Hospital Snapshots 11

This series has looked at instances of providing doctors with visual evidence so important in determining patient progress. Though relatively ad hoc in the middle of the nineteenth century, providing a likeness of the patient became more common as the century progressed. Bethlem case notes for patients from the mid 1880s to the mid 1890s often include a photograph alongside physical descriptions and observations. Over 300 such photographs were taken by some resident medical students and staff; at their own instigation but in the course of their work. In 1892, the hospital installed a darkroom. The majority of the photographs are either head and shoulders shots or a three quarter shot. As in those photographs of the 1850s, there is no background to distract us from the sitter, they are generally full on to the camera and conform to the conventions of the time with regard to dress and posture.

The cases of two young men, Henry Quarterly and Arthur Purchase are illustrative. It might be said to be relatively easy to distinguish the scholar from the rather more racy auctioneer’s clerk. Whilst both are neatly dressed in three piece suits, wing collars and ties, Purchase is arguably a more dandyish figure. He is wearing a white shirt with wing collar and a bow tie patterned with flowers and ferns. His waistcoat and jacket match; both of a soft wool with piping around the edges, pocket and cuffs. The jacket buttons are covered in what might be the same material. The top pocket bulges slightly as if there might be something stuffed into the bottom. These are clothes that he seems used to and comfortable in.

Although twenty first century viewers are less impressed by claims about the objectivity of photography, nineteenth century doctors believed the photograph provided a ‘true’ likeness, free from the subjective impressions of an artist. Moreover, some of the photographs contained within Bethlem’s case notes are dated, allowing the viewer to match the photograph with a particular phase of their subject’s hospitalisation. The photograph of Henry Quarterly was taken shortly after his admission, when he was described as physically pale and thin, having lost weight and suffering from lack of exercise. In the photograph he does present a rather slight figure. His suit is not obviously too big for him, sitting quite well on the shoulders, though the pocket does sag open somewhat. Round his wrists though, the shirt cuffs look quite loose and he appears to be wearing some kind of woollen undergarment. Is this perhaps because his thin frame feels the cold more keenly? The one untidy aspect to his appearance is the loosely knotted tie, skewed off to one side and not sitting properly within the collar. Certainly here he does not cut a particularly energetic figure, his shoulders are lowered, hands loosely clasped with thumbs crossed.

Not all the photographs are dated. We don’t know at what point in his admission, this image of Arthur Purchase was taken. He seems confident, almost challenging, little hint of the anxiety that has brought him to Bethlem. Look again and more closely, and we may revise our opinion. The record states that Purchase is physically ill at the time of his admission and that he does not eat well; the wrists that emerge from the jacket cuffs appear thin. Although the hand on the left appears relaxed, that on the right is held aloft and clenched into a fist, the thumb visible and pointing towards the viewer. As with all the photographs, we are provided with a tiny window onto a past world but one which generates many more questions than it answers.