disease

[peter blackwell]

was it possible to get tuberculosis in the trenches?

[Dai Bach y Sowldiwr]

Yes.

[peter blackwell]

My grandfather died TB in 1934 aged of 40,. i was told he possibly contracted it in either Gallipoli or india, i'm not sure.thanks pete 

[Dai Bach y Sowldiwr]

Tuberculosis has a complicated natural history.

It was an extremely common disease anyway in the UK  up until the 1960s, amongst civilians and the military, so trying to attribute a source in that way would be impossible.

95% of people catch it without knowing about it and are generally immune to it for life.

But in some it can re-activate.

And the other 5% get a 'proper' infection in their lungs, bones, organs etc.

With these, many are fatal, in others, the infection can come and go over the years.

Trying to work backwards and prove where an infection came from is difficult even today.

Trying to show its origins over seveal decades between 80 - 100 years ago is impossible.

Have a read here to see the details:

https://en.wikipedia.org/wiki/Tuberculosis

[peter blackwell]

thankyou very much pete

[kenf48]

 

On 19/03/2019 at 08:47, peter blackwell said:

was it possible to get tuberculosis in the trenches?

 Do you mean by  “in the trenches” the Western Front?

 

If any recruit presented with tuberculosis from the 1st August 1914 to the end of 1917 they were rejected, or if found to have the disease, once serving, were discharged.  After 1917 men who had had no recurrence of the disease were accepted as medical category III.  That does not mean environmental factors did not play a part but generally speaking the soldiers who embarked to France were free of the disease but the conditions exacerbated underlying symptoms, an issue discussed at some length in the Official History Medical Services Pathology.  Over 90% of cases amongst the British troops were pulmonary tuberculosis, essentially a disease associated with the industrial areas of the U.K.

 

In 77% of these cases there was evidence it was a recurrence of the disease that men had been exposed to previously and had been missed on enlistment.  The OH concluded, while acknowledging the evidence was inconclusive, that the disease was progressive, rather than a sudden collapse, and surmised that while resistance had been built up by exposure to constant  small infections in an industrial environment the privations of trench life meant that resistance broke down and men began to present with the disease.

 

The OH notes that in India the incidence of the disease varied from region to region, but where the disease occurred on the Western Front amongst Indian and, to use the words of the OH ‘exotic’ troops, e.g Chinese Labour Corps and French colonial units it presented in a totally different clinical and epidemiological form, that of “glandular” or “abdominal” tuberculosis. There was strong evidence this was the bovine form acquired by drinking infected milk purchased locally.

 

On 20/03/2019 at 09:03, peter blackwell said:

My grandfather died TB in 1934 aged of 40,. i was told he possibly contracted it in either Gallipoli or india, i'm not sure.thanks pete 

 

The campaign in Gallipoli is not discussed in the Pathology section of the OH but  would present similar conditions of privation to those on the Western Front.  In addition to the fierce and bloody fighting there were extremes of weather as well as the endemic tropical diseases such as dysentery.

 

India was not a theatre of war, therefore no trenches, though depending where he was stationed he may have contracted the disease there.  

 

Incidentally as commented by Dai Bach above,  the Chapter on tuberculosis in the OH begins by stating:-

 “It will be some years before the investigation into the records of the war can afford full statistical data as to the incidence and mortality amongst the British troops, during the years of the war and it is safe to assume that, even when the records have been completely sorted out and analysed much of the truth will remain hidden.”

 

it appears your grandfather was on of those whose untimely death was ‘hidden’.

 

Interesting podcast on BBC Sounds

https://www.bbc.co.uk/sounds/play/p0230s9j

 

Ken

Edited 21 March , 2019 by kenf48

[peter blackwell]

would he have been discharged if he caught TB while serving? I know he reinlisted into the welsh regement in 1920, which would  seem to sugest he  could have contracted it. or it reactivated later thanks pete

[Dai Bach y Sowldiwr]

What ken48 says is quite correct.

The big caveat of course is that there is no black and white in the diagnosis of this disease.

The plan was meant to be that only healthy recruits were admitted and retained in the army, whereas TB infected recruits were discharged.

In the real world though, it is inevitable (even today) that depending only on clinical acumen to make the distinction will result in large numbers slipping through the net either way.

This meant that many men examined and found to have no evidence whatsoever of the illness, were in fact suffering from active TB.

I wouldn't myself agree with the wording of the OH that the cases were 'missed' (which to my mind implied misdiagnosed), rather, they were undiagnosed, or even undiagnosable on solely clinical criteria. Although radiograpy had been invented some years earlier, it was not at that time suitable as a reliable diagnostic tool for mass screening of suspected TB cases. And the Mantoux test (TB skin test) invented in the 1900s was unreliable until the development of PPD (Purified Tuberculin extract) in the 1930s.

 

So everything about this disease was shrouded in doubt- Who had it, who was healthy, how could you diagnose it for certain?

Even with the diagnosis, it was by and large untreatable.

Those were difficult enough questions even in a wealthy civilian society, but within a military setting where there were competing priorities for resources,the questions were unanswerable.

[kenf48]

4 hours ago, peter blackwell said:

would he have been discharged if he caught TB while serving? I know he reinlisted into the welsh regement in 1920, which would  seem to sugest he  could have contracted it. or it reactivated later thanks pete

 

It does suggest that, it is very unlikely he would have been accepted for re-enlistment had he presented with any history or symptoms of TB.  Those who re-enlisted were paid a bounty therefore unlike during the manpower crisis of 1918 there was more time for clinical examination (with the caveat noted above) and therefore the Army could screen recruits more effectively. Even when the Army accepted men in 1918  who had a history of the disease as Fitness Category C, in spite of the manpower shortage 3,874 conscripts were rejected for tubercular disease, to be accepted they had to have been free of the disease for a minimum of two years.

 

Had he contracted, or shown symptoms. of the disease whist on active service he would have been discharged and therefore one would expect to see a Silver War Badge, and often a pension if he could show the disease was attributable to war service.

 

3 hours ago, Dai Bach y Sowldiwr said:

 

I wouldn't myself agree with the wording of the OH that the cases were 'missed' (which to my mind implied misdiagnosed), rather, they were undiagnosed, or even undiagnosable on solely clinical criteria. Although radiograpy had been invented some years earlier, it was not at that time suitable as a reliable diagnostic tool for mass screening of suspected TB cases. And the Mantoux test (TB skin test) invented in the 1900s was unreliable until the development of PPD (Purified Tuberculin extract) in the 1930s.

So everything about this disease was shrouded in doubt- Who had it, who was healthy, how could you diagnose it for certain?

Even with the diagnosis, it was by and large untreatable.

Those were difficult enough questions even in a wealthy civilian society, but within a military setting where there were competing priorities for resources,the questions were unanswerable.

 

I fear 'missed' was my interpretation, the OH discusses 'latent re-activation of the disease'.  

Elsewhere in the 'Medical Services General History" (Vol 1) Macpherson discusses the examination of recruits and in particular how the process of medical examination was overwhelmed in 1914 and men were accepted who were clearly unfit for service as was borne out during training.  

 

I agree with your conclusions, trying to identify a source for the disease is impossible and the questions unanswerable, however that does not prevent us on the balance of probability and given the strict policy adopted by the Army towards the disease drawing the conclusion that it is unlikely he would be accepted for re-enlistment in 1920 had he contracted the disease at Gallipoli in1915.

 

Ken

[peter blackwell]

thankyou so much, i forgot to mention he was also a coal miner from 1911 to 1914, and 1924 untill his death in 1934

[Dai Bach y Sowldiwr]

4 hours ago, kenf48 said:

 that does not prevent us on the balance of probability and given the strict policy adopted by the Army towards the disease drawing the conclusion that it is unlikely he would be accepted for re-enlistment in 1920 had he contracted the disease at Gallipoli in1915.

 

Ken

Yes I agree.

 

2 hours ago, peter blackwell said:

thankyou so much, i forgot to mention he was also a coal miner from 1911 to 1914, and 1924 untill his death in 1934

That's extremely interesting Peter.

 

You've not told us where your grandfather was from, but I'll tell you something very interesting about coal miners, pneumoconiosis and tuberculosis in Wales.

In the South Wales coalfield, the further west you go, the harder the coal becomes.

The hardest Welsh Anthracite is west of Swansea in the Carmarthenshire field around Llanelli and the two Gwendraeth valleys.

The further east you go, the softer the coal becomes, so the big important deposits of Welsh Dry Steam  and bituminous coal are in the Rhondda, Aberdare & Taff Valleys, then east into Monmouthshire.

The experienced miners who had worked in the east and west could tell by the noise of the pick hitting the coal seam whether they were in Anthracite (ping!) or in steam coal (crunchy thud!).

Now, the harder the coal, the more silica it contains, and the more silica it contains, the more pneumoconiosis we find, from dust only anthracosis, to massive fibrosis, with bronchitis & emphysema.

And pro rata  there  was more pneumoconiosis the further west you went.

And with all that lung damage you would expect rates of TB in coal miners to be higher than in age and sex matched controls.

Except... they aren't.

Coal miners for some bizarre reason had lower rates of  Pulmonary Tuberculosis than the population at large, and that's why I found your grandfather's case so interesting. But remember, miners had a lower rate than the general population,  (not a zero rate), and of course in the early part of the 20th Century, TB rates were far far higher than today, and with no realistic effective treatment, that resulted in a lot of morbidity.

And I know from experience that trying to work out what the h*** was going on  on a Chest X Ray of a miner who already had Progressive Massive Fibrosis as a baseline, then getting superadded TB, was a bit of a black art.

 

And to go completely off topic, North  Wales slate quarrymen pro rata had a far higher incidence and a more severe silicosis than Anthracite coal miners,

and their incidence of Pulmonary TB was the highest of all!

[peter blackwell]

Thanks for your reply, my grandfather was from Wrexham, North East Wales, he was in the Royal Welsh Fusiliers for six years, and the Welsh Regement for four His name was Thomas Blackwell, and he worked at the Wesminister Colliery  I have included the 1911 census. And a copy of his death certificate

Edited 21 March , 2019 by peter blackwell

[peter blackwell]

[peter blackwell]

[Dai Bach y Sowldiwr]

The Denbighshire coalfield produced steam, bituminous and house coals with a bit of coking coal, so a softer coal than West Wales.

[peter blackwell]

Could this still have caused his TB? or could it just be that it was undiagnosed. pete

Edited 21 March , 2019 by peter blackwell

[Guest]

Mate,

 

I have a number of AIF soldiers who RTA due to illness (TB) relisted either for home service or a small number were sent back overseas.

 

Large numbers of the AIF soldiers I have were either discharged due to that illness on enlistment or were RTA due to it.

 

A small number did die post war, but not all.

 

records din't show where they picked this up (TB) but it was common in most civy life during that time, so the spread in Military service would be common due the grouping of soldiers in camp and transports.

 

Cheers

 

S.B

[Dai Bach y Sowldiwr]

17 minutes ago, peter blackwell said:

Could this still have caused his TB? or could it just be that it was undiagnosed. pete

No. As I mentioned before, coal miners had a lower incidence than the rest of the population (but still not a zero risk).

So him being a miner was not the reason for his TB.

He would have been infected sometime before this, you can't say from where - family, neighbour, a work colleague, you can't say.

He probably didn't have TB during any of his  army service, but you can never say 'Never', so most likely he was infected sometime between 1924 and 1933.

 

Edited 21 March , 2019 by Dai Bach y Sowldiwr

[peter blackwell]

thanks very much for your time and help. pete

[peter blackwell]

9 hours ago, stevebecker said:

Mate,

 

I have a number of AIF soldiers who RTA due to illness (TB) relisted either for home service or a small number were sent back overseas.

 

Large numbers of the AIF soldiers I have were either discharged due to that illness on enlistment or were RTA due to it.

 

A small number did die post war, but not all.

 

records din't show where they picked this up (TB) but it was common in most civy life during that time, so the spread in Military service would be common due the grouping of soldiers in camp and transports.

 

Cheers

 

S.B

Forgive me for sounding stupid, i don't understand AIF or RTA what do they mean? thanks Pete.

[rksimpson]

AIF = Australian Imperial Force

RTA = Return to Australia

 

regards

 

Robert

[peter blackwell]

thanks pete