chrisharley9 Posted 21 November , 2008 Share Posted 21 November , 2008 Just reviewed one of my latest cases Valvular disease of the heart - all the documentation shows that it was attributable to military service & also states that he died from the same 5 years after discharge Chris Link to comment Share on other sites More sharing options...
Neil Clark Posted 21 November , 2008 Author Share Posted 21 November , 2008 Then you know what to do... Submit it. Link to comment Share on other sites More sharing options...
chrisharley9 Posted 21 November , 2008 Share Posted 21 November , 2008 Im going to - wont need a DC Link to comment Share on other sites More sharing options...
Doc2 Posted 23 November , 2008 Share Posted 23 November , 2008 QUOTE (Phil_B @ Nov 20 2008, 06:50 PM) <{POST_SNAPBACK}> As the electrocardiograph was invented in 1924, wouldn`t diagnosis of heart complaints be a bit hit and miss in WW1? And perhaps a handy diagnosis for those doctors who weren`t sure? Phil, your point is well-taken in general, and it is certain that the ECG/EKG was not widely used clinically during the period of the first world war, but in the interests of accuracy, I need to point out that Einthoven invented the ECG/EKG in 1901, and it was reported in use in the medical literature throughout the teens and 20s. Einthoven received the Nobel Prize in Medicine for its discovery in 1924. Clinically, however, even today most heart complaints (other than problems with the cardiac circulation-- e.g. coronary artery disease, angina, etc.) are not first diagnosed with the ECG/EKG, and it is these other diseases (e.g. Rheumatic Fever, endocarditis, etc.) which are more common in young soldiers. Clinical experience, along with good physical examination, are still the primary diagnostic means. They are, of course, being supplemented with all the new modern technologies, but cardiac diagnosis of the WWI period was actually pretty good, GIVEN THE LEVEL OF KNOWLEDGE AND TERMINOLOGY OF THE TIME. The doctors probably were pretty sure about what they were diagnosing (in other words they probably were not using "heart disease" as "a handy diagnosis") though we might disagree with their diagnosis in light of modern knowledge. Doc Link to comment Share on other sites More sharing options...
hillgorilla Posted 23 November , 2008 Share Posted 23 November , 2008 Da Costa's Syndrome may be of interest to you. I googled WW1 Cardiology, and came up with this, it used to be known as soldiers heart, and was also known as Disorderly Action of the Heart. According to the web page I read some WW1 pensions were awarded for it, though it is now not now fully attributed to the heart. Interesting subject this, as it covers my interest in WW1 and also cardiology. Link to comment Share on other sites More sharing options...
Doc2 Posted 24 November , 2008 Share Posted 24 November , 2008 Da Costa's syndrome is a great example of the difficulty in researching old records. It is a term first used after/during the American Civil War, and has nothing to do with the heart. It is one of many synonyms for another obsolete term, "soldier's heart", which has nothing to do with the heart either. Generally, this is felt to be a psychiatric entity, not a cardiology one. Between the Civil War and the end of WWI, Da Costa's syndrome was poorly described and understood, and it was considered to be possibly representative of heart disease (though we now know it wasn't), so it is not surprising that some pensions were given for it. But, the basic underlying pathology was probably psychiatric rather than cardiologic. Doc Link to comment Share on other sites More sharing options...
Neil Clark Posted 24 November , 2008 Author Share Posted 24 November , 2008 I can now confirm that Endocarditis can indeed be caused by WOUND INFECTION. I realise that this is not a common development (in modern times at least) but the numbers we are talking about here are very very low in relation to the numbers awarded a war pension - less than 1.8% in fact. Many of these non-coms recieved rudimentary rushed treatment in the most appalling filthy environmental conditions - Regimental Aid Posts (RAP), Casaualty Clearing Stations (CCS) etc... My GP (and 4 other doctors including 1 heart specialist) have very kindly given me a signed statement which clearly gives this information. When I explained what I was doing and what I needed, they were all delighted to help out without charge. Prothetic Valve Endocarditis - Early Endocarditis occurs up to 60 days after the operation and is typically caused by perioperative bacteraemia from WOUND INFECTIONS or contaminated central lines. The most common causative organisms are Staphylococus Epidermitis, Staphylococus Aureus or Gram-Negative bacteria. If a dirty needle or medical impliment was used on or near to an open wound then that would be sufficient to cause an infection that might eventually result in Endocarditis. My thanks to DOC2 for his own helpful input and advice here. I think I now have enough to re-submit this case which was rejected by the Naval Historical Branch in Portsmouth in 2003. Note he was given the honour of a full military funeral with a 5th Buffs guard of honour and RFA trumpeters sounded the last post! This didn't impress those morons in Portsmouth though - HOSKINS H.F Name appears on 3 local civic war memorials including Ashford's! Able Seaman 202829 Herbert Frederick HOSKINS. HMS “Royal Arthur”. Royal Fleet Reserve (R.F.R). Died 20th January 1915 aged 31 years. Died at 23 Christchurch Road, Ashford, Kent. The given cause of death on the death certificate was heart disease. Husband of Mabel H Hoskins (nee Pilbeam) of Ashford, Kent. Brother of Caroline May Wilkins of 23 Christchurch Road, Ashford, Kent. Herbert normally resided at 66 Lower Denmark Road, Ashford, Kent. Buried locally 23rd January 1915 in the Ashford Cemetery, Canterbury Road, Ashford. Grave reference - 7004. There is a Mabel Harriet Pilbeam buried in the same burial plot. Mabel was buried here on 2nd February 1966 aged 79 years. Death Certificate reference – West Ashford/ASH28/171. Before the outbreak of war Herbert was the Licensee of the Wheatsheaf Public House, Lower Denmark Road, Ashford. Herbert’s death certificate states that he was a sailor. The Ashford Absentee Voters List for 1918 gives – 51, Beaver Road, Ashford Driver 234110 Frank HOSKINS. Royal Field Artillery (RFA). The 1901 census gives – 23, Christchurch Road, Ashford Charles HOSKINS 57 Labourer Baddeley, Hampshire Mary 54 Bungay, Suffolk Arthur 23 Carpenter Joiner Stepney, London Catherine 21 Stepney, London George 19 Hawker Stepney, London Frank 12 Stepney, London Herbert joined the Royal Navy in 1899 for 12 years service. He served on the following ships during this period – St Vincent (1899), Argincourt (1900), Galatea (1900), Empress of India (1900/01), Caesar (1901/02), Wildfire (1903/04), Northampton (1904), Hawke (1904/05). Herbert left the navy on expiry of his service engagement. On the outbreak of war Herbert answered the call of his country and rejoined the navy. He was posted to HMS Royal Arthur on the 2nd August 1914 and remained with this ship until 26th November 1914. On the 27th November 1914 he returned to HMS Pembroke in Chatham and was subsequently invalided on 21st December 1914. The local papers reported his death as follows “Saturday of Herbert Frederick HOSKINS, Royal Navy, the licensee of the Wheatsheaf Public House, Denmark Road, South Ashford who passed away on the previous Wednesday aged 31 years. The deceased who leaves a widow and a baby girl had served 12 years in the navy, and upon the outbreak of war re-joined serving on HMS Royal Arthur and on one of the naval trawlers. He was invalided home in December, and died from valvular disease of the heart. His coffin was covered with the union flag and following the mourners was the funeral party in khaki uniforms of members of the 5th Buffs (East Kent Regiment) under Private Cowell who was wearing the Chitral ribbon. At the conclusion of the impressive service, Trumpeters Wells and Wilkinson of 458th Battery, Royal Field Artillery sounded the last post”. Herbert died only 1 month after discharge! 9% of men who were awarded war disablement pensions were as a consequence of heart problems. The case for Herbert is extremely strong taking into account he died only 1 month after being invalided. Link to comment Share on other sites More sharing options...
PhilB Posted 24 November , 2008 Share Posted 24 November , 2008 The doctors probably were pretty sure about what they were diagnosing (in other words they probably were not using "heart disease" as "a handy diagnosis") though we might disagree with their diagnosis in light of modern knowledge. Doc I appreciate that medicine is not an exact science but isn`t that the same as saying "They were pretty sure but they might have been wrong"? In 1902, Einthoven published the first electrocardiogram recorded on a string galvanometer but I can`t find any record of the actual use of ECGs in hospitals or general practice for some years after, which led me to believe that none would be available for the treatment of WW1 soldiers? Link to comment Share on other sites More sharing options...
Neil Clark Posted 24 November , 2008 Author Share Posted 24 November , 2008 After he was rejected Christine Smith from the local council very kindly paid (£500) for his grave to be restored. We all felt so bloody angry that his case had been thrown out so quickly despite the fact he got a full military funeral. On clearing his grave we found his original anchor and shield which said on it "He gave his Life for his country". I wish there were more Christine Smith's out there in local authorities... Link to comment Share on other sites More sharing options...
Neil Clark Posted 24 November , 2008 Author Share Posted 24 November , 2008 The Shield says "HE LAID DOWN HIS LIFE FOR HIS COUNTRY" Link to comment Share on other sites More sharing options...
Neil Clark Posted 24 November , 2008 Author Share Posted 24 November , 2008 The Naval Historical Branch in Portsmouth (Mr McAloon) told me in no uncertain terms that - Heart Disease can't under any stretch of the imagination be attributed to a mans war service. Rejection followed swiftly... It now appears as if that original adjudication was DEFECTIVE and rushed which seems to be their trademark of late. (Assuming you can get them to make an adjudication in the first place, which according to my latest information is pretty slim) Link to comment Share on other sites More sharing options...
Doc2 Posted 24 November , 2008 Share Posted 24 November , 2008 QUOTE (Phil_B @ Nov 24 2008, 02:08 PM) <{POST_SNAPBACK}> I appreciate that medicine is not an exact science but isn`t that the same as saying "They were pretty sure but they might have been wrong"? In 1902, Einthoven published the first electrocardiogram recorded on a string galvanometer but I can`t find any record of the actual use of ECGs in hospitals or general practice for some years after, which led me to believe that none would be available for the treatment of WW1 soldiers? Phil, yeah that is sort of what I was implying. A previous poster had suggested that "cardiac disease" was possibly used as sort of a garbage can diagnosis if the docs of that time "weren't sure what they were dealing with"-- My point is that they probably thought they knew what they were dealing with and made their diagnoses in accordance with the best medical knowledge of the time, rather than using the term as a garbage can diagnosis, meaning "I don't know what he's got so let's call it cardiac" (as we do today with "it's a viral syndrome"). ECGs during this time period were in fact in use, though primarily in hospitals with research capabilities (and yes, they were using string galvanometers). I agree none would have been used in the field. The problem with using them is that 1) the equipment was not standardised nor easy to use, 2) The data necessary to really interpret the tracings was not readily available to clinicians (OOOH-- I have a neat tracing-- wonder what it means?), and 3) the equipment was pretty fragile. I am sure that the use of an EKG at this period in a GP's office would have been very rare-- and he probably wouldn't have been sure what the tracings meant. My original comment was simply to correct the statement that the EKG didn't exist until 1924, not to claim that it was a commonly used item during WWI. Your assumption in that regard is accurate, I believe. Doc Link to comment Share on other sites More sharing options...
mbloy Posted 10 December , 2008 Share Posted 10 December , 2008 I also had a relative (Great Uncle Charlie) who died of 'vulvular heart disease' aged 20 in 1919 (and as Sue made reference to, this was brought on by rheumatic fever). As far as I know, Charlie isn't buried at Brookwood, but he is commemorated there. It seems somewhat of a coincidence that Andy's relative had VHD and also has a Brookwood connection. Does anyone know whether there was a hospital near Brookwood specializing in Heart Disease, or was it simply an assessment centre for war disability pensions? Regards, Michael Link to comment Share on other sites More sharing options...
Neil Clark Posted 10 December , 2008 Author Share Posted 10 December , 2008 Michael, YES there was a very large military hospital at Brookwood which isn't surprising given it's location so close to Aldershot. I'm not sure if it specialised in Heart problems but it's possible it did. Brookwood civilian cemetery is the largest in the UK. As you probably already know, the CWGC has it's main UK cemeteries there also alongside other commonwealth countries and the USA. Link to comment Share on other sites More sharing options...
chrisharley9 Posted 10 December , 2008 Share Posted 10 December , 2008 I also had a relative (Great Uncle Charlie) who died of 'vulvular heart disease' aged 20 in 1919 (and as Sue made reference to, this was brought on by rheumatic fever). As far as I know, Charlie isn't buried at Brookwood, but he is commemorated there. It seems somewhat of a coincidence that Andy's relative had VHD and also has a Brookwood connection. Does anyone know whether there was a hospital near Brookwood specializing in Heart Disease, or was it simply an assessment centre for war disability pensions? Regards, Michael Michael could you let me have his name as I becoming a dab hand at finding the graves of those on the Brookwood Memorial Chris Link to comment Share on other sites More sharing options...
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