| Description | Sir Robert Carswell's anatomical drawings, with manuscript notes describing the cases illustrated, 1827-1838, and a manuscript catalogue, dated 1864.
The collection contains many items of historical significance, notably the first illustrations of the pathology in Hodgkin's Disease, the first portrayal of the lesions on the spinal cord in multiple sclerosis and the first depictions of iron deficiency anaemia. It comprises over around a thousand finely drafted watercolour and ink drawings, of various dimensions, depicting diseased structures divided into groups by subject.
Not all the drawings in the collection are by Carswell himself. Other named artists are Johnson Savage (17 drawings), W P Cocks (5 drawings) and H B Tuson (1 drawing). There is also an artist known simply by the initials "J A" (3 drawings) and some case notes are signed by B[enjamin] Clarke (3 drawings). In addition there are two (identical) uncoloured printed lithographs, and one unsigned drawing, dated Calcutta, 1852. Carswell's drawings are usually signed, or at least initialled by him, with the date and location on the verso. They date from September 1825 to March 1839, with those dated 1825 to early 1831 having Parisian locations. As well as the hospitals, zoo and abattoirs mentioned previously, some have names of doctors - presumably private cases which Carswell observed. One drawing has the inscription "Santo Spirito 1826", i.e. the Ospedale di Santo Spirito, the oldest hospital in Rome. One other has "St. Valery-sur Somme 1839" on the verso.
Of those executed in London, the majority were done at the North London or University College Hospital. Other locations are the Mount Street Infirmary and the North London Fever Hospital. The Fever Hospital was established for smallpox patients in 1802, in Gray's Inn Road, and moved to Liverpool Road, Islington in 1848.
Many drawings have several numbers on them but Carswell seems to have settled on the seventeen categories [A, B, Ca, Cb, D, E, Fa, Fb, Fc, Fd, G, Ha, Hb, Hc, I, K & L], each dealing with a part of the body or type of disease. The drawings were obviously once numbered in a continuous sequence from 1 to 1,035 but were then arranged into their respective groups which explains the seeming gaps in numbering.
The original drawings vary considerably in size, from as little as 4 x 4 cm to as much as 45 x 30 cm and above. Most are painted in watercolours. Over the years they were much used and handled, becoming very dirty and damaged, particularly at the edges. A project to conserve and re-house the drawings was completed in 2007. The drawings were digitised in 2017 and are now available online. |
| AdminHistory | Biographical information from notes by Sir George Dancer Thane (now in Special Collections filing):
Carswell was born in Paisley, Scotland, on 3 February 1793. He studied medicine at the University of Glasgow where he was noted for his skill in drawing, and was employed by Dr John Thompson of Edinburgh to make a collection of drawings of morbid anatomy whilst still a student. For this, he spent two years working at hospitals in Paris and Lyons (1822-23). He received his MD from Marischal College, Aberdeen in 1826 and returned to Paris afterwards, resuming his studies in morbid anatomy under the celebrated Dr. Louis (1787-1872).
In 1828 Carswell was appointed Professor of Morbid Anatomy, at the University of London. Before the commencement of his teaching duties he was commissioned to prepare a new collection of drawings in Paris, and his appointment was not immediately publicly announced in case it interfered with his opportunities for making drawings. He was engaged to remain abroad for two years on a salary of £350; this was later extended for an additional year, and he took up his teaching post in 1832.
Carswell was not alone in finding better opportunities in Paris. At this time English and Scottish doctors were flocking to Paris to study the new clinico-pathological approach to disease and new techniques in the large French hospitals, and to gain greater access to cadavers for dissection. He visited the wards and attended post-mortem dissections in the hospitals' anatomy theatres. He also visited the zoo and abattoirs to make comparative studies of animals. Most of his drawings are signed and dated, with the name of the hospital or other location. Drawn from this information we know that Carswell worked at the following hospitals in Paris:
Hôpital Biscêtre
Hôpital de la Charité
Hôpital de la Garde Royale
Hôpital de la Pitié
Hôpital de la Salpétrière
Hôpital de la St. Louis
Hôpital des Enfans Malades
Hôpital des Enfans Trouvés
Hospices de la Vieillesse (Femmes)
Hospice des Vénériens
Hôtel Dieu de Paris
He also studied and drew animals at the Jardin des Plantes, and the Abbatoirs of Grenelle and Montfaucon in Paris.
In 1831 Carswell was appointed physician to the dispensary of the North London Hospital and he began lecturing at the University in the winter term of 1832-33. His was the first chair of pathological anatomy in England but was not entirely successful. Resources were tight, the course was not required for the examinations of the Royal College of Surgeons or of the Society of Apothecaries and he found himself squeezed out between the more traditional subjects of normal and practical anatomy and the practice of medicine. In order to earn a living Carswell was forced to divide his time between lecturing in the University and working in the pathological museum, working in the hospital, and in an unsuccessful private practice. Thus he could not focus his energies entirely on building up his fledgling discipline.
In 1837 he published Pathological Anatomy: Illustrations of the Elementary Forms of Disease, illustrated with his own drawings. The volume's contents are arranged according to pathological states under the following headings: Inflammation, Analogous tissues, Atrophy, Hypertrophy, Pus, Mortification, Haemorrhage, Softening, Melanoma, Carcinoma (in two parts, with two sets of plates) and Tubercle. Each part includes a lengthy discussion of each condition and its characteristics before specific cases are illustrated by plates and described in accompanying text. From the preface it is clear that Carswell intended to publish a second edition with additional parts on Calculi, Entozoa and Monstrosities; he states that subscribers to the first edition would be able to obtain these parts separately to form an appendix to the first. However, they never appeared.
One of Carswell's most celebrated achievements was being the first to portray the plaques of multiple sclerosis, although he did not identify them as such. Illustrated in the section on atrophy is 'a peculiar diseased state of the chord and pons Varolii, accompanied with atrophy of the discoloured portions ... the atrophy was more conspicuous in some points than in others, and is particularly well seen in the figure at H, where it affects a portion of the right olivary body'. Carswell notes in the introductory section that 'I have met with two cases of a remarkable lesion of the spinal cord accompanied with atrophy. One of the patients was under the care of Mons. Louis in the Hospital of La Pitié, the other under the care of Mons. Chomel, in the Hospital of La Charité, both of them affected with paralysis. I did not see either of the patients, but I could not ascertain that there was anything in the character of the paralysis or the history of the cases calculated to throw any light on the nature of the lesion found in the spinal cord'. Although unaware of their cause, Carswell meticulously recorded these strange lesions; their distinctive patterns show a specific damaging of the spinal cord and clearly identify them as multiple-sclerosis lesions.
Carswell was also responsible for making the first coloured pictures of the pathology in Hodgkin's disease. Thomas Hodgkin recognised these in leafing through Carswell's 'unrivalled' collection of drawings and displayed them when he read his classic paper on the subject in London in 1832. These plates were first published in 1898 in the New Sydenham Society's atlas of pathological illustrations.
The 1886 entry for Carswell in the Dictionary of National Biography declares that his 'illustrations have, for artistic merit and for fidelity, never been surpassed ... perhaps no such anatomist was ever a better artist. His work has permanent value, and he had considerable influence as a teacher, though the abrupt termination of his scientific career prevented him from taking a leading place in the profession'. The article also describes the matter of the volume as representing the highest point which the science of morbid anatomy had reached before the introduction of the microscope. In fact, in the 1830s the study of morbid anatomy was revolutionised by the use of the microscope; perhaps, therefore, Carswell was unlucky in producing a work that was soon outdated by more modern techniques.
Frustrated, and with his health failing Carswell retired from his professorship in 1840, having secured the post of personal physician to the King of the Belgians. He was knighted for his services to the king while he was in England. Carswell lived at Laeken near Brussels until his death in 1857 after a lingering illness caused by chronic lung disease. |