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Polio and TB: diseases causing disability in Britain in the 1900s

Ceramic teaching doll to show treatment for polio, England, 1930-1950

Ceramic teaching doll to show treatment for polio, England, 1930-1950

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The treatment of disease and disability as a result of the First World War

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The thousands of soldiers disabled in the First World War (1914-18) raised the public profile of disability in Britain. However, there already existed a more hidden civilian population of physically disabled people, a large proportion of whom were children. Some were disabled by accidents, others by inherited conditions. Many more were affected by infectious diseases. Skeletal tuberculosis, affecting bones and joints, was a major cause of physical disability. Poliomyelitis, known as Polio, although less common at this time, could also cause lifelong disabilities. Such infections favoured overcrowded unsanitary environments, so a disproportionate number of poor children were affected. Poverty also gave rise to another common cause of childhood disability: rickets, a bone-weakening disease caused by vitamin deficiency.

The treatment of children with disabilities in the 1900s

In the early 1900s, disabled children begging on the streets of Britain’s cities were not unfamiliar sights. Before the creation of the NHS, their treatment and care depended mainly on charity and philanthropy. If not kept at home they might be dispatched to hospitals and institutions set up by wealthy benefactors. In reality, many of these institutions were little more than centres where disabled children were housed and fed away from the public gaze.

The Lord Mayor Treloar Cripple’s Hospital – a change from the norm

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Something of an exception was a hospital that opened in 1908 which was initially known as The Lord Mayor Treloar Cripple’s Hospital. Here treatment was a priority and alongside hydrotherapy and heliotherapy, prolonged rest through immobilisation was seen as crucial. First championed by orthopaedic pioneer Hugh Owen Thomas, the treatment was taken to new extremes. Limbs, torsos or even whole bodies were encased in plaster or held rigid by splints - sometimes for months on end - to prevent deformity. Children with spines already twisted by disease could be encased in plaster jackets, which were applied while suspended vertically from a structure christened ‘the gallows’, in an attempt to ‘straighten’ their bodies. While such treatments seem harsh, some of them did prove to be helpful.

TB and polio in the 1940s and 1950s

By the middle years of the century, tuberculosis was in decline. This was due to a combination of improved living conditions, mass BCG vaccination and early diagnosis by X-rays followed by antibiotic treatment. Conversely, polio reached epidemic levels. In 1947 there were nearly 8000 cases - more than 10 times the previous yearly average - and thousands more cases appeared into the 1950s. These figures, although dwarfed by those in America, created widespread panic.

The effects of polio

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Polio attacked the body in a number of ways. Its effects could be mild and temporary, but at its worst it left survivors unable to breath without assistance. At the height of the seasonal epidemics, hospital wards were filled with rows of iron lungs mechanically keeping their occupants alive. Other children were affected in one or more limbs, leaving arms and legs permanently paralysed or - as the late musician Ian Dury found - wasted and weakened.

Sister Elizabeth Kenny and her radical treatment of polio in the 1940s

Immobilisation remained a primary course of treatment in these epidemic years. But concerned parents not happy with this passive approach had their hopes raised by the radical treatments devised by Sister Elizabeth Kenny. A highly popular but hugely controversial figure who had been promoting her techniques in America in the previous decade, she advocated massage, stretching, exercise and the application of hot packs to keep muscles warm - the very opposite of immobilisation. She banished splints and considered iron lungs to be ‘torture chambers’.

The decline of polio in the 1950s

Ultimately the merits of either treatment regime were limited and fortunately polio’s era as a major disease in Britain was short. From the mid-1950s the widespread use of the vaccines developed by Jonas Salk and later by Albert Sabin ensured that in most countries the polio threat quickly faded. In Britain, case numbers were negligible by the mid-1960s. Today, British children are protected from both polio and TB, most of whose British-born survivors are now approaching old age.

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Bibliography

A Borsay and P Shapely (eds.), Medicine, charity and mutual aid : The consumption of health and welfare in Britain, c.1550-1950 (Aldershot: Ashgate, 2007)

T Dormandy, The White Death: A History of Tuberculosis (London: The Hambledon Press, 1999)

T Gould, A Summer Plague: Polio and its Survivors (London: Yale University Press, 1995)

A Hardy, 'Poliomyelitis and the Neurologists: The View from England, 1896-1966' Bulletin of the History of Medicine, 71.2 (1997), pp 249-272

S Humphries and P Gordon, Out of sight: The experience of Disability, 1900-1950 (Plymouth: Northcote House, 1992)

Glossary:

Tuberculosis

An infectious disease that is caused by a bacterium first identified by Robert Koch in 1882. The disease usually affects the lungs first, and is accompanied by a chronic cough.

Polio

An infectious disease affecting the central nervous system. Affected individuals can exhibit a range of symptoms if the polio virus enters the blood stream.

Plaster

A term that refers to a variety of protective coverings or dressings.

Splint

A rigid device of plastic, wood or plaster that serves to immobilize or support an injury. Generally strapped alongside an injured limb.

Epidemic

A sudden widespread occurance of an infection with high numbers of people affected.