The Thirties: An Intimate History of Britain. Juliet Gardiner

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СКАЧАТЬ [the commonplace aspirin] in our home remedies, having to endure headaches and other pains until they went away of their own accord … cod liver oil and “Virol” were favourite remedies for winter ailments … and in the case of nerves or depression, a strong iron tonic would be prescribed, with the advice to “pull yourself together”.’

      Diphtheria in children, an infection resulting in the throat thickening and the danger of suffocation, was one of the spectres hovering over the inter-war years, with some 50,000 cases every year. Two thousand children died each year from diphtheria and whooping cough until effective vaccines began to be used towards the end of the decade. Eileen Whiteing recalled that when she and her sister caught ‘the dreaded diphtheria … Mother refused to let us go away to hospital, so a trained nurse was engaged at great expense, and, between the two of them, plus the resident maid, we were nursed safely through the long weeks of fever. Disinfected sheets had to be hung over the bedroom doors, all visitors had to wear white coats and face masks, and the whole house had to be fumigated by the local health officers at the end of the isolation period … People were endlessly kind … since illness was quite a serious event then: I remember hearing the news in hushed tones that straw had been spread over the road outside the house of one of my friends while he lay desperately fighting for his life with double pneumonia in order that the noise of passing traffic should not disturb him until what was known as the “crisis” was past’ and the patient’s dangerously high temperature either fell, or he or she died of exhaustion or heart failure, since in the absence of any effective medication, all the doctor could do was visit several times a day, wait and watch.

      It was not until 1935–36 that real advances in medical treatment were possible with the manufacture of sulphonamides, anti-bacterial drugs effective for the treatment of a range of serious illnesses including streptococcal and meningococcal infections, the ‘miracle drug’ of those pre-penicillin years.

      Tuberculosis was another killer disease that awaited its antidote: in the first decade of the twentieth century it was responsible for one death in every eight, and although that figure was steadily declining by the 1930s, there were still some 30,000 deaths a year from respiratory tuberculosis, and it continued to be seen as a deadly and frightening disease, freighted with social stigma. George Orwell, the most pungent chronicler of the mid-century, who had first contracted TB in 1938, died from its effects in January 1950, aged forty-six. In 1925 the typical tuberculosis dispensary was described by the Chief Medical Officer of the Ministry of Health as ‘an outpatient department, stocked with drugs that are mainly placebos, or an annexe of an office for the compilation of statistics’, and not much had changed a decade later. Although tuberculosis could be managed to an extent, and a diagnosis was no longer an automatic death sentence, there was no effective treatment until BCG (Bacille Calmette-Guérin) vaccine, after fraught years of trials and considerable resistance from the medical profession, started to be used extensively in Britain in the 1950s. Until then treatment consisted either of radical surgery — usually collapsing a lung, an operation performed on the principle of putting the diseased portion of the body to rest so it could combat disease with its own resources — or exposure to fresh air, on much the same principle of encouraging the recuperative power of nature, since there was not much else on offer.

      The notion that sunshine and fresh air helped TB sufferers (and sufferers from other medical conditions) had been popular since the late nineteenth century, and those who could afford it might take the Train Bleu to the South of France or head for the bracing air of the Swiss Alps. The first British sanatorium for the open-air treatment of tuberculosis opened in Edinburgh in 1894, and others followed in Glasgow, Renfrewshire and Frimley in Surrey; they soon spread throughout the country, including one funded by the Post Office Workers’ Union in Benenden in Kent. Some were for the well-off (though the rich usually chose Menton or Davos), many were funded by philanthropists (although, despite its romantic, artistic connotations, TB was regarded primarily as a disease of the poor, and did not attract the same level of donations or research funding as, say, cancer, despite the fact that even at the end of the Second World War it accounted for more deaths between fifteen and twenty-four years of age in Britain than any other condition). Ireland had one of the worst death rates from TB in the world, and although it had been falling since the turn of the century, it started to rise again in 1937, in stark contrast with the rest of the United Kingdom and Europe, due mainly to poverty and a lack of specialist services such as x-ray machines, which barely existed outside Dublin. Faced with the helplessness of the medical profession, those afflicted turned to folk remedies, desperately trusting in the efficacy of a daily dose of linseed oil mixed with honey, swallowing raw eggs or paraffin oil, goats’ milk or dandelion-leaf sandwiches, or positioning themselves in the street outside the Belfast gasworks, since fumes from the vats were reputed to clear the lungs.

      Since tuberculosis was ‘the principal social disease of our time’ in the view of Britain’s Chief Medical Officer of Health, with implications for the whole community, the government, in conjunction with local authorities, funded a network of sanatoria (sometimes using old Poor Law infirmaries for the purpose) for free treatment, and aftercare to be provided by tuberculosis dispensaries. If possible the sanatoria were in isolated locations, since statistics showed that tuberculosis was more prevalent in urban areas than rural, and TB was regarded with such suspicion that any proposal to build a sanatorium invariably met with stiff local opposition. (Indeed, local authorities could obtain a court order for a person suffering from pulmonary tuberculosis to be forcibly removed from their home, although they rarely did so.) Ideally they were surrounded by pine trees (which were ‘much appreciated for their exhilarating resinous aroma’), recalling Otto Walther’s German sanatorium in Nordach in the Black Forest, ‘an abode for Spartans’ 1,500 feet above sea level and ‘exposed to every wind’, the model for so many dilute British establishments with names such as Nordach-upon-Mendip and Nordach-on-Dee. They were governed by strict rules — visitors one Saturday afternoon a month was not unusual — with a regime regulated by bells which included rest, a great deal of food (though not always of the highest quality), some outdoor exercise whatever the weather, and indoor crafts such as wood whittling, raffia work, crocheting and painting, and absolutely no sharing of cutlery or crockery. Spitting, a not uncommon habit in the 1930s, was forbidden, since sputum was know to be a carrier of the tubercle bacillus.

      Belinda Banham, who had trained as a nurse at St Thomas’s Hospital in London, wrote that the treatment provided to tubercular patients in the 1930s by the Royal Sea Bathing Hospital in Margate (founded in 1791 as the Royal Sea Bathing Infirmary for Scrofula)

      consisted, for the main part, in exposure to the elements … each ward gave onto two verandahs, one on either side. The verandahs were equipped with shutters which were never to be closed in the day, and at night only with the permission of the night sister. Permission was rarely granted, even when the snow was falling, as it was thought contrary to the patients’ interest. Cloaks were allowed to nurses only in moving to and from the wards. Strength and stamina were essential to survival … It is difficult today to conceive of the patience and heroism of patients occupying those beds. The length of stay was indeterminate and never less than six months. With tuberculosis of the spine … two or three years was common … with patients often immobilised for two years or more … Efforts were made to protect nurses from contracting tuberculosis, mainly by means of an ample diet … nonetheless, several nursing colleagues did acquire the disease and two died in my time there.

      When Dr W.A. Murray arrived at Glenafton Sanatorium in Ayrshire in 1934, he found chilblains ‘prevalent among staff and patients’, which was hardly surprising since the wards had no heating and the icy Scottish wind blew in round the ill-fitting windows, raising the linoleum from the floors in waves ‘which made a ward round something like a trip on a roller coaster. Rain also came through the windows to such an extent that a patient with some skill as a cartoonist’ depicted the doctor ‘doing his rounds in thigh boots while a patient sailed a toy boat round his bed!’

      Fresh air was also recommended for supposedly susceptible children who might be ‘pre-tubercular’ (though some were actually suffering from malnutrition), and could be removed from their СКАЧАТЬ