London’s Pulse: Life and Health in Modern London

Kathleen Crowther

This past semester in my history of medicine class (HSCI 3423 at the University of Oklahoma), I asked students to design and execute a research project based on the on-line resource London’s Pulse: Medical Officer of Health Reports 1848-1972, one of the digital collections of the Wellcome Library.  This was a group research project, the second of two group research projects in this class.  There were 6 groups, each with 8-9 students.  For the first research project they had to write a collaborative paper of 15 pages with footnotes and bibliography. For this project, I thought it would be more interesting to have them construct a class website with the results of their research, and they created the London’s Pulse Projects site.

L0003051 A cholera patient experimenting with remedies. Coloured
A cholera patient experimenting with remedies. (1832) Wellcome Images.

My goal was to get them to work with primary and secondary sources to construct a historical narrative. I say “narrative” rather than “argument” intentionally.  Some of them actually DID uncover things that were somewhat unexpected and could serve as the basis for more in depth and advanced research projects. In general, I don’t expect students at this level (many taking their first and only history of science or medicine class) to be able to know enough about the historical literature to judge whether or not they are making an original contribution to that literature. At least, I expect they need considerably more guidance to do this. I have another couple of assignments where I work with them on how to make a historical argument.  With this assignment I wanted to encourage students to dig around in an extensive set of primary sources and find things that struck them as interesting.  Further, because this was a website, not a formal research paper, I encouraged students to write in a somewhat more relaxed and informal style, more suited to a broad general audience. In terms of content, this assignment also fit with one of the major themes of the course which is health inequalities, and the importance of the social determinants of health.

The stages of the assignment were:

Explore the database (1 class day plus an on-line discussion). On the first class period of this assignment, I broke each group into 3 subgroups. I asked each subgroup to search the MOH reports for the following keywords: cholera, rats, and fog. I advised them that each of these terms would pull up hundred of records, and recommended that they see what happened if they limited to a certain year or set of years, or to a borough or set of boroughs. Each subgroup was to scan through the reports and note at least THREE trends or things that struck them as interesting or surprising. They were then asked to pick ONE MOH report with their search term and read it more carefully. They had to explain why they picked this particular report, write a brief description of what it said about the search term, and share it with the rest of your group. Once they had discussed the search terms in their groups, all the subgroups shared their findings with the entire class. In this way, they could see certain patterns emerging, but also anomalies and differences introduced by the use of different limiting search terms.

After the first in class discussion, I asked all students to read the “Health of London Timeline” on the London’s Pulse website and get familiar with the key events in the history of public health in modern London. In addition, each student picked one blog post about “London’s Pulse” from the Wellcome Library’s blog. These posts are by scholars explaining how they used the information in the MOH reports in their research. I thought this would give students some idea of the kinds of questions and problems that the historical data in London’s Pulse can answer. Each student read one of these posts and described it in about a paragraph on an on-line discussion with their group members. In addition to their original post, each student responded to at least two other students’ posts.

Choose a topic (1 class day). In the second class devoted to this project, each group had to come up with three keywords of their own to search.  If they found one of my key words particularly interesting, they could use it again, but they had to come up with two more. I gave them some suggestions, but urged them to get creative. My suggestions included: a disease (e.g. syphilis), a type of illness (e.g. diarrhea, infant mortality), an institution (e.g. workhouse, factory, hospital), a time period (e.g World War I), weather (e.g. fog, rain), a public health measure (e.g. immunizations). Once again, they broke into three subgroups and each searched the MOH reports for the keywords. At the end of this class they had to decide which of their keywords would make the most interesting topic for the group project. A few groups needed another day to figure this out, but most came up with a general topic by the end of the class period.

L0046484 Workhouse for 300 paupers - ground plan
Workhouse for 300 paupers – ground plan. From Annual report of the Poor Law Commissioners for England and Wales. (1835-1847). Wellcome Images.

I set up the website (using WordPress) with the six topics they close: child labor, workhouses, pollution, World War II, infant and child mortality, and cholera.

I set up front pages and associated pages for each topic.  I gave every student access to the site so they could edit the site. Students added content, both text and images, to each of the pages.

Find sources and make a work plan (1 class day plus an on-line discussion). I asked students to assemble a bibliography of primary and secondary sources, including MOH reports; and to divide the project into subtopics that one or two students could work on. Each person could contribute something separate, or small groups of 2-3 could collaborate.

Writing (about 3 class days were devoted to writing and editing pages). Each student was required to write 700-1000 words and to use 5 sources (ideally a mix of primary and secondary).

I read through drafts of the pages and made comments. The site remained private until I had graded everything. I corrected grammar and spelling as I read through the final version of each page. I removed images (and sometimes replaced them with others) if they were under copyright.

Things that worked:

  • Many students got really enthused by this project and wrote very thorough, well-researched pages. They wrote longer pages and used more sources than were required.
  • All groups devised interesting projects and did a great job dividing up the work equally.  The fact that each of them was responsible for an individual page alleviated concerns that stronger students were expected to “carry” weaker students (a perennial problem with group work), but the fact that they were working as groups meant that their project was larger and more in depth than an individual research project. They were also able to share sources.
  • Some students made really interesting connections that I didn’t expect. For example, Danya Majeed juxtaposed William Cadogan’s advice on child rearing with the regimen for children in workhouses. While Cadogan’s text was meant for wealthy families, his advice about not “coddling” children and the need to “toughen them up” arguably informed the draconian regimes in workhouses and other places where children were institutionalized. Tracy Turner’s discussion of infant nutrition in the project on Infant and Child Mortality shows how Medical Officers of Health felt they had to educate poor mothers in the proper care and feeding of their children.  There is some acknowledgment of the constraints these women faced in bringing up their children, but considerably more blame placed on them than sympathy. Jenna McGrath draws trenchant parallels between sweatshop labor in Victorian Britain and today.
V0010880 A man covering his mouth with a handkerchief, walking throug
A man covering his mouth with a handkerchief, walking through a smoggy London street. Wellcome Images.

Things that didn’t go so well:

  • Some pages are quite superficial.  I made clear that this website would be public, and that other members of the class would read it, so I assumed since people would not want to display shoddy work publicly, but I was mistaken.
  • Many students did not make as much use of the MOH reports as I would have liked. (They bring in one or two in to illustrate a point they found in the secondary literature. They don’t bring in secondary literature to understand what they read in the MOH reports.)
  • Despite what I thought were pretty extensive discussions in class on how to find scholarly secondary sources in databases like the “History of Science, Technology and Medicine” and “Historical Abstracts,” some students relied heavily on sources they found through Google.
  • I needed to give students more instruction than I did in using WordPress. It’s not that difficult, but there were a few hiccups (e.g. one student inadvertently deleted another student’s work). I don’t feel like I really gave them the skills to blog independently, and I’d like to do that next time.


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