Rebecca Cessford

Stannington Sanatorium for tuberculous children: A potential use of radiographic imagery in reporting on tuberculosis in non-adult human remains.

Rebecca Cessford viewing one of the Stannington Sanatorium Radiographs. Photograph by Jo Patterson, Northumberland Archives
Rebecca Cessford viewing one of the Stannington Sanatorium Radiographs. Photograph by Jo Patterson, Northumberland Archives

Tuberculosis is a disease of many forms. Most commonly known as a pulmonary condition with symptoms including a bloody cough, weight loss and pallor, it can affect almost any part of the body including the bones and joints. It is a disease that was romanticised in the 18th century for making its victims thin and pale, both highly desirable qualities at the time, but it was one of the biggest killers in the pre-antibiotic period. Following the introduction of streptomycin, the first effective antibiotic treatment, in the 1940s tuberculosis declined until it was thought to be almost completely eliminated in the 1980s, although it remained a prevailing issue in developing countries. However, tuberculosis is re-emerging being declared a global emergency in 1993 and features amongst the leading causes of death in the world (WHO 2014). This re-emergence has been attributed to the rise in human immunodeficiency virus (HIV), multi-drug resistance (MDR) and increased immigration.

The history of tuberculosis stems back to the Neolithic period and through studying its history and evolution there is greater potential for combatting it in the present. Currently the understanding of tuberculosis in past populations is limited by the uncertainty with which it can be diagnosed in archaeological human remains. Advances in ancient DNA and biomolecular studies in archaeology mean tuberculosis can be tested for, even in the absence of any physical pathologies. However, these destructive and costly procedures are not without their limitations with much reliance still on routine macroscopic observations of dry bone remains.

My research uses a collection of historic radiographs, from 1936-1953 with corresponding case notes, to assess their use in the identification of skeletal tuberculosis in children’s remains. Radiography is a commonly used method in archaeology to investigate human remains post-excavation, however the use of clinical radiographs to identify disease in human remains is something relatively unexplored. The radiographs to be used span the introduction of effective antibiotic drug treatment for tuberculosis in the UK, offering examples of pre- and post-antibiotic tuberculosis in bones and joints. The research aims to provide scope in understanding the various stages of destruction and healing in tuberculosis and in providing epidemiological data, patterns in the cause and effects of disease, for combatting modern day TB.

The radiographs form part of the Stannington Sanatorium collection, held at Northumberland Archives. This is a unique collection of medical records from the first purpose built children’s tuberculosis sanatorium in the UK at Stannington, Northumberland. The use of archival material within the field of palaeopathology, the study of ancient disease, is non-traditional and is not a targeted audience for archive outreach programs. Within my research, I shall be exploring archive outreach strategy, particularly how archivists embark on publicising traditional and specialised collections to specialty audiences to make them more accessible.

Heritage, which is often confused with history, has no clear definition, meaning something slightly different to everyone. My research is interdisciplinary and combines the examination of archival outreach with other aspects of engaging with the past through the use of archaeology of human remains and medical history to explore and understand tuberculosis in the past to inform on present-day practices. In doing so it seeks to bridge a gap in macroscopic identification of tuberculosis in archaeology, opening up the interpretation of disease in past populations, whilst highlighting the potential of this archive collection as a medical and anthropological teaching resource.

Biography

I am a PhD researcher with the Heritage Consortium looking at the integrated roles of history of medicine, palaeopathology and archival outreach in relation to the infectious disease, tuberculosis. I am currently based at the University of Hull under the supervision of Dr Rosemary Wall and co-supervised by Dr Jo Buckberry of the University of Bradford.

My academic background includes a BA(Hons) degree in the Archaeology of Ancient Civilisations from the University of Liverpool (2008) and an MSc degree in Forensic Archaeology and Anthropology from Cranfield University (2010). Through my MSc program I became interested in the excavation and interpretation of human remains, particularly in the effects of disease. I participated in the excavations at Haslar Royal Naval Hospital, Portsmouth, which focussed on the excavation of naval soldiers from the early 19th Century and was the feature of a Time Team Special.

I have a range of experience in archaeology including excavating a monastic cemetery in Iceland with Grampus Heritage and the University of Iceland, guest lecturing on the archaeology of human remains to A-Level students at Newcastle College and volunteering for a local archaeology company primary school outreach program. In September 2014 I began work for Northumberland Archives as the Project Assistant for the Stannington Sanatorium Project (www.northumbelandarchives.com/category/stannington-sanatorium) which brought about the motivations for my current research.

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