Harris Lines of Arrested Growth

The poor living conditions that many of the children at Stannington Sanatorium came from, outlined in our last post, can often leave physical markers on the skeleton, namely Harris Lines.

Harris Lines are an indication of periods of arrested growth whilst the body is still growing during childhood and can be displayed as opaque, transverse lines on long bones. These can be identified through radiographic imaging or physically on skeletal remains.

The appearance of these lines is considered to show periods in an individual’s childhood when the body comes under stress, which is usually attributed to malnutrition or significant childhood disease. In order for the individual to acquire Harris Lines, they have to have recovered from the period of stress, prolonged malnutrition or disease would not result in their appearance.

HOSP-STAN-07-01-02-1625-06
HOSP-STAN-07-01-02-1625-06

Numerous patients from Stannington Sanatorium demonstrate Harris Lines in their radiographs. One such example is seen above, patient 148/1948. Thi image was taken in November 1948, approximately 10 months after initial diagnosis of tuberculosis was made. On this patient Harris Lines are identifiable on both proximal and, to a greater degree, distal tibiae, as a brighter, opaque line close to the epiphysis.

This individual was admitted to the sanatorium aged 2 with a Primary Complex, primary infection in the mid zone of the right lung. Their medical history indicates that their father had been diagnosed with pulmonary tuberculosis and subsequently died. The family, consisting of mother, father and two children were living in one room for the majority of the individual’s life, only moving to a two roomed house around the time of their admission to Stannington and on admittance to the sanatorium the child was described in the medical notes as being ‘thin’ and ‘ pale’.

Social conditions such as these would have attributed to the premise of the child undergoing one or more periods of stress during growth and alongside the description of the individual being ‘thin’, malnutrition is possible. A poor appetite or anorexia is often noted in the medical notes of patients as being symptomatic of tuberculosis, again suggesting possible malnutrition. However, the effects of the tuberculosis infection alone would have put the body under due stress and may, therefore, have contributed to the presence of Harris Lines. Both malnutrition and acute tuberculous infection are potential causes of the Harris Lines, alone and in conjunction with one another, and demonstrate the secondary effects that disease and social conditions can have on an individual’s body.

This patient was removed against medical advice approximately one month after admittance, only to be re-admitted seven months later with tuberculosis of the cervical vertebrae. They were eventually discharged in December 1950, two years later, but continued to be seen as an out-patient. No further treatment was required at Stannington Sanatorium.

 

For more radiographic images, view the ‘Radiographs from Stannington’ on Flickr https://www.flickr.com/photos/99322319@N07/sets/72157648833066476/

Sources

Roberts, C and Manchester, K (2006). Archaeology of Disease (3rd Edition). Cornell University Press.

This Week in World War One, 12 February 1915

Berwick Advertiser title 1915

BERWICK ADVERTISER, 12 FEBRUARY 1915

 HOLY ISLAND

Patriotic Concert- Amidst a show of bunting and flags an entertainment was given in the schoolroom on Monday last on behalf of the War Funds. The first part of the programme consisted of a series of songs and recitations given by small children. Mr George Wilson sung the popular “Tipperary” song.

This was followed by the pageant “Britannia’s Reception of her Colonies.” The performers were all attired in costumes representing the various countries and performed their parts in a manner which called forth great applause. Mrs Marion Bell represented Britannia (whose train was borne by Florence Spencer and Maggie D Cromarty), to whom father Neptune (Mr Hollingsworth) presented the Ambassadors of Canada (Miss May Wilson), accompanied by the Negro (James E. Walker) and Red Indian (James Brigham). Australia was represented by Mrs Hollingsworth; New Zealand by Miss Fanny Douglas; India by Miss Lalla Bell; South Africa by Ralph Wilson; our ally Japan, by Miss Lulu Bell; On Britannia calling for the representatives of the homeland Mr R. A Wilson bowed to her in the character of John Bull and was followed by Miss Maggie Wilson for Scotland; Miss Rachael Kyle for Ireland; Miss Lalla Allison for Wales. The Army and Navy were seen in the persons of Messrs R Straughan and T. Cromarty.

The schoolroom was well filled with a very appreciative audience who afterwards requested that the performance might be repeated in the near future to enable others to enjoy it. Great credit is due to Mr Riley, who organised the entertainment and was ably assisted by Mr and Mrs Hollingsworth; Mrs Crawshaw; Mrs Riley and Miss Brigham.

 

The Market Square in Holy Island
Postcard of Market Square on Holy Island Ref: BRO/426/1068

 

 

ITEMS OF INTEREST

The family of Sergeant James Ramsay, R.F.A., of Berwick, has a fine record of patriotism. His Grandfather and father were in the Army, and his son is also in the R.F.A. His wife and daughter are both acting as nurses, and his son-in-law, Lieut. Weir, R.F.A., received his commission for bravery at Mons.

2nd Lieut. John Robertson, only son of Alex Robertson of Gateshead, has been promoted Lieut. 11th Battalion Durham Light Infantry. Lieut. Robertson is the grandson of the late John Robertson and of the late Joseph Currie, of West End, Tweedmouth.

 

Advert for films being shown at The Playhouse, Berwick
Advert from the Berwick Advertiser, 12 February 1915.

 

Social Conditions

Many of the children admitted to the sanatorium came from impoverished backgrounds and had poor living conditions, nearly certain to be a contributing factor to them contracting TB.  Some of the common risk factors for contracting tuberculosis include overcrowding, malnourishment, a weakened immune system, being either very young or very old and a lack of access to medical care to ensure treatment and prevention.  Consequently, the following account from the records of Stannington Sanatorium hardly comes as a surprise and is by no means unusual.

 

This particular case from the 1940s perfectly illustrates the challenging conditions and the effect of childhood diseases.  The girl, patient 145/1946, was admitted to Stannignton Sanatorium in October of 1945 at the age of 3.  Her case notes indicate that she had already had measles and pneumonia and had been suffering from her present condition of tuberculosis of the right knee for the past 18 months.  After 4 years of treatment she was considered fit for discharge at which point the living conditions she had left behind at the age of 3 are made clear.  The local medical officer reports that

“The home conditions in this case are appalling.  The housing accommodation is only two rooms, in which are already living four adults and five children.”

With this borne in mind the medical staff, unsurprisingly, consider it counterproductive to discharge the girl home and within 3 months she is instead discharged to the Briarmede Nursery in Gateshead.  Medical staff were obliged to take into consideration the living conditions of all patients and consult with local medical officers in the relevant districts before discharging their patients or risk undoing much of the good that had been achieved during the child’s stay in the sanatorium.  Where conditions were not satisfactory children could be discharged to other institutions, as above, or could find themselves staying at the sanatorium longer than was medically necessary, a situation which the doctors were obviously keen to avoid.

 

For many children coming from backgrounds such as this, being removed to the sanatorium, whilst it may have been difficult being separated from family at such a young age, may in fact have been a blessing in disguise.  Even without the effective drug treatments we have today, the instant improvement in living conditions would have made untold differences to their health and wellbeing.  In each child’s case file it is quite common to see descriptions of their living conditions in their general and family history, taking into account the type of house they were living in, the number of occupants, and the sanitation available.  This information alongside correspondence from the children’s parents requesting support for applications for improved housing gives us a great insight into some of the social conditions across the North East during this period.

 

The image below is taken from a brochure produced by the sanatorium in 1936 to promote their services and show images of one patient at four different points in time to illustrate the success of the treatment that Stannington provided. (HOSP/STAN/9/1/1)

NRO 3000-69 PAGE 9 1NRO 3000-69 PAGE 9 2

See also our later post on Harris Lines.