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Treating Tuberculosis at Stannington Sanatorium

This education resource is a compilation of sources and links to staff research from the Stannington Sanatorium project. This was a two year long Wellcome Trust funded project to preserve, digitise and explore the patient files from Stannington Sanatorium, which have been in the possession of Northumberland Archives since the hospital’s closure in 1984. Our collections also include large numbers of photographs, film footage, oral histories, committee minutes and radiographs. We have selected key sources to highlight the different themes in this resource, looking into Tuberculosis and the history of its treatment, but also examining the sanatorium, its staff and patients. Here we will take a local perspective on a global disease, and examine the personal stories of staff and patients who were affected by it. The resource is designed so you can take an overview using the sources provided, and delve deeper through the links to our blog, online exhibition and Flickr sets. 

Teachers can use the resource to tailor to an examination into the subject of public health for key stages 3 and 4. Older students can use the resource for conducting their own research topic. Stannington Sanatorium has both local and national relevance for those studying TB, looking at local stories and the work of a pioneering sanatorium. Please also explore the online exhibition, or encourage your students to explore it. If you have any further questions please contact us at collections@woodhorn.org.uk.

 

What is Tuberculosis?

Tuberculosis (often shortened to TB) is a bacterium based infectious disease, known as Mycobacterium-tuberculosis. Though most famous for affecting the lungs, TB can affect any part of the body, both the skeleton and the soft tissue. Tuberculosis is generally contracted through the inhalation of infected droplets, usually from a cough or sneeze from someone with the active disease when in close contact. Once inhaled, the infection goes into the lungs where it becomes a primary complex, or a Primary TB. It can also be contracted through infected milk, which is why all dairy cows are now tuberculin tested. The patient gets a fever and night sweats which would last up to two weeks, followed by skin dullness, weight loss, faster breathing and coughing up small amounts of blood. The primary infection multiplies, reducing the immune system’s ability to recognize it. It then spreads throughout the body and can turn into a secondary infection in the tissues (organs such as the liver, spleen, glands, and even the skin!) or into bones and joints. In the brain and spinal cord it can become the very deadly Tuberculosis-meningitis. While the majority whose condition improved were unlikely to infect others the stigma attached to Tuberculosis often made life difficult. Some parents wouldn’t allow their children to play with those who had recovered from TB, while adults often encountered difficulties in finding work. 
Follow these links to the blog for more information on types of TB  and how it can be contracted.

Public health, the sanatorium movement and origin of Stannington 

Though Tuberculosis has affected humans since prehistory our current understanding of it is very modern. The ancient Greeks wrote about Pthisis, medieval kings touched the sufferers of scrofula, and from the seventeenth century consumption was seen as a dangerous disease. However without fully understanding its cause (it was often thought to be hereditary as it affected families), recipes for ‘remedies’ sought to cure it. Here we have some of those remedies taken from the Society of Antiquaries of Newcastle collection. 

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With the appointment of Medical Officers for Health  the awareness of the huge numbers the disease killed led to an emphasis on preventing the disease. In 1913 the county appointed its own Tuberculosis officer and put in a great deal more infrastructure to combat the disease. Below are some of the statistics that show the reported incidence and death rate in the North East from Tuberculosis in 1943.

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In the nineteenth century a link was noticed between tuberculosis and poor housing, as large numbers of patients were found to live in slum housing, where cramped conditions and unventilated rooms meant the disease spread quickly. A pamphlet from 1849 titled "Report to the General Board of Health on a Preliminary Inquiry into the sewerage, drainage [etc…] of the borough of Morpeth and the village of Bedlington" by Robert Rawlinson (NRO 2164) shows just how bad this could be. Rawlinson described the collier’s cottages of the area, where a flagstoned 14ft square room served as living room and bedroom for a large family, with a small bedroom in the roof space ‘open to the slates’. Other houses in Morpeth had 16ft by 15ft bedrooms in which 8 people slept. Worse however were the overcrowded lodging houses. Rawlinson quotes the Town Clerk’s account of them, where beds were occupied by ‘as many as can possibly lie upon them’. When these were full others would sleep on the floor in rows. The Town Clerk added ‘nothing but an actual visit can convey anything like a just impression of the state of the atmosphere… what then must it be like for those who sleep there for hours?’ This description shows an atmosphere in which TB could easily spread, where the occupants of the lodging houses (often labourers moving between work) could then spread it at the next lodging house they came to.

However the problem still wasn't solved over fifty years later when Dr. Allison, who worked for many years at Stannington, described the inside of a house he had visited in 1905.

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You can read more on how the problems of poor housing and TB in the community was treated here.  
Stannington Sanatorium was founded by public conscription at this time, partly due to the awareness people like Dr Allison raised. Sanatoria were being established across the country, but this was the first to only treat children. Read more about its founding here.

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The Sanatorium was opened in 1907, and first took on five patients including Maggie Smith. Many of the children were from poorer backgrounds. It grew over the years and built new wards with donations, eventually reaching its maximum 312 beds in 1926. Several thousand children were treated here over the years, mainly for TB, but also for other illnesses and conditions from the late 1950s, when it became a general hospital. 

Treatments at Stannington Sanatorium 

Stannington originally offered the traditional sanatorium care of bed rest, healthy diet, fresh air and sunlight as its main cures, but later had a surgery, plaster casts and traction, phototherapy, monitored patient’s progress with x-rays, and treated the disease with drugs. Caught early, this treatment could return patients full health over a year or two. Treatment developed over time, and after the introduction of antibiotics like Streptomycin in the late 1940s patients’ speed of recovery improved dramatically, so much so that Stannington became a general children’s hospital in the late 1950s. Here is a little more about each of the treatments. 

Simply resting gave patients a good chance to fight the early stages of disease. Beds would be in wards with large windows kept open for much of the time, or wheeled out onto the verandas to give patients plenty of fresh air when resting.  

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Combining this rest with sunlight was Heliotherapy, also known as sunlight therapy. Stannington had a large pavilion constructed for this purpose, with reclining beds for patients to soak up the sun. 

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Surgery was performed at Stannington until the mid-1940s, after which patients were taken to Royal Victoria Infirmary, Newcastle. Follow the link to read Joyce Thompson’s account of her operation. A common surgical technique was an Artificial Pneumothorax, in which a lung would be artificially collapsed to allow faster healing, while the patient used the other lung as normal. Below we see Dr Farquharson using the technique on a patient.  

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X-rays were taken at Stannington in its own X-ray plant, installed in the 1920s. These would often be used to monitor the disease and check if treatments were working. Some patients had as many as 80 taken in the course of their stay. Here is a link to some interesting examples on our Flickr set
These treatments worked in the majority of cases. In the early years of the hospital a brochure was produced, containing many photographs of the sanatorium. In it are the photographs below of a patient, which show her progress back to health as an example of the benefits of treatment.  

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The antibiotic streptomycin  became available at Stannington from around 1949. A decade later it had made recovery so quick the hospital started to take on patients with other conditions, and became a general hospital. It was often later combined with two others, para-aminosalicylic acid (PAS) and isoniazid (INH) forming an effective combination.

 

The patient files  

Below are some documents from the patient files. These would contain a number of different documents, such as the patient’s medical history, treatment cards, letters between the doctors and their families, temperature charts etc. You can read a list of the types of documents included here. The contents of the files didn’t change too much after the sanatorium became NHS in 1948, but you can see changes in the way the files were written over a longer span of time. However to get a good understanding of the files compare these examples below.  

This is how patients’ notes were first kept from 1937- 1946, in what is called a discharge book. This combines notes, a temperature chart, and a diagram of the ribcage for the doctor to draw marks to indicate suspected areas of disease. 
From the mid 1940s we begin to see a change to files, which could hold other types of documents in them. here is an example of a case of Pulmonary Tuberculosis from before the use of antibiotic drugs at Stannington. 
After the advent of streptomycin and other antibiotics the files look a bit different. Here is another case of Pulmonary Tuberculosis, this time from a few years later and treated with antibiotic drugs.  
Here are links to some other examples of files with different forms and treatment of the disease:

A pre-drug case of TB of the spine; A pre-drug case of Tuberculous cervical adenitis; A post-drug case of Tuberculous cervical adenitis; A post-drug case of Tuberculosis of the left humerus

 

Staff

The staff also lived at the sanatorium, moving with it during its wartime evacuation to Hexham during WWII. Here are a few of their stories:
Matron Campbell; Mr. Johnston; Dr. HunterNurse Florence Parsons; Headmistress Miss Fulcher; Dr. Farquharson; Dr. Allison;  The visiting doctors.

The nurses lived in a Nurse’s home in the grounds, and we get a good insight into what life was like there in the late 1910s and 1920s from photographs taken by a few of the nurses including Hilda Currie , who worked there between 1915 and 1922. She shows some of the quieter times staff had. However most of the nurses’ time there was spent in hard work. In quiet moments they might have to clean the wards. Stannington took on many trainee nurses, who worked towards their qualification by completing a training book. We have an example from the 1950s you can view on our blog about the nurseing staff. Staffing was sometimes difficult as sanatoria like Stannington were situated a long way from towns and cities, making it difficult for staff to meet family and friends. The stigma that surrounded TB nursing was also sometimes a factor in the nurses’ choosing to work elsewhere.  

 

Life for patients in the Sanatorium 

While very lonely and isolating there were some positives to life in the sanatorium. As patients would be there for a long time they still went to school if they were able, with many encouraged to work towards their exams. The sanatorium and hospital had daily timetables which changed through the years, and we fortunately have those from 1966, which you can see here

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The patients were involved in a number of different activities. Many of the patients joined the hospital’s scout and guide groups, and in the early days of the sanatorium patients could contribute to a magazine.

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However the highlight of the year was Sports day. This involved weeks of preparation of inventive costumes for the fancy dress parade, and those who were able took part in races and other sports. Those who were confined to bed were still able to participate in the fancy dress, and were brought out onto the verandas to watch the events. Click the link to learn more and watch footage of the 1957 jubilee sports day