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Matthew Robert Kirtley

The 1901 census shows Matthew, then an engineer aged 43, as a boarder at "Nordrach upon Mendip" in Somerset. There were many other boarders shown, including many professional people.

My first thought was that they were all engaged in some development work and I did an internet search on the name of the building. It proved to be a sanatorium for the treatment of tuberculosis (then known as phthisis.

An article in Somerset Life on what is now a large family home describes how the sanatorium was set up by two doctors who had themselves been treated at the original Nordrach Sanatorium in the Black Forest. The Somerset sanatorium was based on a building previously known as "Willoughby's Farm". Despite charging £20 a week demand was very high and when the house was full other patients lived in villas in the grounds.

The article below gives an indication of the mortality rates the sanatorium experienced. Matthew himself died within three years of the 1901 census.


RESULTS OF FOUR YEARS' SANATORIUM WORK IN THE TREATMENT OF PHTHISIS.

BY

ROWLAND THURNAM, M.D., and CHARLES E. WHEELER, M.D.

Nordrach-upon-Mendip.

THE Sanatorium of Nordrach-upon-Mendip has now been open for five years, and a sufficiently large number of cases has come under observation to give a value to the statistics of results.

Only the first four years' cases have been taken into consideration, for it is only when a case has been tested by the lapse of some time that any confidence can be felt in the permanence of the benefit obtained from treatment, and of the cases of the first four years, only, those have been retained for purposes of argument concerning whom definite news was forthcoming in the summer of 1904.

As far as possible all cases have been followed up, and the figures that follow have been based upon the replies that were made to our inquiries. The total number of cases available for use in this paper is 289. They may be divided into three main classes:

A. Severe (disease affecting either the whole of one lung or considerable areas in both, often complicated with disease of the larynx).

B. Moderately severe (disease affecting not more than one half of one lung, with or without slight affection of the other-laryngeal diseases occurring in this class also fairly frequently).

C. Slight (disease confined to one lobe of one lung).

CLASS A - SEVERE.

This class includes 183 cases.

(a) Of these 56 died either in the Sanatorium or at home within twelve months of commencing treatment. Percentage, 30.6. As no effort is made in this Sanatorium to select mild cases, this class includes a number of patients who come as a last resource, often nearly moribund.

(b) Twenty-three patients died within two years of the time of commencing treatment here. Percentage, 12.7. In these cases treatment may fairly be said to have prolonged life, but nothing in the nature of even a partial cure was obtained.

(c) Thirty patients have been followed for two years, but we have no news of them later. We know only that they were alive more than two years after beginning treatment. Some are no doubt dead, and the others ought to fall into the divisions that follow, but in the absence of exact knowledge it seems better to form a special class for them. Percentage (alive after 2 years), 16.3.

(d) Thirty-nine patients report themselves in fair health in 1904. They are not able to undertake the work of people that have never broken down, but are all able to enjoy life and do a certain amount of work, but need to exercise care in living. Percentage (in fair health), 21.3.

(e) Thirty-five patients are in enjoyment of normal health, working as hard as ever they did, and able to do all that the normal healthy man can do. Percentage (cured), 19.1.

CLASS B.- MODERATELY SEVERE.

This class includes 84 cases.

(a) Corresponding to similar subdivision of Class A, includes 2 cases. Percentage (died within twelve months), 2.3.

(b) Includes 3 cases. Percentage (died within two years), 3.5.

(c) Includes 19 cases. Percentage (alive two years after), 22.6.

(d) Includes 11 cases. Percentage (in fair health), 13.09.

(e) Includes 49 cases. Percentage (cured), 58.3.

CLASS C.- SLIGHT.

Includes 22 cases.

There are no cases in subdivisions a and b.

(c) Includes 1 case. Percentage (alive two years after), 4.5.

(d) Includes 1 case. Percentage (in fair health), 4.5.

(e) Includes 20 cases. Percentage (cured), 90.9.


Taking all the classes together, the percentages are as follows: Total, 289 cases.

Subdivision (a) 58 cases. Percentage (died within twelve months), 20.06.

Subdivision (b) 26 cases. Percentage (died within two years), 8.9.

Subdivision (c) 50 cases. Percentage(alive two years after), 17.3.

Subdiviston (d) 5I cases. Percentage (in fair health), 17.6.

Subdivision (e) I04 cases. Percentage (cured), 35.9.

The classification according to severity sufficiently emphasizes the desirability of commencing treatment early; but if even of severe cases 19.1 per cent. can be wholly cured and another 21.3 restored to a very fair measure of health--over 40 percent., taking both classes together--then there can be hardly any cases of phthisis wherein something may not be hoped for from sanatorium treatment.

Source: The British Medical Journal, Jan 14 1905, p64-5