Tuberculosis in the bones

Posted on May 2, 2014 by Janine Stanford

Today’s case highlights a condition that was fairly common in the late-19th and early-20th centuries, although it’s not very well known today: tuberculosis, but not as you might expect.

It’s easy to think of tuberculosis as purely a lung disease, but in some cases the infection can affect other areas of the body instead. Children’s files in the archive give us examples of tuberculosis in the digestive system, the nervous system, and scrofula (being tuberculosis in the lymph glands in the neck). One of the most common tubercular diseases we’ve found, after tuberculosis in the lungs, is tuberculosis affecting the bones and joints. Often this type of infection occurred after an injury or breakage, with tuberculosis developing in the damaged bone.

Grace was living in Dinas Home For Girls in Brecon, Powys (then in Brecknockshire), when it was taken over by The Children’s Society (then known as the Waifs and Strays Society) in 1909. At this time, Grace would have been 12 years old. She was from London and had entered Dinas home through another charity, the Fulham branch of the Rescue Society, after her parents had separated. Her father had been described as “very unsteady”, with Grace and her three siblings having been neglected when under his care.

While in the Dinas Home, an abscess was found on Grace’s hand, which was identified as being the result of tuberculosis. In early 1911, with Grace around the age of 13, she had an operation to remove the abscess and was then sent to the coast for a month to recuperate. Unfortunately, the operation wasn’t as successful as had been hoped; by December another abscess had appeared on Grace’s wrist.

Grace was seen by a doctor, who recommended that her hand should be bandaged up and that she should be given complete rest and sea air. Because of this recommendation, Grace was sent to The Children’s Society’s new convalescent home, St David’s Home in Broadstairs, Kent.

In St David’s Home, Grace could receive the medical care she needed. Her hand and wrist were treated with poultices and with boracic lotion, which was an antiseptic. Grace was also found to be suffering from head lice, which was treated with sassafras. These treatments seemed to be successful and, in time, the abscess started to clear up and the swelling on Grace’s wrist went down.

After three months in St David’s Home, Grace was transferred to St Audrey’s Home in Bedford. When she arrived at St Audrey’s Home, it was found that Grace was not able to use her hands much. The healed abscess on her right wrist had left it swollen and weak, while the doctor at the home found that she also had a “poisoned” finger on her left hand. After enquiries it was found that just before Grace had left St David’s Home she had pinched her finger in an accident. It was thought that underlying tuberculosis might have caused Grace’s injured finger to go bad.

As it had been discovered that Grace was still suffering from tuberculosis, she quickly returned to St David’s Home in Broadstairs for further treatment.

By September 1912, having been in St David’s Home for a further four months, Grace was described as having put on weight and being in good health. She was now 15 years old and it was thought best to send her to a home where she could start to learn a trade to allow her to go to work when she was well enough.

In October, Grace was sent to St Barnabas’ Home in Newark, Lincolnshire. She didn’t remain in this home for long, however. By January the next year, the doctor at the home had sent on a medical certificate saying that Grace was still suffering from tuberculosis in her wrist, with the disease now in an active state.

And so, in March 1913, Grace was sent to St Anne’s Home in Clapham Park, London, where she could be examined by a doctor. The result of this visit can be seen in the letter below:

March 28th. 1913

Re Grace [surname]

I took this girl today
to Mr. Boyd, 134 Harley St W, to meet Dr.
Rose Turner there for an interview. Dr. Boyd
sent us to X Ray Dept. Charing X
They gave me no messages (although we
waited for the same) as to when to go
there again, nor whether she was
to be made an in-patient at that
Hospital.

E A Bailey
Travelling Matron W. & S. Society

Dr. Turner has case in
hand. 29.3.13

The x-ray must have shown signs of tuberculosis because it wasn’t long before Grace returned to Charing Cross Hospital to have an operation on her wrist. After this she would need extra medical care while recuperating, but the active condition of the tuberculosis meant that she couldn’t return to St David’s Convalescent Home in Broadstairs where the children there, already ill, might be put at further risk of infection.

Instead, in April 1913, Grace was transferred to the Westminster Union Infirmary in Lincoln’s Inn Fields, London and then to the Strand Union Infirmary in Edmonton, London. Here it is said that Grace was staying in a small ward and that “… the Doctor has ordered her special diet, extra milk &c [etcetera]”. When visited by one of The Children’s Society’s travelling matrons, Grace was found to be doing well, with her wrist weak but healed up.

This is all we hear about Grace until November 1913. By this point we find that she had been transferred to the Isolation Hospital in Ramsgate, Kent, but there are no updates as to her condition. With no further correspondence in Grace’s file, we can only guess at how she was doing. The operation on her wrist may perhaps have healed, but the fact that she was still in hospital suggests that her tuberculosis hadn’t cleared up completely and was potentially still active. The prognosis for Grace, then, didn’t look good, and without the option of the antibiotics we have today, it seems like further surgery may have been Grace’s only hope.

As sad as it is, Grace’s file gives us some interesting information about medical treatments in the early-20th Century. We find out that boracic lotion was used as an antiseptic and that sassafras was used to treat head lice. Not to mention, we have evidence of x-rays being used as a tool for diagnosis, and this only 18 years after x-rays had first been discovered.

Most importantly, Grace’s file shows us what it would have been like to live with a tubercular infection in the joints and bones. This was a disabling condition that left Grace living in convalescent homes and hospitals, unable to continue the training she had started. Even invasive surgical treatment, it seems, wasn’t able to stop the infection fully, leaving potential for the disease to return and spread to other parts of the body.

(For more information about the early use of x-rays, see this page from the British Library.)

Our research volunteers

Posted on April 17, 2014 by Janine Stanford

In a previous blog post I talked about our volunteers who are helping to conserve the children’s case files. Today it’s the turn of our volunteers who are helping to research into and document the medical information in those case files. Starting in the middle of last year we’ve had five volunteers and one work-placement student helping with this research task, and together they’ve unearthed a large amount of medical information, which has now been documented in CALM, our catalogue database.

But that’s enough of me talking; here’s what the volunteers have to say themselves:

“The majority of my time involves working with and handling the case files, which go back to the 1880s! Our job is to extract medical notes and information from the case files in order to build up an online database of medical conditions that the Society dealt with.”

“I extract pieces of information from the case files and upload the information onto CALM where all the records are kept. For instance, if a record on CALM says a child went to Hospital; my role is to try and find out why that child went to Hospital. Once I have found the information needed I update it onto CALM.”

“By going through the correspondence and other documents contained in each case file, it will (hopefully!) become apparent why each child’s stay in a hospital or convalescent home was deemed necessary. This information is then added to the ‘case history’ section of the case file’s CALM record, along with relevant medical index terms. The index terms are taken from archival thesauri to ensure that they are the most suitable names for medical conditions and help researchers find the records they are interested in.”

The volunteers are a diverse and motivated bunch. I asked them why they wanted to volunteer with us:

“I felt that I needed some work experience in a history related job and I discovered The Children’s Society was offering this wonderful opportunity to archive medical documents from the 19th century. I was motivated to apply for the volunteering as it seemed such an interesting role and I thought it would be great to volunteer for such a prestigious organisation.”

“I’ve always thought that we have a lot to learn from history and projects such as this are invaluable in teaching us about people and disease. I jumped at the chance to learn from hundred year old documents, many of which have remained untouched!”

“I’d helped out TCS [The Children’s Society] with street collections previously and happy to contribute to a good cause.”

“I was hoping to broaden my experience of archives prior to applying for paid work and postgraduate course in archives. Learning about indexing on CALM is a valuable accompaniment to the cataloguing skills which I have acquired in other voluntary roles.”

This project isn’t always easy. For some volunteers the most challenging part is the condition of the documents. Our conservation team is doing a stellar job of making the files easier to handle, but those documents that haven’t been conserved yet can be tricky to use.

“You have to be flexible when dealing with the case files. From one minute to the next you can be looking at completely different files – some have mould, some are in newer formats, some are small – and you have to respond respectively.”

[The most challenging part of the role is] “Handling some of the files which are in poor condition.”

For other volunteers, the handwriting and the language from 100 years ago can take a bit of getting used to. It seems like some doctors’ handwriting is hard to read no matter when it was written!

“The variety of handwriting and how sometimes letters can be difficult to read make this the most challenging part of the role.”

“The most challenging aspect of the role is trying to read the documents correctly. The majority of the documents I read are hand written, so it takes time and focus to read the documents accurately and find the relevant information.”

“Another minor difficulty which I occasionally face is encountering antiquated names or spellings for illnesses, which can make decisions about indexing the case files more tricky.”

And then there’s the information in the files itself, which can be very moving at times:

“Inevitably, given the medical nature of the project, there are some case files which detail sad stories of children suffering and dying from diseases. It is notable how many children a century ago were afflicted with conditions such as tuberculosis and scarlet fever, which are much less prevalent in Britain today due to advances in medical technology and people’s living conditions.”

Thankfully, despite the difficult parts, the volunteers have been finding the project enjoyable:

[I’ve enjoyed] “Getting an insight into the lives of the poor and disadvantaged 100 years ago.”

“One of things I love most about my role is that no one day is the same as you deal with different children’s case files who have their own unique personality and life. Moreover, as I am currently studying modern British History, the case files really bring history to life as there is real life evidence of a number of things I have studied.”

“It is also rewarding to come across positive stories recorded in the case files, when children have overcome medical problems. A memorable example involved a boy who, having already been in hospital frequently, was accidentally hit in the eye by some putty thrown out of a window by a builder. Despite this incident permanently damaging his eyesight, he was still able to find a job and work successfully in The Children’s Society head office a few years later.”

“I have enjoyed learning about the lives of the children that were under the societies care and getting a glimpse of what life was like for them at the time.”

“I have enjoyed handling the documents and reading peoples’ personal histories. I have found reading documents that are nearly 100 years old something quite special and rewarding.”

“I have really enjoyed working with the Society. Before I started I knew little about the Society’s history or the work it does today. Handling original case files has been a fascinating window onto decades of social history and the role the Society has had in it.”

Many thanks to the volunteers for taking the time to answer my questions and, not least, for being such a great asset to this project! Thanks to their help, our knowledge of the medical information in our collection is coming on in leaps and bounds.

If you would like to learn more about volunteering for The Children’s Society, please take a look at our volunteering pages.

A Legacy of Fun

Posted on April 11, 2014 by Gabrielle St John-McAlister

The Children’s Society has many legacies left to it by people in their wills. An example of such a gift was that left by a gentleman in recognition of the benefits provided to him for the period he spent in care at Hatton Home for Boys (1913-1944), a Children’s Society Home in Wellingborough, Northamptonshire.

Hatton Home for Boys, Wellingborough

Following a reunion of boys who were at the Home in the 1940s and that was held in Wellingborough in the 1990s, he wrote:

“As can be imagined, when this exciting reunion became a reality, floods of memories flowed and were exchanged. There was special praise for our beloved Master and Matron Arthur and Kathleen Silverwood.

Mr & Mrs Silverwood, c1940

He continues:

“Memories of nights spent huddled in the Home’s huge cellar during air raids; helping Home Guards Units practice in the event of an invasion; pillow fights in the dead of night; summers spent under canvas at a nearby swimming resort”.

It’s wonderful to know that the gift this particular gentleman left was for the explicit purpose of being used to fund pursuits which were ‘fun and recreational’. What a lovely gesture and idea! In 2012 an award to this effect was set up and Programmes run by The Children’s Society can apply to it for grants. So far funds have been awarded to Children’s Centres and Projects for activities and pursuits such as:

football training
music sessions
horse riding lessons
gym session
judo sessions
Easter fun sessions
swimming
an environmental play project
monthly youth club

and even an outing to a wildlife park, and a trip to the cinema. Fun activities and recreational pursuits of which I’m sure our donor would have approved!

We know that the boys at Hatton Boys Home often went on Scout camp, where they would learn skills and have plenty of outdoor exercise. The Home’s Scout troop had their own Latin motto ‘Vive ut vivas’, which means ‘Live that you may live’. It could be that experiences such as these prompted our donor’s specific choice of legacy.

Although the following photograph is not of boys from Hatton Boys Home it’s a good example of the fun our donor and his friends might have had at camp.

Group of boys from the Harvey Goodwin Home at a Scout camp ‘making straw mattressess’, c1913.

For more history about The Children’s Society, and to see more images from the archive please visit Hidden Lives Revealed.

Click on the links to find out more about Hatton Home for Boys and Harvey Goodwin Home for Boys.

Misunderstanding mental health in the early-20th Century

Posted on April 4, 2014 by Janine Stanford

Today, we have a guest post written by one of our project volunteers, Leonora Fane-Saunders.

***

It is sadly apparent that mental health was not well understood in the late 19th and early 20th centuries. The prevailing view at the time was one of institutionalisation, and many people with learning disabilities or mental health conditions found themselves sent to asylums and other similar institutions, to live apart from the rest of society. These institutions may have been seen as places of treatment, where people could be given specialised care, but they were also places of segregation.

The records from the Children’s Society [then the Waifs and Strays’ Society] show some of the attitudes and language prevalent at the time. An example of this is a letter recommending that a child be sent to an asylum in 1917. (Click to enlarge.)

Dear Mrs De Gruchy

I am of opinion that
the little girl Gertie [surname]
from St. Cadocs Home Caerleon
whom I saw today is of
defective intellect – and not
likely to profit from the
training given at St. Cadoc’s
Home.

From the statement
of the Matron of the Home it
appears that the child has a
very deficient moral
sense in the matter of
truthfulness & honesty

and I think her example may
have an evil influence on the
other children in the Home.

Both on this account and
on her own I think she would
be much better placed in
an institution for mentally
deficient children where
the training and discipline
would be more suitable to
her case.

Yours Sincerely
Wm. F. Nelis MD
Med Supt. [Medical Superintendent]

In this letter there is nothing that today would today be considered grounds for institutionalisation and the terms used in this letter would now be considered highly inappropriate. It is possible that the child suffered from a learning disability that in turn led to the poor behaviour in the home.

The asylums had very strict rules that seem akin to those found in a prison. A list of rules governing visitors to inmates at the West Ham Mental Hospital (see above, click to enlarge) show that visiting hours were restricted to two and a half hours per week unless under special circumstances in which case written permission was required. Presents could also only be given to inmates through the Attendant or Nurse in charge of the visiting room. Of the twenty four children who were admitted to an asylum or other such mental health institution from The Society’s care between 1894 and 1920 only two are known to have left the asylum. It is interesting to note that the two that left were different in that they were sent to the asylum for what appears to have been stress cause by over work whilst in service. The others were sent to the asylum for difficulties in learning what the children were being taught in the homes and for poor behaviour.

Although now, with the benefit of hindsight, it is easy to look back with horror at these institutions, it is also easy to forget that the first asylums were set up with humanitarian intentions as places that could care for the mentally ill and potentially cure them. Before then such people were usually hidden away under the care of their relatives. Good intentions were lost amidst the increasing asylum population, inadequate staff, lack of understanding of mental health and the fact that any man and his dog could set up a private asylum. Those who started the first asylum probably looked back in horror at the way the mentally ill were treated one hundred years before, and who’s to say people one hundred years from now might not do the same.

Most asylums were shut down in the late 20th Century and our knowledge and understanding in identifying and treating mental health issues has increased since then. While it can be upsetting to us now to see how people used to be treated 100 years ago, records such as those highlighted here are important. It is through understanding and discussing the past that we can begin to learn from previous mistakes and pave the way for a better future.

Want to find out more?
A previous blog post discussing historical attitudes to disability can be found here:
http://www.hiddenlives.org.uk/blog/2012/05/the-changing-perceptions-of-disability

A brief history of West Ham Mental Hospital can be found here: http://ezitis.myzen.co.uk/goodmayes.html

See the Museum of Disability, the Science Museum and this post from the National Archives for more information about the history of attitudes towards learning disabilities and mental health conditions.

Learning about volunteering in Birmingham

Posted on March 20, 2014 by Janine Stanford

Last week David, one of our Unexplored Riches in Medical History project volunteers, and I went on a day out to sunny Birmingham.

Here in Birmingham The Children’s Society Volunteering Team were hosting a forum for volunteers and their managers, from across the organisation, to get together and share experiences. (As a bonus, for those of you interested in history — and puddings — the forum was held at a place called the Custard Factory, which was the home of Bird’s Custard in the 19th and 20th Centuries!)

The day started with two talks. First up was Justin Davis-Smith, Executive Director of Volunteering at the National Council for Voluntary Organisations (NCVO). Justin gave us an overview of volunteering across the UK, how it is being recognised by the government and what politicians can do to help volunteering thrive even further. He also talked about exciting new developments and trends in volunteering, such as ‘micro-volunteering’ projects, where people can volunteer online for only 30 minutes at a time, and organised rock concerts that are used to encourage young people to give volunteering a go.

Next along was Matthew Reed, Chief Executive of The Children’s Society. Matthew talked about how vital volunteers are to the work of The Children’s Society and how everything we do would grind to a halt without them. Interestingly, for us archive folks, Matthew highlighted how volunteering has been at the heart of The Children’s Society right from the very beginning. In 1881 our founder, Edward Rudolf, and those that helped him, gave their time freely to set up a charity to help the poor and neglected children they saw around them in Victorian Britain. What motivated them was the drive to improve the lives of children and young people; and over 130 years later, this is exactly the same force that still motivates The Children’s Society and our volunteers today.

After that there were lots of opportunities for us attendees to get together and discuss how we can make volunteering at The Children’s Society better. It was great to meet volunteers and volunteer managers from across the organisation and find out what they do and how they do it. And it was really useful to hear everyone’s views on what they think we do well in terms of volunteering and what we still need to improve. I definitely came away with ideas to use here in the archive.

All in all it was a great day. In particular, I enjoyed talking to volunteers from all over the country and hearing what motivates them and how volunteering has changed their lives. It was inspiring stuff!

For those of you interested, we have several volunteers here at The Children’s Society archive. Those volunteers involved in the Unexplored Riches in Medical History project are helping to conserve, repackage and catalogue our children’s case files, ultimately making them usable for medical history research. To find out more, check out our volunteers tag on the blog.

If you’re thinking you’d like to get involved with The Children’s Society as a volunteer, take a look at our volunteering pages for more information on current volunteer opportunities with us and how you can help.

Were many ‘waifs and strays’ underweight 100 years ago?

Posted on March 6, 2014 by Janine Stanford

Sometimes in The Children’s Society Archive you come across things that you weren’t quite expecting. In the comments to the post about diphtheria we’ve been discussing the weight and height of children 100 years ago. Spurred on, I decided to do some research of my own. The results I found were a little surprising.

From 1911 onwards a detailed medical form was created for every child who was taken into the care of The Children’s Society (then known as the Waifs and Strays Society). The forms were filled in before the children came into care so that The Children’s Society could see if they needed any immediate medical treatment. An example form is shown below (click the image to see a larger version):

Question number 12 on the form asks for the child’s weight and height. As we know the date the medical forms were created and the date the children were born, this makes it possible to calculate their body mass index (BMI).

I picked out ten case files for children who came into the care of The Children’s Society in 1912 and used the NHS’ BMI calculator to work out the BMI for each of them. My results are below:

Irene – age 11
BMI in the 6th percentile

Norah – age 13
BMI in the 8th percentile

William – age 13
BMI in the 10th percentile

Ronald – age 10
BMI in the 20th percentile

Edith – age 9
BMI in the 45th percentile

Stephen – age 6
BMI in the 52nd percentile

Arthur – age 4
BMI in the 62nd percentile

John – age 8
BMI in the 69th percentile

Ada – age 13
BMI in the 71st percentile

William – age 5
BMI in the 91st percentile

According to the NHS calculator, all of the children were at a healthy weight except for William, age 5, who is classed as overweight. However, if we take a look at the BMI charts from the Royal College of Paediatrics and Child Health, we see that these charts would class both Irene and Norah as having low BMI, being below the 9th percentile.

What does this all mean? Well, I have to admit that I was surprised. For children that came into care in 1912, I was expecting far more than 20% to have a low BMI and be underweight, and I certainly wasn’t expecting any of the children to come out as overweight!

Firstly, I have to acknowledge that my sample was very small. If I had looked at 100 or 1000 files instead of 10, I may perhaps have come to a different conclusion.

As it is, I had to have a look into Irene, Norah and William’s backgrounds to see if there was anything there that might account for their BMI.

Irene, at age 11, was living with her mother. Her parents had separated due to her father’s drinking. Trying to find work, Irene’s mother had moved to London, where she and Irene were staying temporarily with a friend. Job hunting, however, was not easy. With no job and no way to provide for the family, the only option was be for Irene to be taken into care.

Norah, at age 13, was living with her parents and two siblings, with both of her parents in regular work. Norah had been found stealing twice and so was committed by a police court to go to an industrial school for rehabilitation. What Norah had been found stealing and why is not known, but considering that she had a low BMI, poverty and a lack of food may well have had something to do with it.

William, meanwhile, at age 5, was overweight. His parents were separated and his mother was struggling to find work. This makes William’s high BMI a little confusing until we realise that because of his mother’s unemployment, William had been taken into a foster home, where his father and a charity were paying for his upkeep. William came into the care of the Waifs and Strays Society because his foster mother was no longer able to look after him.

So there we have it: ten children and not nearly as many underweight as I would have thought. Cases of malnutrition certainly happened, amongst parents as well as their children, and we have the files detailing their stories, but just how frequent those cases of malnutrition were, we don’t yet know. Time for some more in-depth research with a larger sample of cases. Anybody out there up to the task? Do email us (Hidden-Lives-Revealed@childrenssociety.org.uk) if you are, or if you would like to use The Children’s Society Archive for any other research projects that you have in mind.

Surgery for appendicitis

Posted on February 21, 2014 by Janine Stanford

The story of Phyllis is a particularly sad one. Her father, who had worked on a farm, died of heart failure caused by over-exertion and exhaustion. This was in 1903 when Phyllis was three years old. Her mother was left with six children and another on the way. They were living in Kenton in Middlesex.

A month and a half later and Phyllis’ mother was struggling. Phyllis’ eldest sister, Dolly, was working as a servant and living away from home. Another of Phyllis’ siblings went to live with relatives, but this still left four children for Phyllis’ mother to provide for.

The shock of her husband’s death had made Phyllis’ mother unwell, so much so that the family’s doctor thought she would need to have a serious, and potentially fatal, operation. She wasn’t working and the family was living in temporary accommodation, which they would soon be forced to leave. For all these reasons an application was made for Phyllis and her elder sister, Ida, to enter the care of The Children’s Society (then known as the Waifs and Strays Society).

One month later, both Phyllis and Ida entered The Society’s Lampson Home in Dulwich, London. Here they both stayed until 1908 when Ida returned back to their mother. At this time their mother was unwell again, as was their grandmother who had been helping her. Ida was 15 years old by this point; she returned home to help her mother, and the intention was for Ida to go to work in domestic service once her mother was well again and no longer needed assistance.

As she was only eight years old, Phyllis remained in the Lampson Home. We don’t hear anything more about her until a year later, when there is the following letter:

500 Lordship Lane. S.E.
May 13/09

Lampson Home

Dear Mr. Rudolf,

It will grieve you to hear that
Phyllis [surname] [died] on the 9th. inst. [instant] at Guy’s
Hospital after an operation for Appendicitis.
She was a very good girl, and we are all much
saddened by her loss. We have arranged for
the funeral at Honor Oak Cemetery at 11.30
on Saturday next.

Yours sincerely
Ths [Thomas] Douglas.

Another letter tells us something about Phyllis’ character:

… she was one of the nicest little Girls in the Home & a great favourite with us all & also with her teacher & her school-fellows, her teacher was particularly fond of her.

Sadly for Phyllis, it seems that the operation wasn’t able to save her, despite having been treated at the prestigious Guy’s Hospital in London. The causes of her death are given as appendicitis, peritonitis (inflammation of the lining of the abdomen) and heart failure.

Appendicitis was first named in 1886 and surgery to treat the disease started to become more common after that point. Most famously King Edward VII had to postpone his coronation in 1902 in order to have urgent surgical treatment for appendicitis. Edward VII’s operation was successful but, sadly, not everybody survived the new surgical technique. From what we have found so far in the Unexplored Riches in Medical History project, appendicitis was fatal in 40% of cases of the disease. These figures only come from a small sample, so they are likely to change as the project continues, but it does suggest that surgery to treat appendicitis over one hundred years ago was not any way near as successful as it is today.

In many cases, it was not the surgery itself but complications of the disease that proved to be fatal. Mortality rates were high for people, like Phyllis, who were also suffering from peritonitis, which is an infection of the lining of the abdomen. Surgery to treat appendicitis would remove the infected appendix, but if the infection had already spread to the rest of the abdomen, there was little that could be done. Mortality rates only began to drop when antibiotics started to be used alongside surgery in the 1940s and 1950s.

Unfortunately for Phyllis, in 1909, with her complications her prognosis wouldn’t have been good. Surgery would have been her only hope for treatment, but it seems that her disease was so far gone that even that wasn’t enough to help her.

Burning books, toys and clothes?

Posted on February 7, 2014 by Janine Stanford

Diphtheria can be fatal, and before 1940 it was one of the leading causes of death in children. It’s an infectious bacterial disease that affects the upper respiratory tract and instances of it were common in the early-20th Century before vaccination against it became widespread.

Due to the infectious nature of the diphtheria, it could spread quickly through children’s homes if any of the residents caught it, and a number of our records mention outbreaks of the disease.

The letter below sent to head office from St Nicholas’ and St Martin’s Orthopaedic Hospital and Special School in Pyrford, Surrey, dated 1927, shows some of the measures taken to try to combat outbreaks of diphtheria.

Dear Dr. Westcott

Dr. Hardy is of the opinion that
all suspect school books & material should also be
burnt at S. Martins, in view of Diptheria [sic] which
is still going on there. Miss Hutchinsons estimates
that to replace these would cost from £30-£35.

As we are £15. in hand, on the £35. sanctioned
by you at your last meeting, on S. Nicholas School,
may we please be allowed to add £15.0.0
to our expenditure for S. Martins.

My Cttee. [Committee] recommend this for your approval.

Yrs sincerely
K.A. Tringham. Hon Sec

Other letters in the file show that it was thought, in this instance, that the disease had entered the home through books and toys that had been donated by the public for the children to use. As they were thought to be the cause of the outbreak, the books and toys were burned in an attempt to stop the disease from spreading further. The rest of the letter asks The Children’s Society (then known as the Waifs and Strays Society) for further funding for new replacement books and toys to be bought; which later letters show was granted.

As a result of the incident, it was decided that used toys and clothes should no longer be donated to St Nicholas’ and St Martin’s due to the risk of infection. At first glance, this may seem like a strong reaction, but things become more clear when you realise that St Nicholas’ and St Martin’s specialised in looking after children with conditions such as tuberculosis, polio and rickets. These children would have been very susceptible to diphtheria and other infectious diseases and the managing committee didn’t want to put their health at further risk.

Rickets returns

Posted on January 24, 2014 by Janine Stanford

Today, we have a guest post written by one of our project volunteers, David Lamb.

***

Earlier this month, the Royal College of Paediatrics and Child Health released guidance for healthcare staff on identifying the symptoms of rickets. This is in response to the rise in rickets, a condition common in Victorian times, but that had largely disappeared through the 20th century. Rickets is a bone-deforming disease caused by vitamin D deficiency, stunting growth and inhibiting walking.

Hospital admissions with rickets in England increased from 561 in 2008/09 to 702 last year. January and February are the worst months because of the low levels of UV light. Observations suggest a link with some children not playing outside. The issue was covered recently in the [London] Evening Standard (13.1.14).

Over 5% of the children who passed through The Children’s Society’s care between 1881 and 1917 had rickets recorded in their case files. Below are extracts from various cases to illustrate the situation in which rickets developed and a range of its impacts.

Three year old Lydia “lives in unhealthy street (in Hackney), and never goes out during the last three months I have known it. She sits with her feet under her, not attempting to walk, and seems to require nourishment and care. The room constantly is so close and smelly it is not conducive to the child’s health, and the mother is too deformed to do her own scrubbing. I think it one of the saddest cases I have ever known”.

The medical certificate for Annie aged six records rickets resulting in bowed legs and curvature of the spine, but “with proper care she is said to be curable”. Almost ten years on, boarded out in Suffolk, she is not considered “capable of carrying heavy weights or doing much hard work. … She takes great pleasure in, and does needlework nicely”.

With six year old Allan from Teesdale, rickets in both legs and wrists had left him “hopelessly crippled unless the deformity is corrected by operation”. The file does not record whether he had that operation. After seven years in Bradstock Lockett Home in Southport, he returned to his mother.

Some children did have their ‘rickety’ condition alleviated by surgery, as in this case below. (Like all the images in this blog, click on the image below to see a larger version.)

Others required special medical or ‘surgical’ appliances, for which funding had to be secured, as in this Welsh case:

Lily from Richmond, Surrey had genu valgum [knock knees] resulting from rickets when younger.

Another rickets case, Sarah, originally from Beverley, Yorkshire was “close upon 15 – but no bigger than a child of 8 – and thus quite debarred from domestic service as she is almost a dwarf”.

With Margaret from Oxfordshire, her rickets developed soon after birth deformities, such that as an eight year old she could not use her legs beyond standing a little. However, she could use her arms well and do needlework. At nearly 16, “she is deformed, height 4ft 3in – not a girl suitable for service – does housework very nicely but her height and limbs are very much against her. She has been through our laundry, but complains of her legs hurting her, after standing or walking far.”

Hopefully, raising the alert about rickets will avoid our generation of children any of the pain, discomfort and disabilities suffered in Victorian and Edwardian times.

Lotions, ointments and eczema

Posted on January 10, 2014 by Janine Stanford

Thomas’ father died from congestion of the lungs in 1891 when Thomas was 7 years old, leaving a widow and four young children. The family lived in Islington in London and the situation must have been hard for Thomas’ mother who was a cleaner, earning 4 shillings per week, which equates to only around £12 per week in today’s money.

With an extended family who couldn’t afford to help, the only option for Thomas’ mother was for her to place her children into care so that she would be able to work full-time in domestic service.

That year, Thomas’ case was accepted by The Children’s Society (then known as the Waifs and Strays Society) and he went to live in the recently-opened St Michael’s Home for Boys in Lyme Regis.

A medical form completed when Thomas entered St Michael’s home suggests that Thomas was suffering from a ‘condition’. The exact nature of this condition isn’t stated on the form, although the doctor’s opinion was that it wouldn’t need medical treatment.

Everything becomes clearer in the following letter from St Michael’s home to The Society’s head office, dated 1893:

Dear Mr. Rudolf.-

Mr. Peek is much vexed at the
intrusion of the 21st. for which I enclose
a cheque from The Hone. [Honourable] Mrs. Cuthbert Peek
for £5. I must therefore ask you as
soon as possible find a vacancy for
Thomas [surname]. He is a sharp
boy. & would do well in learning
an industry such as printing or carpentering

& is not of the sort to make a
good indoor servant. I am truly
grieved to part with any of them
just yet. for they are all doing
well in every respect. Thomas
[surname] suffers constitutionally
from excima [sic] & perhaps inland
air would be better for him than
sea. for these two reasons I decide
on asking you to make arrangements
for his being received elsewhere.
I will send you the tax papers
early in the week. you will be aware
of course that I have not received
a cheque from you since Oct 11th.

I remain
Yours very truly
J Waring

From this letter, we see that Thomas was suffering from eczema. For a reason that is not entirely clear, it appears that one or more boys had to leave the home. In particular, it was thought that living near the coast wasn’t helping Thomas’ condition and that the air found further inland might be better for him.

Instead of moving inland, however, we find next that Thomas was moved to another home on the South Coast; this time to Bognor Home for Boys in Sussex. Sadly, no correspondence about this move survives, so we don’t know if this move to another costal home was due to conflicting medical advice or not.

Thomas was still having problems with eczema in 1895 when he would have been 11 years old. In order to help him, he was sent to the Hospital for Skin Diseases at Blackfriars in London.

After staying in hospital for two weeks, Thomas was discharged back to the Bognor Home. A letter from the hospital states that he was ‘quite cured’.

Sadly, this prognosis appears to have been overly-optimistic, as two months later there is the following note from the Bognor home:

Could lotion & ointment used
by [Thomas’ surname] in “Skin Hospital”
be sent us?

In response, Thomas returned to London to be seen by the doctor who had treated him at the hospital. We don’t know the exact outcome of this visit, but it is possible that the doctor gave Thomas a prescription for more medicine.

The next year, when Thomas was 13 years old, he was transferred to the Diocesan Home for Boys in Cambridge, which had recently been taken over by The Society. While he was in this home, a letter tells us that he was visiting hospital once a fortnight for treatment for his eczema, which was described as ‘getting better’.

Thomas was now of an age where he could begin to learn a trade. It was thought that Thomas would be well-suited to farm work and so in 1897 he was sent to Standon Farm Home for Boys in Staffordshire, which specialised in agricultural teaching. His training appears to have gone well as just over a year later, when Thomas was 15 years old, he went to work for a farmer in Market Drayton in Shropshire.

Thomas stayed in this job for one year, then left to go live with his mother who had moved to Huddersfield. Whether he was still continuing his hospital visits at this time, we don’t know.

This case, like so many of those that mention medical treatment, is tantalisingly vague. We know that Thomas was visiting hospital and that he had been given lotion and ointment to help with his eczema, but we don’t know exactly what those lotions, ointments and hospital treatments were.

Most intriguing for me is the fact that sea air was thought to be bad for eczema. In the late-19th Century so many diseases and conditions were treated with exposure to fresh sea air that it seems strange to find a case where it was recommended that sea air be avoided. If you know why this recommendation might have been made, I’d be really interested to hear your thoughts.

(The records of the Hospital for Skin Diseases at Blackfriars are held at London Metropolitan Archives. Click here for more information.)

Hidden Lives Revealed blog

Children in Care 1881-1981