously ill in 1909.

Want to know more? The good news is that you can now listen to my talk and see my slides on the Child Care History Network website. Hopefully video recordings from the conference and slides from some of the other talks will go up in the next few weeks, so keep an eye out for them!

The other talks on the day were really interesting. We heard about the Charity Organisation Society and its 19th Century involvement in healthcare in Oxford. There was a lot of discussion about 20th Century views on children’s healthcare and development, including the child guidance movement, and the work of people such as Truby King and John Bowlby. We heard about historical views on adoption and its effects on children. Finally, we learned about modern practice and how art therapy can be used to help treat mental health problems.

It was all fascinating stuff, as were the conversations held during the tea and lunch breaks about people’s research interests and backgrounds in child care or medical practice. On top of all that, as with the previous conference we went to, we had a stand with leaflets about the Unexplored Riches in Medical History project, where we could talk to the delegates about the project in more detail.

All in all, it was a great day. But you don’t have to take my word for it! Visit the Child Care History Network website to listen to the talks for yourself. And as I said, more slides and hopefully video recordings will go up over the coming weeks so make sure to keep checking the webpage for more.

Life after polio for a child in care

This week I’ve been tracing lives through the Historic Hospital Admissions Registers Project (HHARP). The HHARP website contains a database of children who went to 19th Century children’s hospitals, and I wanted to see if any of those children were also in the care of The Children’s Society (known as the Waifs and Strays Society until 1946).

I found a few children in the database that could be matched to our case files here at The Children’s Society Archive, and today I’m going to tell you about one of them. John went to hospital with a deformity in his feet, which is described in John’s case file as both club feet and flat feet. He had had polio (also known as infantile paralysis) when he was younger, which is likely what had affected his feet.

In October 1911, the HHARP website lists John as entering Great Ormond Street Hospital in London. He was four years old and had been living at the Home for Sick Children in Battledown, Gloucestershire (this was a home that wasn’t operated by The Children’s Society). John stayed in hospital for about two months to have treatment for his feet.

While in hospital, an application was made for John to enter the care of The Children’s Society. It appears that the whereabouts of John’s parents and family was unknown. They had last been heard of in Winchcombe in Gloucestershire but they hadn’t been in contact while John was in the Battledown children’s home, and it had been assumed that the family had abandoned him.

John was discharged back to the Battledown home in December, and was described as “cured”. One month later, in January 1912, John re-entered Great Ormond Street Hospital in order to have more treatment for his feet. This time he was in hospital for just two days and was discharged back to Battledown with his condition described as “relieved”. In one of his two hospital stays, it seems that John had undergone an operation on his feet. As he was still recuperating from the surgery, the application to The Children’s Society was put on hold for a while.

By August 1912, John was able to “walk splendidly”. His application to The Children’s Society was restarted and in October, aged 5, he went to live in The Children’s Society’s St Nicholas’ Orthopaedic Hospital and Special School in Pyrford, Surrey.

John stayed in this home for about a year and a half and then, in 1914, he went to live in a foster home in Frettenham, Norfolk, along with another boy from St Nicholas’ Home. At this point, John was seven years old and we know that he was attending the local school while he was in foster care. Correspondence in our case file for John tells us that he received a medical examination at school, and that a doctor from The Children’s Society also came to see him. One of the doctors prescribed special boots for John’s feet and the other prescribed exercises for John to do; we don’t know what exercises these were, but we do know that the boots cost 15 shillings, 10 shillings of which were donated by a local person in Frettenham.

For a number of years, there’s little medical information to be found in John’s case file. He stayed in foster care in Frettenham until 1920 when he was twelve years old. It was normal for children at the age of twelve to leave foster care and go live in a children’s home where they could begin to learn a trade. And so, at the age of twelve, John left Frettenham and went to Peckham Receiving Home for Boys in London, which was a home that boys normally stayed in temporarily before moving on to other children’s homes.

At Peckham Receiving Home, John was seen by a doctor, who recommended that he have hospital treatment for his ankle. For a second opinion, John was also seen by the doctor from The Children’s Society who’d gone to see him in Frettenham. Her response after seeing John is below:

Letter about treatments for John's feet and legs, 1920, from case file 17217

Letter about treatments for John's feet and legs, 1920, from case file 17217

Letter about treatments for John's feet and legs, 1920, from case file 17217

March 15 1920

Dear Mr. Swann

Re John [surname]

This boy has had a form of
club foot due to infantile
paralysis which has been
operated on when he was
very young. The condition of
the legs and feet is good
and nothing further can be

done at the present time for
them.

There is no reason why he should
not do a certain amount
of walking but he should
be allowed to take his time.
The condition, of course, will
have to be watched from
time to time in order to see
that the bones of the legs grow
sufficiently as the boy gets
bigger. I should advise letting
the legs be sponged down every
day with Tidmans Sea-Salt –
a tablespoon of the salt

to a washing basinful of
warm water. Massage would
of course, improve the muscular
development.

The boy would like to be a
tailor and this life or that
of a boot maker, would be
very suitable.

With kind regards

Yours sincerely

R Turner

Dr Turner’s recommendations are wonderfully detailed. We see that she recommends massage for John’s legs, which seems like something a child could be prescribed today. She also recommends bathing John’s legs in a salt solution, which is a little more unusual. I’m not sure what the purpose of this salt-bathing would be; let me know in the comments if you have any ideas!

John stayed in Peckham Receiving Home while a place was found for him elsewhere. After a few months he went to St Andrew’s Home for Boys in Matlock, Derbyshire. However, after only three months there it was clear that St Andrew’s Home wasn’t well-equipped to look after a boy like John who had difficulty walking. As a result, John was sent back to Peckham Receiving Home.

Once again enquiries were made as to a suitable children’s home for John. John wanted to become a tailor, and so he was sent to St Benet’s Home for Boys at Emmer Green, Berkshire, where they taught tailoring skills.

Sadly, however, it seems that this home wasn’t suitable for John either. After only a month, John was seen by a surgeon at Berkshire Hospital in Reading, who had the following to say (click the image for a larger version):

Letter about treatment for John's feet, 1921, from case file 17217

The surgeon recommended that John have special boots again, and suggested that John be sent to a home that would provide him with specialist medical supervision. Once again, we find that the home John was currently living in was not equipped to look after boys with conditions like his.

And so, for the third time, John was sent to Peckham Receiving Home. He was there for only a short while this time before being sent to St Martin’s Orthopaedic Hospital and Special School in Pyrford, Surrey. This home was next door to St Nicholas’ Home which John had lived in when he had first entered the care of The Children’s Society. Like St Nicholas’ Home, St Martin’s also specialised in looking after children with orthopaedic conditions; St Martin’s, however, took in older boys and often taught them trades such as tailoring.

Finally, John was able to settle down in a home for a decent period of time. He stayed at St Martin’s for three years until 1924 when he was seventeen years old. By 1924 John’s feet were described as cured and a report states that he had completed his training in tailoring. For a job, however, John had since decided that he would rather work as a servant than as a tailor.

There was initially some difficulty in finding John a job. He had a speech impediment which led some potential employers to turn him down because they didn’t think him suitable for answering the door to visitors.

In order to increase his job prospects, John returned to Peckham Receiving Home, as this home was often used as a temporary home for boys looking for work. It was successful. After just two days in Peckham, John went to work as a hall boy in Pimlico in London, earning seven shillings and sixpence a week.

John stayed in this job for about a month and a half. We don’t know why he left, but he soon went to another job on a farm in Plumpton, Sussex, earning six shillings a week. John started this job in July 1924 and stayed there until Christmas 1924 when he returned to Peckham Receiving Home for a brief holiday. However, when in Peckham, John said that he didn’t want to go back to the farm in Plumpton but instead wanted to go live with his father.

John’s father had just sent John a letter. After a number of enquiries over the previous year, The Children’s Society had finally tracked down John’s family. They found that John’s father and siblings had moved away from Winchcombe in Gloucestershire and had gone to live in Llantwit Fardre in Glamorgan. John’s mother had died, leaving John’s father and John’s eldest sister to look after John’s five other siblings. They were struggling to get by, and when their house was condemned as unfit for habitation, John’s father had become homeless and John’s siblings had been sent to a children’s home nearby. Previously, when John had been struggling to find work, it was suggested that he could go live with his father, but the local vicar of Llantwit Fardre warned that “It would be fatal to send the boy home under the circumstances”.

It is understandable, then, that when John returned to Peckham in Christmas 1924 and said that he wanted to go live with his father, The Children’s Society didn’t let him go straight away.

Instead, in January 1925, John went to work in another job as an under butler in a college in Chelsea, London, earning six shillings a week. Meanwhile, The Children’s Society wrote to the vicar of Llantwit Fardre to see if John’s father’s circumstances had improved and if it would be possible for John to go live with him.

Unfortunately, John’s case file ends there so we don’t know what happened next. Did John stay working as an under butler in Chelsea or did he go to live with his father in Llantwit Fardre? Presumably John thought that he’d be able to help his father earn money to support the family, but it wouldn’t have been easy if they had nowhere to live. And why did John’s family never contact him when he was first put into a children’s home all those years ago? Were their circumstances as dire in 1911 as they were in 1924? It seems that John’s story still has more to tell.

Despite the gaps in our information, what have we been able to learn? Firstly we have seen just how fascinating it is to link our records to those of Great Ormond Street Hospital using the HHARP website. We can follow John’s treatment from surgery in hospital through to orthopaedic boots, to massage and to bathing in salt water. By the end of his file in 1925, it seems that all the treatments had paid off, with John gaining enough mobility to work as a servant.

What seems most clear to me though, is just how difficult it must have been for John and for other disabled children in similar situations. With John’s difficulty walking, it seems that there were many children’s homes which just weren’t able or weren’t willing to look after him. This led to a long period of being shuttled back and forth from one children’s home to another, which for John must have been as disheartening as it was unsettling. Then, when looking for work a few years later, we find that John’s speech impediment was another thing that caused people to discriminate against him.

John’s story is not an easy one to read. It does, however, give us an insight into social attitudes at the time.

Find out more
Have a search of the Historic Hospital Admissions Registers Project (HHARP) website for yourself and discover the children’s stories there.

Artificial sunlight and sunshine suits

Today’s photos might look a little like something out of a vintage science-fiction film, but they are, in fact, pictures of real early-20th Century medical treatments. These treatments were carried out in some of children’s homes that were run by The Children’s Society (then known as the Waifs and Strays Society) and they both involve light.

You may have heard that exposure to sunlight helps our bodies to synthesise vitamin D, and that a lack of vitamin D can lead to rickets. It’s perhaps not surprising, then, that the children’s homes which carried out this light therapy were ones that looked after children with orthopaedic problems.

As well as cases of rickets, The Children’s Society’s orthopaedic homes often looked after children who were suffering from tubercular diseases of the bones and joints. Light therapy could be used to treat these diseases too, as light kills the tuberculosis bacteria.

The most obvious way to carry out light therapy is to expose the patient to sunlight, as in the photo below from 1927.

Photo of children in sunshine suits at St Nicholas' Home, Pyrford, Surrey, taken from the annual report for the Children's Union, 1927

These children at St Nicholas’ and St Martin’s Orthopaedic Hospital and Special School in Pyrford, Surrey, are wearing what the caption calls ‘sunshine suits’. To me these suits look rather like a pair of swimming shorts or underpants (and baggy ones at that!) It would seem that the aim was for the children to wear minimal clothing so that as much of their skin as possible could be exposed to the sunlight while they played outside.

However, as the British weather means that sunlight can’t be relied upon at all times, some of the homes also carried out artificial light therapy using electric lights.

Photo of girls undergoing artificial light therapy at Halliwick School for Girls, Winchmore Hill, London, taken from the school's annual report, 1937

In the above photo from 1937 we see girls at Halliwick School in Winchmore Hill, London, undergoing this ‘artificial sunlight’ treatment. The girls are sitting so that the skin on their backs is exposed to the electric light, while they are wearing goggles to protect their eyes.

From these photos and from others that I’ve come across in the archives, it seems that light therapy, be it natural or artificial, was a very popular treatment in The Children’s Society’s orthopaedic homes during the early-20th Century. When was this treatment first used and how successful was it for the patients? We won’t know without further research. Anyone interested? Please contact us (Hidden-Lives-Revealed@childrenssociety.org.uk) if you are, or if you’d like to use the archive for any other research projects.

For more information about light therapy see the following articles from:
The Wellcome Trust
The Science Museum

Learn about our project at the Child Care History Network conference

Here’s a quick reminder that I’m going to be speaking at the Child Care History Network conference next month. It will be held at the Buckerell Lodge Hotel in Exeter on 3 October 2014.

Visit the conference website to book your place:
Healing the Wounds of Childhood – the Medical and Psychological Care of Children: Historical and Current Perspectives

Children and staff at St Denys’ Home, Clitheroe, Lancashire, 1919

Please consider coming along if you’d like to hear more about our Unexplored Riches in Medical History project. It would be great to meet some of you there.

The keynote address of the conference will be given by Professor John Stewart from Glasgow Caledonian University. Other speakers include Jeremy Holmes, Sarah Hayes and Annie Skinner, and I’ve just heard that another exciting speaker may be added soon.

Click here to see the conference programme and book your place.

A further grant for the Unexplored Riches in Medical History project

We are pleased to announce that The Children’s Society Records and Archive Centre has obtained a further £42,180 grant from the Wellcome Trust for the ‘Unexplored Riches in Medical History’ project to continue paper conservation work on the earliest children’s case files. The additional money will allow our two professional paper conservators to work for a further eight months to better preserve the files and make them accessible to the public and researchers.

The project, including the launch of an online catalogue of case files and children’s homes records, is due to be completed in March 2015.

By creating an online archive catalogue and through conservation work, the records will be widely accessible to The Children’s Society, medical, social and academic researchers and the general public.

To find out what we’ve discovered during the project recently, take a look at some of our blog posts:

For more information, the project’s homepage can be found here: http://www.hiddenlives.org.uk/unexplored_riches

And check out our Facebook page for updates: http://www.facebook.com/HiddenLivesRevealed

Lining fragile documents (aka I hope you like jigsaw puzzles)

Today, we have a guest post written by one of our Project Conservators, Lianyu Feng.

***

Lining is used to give support to an original paper document or artwork. When paper deteriorates, it gradually loses its strength, thus becoming brittle and weaker. Any unsuitable handling can cause further damage such as tearing, and could even cause the paper to fall to pieces. In our Unexplored Riches in Medical History project, such weak documents cannot be handled or read and so can’t be used for research. In order to repair these torn and fragmented documents and make them usable again, we line them with a supporting material.

The document below had many small fragments before it was repaired. These fragments needed to be re-attached to the document. Lining is a good method to do this in a fast way and give the whole document more support.

A typed letter with fragments before lining

Below is another example showing severe deterioration, which has made the document fall to pieces. It would be impossible for anyone to read this easily.

Deteriorated document that has broken into pieces

A light box, such as the one below, helps us to place the fragments into the right position. It makes it easy to see where the gaps are, and then we can align the fragments into the exact positions.

Fragments are re-joined to the typed letter on the light box

If the object contains ink which is not sensitive to water, wet lining using Japanese tissue and special conservation adhesive is one of the most common methods. As lining should not obscure the information on the object, the back of the document or the side which contains the least information is the most suitable for lining. For example, the document below has had Japanese tissue placed on the back of it so as not to obscure the text on the front.

Typed letter, which has been lined on the back

When wet lining has been carried out, the document will then need to dry. The document is dried under tension; this means that the document stays flat as it dries. This flattens existing creases and prevents new ones from appearing.

Once a document has been lined, the object will be stronger, and completely flat, with all the fragments having been re-attached and any tears stabilised. A lined document is both easier to handle and looks better aesthetically.

Below, we return to the document we saw earlier, which had completely fallen to pieces. Here it is after lining. All the pieces have been placed in the right position, although unfortunately some parts are still missing, such as the line in the middle. However, we can now handle and read this letter without difficulty.

Same document after lining