St. Nicholas’ Orthopaedic Hospital, Body Braces and Little’s Disease

Today we have a guest post written by a member of our project team, Clare McMurtrie.

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Girls at St. Nicholas’ Hospital and Special School, Pyrford, Surrey. Three are in wheelchairs. [1915]

As a volunteer indexing some of the 30,000 case files at The Children’s Society (previously known as the Waifs and Strays Society) and focusing on medical histories referring to children who were admitted into convalescent homes, what seems most prescient is their place in history. Travelling in an archivists’ TARDIS through the case files we discover allusions to mystery diseases and children who suffered lifelong debilitating disability, many of which were unrecognised or untreatable at the time.

One of these conditions is cerebral palsy (CP), or spastic diplegia as it was commonly referred to. Historically known as Little’s Disease, spastic diplegia is a form of CP, a chronic condition seen in a high and constant muscle tightness or stiffness, usually affecting the legs, hips and pelvis. Dr William John Little named the condition in the mid-1800s. His first recorded encounter with CP is reported to have been with children who displayed signs of spastic diplegia; this condition is by far the most common type of CP, occurring in around 70% of cases. Little’s personal childhood experience of mumps, measles, whooping cough, polio and clubfoot (all conditions seen in The Children’s Society’s case files) led him to establish pioneering treatments for the condition. Some of these early treatments included the use of a wheelchair or crutches to aid movement, as well as full body braces!

Girls at St. Nicholas’ Orthopaedic Hospital and Special School, Pyrford, Surrey; with a kid goat third from the right [c1910s]

Group photo of a teacher and ten girls, one of whom is in a wheelchair and another is using a crutch; St Nicholas’ Orthopaedic Hospital and School, Pyrford, Surrey [1917]

The Children’s Society has six recorded cases of cerebral palsy, five of whom were received into St Nicholas’ Home, West Byfleet, Surrey or to St Nicholas’ Home when it later moved to Pyrford in Surrey. St Nicholas’ home originally opened in Tooting in London in 1887, the year of Queen Victoria’s Golden Jubilee, after founder Edward Rudolf saw a need for medical centres catering to the countries poorest children. The home moved to West Byfleet in 1893 and then to Pyrford in 1908, with the home in Pyrford also operating as a hospital. In many cases the cost and time needed to care for children with CP meant that children who otherwise would stay with their parents were taken into The Children’s Society’s care.

Cases resulting from poverty include Vera, whose parents also had a small baby and elderly parent to care for, and Mabel, whose father was regularly out of work and then fought France during the First World War. In other cases the loss of income of one parent, through death or absence, caused children with CP to be admitted to St Nicholas’. These include Dorothy, whose father had left, and George, Lora and Phyllis, whose fathers died, leaving families unable to keep them. In a time when men were typically the main money-earners in a household, The Society acted as a short term buffer in many of these cases, offering food and a home for the children, rather than medical treatment. In all cases the children were returned to their family after as little as a year with The Children’s Society. In the case of Mabel, received into St Nicholas’ in 1910, medical treatment was given at the revolutionary Great Ormond Street Hospital, twice (in 1912 and 1913), where she had an operation to straighten one of her feet. Great Ormond Street Hospital opened its doors in Bloomsbury in 1852, as The Hospital for Sick Children, and remains one of the world’s leading children’s hospitals.

The outside of the building of St. Nicholas’ Home, Pyrford, Surrey, c1910s

Overall the case files that refer to children with cerebral palsy reveal more of the lives of the children than of the treatments and conditions that they endured. We are left to fill in the gaps in early-20th century medical knowledge!

Find out more:

Learn more about cerebral palsy: http://www.cerebralpalsy.org.uk

Discover the more about some of the conditions and treatments mentioned in the case files: http://wellcomecollection.org

Learn about the history of Great Ormond Street Hospital: http://www.gosh.nhs.uk/about-us/our-history

Find out why a set of instruments in the Science Museum’s collection is important to the history of cerebral palsy: http://www.sciencemuseum.org.uk/online_science/explore_our_collections/objects/index/smxg-96574

Neglect, Ambition, Bad Fortune, and the Early Years of Blood Transfusion

Today we have a guest post written by one of our project volunteers, Ella St John-McAlister.

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Reading Alfred’s case file left me with the impression that he had been a bright and ambitious boy. He came into the care of The Children’s Society (then known as The Waifs and Strays Society) in 1916. Unlike the subjects of most case files I come across (I am researching children’s illnesses and their medical history) he was a healthy boy. This was in spite of Alfred’s father having passed away when Alfred was five years old and his mother being jailed twice for neglecting her children – although the nature and extent of her “immoral life” is unclear.

We know little about Alfred’s life before he entered The Children’s Society except that he had six brothers and sisters, one of whom was the illegitimate child of a “sergeant who was called to France and killed”. It was for neglecting this child that Alfred’s mother was first jailed in 1916. We also know that all of Alfred’s brothers and sisters were in the workhouse: a desperate, destitute sanctuary for those who were unable to support themselves. Something of Alfred’s character comes across in the application form submitted to The Children’s Society, where it states that Alfred played truant despite being “quick and sharp”.

Alfred was admitted into The Children’s Society’s care at the age of eight in 1916, and at the age of 14 he applied for an apprenticeship on a Navy training ship called the Arethusa, indicating a desire to travel and a willingness to “obey his [the Commander’s] and [his successors’] lawful commands”.

Alfred’s acceptance letter from the Arethusa Navy Training ship, 1922 (case number 20702)

The fact that he was allowed to join the ship indicates that he must have been at a certain level of health because there were strict requirements on the height and health of those who joined:

Age: 13½-15   Height: At least 4ft. 8 in. (without boots.)
Age: Over 15   Height: At least 4ft. 10½in. (ditto.)

Once on board a typical daily menu aboard the Arethusa might have looked something like this:

  • 1lb soft bread
  • 8oz biscuit
  • 7oz fresh meat
  • 8oz potatoes
  • 3/4oz cocoa
  • 1/8oz tea
  • 2/3oz sugar

A pretty meagre and dour menu by today’s standards. After he joined the Arethusa Alfred vanishes from view. Sadly, it is a letter from Alfred’s mother reporting his death in 1926 at the age 18 that enables us to piece together an idea of his last years.

A letter from Alfred’s mother informing The Children’s Society of his death, 1926 (case number 20702)

A letter from Alfred’s mother informing The Children’s Society of his death, 1926 (case number 20702)

Dear Sir,

I feel I must write to tell you the sad news of
my poor boy, Albert [middle initial, surname], he went out to America 2 ½
yrs. ago. I was Expecting him home last Easter, I received
news a fortnight ago to-day to say he met with an accident
on Jan 11th and died Jan 19th it is a terrible shock to me,
I shall never, never get over it, he had an operation and
transfusion of blood, but they could not save him.

When the snow was about, he was in a sled coasting
down a steep hill, when the sled struck a stick, causing it
to swerve into the gutter seriously injuring him, they took
him to St. Vincent’s Hospital, West New Brighton, he was
provided with a private room and two trained nurses, at the
expence [sic] of the New York Telephone Coy. [Company] where he had been
employed only two months, previous to that, he
served 12 months in the U.S Army, so ten of his soldier
friends acted as ball [sic] bearers and firing squad over his
grave, he put his age on 3 years, by letters I have had his
friends were surprised at his correct age, he was a fine
fellow. The British Society and his firm gave him a good
burial, plenty of flowers, in fact, he was far better
treated than he would have been in England, I hope you don’t
mind me writing, but I felt I must.

I don’t know what I shall do without him, he
was always a man in his ways, I would not mind so much if
I could have seen him the last of him, or if I only I could see
his grave.

I hope this will find Matron quite well,

I am,

Yours Truly,

(Sgd. [Signed]) Alice [middle initial, surname]

It is a sad ending to what looked as if it could have been a very promising future, but this letter also holds some fascinating information. The reference to a blood transfusion is the first instance we have found of this procedure in The Children’s Society’s case files. The technology behind the procedure for extracting, storing, and transfusing blood was still developing at the time Alfred received his transfusion.

The first recorded, successful attempts at blood transfusions happened in the 1600s, although these experiments used animals. Even in the late 1800s blood transfusions were shunned by medical professionals and considered extremely risky. In fact, in Britain in the early 20th century, surgery textbooks referred to blood transfusions as a quaint relic of medical history. If only they had known! However, just as the idea of blood transfusions was being cast aside, the discovery of different blood types was made. The medical and surgical needs brought on by World War I also acted as a catalyst for the idea of blood transfusions gaining respectability within the medical field.

Click here for more information about blood transfusions (including an interesting image) from The Science Museum.

What makes Alfred’s story so exciting is that in 1926 when he received his blood transfusion, the first hospital blood bank in the United States had not even been established. Whilst blood was donated voluntarily in Britain from the early 1920s onwards, donors were being paid up to $100 for a pint of blood in the U.S., meaning Alfred’s procedure could have been quite a costly one.

Although Alfred’s case file is fairly slender, it contains useful information on what it was like to be a child at that time and a child under The Children’s Society’s care, and also on an important medical advance, one many of us might take for granted today.