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The role of TB in the books
http://www.the-cbb.co.uk/viewtopic.php?f=8&t=9030

Author:  Alison H [ Mon Jan 24, 2011 10:20 pm ]
Post subject:  The role of TB in the books

Just following on from the discussions about a) the original location and b) Die Rosen :D . TB doesn't feature in the first book, and health generally isn't much of an issue apart from Joey's interesting-heroine-delicateness (I was going to put "delicacy" but it made her sound like something to eat). Then Robin comes along and suddenly everyone's on alert to spot early signs of TB, we're told that Mr Denny is living in the area because the air's good for his health, and then Jem sets up the San, and before long the school is putting huge emphasis on rich creamy milk and lots of fresh air, which were associated with preventing TB.

I've always wondered if EBD wanted to find a husband for Madge and needed a reason for a wealthy, solvent, professional class Englishman to move to the Briesau area and the rest developed from there, or if she decided that setting up a sanatorium nearby was a good way of enlarging the CS community - providing extra pupils and a supply of suitable husbands and decided to marry Madge off to a doctor as a way of linking the two organisations.

The original point was that the school starts off as An English School Abroad, and it soon turns into A School Linked With A San, and I wonder when and why EBD decided to do that - what do people think?

(Of course, it could just be that she borrowed the idea from EJO's Swiss books ... :wink: )

Author:  Mel [ Mon Jan 24, 2011 11:06 pm ]
Post subject:  Re: The role of TB in the books

Certainly the San started to influence the school from quite early on. I can understand it in Tyrol, but it does get to be jarring later. I'm thinking Of Gay where wicked Miss Bubb doesn't understand the close connection. It was part of Dr Jem's careful programme that the girls had exams outside - and this is in the UK!

Author:  Cosimo's Jackal [ Mon Jan 24, 2011 11:14 pm ]
Post subject:  Re: The role of TB in the books

Largely irrelevant to your question, Alison (sorry!), but I never thought of it like that before - why isn't everyone on the lookout for TB with Joey? She's continually unwell with chest ailments since an early attack of pneumonia, and has a persistent cough and is described as 'delicate and shouldn't live in a wet climate' at the start of School At - but, as you say, TB is never mentioned as a fear for her at all, despite the fact she seems like an obvious candidate.

Then from the time the San and school become intertwined and Robin, another delicate child, arrives, everyone's in continual fear of TB for her, and potentially for any other 'fragile' girls. Is the difference that Joey doesn't have a family history of TB and Robin and the others do? Or is it just that the presence of the San and a noted TB expert gives Madge the idea of a special 'TB link' and consequently puts the idea of susceptibility to TB into everyone's minds...?

Author:  lindsabeth [ Tue Jan 25, 2011 3:52 am ]
Post subject:  Re: The role of TB in the books

Alison H wrote:
I've always wondered if EBD wanted to find a husband for Madge and needed a reason for a wealthy, solvent, professional class Englishman to move to the Briesau area and the rest developed from there


Maybe she wanted Madge to play a lesser role in the series so she married her off. I really like Madge as a character at the beginning of the series, but she becomes less prominent throughout. Perhaps she wanted Joey to be the solo heroine. I don't know about other people, but reading the first books as a child, I tended to group Madge and Joey together and think of them as The Main Characters. Creating Jem and the san would allow Madge to be featured less while still remaining connected to the school. I don't know why she'd want to feature Madge less, but I always did think it was strange how she goes from being such an important character to hardly being mentioned at all...

Author:  Alison H [ Tue Jan 25, 2011 9:00 am ]
Post subject:  Re: The role of TB in the books

From Madge's point of view, she'd never intended to become a schoolmistress or to run her own business, and she'd probably always imagined that at some point she'd get married and spend her life being a housewife and maybe getting involved in charity work. There's no suggestion that she ever had a job in Taverton. So marrying Jem took her back to what the pattern of her life would probably have been anyway if the family hadn't run into financial problems. But she does still feature in a big way whilst the school's in Tyrol, and even whilst it's in Armishire: she's not necessarily as involved in school affairs, but we get a lot of scenes at Die Rosen.

Then EBD just seems to decide to push her out of the way: first she spends a couple of years in Canada, and then she and Jem are left behind when the school goes to Switzerland - the arguments for them not moving make sense, but equally good arguments for them moving would have made sense too. Maybe EBD did just want Joey to take over, and felt that there was no room for two adults who weren't on the CS staff to be involved in the books. It could also explain why Robin was packed off to Canada: she could just as soon have entered a convent in Switzerland and so been near the school.

I always feel that Jem never gets enough credit in the books: he's one of the world's leading experts in what really was the scourge of the Western world at the time: the statistics for the proportion of the population for whom the cause of death was TB are frightening, certainly in the late 19th century and even by early CS times. But by the later books, the main role of the doctors seems to be fishing people out of lakes or retrieving them from craters on cricket pitches :roll: :lol: .

Author:  Caroline [ Tue Jan 25, 2011 10:22 am ]
Post subject:  Re: The role of TB in the books

Perhaps she'd read the various EJO books which feature an English school situated near to a sanatorium (in Switzerland, rather than Austria) and thought "hmmm, interesting idea...".

The first two of EJO's Swiss set were published in 1921 and 1922...

Author:  Cosimo's Jackal [ Tue Jan 25, 2011 10:43 am ]
Post subject:  Re: The role of TB in the books

Alison H wrote:

Maybe EBD did just want Joey to take over, and felt that there was no room for two adults who weren't on the CS staff to be involved in the books. It could also explain why Robin was packed off to Canada: she could just as soon have entered a convent in Switzerland and so been near the school..


I can entirely see why EBD would do this - apart from anything else, her cast of characters is just too huge to keep track of by the Swiss period, so there's a logic to getting rid of as many characters as she can. Only then she does keep an awful lot of ex-mistresses on the Platz, as well as reintroducing people like Winnie Embury, Grizel and Stacie - and lots of others - which doesn't make a lot of sense if we think of her as trying to slim down her cast of non-school characters...?

Alison H wrote:
But by the later books, the main role of the doctors seems to be fishing people out of lakes or retrieving them from craters on cricket pitches :roll: :lol: .


I can't help laughing at the bit in Coming of Age when Joey is talking about selling Plas Gwyn, and how she has to go back to England to close it up - she says that 'Jack can't be spared, of course', but that Laurie Rosomon can, so he and Daisy are coming with her to help her! Now, just maybe Laurie was already booked for a holiday from the San (though helping Joey get the international movers in doesn't sound like a lot of laughs for a holiday for him and Daisy, I must say!), but it does sound slightly as if San Heads Are Really Important; Ordinary Doctors, Not So Much! :)

Would still be interesting in anyone else's thoughts on why no one appears to think Joey is at significant risk for TB at the start of the series, given her susceptibility to chest ailments and chronic ill-health...?

Author:  Alison H [ Tue Jan 25, 2011 11:19 am ]
Post subject:  Re: The role of TB in the books

Cosimo's Jackal wrote:
Would still be interesting in anyone else's thoughts on why no one appears to think Joey is at significant risk for TB at the start of the series, given her susceptibility to chest ailments and chronic ill-health...?


I don't know :? . There's not a lot of consistency in who is and isn't considered to be at risk. Robin is watched like a hawk because her mother died of TB, yet no-one seems to think that Gillian and Joyce Linton, whose mother also died of TB, are at any more risk than anyone else.

Author:  julieanne1811 [ Tue Jan 25, 2011 3:59 pm ]
Post subject:  Re: The role of TB in the books

Caroline wrote:
Perhaps she'd read the various EJO books which feature an English school situated near to a sanatorium (in Switzerland, rather than Austria) and thought "hmmm, interesting idea...".

The first two of EJO's Swiss set were published in 1921 and 1922...


What are the titles please?

Author:  Alison H [ Tue Jan 25, 2011 4:04 pm ]
Post subject:  Re: The role of TB in the books

EJO's Swiss books are mentioned in the bit in tiny writing at the end of my opening post :wink: .

The titles are:

Two Form Captains
The Captain of the Fifth
Camp Mystery
The Troubles of Tazy
Patience and her Problems

They feature an incredibly sweet couple called Karen and Rennie who are one of my favourite couples in any GO books, and a proposal (to Tazy of "The Troubles of Tazy") which makes Reg Entwistle's look like the most romantic effort ever :lol: . Some of the character's feature in Rosalin's (sadly as yet unfinished) drabble here.


ETA - maybe EBD also just had a general thing about the idea of doctors as romantic heroes.

Author:  emma t [ Tue Jan 25, 2011 6:44 pm ]
Post subject:  Re: The role of TB in the books

Does anyone else think that EBD might have married Madge off to Jem so he could also be on hand to look after Joey when she is ill? It's an interesting theory that no-one was on the look out for TB with Joey, looking back, you would have thought that Jem would have been onto it like a shot.

Author:  ClaireK [ Tue Jan 25, 2011 7:17 pm ]
Post subject:  Re: The role of TB in the books

Alison H wrote:
Cosimo's Jackal wrote:
Would still be interesting in anyone else's thoughts on why no one appears to think Joey is at significant risk for TB at the start of the series, given her susceptibility to chest ailments and chronic ill-health...?


I don't know :? . There's not a lot of consistency in who is and isn't considered to be at risk. Robin is watched like a hawk because her mother died of TB, yet no-one seems to think that Gillian and Joyce Linton, whose mother also died of TB, are at any more risk than anyone else.


There was a fear that TB could be transmitted to a baby while the mother was pregnant - so if Robin's mother had TB before she was born, this would account for their fears. ANd if Mrs Linton only developed the illness after her children were born, there would not be the same fears. I was born in 1963 and was given the BCG at 6 weeks, as my mother had had TB during the war and the doctors were worried about the risks.
Rather ironically, we now know of the risks of catching TB by prolonged contact with a sufferer, which rather makes all these visits by schoolgirls to the San rather suspect!

Author:  MJKB [ Tue Jan 25, 2011 7:22 pm ]
Post subject:  Re: The role of TB in the books

I'm a little confused as to whether TB and Consumption are one and the same disease. Anyone know for definite? In the Ireland of the 30's and 40's, TB/Consumption was regarded very much the way AIDs was in the 80s and 90s. Men, especially were reluctant to marry a girl who had TB in her family. Recovering Consumptives were warned against getting married by their doctor.

Author:  KathrynW [ Tue Jan 25, 2011 7:28 pm ]
Post subject:  Re: The role of TB in the books

MJKB wrote:
I'm a little confused as to whether TB and Consumption are one and the same disease. Anyone know for definite? In the Ireland of the 30's and 40's, TB/Consumption was regarded very much the way AIDs was in the 80s and 90s. Men, especially were reluctant to marry a girl who had TB in her family. Recovering Consumptives were warned against getting married by their doctor.


Pretty much - according to wikipedia (the source of all knowledge) consumption is an old name for pulmonary TB which is what I've always thought.

Author:  ClaireK [ Tue Jan 25, 2011 7:29 pm ]
Post subject:  Re: The role of TB in the books

MJKB wrote:
I'm a little confused as to whether TB and Consumption are one and the same disease. Anyone know for definite? In the Ireland of the 30's and 40's, TB/Consumption was regarded very much the way AIDs was in the 80s and 90s. Men, especially were reluctant to marry a girl who had TB in her family. Recovering Consumptives were warned against getting married by their doctor.

Yes, they are.
As proven by my mother (now 84!) you can have TB in the 1940s and still go on to get married, have children, work as a teacher and lead a totally normal life. So that medical advice was completely wrong.
BTW - my mother was *never* told such a thing, nor did she get any special pre-natal care. All that happened was that my sister and i were both vaccinated against TB at 6 weeks. And neither of us contracted the diesase either. Not were we specially monitored.

Author:  KathrynW [ Tue Jan 25, 2011 7:36 pm ]
Post subject:  Re: The role of TB in the books

ClaireK wrote:
As proven by my mother (now 84!) you can have TB in the 1940s and still go on to get married, have children, work as a teacher and lead a totally normal life. So that medical advice was completely wrong.
BTW - my mother was *never* told such a thing, nor did she get any special pre-natal care. All that happened was that my sister and i were both vaccinated against TB at 6 weeks. And neither of us contracted the diesase either. Not were we specially monitored.


My grandmother had TB when she was pregnant with my mother and it resulted in my mother being taken into care for a while (as my grandmother was too sick to look after her). The doctors also think that the drugs my grandmother was on seriously damaged my mother's kidneys so I can understand the concern although it may not be such a danger if you've had and recovered from TB.

Author:  Cosimo's Jackal [ Tue Jan 25, 2011 7:41 pm ]
Post subject:  Re: The role of TB in the books

MJKB wrote:
I'm a little confused as to whether TB and Consumption are one and the same disease. Anyone know for definite? In the Ireland of the 30's and 40's, TB/Consumption was regarded very much the way AIDs was in the 80s and 90s.


Same thing, but consumption is the older name - because it often caused rapid weight loss, so it looked as if the sick person was being 'consumed'.

Though the thing I'm not sure about is whether you would correctly have used the term 'consumption' to designate the non-pulmonary type of TB. I know most cases are the type that attacks the lungs, but the CS does refer at one point to one of the other kinds, in bones. (Jem or Jack's research, or a conference, or something?) My sense is that you wouldn't have said someone had 'consumption of the spine', you'd have said 'spinal TB'...?

Absolutely on the stigma traditionally associated with consumption in Ireland - I remember being surprised as a child reading Victorian novels in which beautiful heroines wasted gracefully away from consumption, because they made it sound bizarrely ladylike, even glamorous!

But it's interesting that, for EBD, there appears to be no stigma at all associated with TB sufferers or Sans during the 30s and 40s. My mother remembers regularly passing a TB San on the bus in the 50s, and people telling one another to hold their breath as they went past, so they didn't catch anything, and anyone getting off to go and visit a patient was looked on with suspicion! The San on the Sonnalpe - and the CS - would have been very different places if TB was greeted with such fear and horror by the surrounding population, and of course, no parent of a healthy child would have wanted to send their daughter to a school viewed as a potential source of infection! Plus in Ireland it was seen as a disease associated with poverty and over-crowding, so the idea of an expensive boarding school with a TB San affiliation would be seen as a very odd idea!

Was there no stigma at all associated with TB in the UK when EBD introduced the TB storyline?

Author:  ChubbyMonkey [ Tue Jan 25, 2011 8:06 pm ]
Post subject:  Re: The role of TB in the books

Alison H wrote:
Then EBD just seems to decide to push her out of the way: first she spends a couple of years in Canada, and then she and Jem are left behind when the school goes to Switzerland - the arguments for them not moving make sense, but equally good arguments for them moving would have made sense too.


She was sick of Jem taking over and bossing her :wink: Also, what with Joey needing to be in control of everything, she couldn't have both of them in as confined a place as the Platz. They'd have been fighting after a few days!

Author:  sealpuppy [ Tue Jan 25, 2011 8:22 pm ]
Post subject:  Re: The role of TB in the books

The impression I've always had is of TB as something 'scary' and carrying, if not a stigma, then a definite 'do not approach' sort of impression! Even now the headlines are panicky if there's a case anounced.

Re Joey as a child. I always took it for granted that they were worried about Jo's constant attacks of bronchitis as likely to develop into TB and that was why they chose a mountainous area. Maybe EBD assumed her readers would be familiar with this reasoning and didn't think it needed stating?

As Jem is referred to in the first book as 'Mr Russell' I imagine it wasn't EBD's original intention to make him a doctor, but that, as suggested earlier in this thread, when she needed a potential husband for Madge, the doctor/San idea sprang to mind. (Plus she'd probably remembered the EJO books. :) )

I've always liked Jem; I like people who are confident in their own skins - but then, as an insecure twitching marshmallow, I would do! I'm sure Madge didn't really put up with his Doctor as God manner, but that she let EBD think it; plus Jem probably couldn't stand EBD reporting their every conversation so he laid it on thickly to get her off their backs!

(OK, backs away slowly - I'm in danger of thinking these are real people. :? )

Author:  ClaireK [ Tue Jan 25, 2011 8:52 pm ]
Post subject:  Re: The role of TB in the books

KathrynW wrote:
My grandmother had TB when she was pregnant with my mother and it resulted in my mother being taken into care for a while (as my grandmother was too sick to look after her). The doctors also think that the drugs my grandmother was on seriously damaged my mother's kidneys so I can understand the concern although it may not be such a danger if you've had and recovered from TB.


Funnily enough, my mum had kidney disease too and had to ahve a kidney removed between having my sister and then myself. Her doctors never related that to the TB drugs though, but you have made me wonder.

Author:  Alison H [ Tue Jan 25, 2011 9:50 pm ]
Post subject:  Re: The role of TB in the books

Cosimo's Jackal wrote:
Was there no stigma at all associated with TB in the UK when EBD introduced the TB storyline?


I don't think there was as much as there seems to've been in Ireland but, as you say, it's often associated with poverty and overcrowding, especially in industrial cities. The main industries in our area were coal and cotton, so people often inhaled a lot of dust at work and had lung problems anyway, and TB was rife, but if people from round here went to sanatoria they were usually either local or in British seaside resorts, whereas the sort of people who could afford to go abroad would be the sort who could afford expensive school fees ... if that makes sense!

I remember once going somewhere from school and a rather elderly bus taking us (our school didn't have the best of reputations with the bus companies, which was probably why we didn't get a shiny new one!) and there being "No spitting" notices on it, like there used to be in a lot of places. One precaution that EBD never feels the need to mention.

Author:  MJKB [ Tue Jan 25, 2011 11:03 pm ]
Post subject:  Re: The role of TB in the books

ClaireK wrote:
As proven by my mother (now 84!) you can have TB in the 1940s and still go on to get married, have children, work as a teacher and lead a totally normal life. So that medical advice was completely wrong.


Absolutely, but that didn't stop doctors giving out that advice then. A close friend of my mother's was diagnosed as being in the early stages of the disease at the age of 14 in the 1930s. She subesquently spent three years in hospital fighting the disease, and before she was finally released at the age of 17, her doctor very nearly extracted an oath from her never to marry. One of her three sisters died of the disease as a young child, and one of her two remaining sisters was 'watched' carefully as she showed various symptoms. The two sisters married but neither had children, and my mother's friend remained single, as she would as soon jump off a cliff as disobey the doctor. She died two years ago at the age of ninety, the last of the 'girls' in her family to go. Her nephew, an ENT man operated on my 16 year old last September, and we got to talking about the devastation caused by TB in the early-middle 20th century. He and two of his brothers who are also doctors, one a heart specialist, the other a pulmonolgist (?) think that TB may caused infertility in their two married aunts.

Author:  KB [ Tue Jan 25, 2011 11:23 pm ]
Post subject:  Re: The role of TB in the books

One thing I find very interesting is that, for all of the emphasis about the number of girls who have relatives at the San, when you sit down and work it out at any given point in the series, there aren't actually all that many. This is the list of contacts I have for the period of Jo Returns/New:

Louise Redfield - brother Leonard
Anne Seymour - aunt Lucia
Gillian and Joyce Linton - mother
Marie Varick - mother
Greta and Ailsa McDonald - father

Have I missed anyone?

Author:  Mel [ Tue Jan 25, 2011 11:27 pm ]
Post subject:  Re: The role of TB in the books

Lorna Hill's Ella is sent to Switzerland to recuperate from pneumomia(I think) and thinks that she has TB and will never be able to dance again. She regards it with shame, but of course has been brought up by nasty working class characters!

Author:  JB [ Tue Jan 25, 2011 11:46 pm ]
Post subject:  Re: The role of TB in the books

KB wrote:
Have I missed anyone?


Elsie Carr's sister Lilias is a San patient.

Alixe von Elsen's mother is under observation at the San in Jo Returns.

Author:  Alison H [ Tue Jan 25, 2011 11:54 pm ]
Post subject:  Re: The role of TB in the books

*With historian's hat on*
It killed several of the Tudors, and I think a number of French kings too, but by CS times I'd think it'd've been associated more with poverty and urban industrial areas.

There's a Wikipedia article here about TB in popular culture (I'd add the CS on to it if I knew how to!).

Author:  KB [ Wed Jan 26, 2011 12:34 am ]
Post subject:  Re: The role of TB in the books

JB wrote:
KB wrote:
Have I missed anyone?


Elsie Carr's sister Lilias is a San patient.

Alixe von Elsen's mother is under observation at the San in Jo Returns.


Thanks. Actually Lilias is a bit confusing because in Lintons she is "cured now, and was only remaining on in the Tyrol till the summer as an extra precaution" but is only "practically cured" in New. But I'd forgotten Alixe's mother.

Author:  Cel [ Wed Jan 26, 2011 1:19 am ]
Post subject:  Re: The role of TB in the books

Cosimo's Jackal wrote:
But it's interesting that, for EBD, there appears to be no stigma at all associated with TB sufferers or Sans during the 30s and 40s. My mother remembers regularly passing a TB San on the bus in the 50s, and people telling one another to hold their breath as they went past, so they didn't catch anything, and anyone getting off to go and visit a patient was looked on with suspicion! The San on the Sonnalpe - and the CS - would have been very different places if TB was greeted with such fear and horror by the surrounding population, and of course, no parent of a healthy child would have wanted to send their daughter to a school viewed as a potential source of infection! Plus in Ireland it was seen as a disease associated with poverty and over-crowding, so the idea of an expensive boarding school with a TB San affiliation would be seen as a very odd idea!

Was there no stigma at all associated with TB in the UK when EBD introduced the TB storyline?


Thinking back on it, EBD doesn't really treat TB as an infectious disease, does she? There are lots of precautions for those who have it, in terms of getting plenty of rest and not being allowed to 'fret' and so on, but no sense at all of having to protect others from the risk of infection. And presumably the fear of catching it is what led to the stigma in real life. I wonder... was the infectivity of TB not well understood at the time she was writing? Must do some research...

Author:  lindsabeth [ Wed Jan 26, 2011 3:54 am ]
Post subject:  Re: The role of TB in the books

I get the impression EBD didn't know that much about it, nor about other illnesses in general. I don't think it occurred to her that Joey's symptoms at the beginning of the series sound an awful lot like TB.

This discussion has made me want to read through all the books for descriptions of illnesses just to see how she described them and what the similarities/differences were between them... :)

Author:  Alison H [ Wed Jan 26, 2011 8:44 am ]
Post subject:  Re: The role of TB in the books

There's a lot of vagueness. Robin's mother's illness is initially described as "rapid decline". Margot Venables just "slips out of life" despite only being in her 40s and having been well enough to work as a CS matron not long before. Erica's mother's illness isn't specified. & a lot of people are just described as being "delicate".

There doesn't seem to be any concept of TB being infectious. I appreciate that EBD wouldn't have wanted to harp on about "No spitting" or "Coughs and sneezes spread diseases", but there's a lot of emphasis on other measures thought to have been effective in preventing TB - fresh air, milk, etc - and none on isolating patients and avoiding people who were infected.

Author:  JB [ Wed Jan 26, 2011 10:06 am ]
Post subject:  Re: The role of TB in the books

The only reference that comes to mind which might hint that TB was infectious is in Lintons when Sir James Talbot tells Mrs Linton that she shouldn't go to the cinema.

Quote:
On the Saturday, there was trouble with Joyce, who wanted her mother to take them to the local cinema to see a big picture. Mrs Linton was obliged to refuse, for all public assemblies had been forbidden her.

Author:  Llywela [ Wed Jan 26, 2011 10:16 am ]
Post subject:  Re: The role of TB in the books

This is a really interesting discussion.

We had a woman in my church when I was growing up who'd spent several years away at a TB sanatarium when she was a teenager back in the 40s. She lived to her 70s, but was always rather frail and never had any children - I don't know, though, whether she couldn't have any or had been told not to.

My grandmother had a sister who died of tuberculous meningitis in the early 30s - I don't know how common that strain of the disease was, but it's one that EBD certainly never mentions. I'd never heard of it until I saw my great-aunt's death certificate recently; the family only ever said that she'd died of TB. She was one of 12 children who lived together in fairly cramped, very working class surroundings, but none of the others ever became ill.

Author:  Cosimo's Jackal [ Wed Jan 26, 2011 12:44 pm ]
Post subject:  Re: The role of TB in the books

JB wrote:
The only reference that comes to mind which might hint that TB was infectious is in Lintons when Sir James Talbot tells Mrs Linton that she shouldn't go to the cinema.

Quote:
On the Saturday, there was trouble with Joyce, who wanted her mother to take them to the local cinema to see a big picture. Mrs Linton was obliged to refuse, for all public assemblies had been forbidden her.


That's right - I remember noticing that, when there's no suggestion elsewhere that infection may be an issue with TB, for instance, when visiting the San - despite the fact that the CS is very alert to isolating girls with other infectious illnesses, like measles, and the girls aren't allowed to go into shops in New CS during the smallpox outbreak in the area.

People have pointed out lots of times the irony of Joey being annoyed that a girl who's had prolonged contact with a TB case doesn't kiss a child who's considered a TB risk - but also, there's never any mention of Joyce and Gillian being checked out by a doctor before or after arriving in Austria, to see whether they mightn't have been infected by their mother, who's clearly at a quite advanced stage of ilness...? It's true that most of the time, EBD doesn't seem to think of it as an infectious disease.

Also, what about the doctors and nurses who cared for TB patients atthe San longterm? Pre BCG, wouldn't they have been at risk, too? I remember in The Nun's Story, Sister Luke volunteers for TB nursing because she's already had it herself, and says she has a resistance established.

Author:  Eilidh [ Wed Jan 26, 2011 1:08 pm ]
Post subject:  Re: The role of TB in the books

Isn't there a bit in Challenge where Evelyn goes to bend over her mother while she's coughing and her mother pushes her away? I can remember the scene, but I'm at work so can't put in the quote.

Author:  julieanne1811 [ Wed Jan 26, 2011 4:46 pm ]
Post subject:  Re: The role of TB in the books

We have a local hospital here called colloquially 'Milford Chest'. Patients were sent from London to be treated for TB in the country. When I was a child in the 1960s we had a village carol singing thing - we'd dress up in red velvet cloaks and bonnets and go around to hospitals, parties and the village singing. Well, we used to go to Milford Chest - it was way in the country and each ward was a seperate bungalow. They were reached by going along covered walkways. We (the children under 13, I think it was) were sllowed in all but one, where the most acutely ill patients were - there was a sign up syaing that no-one under that age was allowed into that ward, so the adults wold go and we had to wait outside. That was the best place though - the tea we were always given was delicious!

I had my BCG at 13 or so but it's not given as routine now, I think. It was thought that my maternal grandmother had died of TB when I was about 4 or 5 - I remember going to Milford Chest for a chest X-Ray and having a BCG then - although she actually died of lung cancer, not TB at all, which says something pretty bad about basic diagnosis in the early 60s. Anyway, I had to have another BCG when I started nursing in 1979 - I had thought that it lasted all your life, but that's not necessarily the case, apparently. So that would mean that even those who care for people with TB would need routine chest X-Rays and vaccination if necessary.

It is odd then that Elinor didn't seem to recognise TB has infectious, isn't it? She definately went much more down the hereditary persuasion. And even believing that, she accorded no special 'care' of people who had direct links. Apart from the Robin.

Author:  Alison H [ Wed Jan 26, 2011 5:35 pm ]
Post subject:  Re: The role of TB in the books

Jem's supposed to be one of the world's leading experts, which suggests that he's doing research and probably conducting trials of drugs, surgical procedures and other treatments, but that never really comes across in the books.

Author:  Llywela [ Wed Jan 26, 2011 5:47 pm ]
Post subject:  Re: The role of TB in the books

Alison H wrote:
Jem's supposed to be one of the world's leading experts, which suggests that he's doing research and probably conducting trials of drugs, surgical procedures and other treatments, but that never really comes across in the books.

So true! It comes across more as if he devises his exemplary TB-curing regime very early on and then sticks to it rigidly.

Author:  sealpuppy [ Wed Jan 26, 2011 6:07 pm ]
Post subject:  Re: The role of TB in the books

Slightly OT: It's not just EBD who seems not to think of TB as infectious. My favourite Charlotte Yonge book, Pillars of the House, opens with the delicate curate dying of TB and on the day he actually dies, his last children are born - twins, the 12th and 13th children. He hears the babies cry, asks to have them brought to him to bless them, kisses them :shock: , and promptly dies. CMY seems to think this is a sign of his extreme saintliness as a father, but to a modern reader it's evidence of extreme fecklessness and criminal stupidity!
(He leaves an invalid wife (semi-dotty) and a 16 year old boy in charge of the huge family.)

Author:  MaryR [ Wed Jan 26, 2011 6:39 pm ]
Post subject:  Re: The role of TB in the books

Cosimo's Jackal wrote:
Absolutely on the stigma traditionally associated with consumption in Ireland


Oh yes! When I was diagnosed with TB in the uterus in 1977 when I was 31 (and hence rendered infertile) my very Irish mother had me at death's door and wept for weeks. Great medicine! :roll: I don't think she ever totally convinced herself that the cocktail of drugs cured me.

Author:  MJKB [ Wed Jan 26, 2011 7:01 pm ]
Post subject:  Re: The role of TB in the books

Interestingly, Marilla in Island is worried about Anne visiting Ruby Gillis because she's afraid of infection. LM. Montgomery appears to treat this as ignorance of the disease on Marilla's part.

Author:  whitequeen [ Wed Jan 26, 2011 7:28 pm ]
Post subject:  Re: The role of TB in the books

MJKB wrote:
Interestingly, Marilla in Island is worried about Anne visiting Ruby Gillis because she's afraid of infection. LM. Montgomery appears to treat this as ignorance of the disease on Marilla's part.



oh yes, I was actually just wondering if it was TB that Ruby had because I couldn't remember - only that she didn't seem to realise/accept that she was sick.

Author:  MJKB [ Wed Jan 26, 2011 7:37 pm ]
Post subject:  Re: The role of TB in the books

They called it 'galloping consumption', which presumably was a very aggressive form of TB.

Author:  KB [ Wed Jan 26, 2011 10:03 pm ]
Post subject:  Re: The role of TB in the books

Eilidh wrote:
Isn't there a bit in Challenge where Evelyn goes to bend over her mother while she's coughing and her mother pushes her away? I can remember the scene, but I'm at work so can't put in the quote.


Yes, you're quite right:

Quote:
In her anxiety Evelyn forgot that she had been warned not to stoop over her mother. Mrs Ross did not forget. Fighting with the cough, she pushed the girl back with all her feeble force, “No! Keep away! I’ll be – all right – in a – moment!”

Author:  Mia [ Wed Jan 26, 2011 10:42 pm ]
Post subject:  Re: The role of TB in the books

Also, IIRC, Mrs Ross's nurse slips on her mask before going to her patient? It would be a bit odd EBD not knowing that TB was contagious - she grew up in the industrial North.

Author:  julieanne1811 [ Wed Jan 26, 2011 11:17 pm ]
Post subject:  Re: The role of TB in the books

I'm pondering on the title of this thread - 'the role of TB in the books', and it's made me wonder what the role actually is/was ... was it to provide extra characters? Or to provide doctors so that other characters could marry? It certainly gives the chance to have some back stories for some people. Is there anything else?

Author:  Alison H [ Thu Jan 27, 2011 12:04 am ]
Post subject:  Re: The role of TB in the books

I think it influences the whole ethos of the school. When the school first opens, its ethos is being An English School Abroad - it's all about playing jolly pranks as mentioned in English school stories, having a school magazine because someone read about one in an English school story, celebrating Madge's birthday for the same reason, making sure that everyone speaks English all the time, etc. Then it evolves into A Very Cosmopolitan School and it's all about being trilingual, Protestant girls attending Catholic services if they want to, wearing nailed boots in bad weather unlike the Silly Saints, and so on.

Then, by the end of the Austrian era, the school's main concern seems to be health. A separate establishment's opened for "delicate" girls, and there's huge emphasis given to fresh air, drinking lots of milk, getting plenty of rest, and so on. By the time Miss Bubb arrives, it's got to the point where everything she wants to do is dismissed on the grounds that it might interfere with the girls' health, and Matron proclaims that she'll get Jem in to tell Miss Bubb that there's no way she should be thinking about such unimportant things as exam results and university entrance rather than fresh air and plenty of rest! & in the Swiss books we're always being told that no-one's allowed to work too hard (although they all get into Oxford anyway!), and the concerns about health would explain why everyone's so obsessed with fresh air and exercise that lessons are frequently abandoned in favour of going out and enjoying the nice weather.

Just my humble opinion :D , but I'd think that the original idea of the San was to provide extra characters and to enable Madge to get married without ending her involvement with the school, but that the health issue kind of took over.

Author:  MJKB [ Thu Jan 27, 2011 12:26 am ]
Post subject:  Re: The role of TB in the books

Alison H wrote:
Just my humble opinion :D , but I'd think that the original idea of the San was to provide extra characters and to enable Madge to get married without ending her involvement with the school, but that the health issue kind of took over.
Post P

I think that sums it up nicely. What could be more romantic for the heroine of any novel than marriage to a brilliant young physician, whose life's ambition is to eradicate the most feared and destructive disease of the age. There's almost a God like aura about the medical staff of the san. It's also significant, imho, that Jem, the original hero of the series, remains leading medic and Jack his deputy.

Author:  Alison H [ Thu Jan 27, 2011 8:04 pm ]
Post subject:  Re: The role of TB in the books

MJKB wrote:
. It's also significant, imho, that Jem, the original hero of the series, remains leading medic and Jack his deputy.


That always gives me a great sense of satisfaction, because it annoys me that Madge was relegated to the sidelines when the school moved to Switzerland. I'm not sure that this is how EBD intended us to see it :lol: , but I always feel that Jack's like Mr Bingley compared to Jem's Mr Darcy - he's a very good catch on his own merits, but he's nowhere near as important, as wealthy or as well-connected as his friend. I don't think EBD would have wanted zany Joey becoming Lady Maynard, but normally the heroine of a book/series gets the top man whereas her sister has to settle for his less eligible friend/younger brother, and I wonder if it occasionally rankled with EBD that she ended up with a situation whereby Joey couldn't really stay near the school if she married someone other than Jem's junior :wink: .

Author:  shesings [ Thu Jan 27, 2011 9:33 pm ]
Post subject:  Re: The role of TB in the books

TB was a frightening shadow that hung over all my girlhood. My father was invalided out of the Navy with TB just before I was born and my mother died of tuberculous meningitis when I was two and my brother was five.
We were both checked and X-rayed much more than would be thought advisable nowadays and my father worried if we coughed, had a headache or, particularly, a nose bleed.

My poor mother had been in the sanatorium for months and we weren't allowed anywhere near her. She could just look over the verandah at us, not even allowed to wave.

She was hoping to get home for a weekend visit, so, for fear the visit would be cancelled, she didn't tell the staff she had a headache and persuaded her younger sister to take home her blood-stained hankies to wash.

Sadly, it caused a bitter family quarrel which wasn't resolved for years. My mother's family blamed my father for infecting my mother. My father and his family blamed my aunt for hiding the hankies. Both my father and brother spent time in a sanatorium in the early 50s but I was more fortunate.

Author:  Llywela [ Fri Jan 28, 2011 11:40 am ]
Post subject:  Re: The role of TB in the books

Wow, that's a terrible story, shesings - your poor family. Whenabouts did all this happen? My great-aunt who died of tuberculous meningitis in the early 30s must have been ill for quite some time, but as far as I know she was never hospitalised and certainly was never sent away to a sanatorium - she died in her own home with the family in attendance (she'd have been in her mid-20s). There aren't any stories in the family about fear of infection or any follow up for the rest of them, and they were a big family living at close quarters - but then again, there is no one left now to ask for more detail about what actually happened back then and how it was dealt with, so if no stories were passed down, they are lost for good.

Author:  Alison H [ Fri Jan 28, 2011 3:12 pm ]
Post subject:  Re: The role of TB in the books

I know that a lot of people from the Manchester and Liverpool areas were sent to either Southport or the North Welsh coast, as the sea air was thought to be good for TB sufferers, and there were also sanatoria in rural parts of Cheshire. I think there was a sanatorium in Abergele which was specifically for children from the Manchester area: the authorities genuinely believed that they were doing their best for them by sending them away from polluted industrial urban areas, even though it meant separating them from their families, and you can see their point. It never seemed to be a problem for people like the Carrs and the Redfields to move their whole families to Tyrol, even though presumably it meant the dads giving up their jobs temporarily, but surely very few people would've had that option realistically, even with a sanatorium in the same country.

IIRC, Mary-Lou says something assuming that Sir Guy Rutherford won't be able to move to Switzerland when Alix is being treated (although I think he does in the end), but with other families it never seems to be an issue.

That's so sad, shesings.

Author:  JB [ Fri Jan 28, 2011 3:28 pm ]
Post subject:  Re: The role of TB in the books

There were a couple of sanitoria near here - one just down the road and another on the edge of Morecambe Bay.

Wrightington Hospital near Wigan was a TB hospital. When I was in there in the summer, the staff still referred to one half of the ward as "the verandah". It must have been open to the elements at one time.

Author:  MJKB [ Fri Jan 28, 2011 7:09 pm ]
Post subject:  Re: The role of TB in the books

Was there any evidence that suggested treatment in alpine areas would be more effective than say England or Ireland?

Author:  Alison H [ Fri Jan 28, 2011 10:20 pm ]
Post subject:  Re: The role of TB in the books

I don't think there's much actual proof, but it was believed that clean, cold mountain air, the sort that EBD's always talking about, was good for TB sufferers. Before antibiotics, I don't think there was much that doctors could do - apart from some strange surgical procedures which were meant to collapse and re-inflate the lungs (trying to remember some drabble research from a while back!) - apart from set up a regime of fresh air, a healthy diet and lots of bed rest, and it does sound logical that clean dry air'd be healthier than polluted damp air. I know that as late as the '50s people were being told that the damp English air and urban pollution was bad for lung conditions and they might want to consider moving to somewhere like Switzerland (all very well if you've got a "private income"!).

It'd be interesting to see some statistics on comparative recovery rates, but I don't know if there are any anywhere.

Maybe I've read too many EBD books :D , but I think there is something about Alpine air. Not sure it'd have much effect on something as serious as TB, but it definitely feels different from the air in a British city. & even in the '80s and '90s we grew up with the idea that a trip to the seaside'd do you good because of the air there.

Author:  KB [ Fri Jan 28, 2011 10:22 pm ]
Post subject:  Re: The role of TB in the books

I found this quite an interesting article on the subject.

Author:  Pat [ Fri Jan 28, 2011 10:30 pm ]
Post subject:  Re: The role of TB in the books

There is mention a few times of not kissing/bending over TB patients because of infection. I think one involved Mrs Linton, but can't be sure.

When I was a kid Dad went for a routine x-ray & they found a shadow on his lung. We had sunlight treatment, which I think was sitting in front of lamps. We also had the BCG as soon as it was available. As it turned out, the shadow was left from when Dad had flu at the end of WW1. He lived till a month short of his 98th birthday!

Author:  shesings [ Fri Jan 28, 2011 11:01 pm ]
Post subject:  Re: The role of TB in the books

We lived in Dundee and had hundreds of factory chimneys belching out smoke. The sanatorium was in Monifieth, just six miles away, but the air was cleaner and the fresh breezes off the North Sea were reckoned to be healthy.

Beds were often out on a balcony, and there were small chalets with little verandas, the whole edifice able to be moved round to follow the sun. Apparently, TB patients were able to tolerate, and indeed benefitted from, a high level of cold and slept out on the balcony when the weather was dry.

By the time my father and brother were ill, in the early 50s, Sir John Crofton's Edinburgh Method, combining streptomycin and other drugs, was beginning to take the terror out of TB. The Mass Radiography campaigns were also important in identifying victims, often before the symptoms showed. This enabled them to get early treatment and, equally importantly, removed sources of infection from the community.

Author:  Cosimo's Jackal [ Sat Jan 29, 2011 5:04 pm ]
Post subject:  Re: The role of TB in the books

KB wrote:
I found this quite an interesting article on the subject.


Very interesting - I particularly enjoyed this bit about (one hopes!) somewhat earlier-than-Jem beliefs about the causes of TB:

Quote:
There was also belief that a wide variety of other environmental factors and behaviors caused TB: poor air quality, rebreathing the same air too many times, depravity and sexual promiscuity, spiritual anguish and alcoholism to name a few.


It's enough to make one think of Mrs Linton, Robin's mother and of course the Engelkind herself with an entirely different mind! :shock: :)

Less frivolously, that article says it was firmly established by Koch in 1882 that TB was caused by bacteria, though many resisted the implications of this finding:

Quote:
“At first, the shocked scientific establishment, in Germany and elsewhere, refused to believe that bacteria caused tuberculosis. How could well-meaning, good, dedicated physicians have been wrong for so many years? How could tiny, invisible bacteria cause this devastating disease that killed so many? Was it at all possible that tuberculosis was not inherited? The controversy went on for years and became part of a larger international debate over the germ theory itself. Many scientists found it difficult to believe that germs could cause any disease at all. Some dug in their heels and refused to consider the evidence that Koch had so carefully amassed, stubbornly believing until they went to their graves that TB was hereditary.”


Given that Robin is depicted at risk of having inherited TB from her mother, does this mean Jem still holds to the 'hereditary' theory in the 1930s? Or does EBD actually mean Robin may have been infected by her mother, but doesn't want to point it out so brutally? There's no suggestion, is, there, that Marya was in a San between Robin's birth and her own death, so presumably the three Humphries lived together?

The bit on the death rates at sanatoria being pretty much exactly the same as for patients with TB who stayed at home is also interesting!

Quote:
Not wanting to register deaths, the hospitals often did not accept people with more advanced disease, and because of the cost of sanatorium care, poor patients were left to die at home with their families. In the final analysis, the death rate in sanatoriums or at home were the same – about half of patients died whether they were treated in a sanatorium or not treated at home.

Author:  shesings [ Sat Jan 29, 2011 5:30 pm ]
Post subject:  Re: The role of TB in the books

Cosima's Jackal, I'm not sure how many in the medical profession were still thirled to the 'heredity' theory but it was still a commonly held belief among otherwise sensible adults in the early 50s and beyond!

Not long before I married, one of my aunts, a nosey old bat of the parish, took it upon herself to tell SLOC that we shouldn't have children because they would almost certainly get TB. He was startled, to say the least, particularly as the incidence of the disease was minimal by then. Luckily, one of my other aunts was there and swiftly put Auntie Jessie's gas at a peep!

Author:  MJKB [ Sat Jan 29, 2011 6:18 pm ]
Post subject:  Re: The role of TB in the books

All this information is fascinating. Does anyone know if the old treatment of sleeping outdoors etc alleviated the symptoms?

Author:  julieanne1811 [ Sat Jan 29, 2011 6:21 pm ]
Post subject:  Re: The role of TB in the books

MJKB wrote:
Was there any evidence that suggested treatment in alpine areas would be more effective than say England or Ireland?


This is from The Plague and I (published 1948):

Quote:
Kate sadi, 'The way I understand it, pulmonary tuberculosis is caused by tubercle bacilli in the lungs and to date the only way found to render these tubercle bacilli inactive is to wall them off in the lungs with fibrosis. The fibrosis forms quickest when the lung is at rest. If your lung was put at rest with pneumothorax or other surgery I shouldn't think it would matter whether you where were in Alaska or South America, but you if had to depend on bed-rest to build your fibrosis then I think a year-round cool climate at sea level would be the most pleasent.'
'Why sea level?' I asked.
'Because,' Kate said, 'mountain air is thinnner, requires the lungs to work harder for their oxygen, and is also exhilarating, which makes it more difficult to rest.'


There's a lot of very interesting info about life in a San in this autobiography. Here're some bits:

Having to be bathed on admission, and hair washed with green soap (!).
No reading, writing, talking, laughing, moving in bed, reaching for things, although ...

Quote:
'It has been my observation that, in all things in life, the man is favoured. Here at The Pines, in the Men's Bed Rest Hospital, which is one floor below this, a man may read all the daily paper from the day he enters.'
Sylvia said, 'Men are stringer than women. They don't need such complete rest.'
Kimi said, 'Nonsense. it is because the Medical Director is also a man. He thinks, 'The woman's mind is little. She can lie twenty-four hours a day for thirty day, a total of seven hundred and twenty hour, doing nothing. The man's mind is big. He must give it something to think about. I will let him read the paper immediately.'


No HWBs until October, windows open to the sea, very damp and cold.
Washing in bed at 0530, no curtains, bed-pans at stated intervals.

A breakfast of: half a grapefruit, cornmeal and cream, boiled eggs and coffee - 'very good and very cold'.

Quote:
' ... All the eggs are hard-bolied and if you take less than two, old Gimlet Eyes will say you're not a co-operative patient and you'll get a warning letter from the MD.'


Daily weighing, taking one's own temperature and telling the nurse what it was.

The MD told the room of four women:

Quote:
'It is better to be too cold than too warm ... too much heat makes patients restless ...'
(although I'd be more restless if I was cold, myself),
Quote:
'... the nearer a comatose state tuberculous patients can be kept the better their chances of recovery ... rest is the thing, only rest and more rest ... Just lying in bed is not resting ... resting is done with the mind as well as the body ... the only way a patient can get rid of the TB is to wall it off in the lungs ... done by fibrosis which is more delicate than a spider's web and can be torn by the slightest activity ... the poisons sloughed off ... make the TB patient nervous, make his heart pound, make resting difficult ... rest is the answer. Just rest, rest and more rest ... '


They were also given 'golden thoughts' on their tray every time they had a meal - these were supposed to inspire the patient to co-operate fully with their treatment and not rail against it, but Betty MacDonald found them rather more nauseating than helpful!

Author:  MJKB [ Sat Jan 29, 2011 6:57 pm ]
Post subject:  Re: The role of TB in the books

Wow! All I can say is that I've a new and deeper respect for all those unfortunate people who found themselves in 'treatment' centres such as the one quoted above. And it appears that all the money spent on sending the likes of Mrs. Linton to the Alps was for wasted, and she would have been better off in some seaside resort.

Author:  KB [ Sat Jan 29, 2011 10:01 pm ]
Post subject:  Re: The role of TB in the books

MJKB wrote:
And it appears that all the money spent on sending the likes of Mrs. Linton to the Alps was for wasted, and she would have been better off in some seaside resort.


Ah, but then we would have been reading a series call The Beach-house School instead...

Author:  Shander [ Sat Jan 29, 2011 11:40 pm ]
Post subject:  Re: The role of TB in the books

It is an interesting thought though. How would the series have been different if EBD hadn't come up with the connection with the San? What Jem had been a lawyer or a teacher or something else? Or what if there had never been any connection with Jem after the train accident?
The school's emphasis becomes so much about health because of the connection to the San, but that connection isn't there in the first book.

Author:  Myth Tree [ Sun Jan 30, 2011 1:00 pm ]
Post subject:  Re: The role of TB in the books

Shander wrote:
The school's emphasis becomes so much about health because of the connection to the San, but that connection isn't there in the first book.


But isn't there an arguement that it was only because of Joey's health that the school was in Austria at all? Even in the first book the school seems to gravitate towards health issues probably because its guidelines would have been put in place for the head's sister's benefit. If Joey hadn't been frail then the school wouldn't have existed.

*that sentence is wrong somewhere :? *

Author:  Cosimo's Jackal [ Sun Jan 30, 2011 1:38 pm ]
Post subject:  Re: The role of TB in the books

julieanne1811 wrote:

Quote:
'... the nearer a comatose state tuberculous patients can be kept the better their chances of recovery ... rest is the thing, only rest and more rest ... Just lying in bed is not resting ... resting is done with the mind as well as the body ... the only way a patient can get rid of the TB is to wall it off in the lungs ... done by fibrosis which is more delicate than a spider's web and can be torn by the slightest activity ... the poisons sloughed off ... make the TB patient nervous, make his heart pound, make resting difficult ... rest is the answer. Just rest, rest and more rest ... '



Julianne, how fascinating and awful - very reminiscent of Charlotte Perkins Gilman's story 'The Yellow Wallpaper' in terms of enforced total bedrest (and it being gendered). But if that was a common way of considering the cure of TB, it throws a certain amount of light on the insistence on total rest we come across so often in the CS, even in cases that are nothing to do with TB. Like Stacie - whose total rest seems at times to be more about her mind than her back muscles healing:

Quote:
There is only one way at present in which you can be cured, and that is by absolute rest. You must not try to do much with your arms, even [...] And, above all, you must be happy and cheery. Nerves and muscles are closely allied, you know, and the one reacts on the other. If you fret and grumble, and upset your nerves by crying, you will be months longer in winning a real cure.


And again in Challenge, Jack insists on a entire month of enforced doing nothing before deciding it's OK for her to teach at the CS, but not apparently to do her own work! And of course is totally reminiscent of Robin's 'training' in not fretting. Maybe it also feeds into EBD's ideas about work after hours or cramming being very bad for you, and the bedrest she tends to have Matey enforce after someone cries...?

Myth Tree wrote:
But isn't there an arguement that it was only because of Joey's health that the school was in Austria at all? Even in the first book the school seems to gravitate towards health issues probably because its guidelines would have been put in place for the head's sister's benefit. If Joey hadn't been frail then the school wouldn't have existed.


I think that's true - Madge and Joey would probably have gone with Dick to India, from what Madge says in School At, had Joey had normal health. But Joey's original frailty is never linked to TB, despite what would seem an obvious match of symptoms. Whereas later frail girls who arrive after the San and the school's link is established are often grouped as TB risks. So the specifically TB-centric element of the school seems to date from the San link, even if the original fragile girl predates that.

Though again, in view of what would have been known about infection, surely the Annexe was not necessarily such a great idea - putting the most 'at risk' girls all together to potentially infect one another? Or again, is this EBD cordoning off the most obvious sources of infection from the rest of the school, but not putting it so bluntly? Ie, is the Annexe a mini-San whose big advantage is not that it can do anything in terms of rest, air, milk and observation that the CS itself can't, but that it keeps the most probable infectious school population away from the school at large?

Author:  Tor [ Sun Jan 30, 2011 3:31 pm ]
Post subject:  Re: The role of TB in the books

Quote:
Ie, is the Annexe a mini-San whose big advantage is not that it can do anything in terms of rest, air, milk and observation that the CS itself can't, but that it keeps the most probable infectious school population away from the school at large?


I don't know if that was EBDs intention, but I know that, to me, the Annexe and the San were very much a dark element to the stories. Their presence hovered in the background like a malignant spirit, and for a character to be sent there away from the main school... Well, my childhood self didn't like it at all. In fact, the Sonnalpe seemed like something tainted by aspects of Grimm's fairy stories - characters got spirited away to this place, by marriage or illness, rarely to return.

Even visiting it at half term gave me the shivers - it was as if the shores of the Tiernsee were this golden, wonderful place, where all was healthy, bright and fun, fun, fun. The mountains around the lake were monstrously beautiful, populated by madmen and the dying, where terrible accidents befell schoolgirls... I had (have) a rather over active imagination :roll:

Which makes me wonder if TB, and the San and the Annexe, played a two-fold role in the series (even if this wasn't deliberate on EBDs part): (i) by having a much more serious illness in the background for other characters, especially the Robin, it freed Joey somewhat from her original frail persona and meant EBD could focus on her more dynamic, attractive qualities while (ii) still indulging her Victorian-era love of sickly melodrama.

If she'd combined the two into Joey's character development, I don't think the series woud have been half so attractive!

Author:  Llywela [ Sun Jan 30, 2011 6:30 pm ]
Post subject:  Re: The role of TB in the books

KB wrote:
MJKB wrote:
And it appears that all the money spent on sending the likes of Mrs. Linton to the Alps was for wasted, and she would have been better off in some seaside resort.


Ah, but then we would have been reading a series call The Beach-house School instead...

I actually quite like the sound of The Beach House School!

*has mental images of Mary-Lou and co surfing before breakfast* :lol:

Author:  KB [ Sun Jan 30, 2011 9:38 pm ]
Post subject:  Re: The role of TB in the books

Cosimo's Jackal wrote:
But if that was a common way of considering the cure of TB, it throws a certain amount of light on the insistence on total rest we come across so often in the CS, even in cases that are nothing to do with TB. Like Stacie - whose total rest seems at times to be more about her mind than her back muscles healing:


Yes, and I think you see it particularly with Grizel when Jack admits that she could be walking around in her plaster cast after she saves Len, but they keep her lying down and without excitement (except Bruno) until she has completely healed in her mind as well as body.

Author:  Pat [ Sun Jan 30, 2011 9:52 pm ]
Post subject:  Re: The role of TB in the books

There was a dual reason for choosing Austria for the school. One was obviously Joey's health, but the other was the financial side. Austria was extremely cheap for British people then because of galloping inflation, and therefore was an important consideration for Madge.

Author:  Cosimo's Jackal [ Sun Jan 30, 2011 10:13 pm ]
Post subject:  Re: The role of TB in the books

KB wrote:
Cosimo's Jackal wrote:
But if that was a common way of considering the cure of TB, it throws a certain amount of light on the insistence on total rest we come across so often in the CS, even in cases that are nothing to do with TB. Like Stacie - whose total rest seems at times to be more about her mind than her back muscles healing:


Yes, and I think you see it particularly with Grizel when Jack admits that she could be walking around in her plaster cast after she saves Len, but they keep her lying down and without excitement (except Bruno) until she has completely healed in her mind as well as body.


Is it total bed rest as gendered in the CS world as Julianne's quotation (and Woolf's diaries and Charlotte Perkins Gilman) imply it was in the world of real-life medical treatment in the late 19th and early to mid 20thc?

I know we don't see that many male patients in the CS world, but I was just wondering , it if was a girl or woman who'd undergone the same accident as Reg has in Prefects - back wrenched and strained by bashing against submerged boulders in a flooded stream, followed by prolonged exposure and a period of semi-consciousness - whether the man who loves her would be allowed to be her first visitor immediately after she recovers consciousness? Wouldn't it be seen as bad for her recovery for her to have a moment of strong emotion like a marriage proposal? And wouldn't she have had dozens of instructions about not moving her arms, or putting them outside the covers, whereas Reg grabs Len's hands and pulls her down beside him and puts his arm around her, without any medic appearing to tell him not to?

Is this because Men Are Tough and a little thing like a marriage proposal and a kiss isn't going to faze them or threaten their recovery?

Author:  Alison H [ Sun Jan 30, 2011 11:14 pm ]
Post subject:  Re: The role of TB in the books

I reckon Joey was so desperate for Len to stop messing poor dear Reg around that she let her go in to see him knowing that once they had been alone in a bedroom together Len's reputation would be compromised and she would be forced to marry him! Seriously, I don't think a female patient would have been allowed a visit like that either.

Author:  julieanne1811 [ Mon Jan 31, 2011 7:37 am ]
Post subject:  Re: The role of TB in the books

Cosimo's Jackal wrote:
Is it total bed rest as gendered in the CS world as Julianne's quotation (and Woolf's diaries and Charlotte Perkins Gilman) imply it was in the world of real-life medical treatment in the late 19th and early to mid 20thc?


Well ... my quote is from an autobiography and Woolf's would be based on real events too, I'm guessing (since I haven't read her). ANd the bit I quoted from Kimi (she was a Japanese American girl, about 18 I think) suggests that female patients of the time thought this was the case too.

But then, Madge let Jack in to see Joey after the loss of Robin during the misfired Hide and Seek game - the SLOC event. So despite Joey being physically feeble (so we're told but I am not convinced!), female and in great mental distress, in goes Jack to aid her. Although perhaps that's more a case of He's a Man and Can Handle Emotional Women Without Endangering Them Further?

Author:  Cosimo's Jackal [ Mon Jan 31, 2011 12:13 pm ]
Post subject:  Re: The role of TB in the books

julieanne1811 wrote:
Cosimo's Jackal wrote:
Is it total bed rest as gendered in the CS world as Julianne's quotation (and Woolf's diaries and Charlotte Perkins Gilman) imply it was in the world of real-life medical treatment in the late 19th and early to mid 20thc?


Well ... my quote is from an autobiography and Woolf's would be based on real events too, I'm guessing (since I haven't read her). ANd the bit I quoted from Kimi (she was a Japanese American girl, about 18 I think) suggests that female patients of the time thought this was the case too.


Yes, that's what I'm saying - your quotation was from a non-fictional source, as are Woolf's diaries, so they plausibly represent the real world. What I was wondering was whether there's enough evidence in the CS universe (given the lack of men patients) to show EBD was reflecting a similar gender bias in terms of total bed rest being more stringently applied to women? We don't see it with TB at all, but Reg seems to be allowed to do a lot more immediately after his accident (which is depicted as quite serious at the time) than Stacie or Grizel or any of the many others who also hurt their backs. I know Reg says it's 'just' strain and wrenching, but usually there would be a lot of consultation, total rest and no excitement, before declaring a similarly injured girl on the road to recovery! Maybe EBD was uncomfortable with the idea of the Manly Doctor as Patient (because surely the Founts of All KNowledge can't be bossed about and told what's good for them?) - pity we don't see more of Jack's recovery from his war injury to compare.

Or wouldn't it have been terribly interesting (and not implausible) if Jem caught TB?

Author:  Myth Tree [ Mon Jan 31, 2011 12:23 pm ]
Post subject:  Re: The role of TB in the books

The Yellow Wallpaper by Charlotte Perkins Gilman is fiction but it is based on her very real treatment but the great Weir Mitchell when she suffered from what we would call post-natal depression. He even gets mentioned in the text.

In CS, as stated, we don't see male patients but the little we do see does imply they are treated differently. IIRC, and I'm not sure, isn't there a reference to JAck turning up after his major incident and attending some function though he obviously isn't in a fit state? He also returns in Exile and has to be kept quiet, but I can't recall the details.

Author:  Alison H [ Mon Jan 31, 2011 12:56 pm ]
Post subject:  Re: The role of TB in the books

Mr Denny might be the exception that proves the rule. He's always described as being "delicate", and several times we're told that he can't come into school because he's ill. &, rather than the usual (and IME not very realistic!) situation where a man takes care of a delicate female, sturdy Sally Denny is always rushing round worrying about her delicate brother.

I think Blossom Willoughby's brother is "delicate", but none of the boys in the MBR clan are, except possibly Charles on occasion. Peggy nearly dies of German measles whereas Rix is fine, Phil gets polio but Geoff is always healthy, Josette is the one who has the accident, etc. On one occasion (mentioned in passing in one of the British books), David falls out of a tree and breaks his arm and it's pretty much laughed off as "Oh, boys will be boys," whereas if it'd been a girl then Jem would've been there with his syringe administering a large dose of sedatives.

Author:  MJKB [ Mon Jan 31, 2011 8:47 pm ]
Post subject:  Re: The role of TB in the books

Alison H wrote:
Mr Denny might be the exception that proves the rule. He's always described as being "delicate", and several times we're told that he can't come into school because he's ill. &, rather than the usual (and IME not very realistic!) situation where a man takes care of a delicate female, sturdy Sally Denny is always rushing round worrying about her delicate brother.

Perhaps that's because Mr. Denny is 'not the marrying kind?' If you know what I mean......

Jack's remedy for Grizel's 'mental exhaustion' makes me wonder how depression was treated in the 50's. One hears of women (always women) being sectioned for condtions such as PND and other forms of depression. In Ireland up to the 70's a husband could have his wife sectioned on the signature of one doctor, but the other way did not apply. Joey, at some point, comments that Jack has had to lie by omission to Grizel in order to give her the rest he believes she needs for a return to mental health. I wonder if Grizel had not recovered or if Neill had not happened on the scene, what sort of medication would she have been prescribed.

Author:  Cosimo's Jackal [ Mon Jan 31, 2011 9:33 pm ]
Post subject:  Re: The role of TB in the books

MJKB wrote:
Jack's remedy for Grizel's 'mental exhaustion' makes me wonder how depression was treated in the 50's. One hears of women (always women) being sectioned for condtions such as PND and other forms of depression. [...] Joey, at some point, comments that Jack has had to lie by omission to Grizel in order to give her the rest he believes she needs for a return to mental health.


I have the impression there was quite a bit of (no doubt well-intentioned) lying for the 'benefit of the patient' - as when Jacynth's aunt's death is concealed from her for more than a fortnight while she's ill, which, in her position, I would have found difficult to forgive. I could understand for a short period, if Jacynth were very seriously ill and its concealment a matter of life and death in her case. But I don't think it's justified to lie for such a long period in the circumstances - feeling a bit weak after German measles. And it is a lie, let's face it, for all that Joey claims it isn't - there's something pretty dubious about claiming that Nurse hadn't told a lie when she said the 'operation had been a success', it was Auntie's heart that failed.

But presumably EBD is drawing on some of the TB-related assumptions other people have mentioned up the thread - the necessity for total mental rest and 'golden thoughts' etc.

I don't see Jack being heavy on the Valium, in fairness to him, though - plus I'm not sure EBD would have recognised depression as an illness, as distinct from 'unhappiness'. Grizel would have got a loving lecture from Joey about what she had to be thankful for, and the usual regime of milk, rest and fresh air, and a doctor of her own! Which sounds preferable to an exhausting school reunion with compulsory activities, though!

Author:  Alison H [ Tue Feb 01, 2011 10:31 am ]
Post subject:  Re: The role of TB in the books

Cosimo's Jackal wrote:
I have the impression there was quite a bit of (no doubt well-intentioned) lying for the 'benefit of the patient' - as when Jacynth's aunt's death is concealed from her for more than a fortnight while she's ill, which, in her position, I would have found difficult to forgive.


After Mary-Lou's accident, Doris isn't told because she's ill with flu. I can just about understand that, as Doris was presumably too ill to travel, but Cdr Carey said he'd go to Switzerland to be with Mary-Lou and Jack "refused the offer" and told him to stay with Doris! I appreciate that EBD wanted Mary-Lou's own family out of the way so that Joey could be the one to sit by her bedside and mop her brow, but I find the wording very irritating - it sounds as if it were one of the Maynards who was ill and Jack had refused a friend's offer to try to help out. & Cdr Carey just does as Jack says!

Author:  Cosimo's Jackal [ Tue Feb 01, 2011 8:22 pm ]
Post subject:  Re: The role of TB in the books

What was the logic in 'prescribing' long sea-voyages for convalescents? I know sea air was thought to be beneficial, but what benefit would a voyage bring that going to live by the sea would not?

Althea Glenyon's mother is
Quote:
not getting strong as fast as we should like and the doctor has told your father that the best thing for her will be a long sea-voyage.”


I don't think we're told what her illness is, only that it was serious, but she's now recovering. Or whether the fact that Althea herself catches cold all the time and has led a 'semi-invalid life' till now is supposed to signal inherited problems?

Author:  KB [ Tue Feb 01, 2011 10:21 pm ]
Post subject:  Re: The role of TB in the books

There are quite a few sea voyages for health reasons:

Leila Elstob - TB
Amy Dunne's mother - upset at 'losing' her daughter to marriage
Alixe Rutherford - TB
Grizel (to a certain extent) - general malaise
Althea Glenyon's mother - not specified
Nan Blakeney's father - shock from his wife's death

Author:  Josette [ Wed Feb 02, 2011 2:41 pm ]
Post subject:  Re: The role of TB in the books

And we're told by Margot Venables that the sea voyage from Australia "has done Daisy good" and that she was white-faced and washed-out before they left.

Author:  Cosimo's Jackal [ Wed Feb 02, 2011 3:28 pm ]
Post subject:  Re: The role of TB in the books

I can understand it in Daisy's case, as - according to EBD - the climate of North Queensland is a killer, so Daisy does better once she leaves. But why would an ordinary convalescent do better on a voyage than he or she would just living by the sea and relaxing completely? I was just thinking about things like sea-sickness not being much fun for someone still weak if you got a run of stormy weather...

Author:  Llywela [ Wed Feb 02, 2011 3:33 pm ]
Post subject:  Re: The role of TB in the books

Sea air is meant to be bracing, isn't it? I can well imagine that the school of thinking which states that bracing mountain air will cure any chest complaint would also state that bracing sea air will speed along any convalescence.

Author:  mell [ Wed Feb 02, 2011 3:56 pm ]
Post subject:  Re: The role of TB in the books

I think that EBD would imagine a boat trip to be very relaxing with little to do except maybe walking between cabin, deck and restaurant, and no household duties to attend to. Plus cruise boats have medical staff in case of a relapse, so a doctor would always be on call. Although I don't know if EBD did a cruise at any time and, apart from watching Agatha Christies and the like on TV, I have no idea what a normal cruise would be like then.

Author:  Mel [ Wed Feb 02, 2011 6:00 pm ]
Post subject:  Re: The role of TB in the books

I think the cruise idea is just an excuse for a good time. To say you are going on a cruise 'for health reasons' sounds quite self-sacrificing.

Author:  Alison H [ Wed Feb 02, 2011 6:07 pm ]
Post subject:  Re: The role of TB in the books

Especially if, like Althea's parents, you were taking it for granted that you could dump your daughter on her aunt!

The idea of taking a holiday and saying that it's for health reasons does go back a long way, except that it used to be "taking the waters" at a spa resort instead of taking a cruise, but at least at a spa or a "wellness" (silly word!) resort you'd actually be bathing or having treatments, rather than just taking the air.

Author:  julieanne1811 [ Sat Feb 05, 2011 7:47 pm ]
Post subject:  Re: The role of TB in the books

I was trying to find something I read in the Drina books just recently, about sea voyages ... but I can't locate it. It said something like, ' Drina was amused by the way many passengers wrapped up themselves and lay in rows on loungers on deck. They were served with hot soup every few hours by stewards. It made Drina think of hospital patients and nurses.' Something like that, anyway.

So I guess the thinking would be that brest would be absolute - no having to manage one's own meals, being served while one rested. But then, didn't Grizel save money by using a cattle boat (am I making that one up???)? Unless an invalid could afford upmarket cruises I can't see that being on a boat would be particularly beneficial.

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