Stannington Sanatorium

Patient 133/1959 – A Case of Fibrocystic Disease

10/06/2015 by Stannington Sanatorium Project

The radiographs held within the Stannington Sanatorium Collection date between 1936 and 1953 and are specific to the period when the sanatorium was used as a hospital for tuberculous children. However, through the process of listing the patient files for Stannington, which continue up until 1966, well into its use as a general children’s hospital, we have uncovered a set of radiographs for one other patient, a 6 year old boy who was admitted to Stannington on 15^th June 1959: Patient 133/1959.

Patient 133/1959 was diagnosed with Fibrocystic Disease of the Pancreas, a generalised hereditary condition amongst children which, despite its name, can affect not only the pancreas but also the liver, lungs and sweat glands and was considered to be the most common cause of chronic non-tuberculous lung disease in children during the 1950s.

This patient was admitted to Stannington with widespread cystic change in both lungs, retarded growth and signs of chronically infected bronchiectasis. His medical notes also refer to ‘finger clubbing’, which involves changes to the areas of soft tissue under and surrounding the finger nails but may also involve the nails themselves. At this stage in his treatment the patient was prescribed penicillin, monitored for changes in weight and subjected to postural drainage.

By September 1959, the boy’s medical notes read:

‘No gain in weight and very little sputum but he has many loud râles in both sides of chest and a loose cough.’

At this time it is also noted that he has been prescribed pancreatin, a drug to help treat the symptoms of cystic fibrosis and to aid with digestion of fat, starch and protein. His lack of weight gain was considered to be associated with problems in the colon and as such his stools were also monitored regularly.

Little change is seen in the notes for the following year, weight gain is still elusive and the patient is often referred to as being small, with râles in the chest and having shortness of breath. However, in October 1960 the severity of this patient’s condition becomes clear as the attending physician writes:

‘Very poor appetite and very difficult.

I do not understand how this problem can be solved.’

However, from May 1961, this boy began to show slow improvements especially within regards to the colon and weight gain is evident with a total gain of 8lbs since admittance. Râles are still noted in the left side of the chest, see lung x-ray in Figure 1.

In addition to his medical problems this boy also had learning difficulties according to notes from the hospital school teacher stating he was:

‘very much retarded and would need more individual help and attention ….

He is slow to complete written assignments but makes a good effort. His reading and arithmetic are well below average for his age but he has made satisfactory progress in both within his limited ability.’

As a result the doctors approached the subject of finding this boy a long term residential school for handicapped children to be transferred to following his discharge.

Patient 133/1959, remained in Stannington until 1962, where he continued to make improvements regarding his weight and height and the râles in his chest diminished significantly. In March 1962, he contracted German measles and then later chicken pox in June 1962. Despite these short term illnesses, this patient was discharged home in August 1962, having secured a place at the Windlestone Hall residential school near Ferryhill, County Durham, to begin in September 1962.

Sources:

di Sant’agnese, Paul. A (1955). The Pulmonary Manifestations of Fibrocystic Disease of the Pancreas. Chest. 27(6):654-667

Medline Plus (2015). Clubbing of the Fingers and Toes. http://www.nlm.nih.gov/medlineplus/ency/article/003282.htm

Patient (2015). Pancreatin. http://patient.info/medicine/pancreatin

Mary Ann Fulcher – School Headmistress

03/06/2015 by Stannington Sanatorium Project

There were many individuals that contributed to the successful running of Stannington Sanatorium and helped to make it the thriving institution that it was. This week we will have a look at the role of one of these individuals, Mary Ann Fulcher, headmistress of the Sanatorium School.

Mary Ann Fulcher served as the headmistress of Stannington Sanatorium School for over 32 years from 1^st February 1921 up to her retirement on 18^th December 1953. During her time as headmistress she presided over the school’s transition to state control and away from the management of the Poor Children’s Holiday Association following the passing of the National Health Act as well as witnessing the effects of WWII with the bombing of the sanatorium and its temporary relocation to Hexham.

In the annual report of 1938 Miss Fulcher details the work of the sanatorium school and the effect of illness upon the children:

‘Every other Friday a fresh group of children enters the Sanatorium School. behind each lies a little tragedy; weeks of ill-health followed by a visit to a doctor, then another consultation, and finally a parting from the old, familiar, well-loved things to enter a strange new world, and in the midst of the newness and strangeness they meet with a school and they all know something about schools, even if it is not quite the same as those they have known. About the school they are critical for they have a standard by which to judge. This big fellow says firmly, “I have left school,” and infers that he has put away with such childish things. The secondary school girl, until her health gave way, had had dreams of examination successes and is a little superior in her manner. Ill-health seems to her such an unfair handicap, and she half resentfully wonders what this school has to offer her …

Different in all, save that they are infected with tuberculosis, they come into the melting pot of school and it is the aim of the school, not so much to teach this fact or that, as it is to help all to face life with courage and to demonstrate that in spite of an early introduction to ill-health and suffering, the world is full of beauty and joy. …

The Sanatorium does not only attend to the children’s physical ills but adjusts their mental outlook … From time to time we hear of their achievements in the great outside world and are content.’ [HOSP/STAN/1/3/5]

Open Air School. Class II Writing Lesson. [HOSP/STAN/11/1/27]

As a school attached to a hospital the challenges met by Fulcher were much more varied than those faced by many other head teachers. Looking through the school log books for the period (CES/243/2/1-2) we see that certain restrictions were placed on the children’s activities by the medical staff including insisting on outdoor teaching in good weather, strict periods of rest and the facilitating of summer sun treatment. In addition children could be absent from school for long periods owing to illness and having to be confined to the sanatorium, although in later years teaching was also conducted on the wards.

Miss Fulcher’s work was recognised in the 1951 New Year’s Honours List when she was awarded an MBE for her service to the school. In the same year the school inspector’s report, recorded in the log book, gives a glowing report of her work and reads as such:

‘The Head Mistress, who has almost completed her thirtieth year of devoted service to the school, has never allowed the isolation of the premises or the specialised character of her work to cut her off from the main stream of educational interests. She shows close acquaintance with modern school practices & recent literature. She is a capable organiser in a complex field, maintains a good sense of proportion, leads her staff well, & imbues them with her inflexible regard for good standards of work. Her relations with the children are good, & she has equal regard for the needs of the youngest & the oldest. Her personal integrity, courage & humanity are pillars of support to the school.’

NRO 10321-3 [MAG P4] — NRO 10321-3 – 14 year old boy’s account of schooling in the sanatorium, 1931

Genitourinary TB – Part 2

27/05/2015 by Stannington Sanatorium Project

Having looked at a case of genitourinary TB in a young male in our first post from 01/05/2015, part 2 will focus on a case of genitourinary TB in a young female.

Patient 83/1952 was 14 when she was admitted to Stannington from Newcastle General Hospital in May 1952 diagnosed with abdominal TB. She had first presented with serious illness in November of 1951 with lassitude, loss of weight, loss of energy, and a chest x-ray showing a probable primary in the right lower zone and enlargement of the hilar glands. Following three months bed rest an additional chest x-ray showed an improvement in the hilar glands and the disappearance of the primary focus and she was able to return to school. However, it was only a month later that she began to complain of abdominal pains and her abdomen began to swell and loss of weight and appetite recurred.

On admission to Newcastle General Hospital the quantity of fluid in the abdomen began to increase rapidly and her temperature was often raised so treatment with streptomycin and PAS was begun. She continued to receive the drug therapies when she was transferred to Stannington. An examination of the abdomen on admission to Stannington read as such:

‘Abdomen distended and taut. Ascites present. No enlargement of liver. Spleen not palpable. No masses palpable (probably due in part to tautness). Circumference = 32.5 inches.’

A continuation of the drug therapies throughout her stay at Stannington led to a marked improvement of her condition and she was eventually discharged as quiescent in March 1953. At no point in her case notes do the medical staff suggest that there might be any signs of genitourinary TB and continue to describe her condition as abdominal TB. However, the case was followed up by Doctors Miller and Taylor in the following years and published in a book of 1963, in which they describe the case:

“On examination she had pelvic masses clinically characteristic of bilateral tuberculous salpingitis (inflammation of the fallopian tubes). Despite chemotherapy (streptomycin and PAS) and bed rest the pelvic swellings, especially on the left side, became larger. A month after chemotherapy began they slowly regressed and in six months had disappeared.” [F.J.W. Miller, R.M.E. Seal, & M.D. Taylor, Case No. 114]

Later correspondence in her file from the Newcastle General Hospital dated from February 1963 indicates the lasting effect that this form of TB had on the patient. The patient is by this point 25 and married and attending an Infertility Clinic at NGH. The doctors there are requesting her medical history from Stannington in the hope that something within it might help to explain her current infertility.

Sources:

MILLER, F. J. W, SEAL, R. M. E, and TAYLOR, M. D. (1963) Tuberculosis in Children, J & A Churchill Ltd. p.558

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