TB drawings

We reported last month on a drawing found amongst the Alexander Miles case notes and this week we feature some more drawings from this case note collection. They are highly detailed drawings from 1919 showing the progress in treatment of a patient’s right elbow which contained tuberculosis (TB) in the joint. It is not known whether the drawings were used in teaching, but their discovery alongside the case notes would indicate that they were used solely for the purpose of treatment.

TB is a highly contagious disease, usually affecting the lungs but which can attack other parts of the body. It is spread through the air by coughing, sneezing or spitting. It was very common in Edinburgh throughout the 19th and the first half of the 20th centuries, with the poor condition of tenements and overcrowding leading to its spread throughout the population. The health of those affected declined slowly over a period of months and years, if untreated, meaning that they were able to move around the community spreading the infection.

Drawing of TB in joint found in Miles case notes

Dr Robert Philip’s famous ‘Edinburgh Scheme’ resulted in a decline in deaths from TB from 1899 onwards by identifying those with the disease and preventing its spread. Before the discovery of antibiotics, sanatoriums, such as the Royal Victoria Hospital, were built where early onset TB patients could recuperate with plenty of sunshine and fresh air whilst being kept separate from the rest of the population. Colonies such as Southfield and Polton opened to provide recovering patients with work in an environment conducive to their health. A concentrated effort was deemed essential to eradicate the disease and in 1958, a mass x-ray screening of the population for the disease took place. As a result of improvements in treatment from the 1950s there has been a steep decline in TB cases although there are still around 400 cases in Scotland every year.

Drawing showing progress of treatment of TB in joint