Rickets returns

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

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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.)

Letter from case file 9953, mentioning proposed treatments for two children with rickets at St Thomas' Hospital, London, 1903

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

Letter from case file 7207, discussing the funding required for a medical boot and leg support for a child with rickets, 1911

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

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:

Letter from case file 2965, mentioning the benefit of inland air for eczema, 1893

Letter from case file 2965, mentioning the benefit of inland air for eczema, 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.)

Green dresses and white caps: nursery nurse training in Windsor

Page from a prospectus for HRH Princess Christian's Nursery Training College, Windsor, including a photograph of the exterior of the college, c1950s

In the mid-20th Century The Children’s Society had a number of colleges and hostels where students could train to become nursery nurses. The records of these places give an insight into the skills that nursery nurses were required to have.

One of the training colleges was HRH Princess Christian’s Nursery Training College based in Windsor. A prospectus for the college from around the 1950s tells us what student nurses were expected to learn:

  • Care and handling of children from birth to 5 years
  • Management of premature infants
  • Artificial feeding
  • Needlework and laundry
  • Knitting
  • Hygiene
  • Children’s ailments and infectious diseases
  • Cookery
  • The physical and mental development of the child

Page from a prospectus for HRH Princess Christian's Nursery Training College, Windsor, including a list of the subjects on the curriculum, c1950s

Once students had completed the training they were allowed to sit exams for a range of qualifications:

  • The National Nursery Examination Board Certificate
  • The Certificate of the Royal Sanitary Institute Examination for Nursery Nurses
  • The college’s own certificate

Further pages of the prospectus give us a glimpse of what it would have been like to study at the college. The image below shows photographs of a student bedroom and the corridor leading to it.

Page from a prospectus for HRH Princess Christian's Nursery Training College, Windsor, including photographs of a student bedroom and the corridor leading to it, c1950s

The final page contains details of the uniform that students were expected to wear. (As with all photographs on this blog, please click the image for a larger version.)

Page from a prospectus for HRH Princess Christian's Nursery Training College, Windsor, including details of the students' uniform, c1950s

Delving further into the records of this college, and the others like it, may unearth more information about just how nursery nurses were trained and what they were taught, particularly with regards to children’s medical care at the time.

Four nurses, wearing face masks, feeding babies, c1940s

If you want to find out more, take a look at this page from the 1952 Handbook for Workers, which explains what the aims of The Children’s Society’s nurseries were.

Fresh air for epilepsy

William was five years old when his father died in in 1889. By the time William was eleven, at least three of his older siblings were working, two of his siblings were living in children’s homes, and William and his younger brother Sydney were living with their mother in Stepney in East London.

Life was not easy for the family. William’s mother worked by washing clothes. She had poor health, which made it difficult for her to earn much, and so William’s three elder sisters, who all worked in domestic service, sent her money to help with the rent. When their mother went out to work, there was no-one to look after William and Sydney and so they were often left on their own.

In 1895 an application was made for help from The Children’s Society (then known as the Waifs and Strays Society). The application was successful and William was taken into The Society’s Dover Home For Boys in Kent, and was shortly afterwards transferred to Leicester Home for Boys where he would be able to learn a trade.

William had been living in the Leicester Home for about a year when he first started suffering from seizures. As a result, he was returned to London and admitted into the National Hospital for Paralysis and Epilepsy in Queen Square, where his mother was able to visit him.

After over a month in the hospital, and not having had another seizure, William went to stay with his mother. He was there for one month until he was transferred to the Diocesan Home for Boys in Cambridge, which had recently been taken over by The Society.

The following letter was written when William had been in the Cambridge Home for just two days.

Letter from case file 4748, giving an account of the child's epileptic seizure, 1896

Dear Sir,

I am sorry to
tell you that W. [surname]
had another fit last
night. He was rather
sadly on Mony. [Monday] night
when he got in bed, but

yesterday he seemed much
better until he was
going to bed when he
fell down without any
warning. This morning I
sent for the Dr. & he gave
me the enclosed certificate.
Will you let me know
what to do. I should
like to try the boy a
little longer. He has
not been to school yet,
as I thought the air
would do him good.

Yours Obedily. [Obediently]
J Shead

Interestingly, from this letter we see that fresh air was thought to be helpful for people with epilepsy, and another letter states that ‘In cases of Epilepsy, open air work is always recommended.’

The enclosed doctor’s certificate confirmed that William was suffering from epilepsy and stated that the Cambridge Home wasn’t suitable for children with the condition. It was decided, however, that William was well enough to stay in the home for longer and attend school.

William didn’t suffer from another seizure until the next year, and after almost a year at the Cambridge Home, at age 13, it was decided that it would be best for William to leave. He returned to his mother in July 1897 while other arrangements were made for him. We don’t know where William went to afterwards, but there was talk of sending him out of London to a farm, where it was thought that the fresh air would be beneficial for him.

It may seem strange to us now that fresh air was the recommended cure for epilepsy in William’s time. But without the medication and other therapies available to us now, there must have been few options available.

Swimming lessons in Cumbria

One of my favourite documents in our collection is about swimming. Within the records of the children’s homes that were run by The Children’s Society, there are a number of documents that mention physical exercise. This suggests that exercise was something that the children in the homes were encouraged to participate in.

The boys living at St Mark’s Home for Boys in Natland, Cumbria, in the early-20th Century were known for swimming, and a number of boys from the home had been awarded swimming certificates by the Royal Life Saving Society.

The secret of St Mark’s Home’s swimming success was down to the way the boys were taught to swim. In fact, their method was seen as so effective that the home published a manual for other swimming instructors to learn from.

St Mark’s Home was three miles away from the local swimming pool, which meant that they weren’t able to use the pool very often. Instead, they decided on a method of teaching that may seem unusual to us now. The swimming manual states:

The method now adopted is to instruct and drill our beginners in class on land until they are at home with every position and movement for breast stroke, and the positions for floating and diving; at least a dozen drills, occupying a quarter of an hour each drill, are necessary before taking the class to the baths at all.

Helpfully, the manual comes with photographs of the boys doing their land drills for different swimming strokes, showing the positions they needed to learn and the numbers they had to call out while doing the drills.

Photograph of boys learning to swim at St Mark's Home, Natland, Cumbria, 1914

Photograph of boys learning to swim at St Mark's Home, Natland, Cumbria, 1914

For the boys at St Mark’s Home, this method of teaching seemed to work very well. I can’t help but wonder, though, if it wasn’t the method itself but instead the attitude of the instructors that helped the most. As the manual says:

Confidence is all-important to the learner, so no ducking is allowed, and we think the method of teaching by throwing a water-shy boy or any other boy into deep water is the last effort that should be resorted to.

Lying beneath these words is a hint at how other instructors were teaching children to swim at the time. I don’t know about you, but I certainly know which method I’d prefer!

The reality of living with a mental health condition in Victorian London

Today, instead of focussing on a particular child we will be focussing on a particular parent. The case files we hold give the family circumstances of most of the children that came into The Children’s Society’s care and so can go into a lot of detail about the health of the child’s family.

Charlotte came into the care of The Children’s Society (then known as the Waifs and Strays Society) aged 7 in 1895. As with all children that came into The Society’s care, an application form was written for Charlotte detailing why it was thought necessary for her to go into care.

The form states that Charlotte and her family came from Marylebone in London. Her father had been a chimney sweep but had died of bronchitis when Charlotte was around three years old.

The second page of the form, shown below, continues the story.

Part of the application form from case file 4658, detailing the health of the child's mother, 1895

Mrs. [surname] after the birth of a child
went out of her mind for a time & was
sent to an Asylum. On leaving,
the Doctor said she would never
again be fit for work. this hap-
-pened after her husbands death
& was partly brought on by the
shock. The family was very res-
-pectable & well cared for during the
Fathers lifetime. the poor widow
has had 9 children only four now
living.

“Charlotte” is a bright little thing
but has not had food enough
for some time, & is thin, with
the look all hungry children
have. sharing her poor mothers
uncertain fate has given her
an anxious face & way, that
are quite Pitiful

(Miss) Emma E Maingay
Hon. Sec

Elsewhere in the form, we learn that the child’s mother was doing light housework as an occupation and that she and Charlotte had no settled place to live.

This form illustrates quite clearly what could happen to a late-Victorian family if the parent or parents were unable to do much work due to an illness or disability. With few safety nets around, save for the workhouse, parents and their children had to struggle to find enough to eat.

Charlotte’s case was accepted by The Society and she went to live in St Hilda’s Home in Marylebone. A few months afterwards she was transferred to a home that wasn’t operated by The Society, St John’s Convalescent Home in Brighton. At this time The Society had no convalescent homes of its own and so often sent children to St John’s Home if they were unwell and needed extra care.

The reason that Charlotte needed to go to a convalescent home isn’t stated, but it seems likely that she was suffering from malnutrition; in other letters in her file she is described as being ‘delicate’ and like a ‘little white ghost’.

After two years at St John’s Home, Charlotte must have been strong enough to return to one of The Society’s children’s homes, this time the Brighton Home for Girls. Charlotte stayed in Brighton until 1903 when she would have been around 15 years old. At this point, a letter from Charlotte’s sister Louisa was received.

Louisa was about eight years older than Charlotte and was married and living in East Barnet near London. She asked if Charlotte could come to live with her; this was agreed and Charlotte went to her sister a few weeks later.

Within the file, we never find out what had happened to Charlotte’s mother after Charlotte was taken into care, as Louisa doesn’t mention her. We can only hope that she was doing well, although her previous circumstances didn’t bode well.

At this distance, it is very hard to discover what condition Charlotte’s mother was suffering from that had required her to enter an asylum for a period of time. As with a number of diseases, the diagnosis of mental health conditions in the late-19th Century was not as sophisticated as it is today. All we can do is go by what we’re told: Charlotte’s mother’s illness had been brought on by the shock of her husband’s death and perhaps by the birth of a child; it had left her unfit for work; and, according to one doctor, ‘she would never be the same woman again’.

What is clear is that she left the asylum with little assistance, despite finding it difficult to work, which meant that being able to care for herself and for Charlotte was an almost impossible struggle, and perhaps one that she was unable to survive.

Instant Whip and Ovaltine

It’s easy to forget that the past not only looked different to the present, it tasted different too. In today’s post we’ll take a look at some dietary diaries to see how people’s diets have changed over the past 60 years.

A lot of The Children’s Society’s children’s homes started keeping dietary diaries in the mid-20th Century. These diaries list the food that was fed to the children in the homes each day and so are a great resource for studying diet. (As long as you don’t study them on an empty stomach, that is, otherwise you may find yourself daydreaming about food rather than working, as I have found out to my own embarrassment!)

The first dietary diary I’m going to share with you today comes from St Agatha’s Home for Girls in Princes Risborough, Buckinghamshire, and dates from 1955.

Page from a dietary diary for St Agatha’s Home, Princes Risborough, Buckinghamshire, 1955

1955 Feb. 13th
Sunday
Breakfast – Swiss porridge. Breakfast sausage B&B marm. tea.
Dinner – Cold beef. Cress tomatoes. beetroot. celery Mashed potatoes. Raisin pie – custard
Tea – Banana jelly. B&B. jam. cake. Tea.
Supper – Bread & dripping. Milk.

Monday
Breakfast – Cornflakes. Tomatoes & fried bread. B&B. marm. Tea.
Dinner – At School.
Tea – Mince, peas and carrots. B&B. jam. Gingerbread. tea.
Supper – Biscuits. Cocoa.

Tuesday
Breakfast – Swiss porridge. Scrambled egg on toast B&B. marm. tea.
Dinner – At School.
Tea – Shepherd’s Pie with baked beans. B&B. jam. cake. tea.
Supper – Cream crackers & cheese. Milk.

Wednesday
Breakfast – Puffed wheat. Bacon & fried bread. B&B. marm. tea.
Dinner – At School
Tea – Sausage & tomato pie. B&B. jam. cake. Tea.
Supper – Jam tart. Lemonade.

Thursday
Breakfast – Porridge. B&B. marm. tea.
Dinner – At School.
Tea – Grated cheese. beetroot. tomatoes. carrot. B&B. Jam. Birthday cake. Tea.
Supper – Gingerbread. Milk.

Friday
Breakfast – Cornflakes. Bacon & fried bread. B&B. marm. tea.
Dinner – At School.
Tea – Smoked haddock. B&B. jam. Biscuits tea.
Supper – Rice pudding.

Saturday
Breakfast – Puffed wheat. Scrambled egg & fried Bread B&B. marm. Tea.
Dinner – Roast mutton. Roast & boiled potatoes. Cabbage. gravy. Junket.
Tea – B&B. paste. Almond buns. Tea.
Supper – Buns & milk.

A lot of this food may seem rather conservative now: cooked breakfasts and fish on Fridays, all eaten with lots of bread and butter. However, this was a time when food rationing had just ended in the UK so you can imagine that many of the items here, like banana jelly, would have been quite exciting for the children eating them.

There doesn’t seem to be much processed food in this diet, with the notable exceptions being breakfast cereals, paste, baked beans and cream crackers. It’s also to interesting to note just how much tea the children were drinking, which is not necessarily a drink we associate with children these days.

And if anyone has eaten Swiss porridge or junket, I’d love it if you could tell me a bit more about them in the comments!

The next diary we have comes from the Harvey Goodwin Home in Cambridge and dates from 1971.

Page from a dietary diary for Harvey Goodwin Home, Cambridge, 1971

1971 Dec 12th
Sunday
Breakfast – Cereal Egg & bacon toast, & tea
Dinner – R. Lamb pots peas cab York, fruit & cus
Tea – Out to tea at South Malling
Supper – Instant whip Ovaltine or Choc.

13th
Monday
Breakfast – Cereal bacon & tom toast & tea
Dinner – School dinners
Tea – Baked beans on toast b&b cake & tea.
Supper – Crisps milk drink

14th
Tuesday
Breakfast – Cereal Egg bread & tomatoes. Toast & tea
Dinner – School dinners.
Tea – Chicken supreme. B&B jam & tea.
Supper – Weetabix and milk drink.

15th
Wednesday
Breakfast – Cereal. Bacon, beans Toast & tea.
Dinner – School dinners.
Tea – Spaghti on toast. B&B jam & tea.
Supper – Cheese & biscuits milk drink.

16th
Thursday
Breakfast – Cereal scrambled egg toast & tea.
Dinner – School dinners.
Tea – Fish finger & beans. B&B jam & tea
Supper – Crisps milk drink.

17th
Friday
Breakfast – Cereal. bacon spaghti toast & tea.
Dinner – School dinners.
Tea – Herrings on toast B&B jam & tea.
Supper – Weetabix milk drink.

18th
Saturday
Breakfast – Porridge toast & tea
Dinner – Spam fritters, chips. beans. Fruit & custard
Tea – Cheese sand. biscuits, fruit & tea.
Supper – Cheese & biscuits milk drink.

In this diet we begin to see the rise of processed foods: fish fingers, spaghetti on toast, crisps, instant whip and Ovaltine. Baked beans and breakfast cereals also seem to be eaten with more frequency than they were a decade and a half before.

And then there are some foods that seem to be very much of their time, such as chicken supreme and spam fritters! Do you remember those?

That said, there are similarities with the previous diet. A lot of bread and butter is being eaten and a lot of tea is being drunk; roast meals are a weekly occurrence; fish is eaten on a Friday; and there is always a cooked element to breakfast.

Our last diet dates from 1991 and comes from the Pimlico Road Home in Clitheroe, Lancashire.

Page from a dietary diary for the Pimlico Road Home in Clitheroe, Lancashire, 1991

2.1.91 [Wednesday]
B/Fast – Cereal Toast Jam Tea coffee.
Lunch – Soup & Sandwiches cakes. milk.
Dinner – Chicken Curry rice & chips fresh. Fruit Tea coffee.
Supper – Cakes Crisps Milk

3.1.91 [Thursday]
B/Fast – Cereal. Toast. Eggs, Tea Coffee
Lunch – Beef Burger Tea Coffee.
Dinner – Lamb chop’s Pot Pea’s Rice Pud. Tea coffee.
Supper – Milk. Crisps

4.1.91 [Friday]
B/Fast – Cereal, Toast, Tea/Coffee.
Lunch – Pies. Spagetti. Cakes. Tea/Juice.
Dinner – Stew, Beetroot, Pickles, Mince Pies & Ice Cream. Tea/Juice.
Supper – Chocolate bars & fresh fruit.

5.1.91 [Saturday]
B/Fast – Cereal, Toast, Tea/Coffee.
Lunch – Poached Eggs, beans, Toast, Fruit, Tea/Juice
Dinner – Sausage & Mash, Gravy, Peas. Biscuits/Cakes. Tea/Juice.

You might notice that by this time the standard printed dietary diary books have gone and that the staff have had to draw up their own book. This means that we can now see a difference in the names of the meals; ‘tea’ is gone and ‘lunch’ has suddenly appeared, pushing ‘dinner’ into the slot that ‘tea’ used to take. Of course, the names of meals can differ by place as well as by time, so there’s nothing to say that these names were in country-wide use in the 1990s.

As for this diet, we can see some less traditional food creeping in, such as curry and rice. Beef burgers are also present while a cooked breakfast in the morning and the ubiquitous bread and butter are almost completely lost. The availability of coffee in the morning is interesting, but this may be down to the age of the children in the home rather than the decade.

All in all, though, there is not too much to separate this diet from the diets of the 1970s and 1950s. Main meals are often made up of ‘meat and two veg’; tea is given to the children throughout the day; and supper is regularly made up of something sweet and a milky drink. It would be interesting to know what this sort of diary would say today. Do these diets represent how the population ate as a whole or were the meals cooked in residential homes slightly different to those eaten in other households?

A point we mustn’t forget is that diet can vary by region and by age as well as by the time-period, so it’s not possible to conclude that the differences between these three diets are based on the decade alone. It would be worthwhile, therefore, to take diaries from the same year for several different homes and see if there was much variation between them.

That’s a potential project for the future, though. Right now, I’ve managed to make myself hungry again! (Oh dear.)

If you’d like to share your experiences of any of these foods in the comments, then please do. Or perhaps you know some other foods that bring back memories of a certain era. Arctic Roll, anyone?

Caring for a child with scrofula

James was an orphan. He was born in Oxford in 1886 where his father worked as a guard on the railway. James would have been about two years old when his father died from heart disease.

After the death of James’ father, James’ mother found work as a nurse for a family living in East Grinstead in Sussex. Then, when James was about seven years old, James’ mother moved the family to Westminster in London where she started keeping a lodging house.

Unfortunately, two years later in 1895 when James’ was only nine years old, his mother died of bronchitis and pneumonia during a cold winter, leaving James and his brothers and sister as orphans.

James was the youngest of his siblings. His eldest brother, aged 25, was a soldier serving in India, while his three other brothers, aged 21 to 16, worked in Westminster; one as a road sweeper, one as a clerk and the other as an errand boy. Meanwhile James’ sister, aged 12, was adopted by their aunt.

Neither James’ elder brothers in Westminster nor James’ aunt, who also paid money to help his grandmother, were able to look after James. Temporarily, therefore, James was taken into a home for working boys, St Matthew’s Home in Westminster, which was also looking after his 16 year-old brother, Robert.

St Matthew’s Home wasn’t run by The Children’s Society (then known as the Waifs and Strays Society). It was a home for older boys, like Robert, who were working. At only nine years old, James was too young to stay in this home, and so an application was made for him to be taken into the care of the Waifs and Strays Society.

In May 1895, two months after his mother’s death, James entered The Society’s Talbot Home for Boys in Bournemouth.

Three years later in 1898 when James was aged 11 and still living in the Talbot Home, a medical certificate was filled out for him. This stated that he had a tendency to scrofula.

There had been no mention of scrofula in a previous medical certificate for James, which had been completed when he first entered the Talbot Home, so perhaps James had recently contracted the disease or perhaps the symptoms had only just started to show. Scrofula is an infection of the lymph nodes in the neck which leaves them swollen; it is sometimes caused by tuberculous bacteria, but can also be caused by other types of bacteria instead.

James remained in the Talbot Home until he was 12 years old. The Talbot Home looked after younger boys, and when they reached the age of 12 the boys often left the home to start apprenticeships in Bournemouth. It was considered that James wouldn’t do well in an apprenticeship and so instead, in 1898, he was moved to Standon Farm Home for Boys in Staffordshire. This home usually looked after boys until they were 14 years of age and trained them for farm work.

The next we hear of James is five months later in 1899 when James would have been 13. He was examined by the doctor who worked as the medical officer for the Standon Farm Home; the doctor’s report is below.

Medical report from case file 4772, stating that the child is suffering from ‘Tubercular disease of the glands of his neck’, 1899

April 4. 1899.

Jas. [surname].

This boy I have examined carefully
& I do not consider him to be a fit
inmate of this institution. He is suffering
from Tubercular disease of the glands
of his neck, of some duration, one of
which has ended in suppuration.
I should advise his removal from
this home as I do not consider the
climate here suitable to the case.
It is quite possible that the Tubercular
disease may spread to the lungs.

Thomas Dixon.
M.R.C.S. Eng.
L.R.C.P. Lond.

Reading the report, we see that James’ scrofula was tubercular and that one of the swellings on his neck had become suppurative (meaning that it had become an open wound). It also suggests that the disease could spread, leading to pulmonary tuberculosis, if it was not treated.

As the doctor advised, it was considered best for James’ health for him to be removed from the Standon Farm Home, and arrangements began to be made for James to go to hospital in London for treatment.

At the time, James’ elder brothers were still living in London and it was thought best for James to stay with them while he was receiving hospital treatment. And so in 1899, when James was 13, he was returned to his second-eldest brother William who was then aged around 25 years and was living in Lambeth in London.

A few days later, we find that James went into St Thomas’ Hospital in Lambeth for an operation. Presumably this surgery was to remove the infected lymph nodes. The success of surgery to treat tuberculous scrofula can be variable, but before the use of antibiotics it may well have been one of the only treatment options available.

Unfortunately, James’ case file ends there. Perhaps his brother William arranged James’ stay in hospital and any later care, which could be why the Waifs and Strays Society didn’t create any more correspondence about the case. If we want to know more about how James got on, a search of the records of St Thomas’ Hospital might be able to give us the outcome of his treatment there.

Scarlet fever

One of the diseases we find mentioned in early children’s case files is scarlet fever. In some cases children who contracted the disease recovered and went on to find employment or to return to their families. Sadly, some were not so fortunate.

Alice was five years old in 1890 when her mother died of tuberculosis. Three years later, Alice’s father was admitted into Birmingham Infirmary with the same disease, being described as “in the last stage of consumption” (an old term for tuberculosis). One of Alice’s brothers was admitted into Birmingham Infirmary at the same time suffering from a brain tumour.

With no-one else to look after them, Alice and her remaining brother were sent to Birmingham Workhouse. It was then that an application was made for Alice to enter the care of The Children’s Society (then known as the Waifs and Strays Society).

At seven years of age, in 1893, Alice entered The Society’s new home for girls in Handsworth, Birmingham, known as the Calthorpe Home.

Medical certificates were completed for all children who entered The Society’s care. Alice was seen by the medical officer at Birmingham Infirmary before entering the Calthorpe Home and was described as having good general health. It appeared that Alice had escaped the tuberculosis that had afflicted her parents. Unfortunately, there were many other diseases that could prove fatal to children in the late Victorian era.

One of the questions that the medical certificates asked was if the children had previously had certain diseases, such as whooping cough, measles, small pox or scarlet fever. Alice’s certificate states that she had had whooping cough but none of the other diseases, meaning that she could be susceptible to them not having been vaccinated against them.

The next we hear of Alice is in 1900, when she would have been fourteen years old. The letter from Handsworth is below.

Letter from case file 3916, about the child's death from scarlet fever, 1900

[…] Alice [surname], one of
the first girls to enter the Home
6 1/2 years ago, died last week,
of scarlet fever & complications
at the Fever Hospital. It
is a great shock, as it was
not at all expected & she was
up & convalescent till Monday
when internal haemorrhage
set in & she died on Tuesday
night.

There is no further correspondence about Alice’s illness in her file so it is not possible to know how long she had suffered from the disease or when she had gone to the Fever Hospital. What is clear is that her death from the disease was sudden and unexpected.

The fact that The Society’s medical certificates asked if the children had ever had scarlet fever shows that the disease was a common and a contagious one. Perhaps other children at the Calthorpe Home fell ill at the same time, although we won’t know without further research.

It would appear, then, that Alice’s brief life was beset by illness; both hers and her family’s. We can only hope that her years in the Calthorpe Home before she fell ill had been happy ones.

What medicines do you remember?

In previous posts, I’ve mentioned treatments and medicines that aren’t so commonly used any more although they were very popular in their time. If you can remember any of these, or would like to tell us about any other common medicines or treatments that you can remember, please let us know in the comments section below.

M&B 693

In the post about influenzal colds in 1940, the medical book notes that the children were treated with 693 tablets.

693 was a name for an antibiotic medicine called sulphapyridine. It was produced by the firm May and Baker and so was often also known as M&B.

The drug was first discovered in 1937. In tests it was found to be an effective treatment for pneumonia and it was also used to treat other infections such as sore throats and gonorrhoea. In fact, it became so popular that it was widely used during the Second World War and May and Baker had trouble keeping up with wartime demand for the drug.

Famously, Winston Churchill was successfully treated with M&B when he was suffering from pneumonia in 1943 which he contracted shortly after attending the Teheran conference that finalised the strategy for the war against Nazi Germany.

693 was later superseded by penicillin and other antibiotics.

Cod liver oil

In the post about tuberculosis in the early 1900s, we find that when John was ill, but before the cause of his illness was known, he was treated with cod liver oil.

Cod liver oil contains vitamin A and vitamin D and it is still used today as a supplement to help with joint problems. In the past it was regularly given to children; this was to help prevent rickets, which was very common in the early-20th Century.

Presumably, as in the case of John, it was also seen as a cure-all that could help to relieve someone’s symptoms when they were ill.

Port wine and brandy

Another treatment mentioned in the post about tuberculosis in the early 1900s is the use of port wine and brandy. When John entered a convalescent home with tuberculosis, he was prescribed port wine, brandy and a generous diet to help build up his strength.

Alcohol has been used as a medical treatment for a long time and spirits such as brandy were popular in the late-19th and early-20th Centuries. They were often used as cardiac stimulants that were thought to increase blood pressure, but some doctors used them as treatments for a whole variety of diseases.

One of the uses of brandy and other spirits was as a supposed aid to digestion and metabolism. They were often prescribed in the diets of people convalescing from illnesses and it is probably for this reason that they were prescribed for John.

Fresh air

In a number of cases we see that children convalescing from illnesses were sent out to homes in the countryside or on the coast. Several of The Children’s Society’s children’s homes were built on the coast for this reason, such as St David’s Convalescent Home in Broadstairs, Kent and St Agnes’ Convalescent Home at Pevensey Bay, Sussex.

Photograph from a leaflet advertising the Children’s Union, showing boys on the beach at St Agnes’ Convalescent Home, Pevensey Bay, Sussex, c1936

Leaving the big cities was thought to aid recovery although, interestingly, a number of children’s homes in London took in children with illnesses too. This was because a stay in London meant that the child would be able to attend hospital for treatment. Often they would be sent to London for a brief period of time and then go out to the countryside once the hospital treatment was complete.

What do you remember?

Do you remember any of the treatments I’ve mentioned here? Please tell me in the comments. It would be interesting to find out how popular they really were.

And that’s not all. I’d love to hear about other treatments and medicines that you remember. I’m sure my list is just the tip of the iceberg!