Philip Titheradge and a Case of Measles

Philip Titheradge at Prize giving at Bickley Hall School in 1937

A Dangerous Virus

This is a quote from the Public Health England website:

“This is the most infectious illness known to man and is much easier to catch than flu or Ebola. This virus is spread through the millions of tiny droplets that come out of the nose and mouth when an infected person coughs or sneezes. You can easily catch it by breathing in these droplets or touching a surface where they have settled and then placing your hands near your nose or mouth, as the virus can survive on surfaces for a few hours.” 

No, I am not talking about Corona virus, this article was written long before anyone had heard of or even imagined corona virus. The disease is measles.

Measles starts with cold like symptoms followed by a rash, other symptoms can include fever, sore eyes, aches and pains, loss of appetite and tiredness. Measles can be serious and lead to life threatening complications. Complications of measles can include diarrhoea and vomiting, fits caused by fever and infections of the middle ear, eyes, brain or airways. Worldwide more than 140,000 people died from measles in 2018, according to new estimates from the World Health Organization.

Philip Titheradge

Today’s blog is the story of how a 9-year-old boy suffered after catching measles in 1935 and the lifelong effect this had on him. Philip Anthony Lester Titheradge was born in October 1925 in the Paddington district of London. He was the elder of two sons born to William Charles Titheradge and Lilian Gertrude Hicks. He was sent to Bickley Park School, near Bromley (Kent) where he was a boarding pupil. In July 1935 he was taken ill at school with measles.

Health care in 1935

The story takes place 85 years ago in an era before a National Health Service, and an era without many of the vaccines, such as MMR, that we take for granted today. The measles vaccine was not introduced to the UK until 1968. There were also no antibiotics for treating any of the complications that might arise from measles. Although Alexander Fleming discovered the first antibiotic, penicillin, in 1928 it took over a decade before penicillin was introduced as a treatment for bacterial infections and 1945 before it was introduced on a large scale.

Letter Home

Below is a copy of the 1935 doctor’s letter that was sent home to Philip’s parents which details the progress of his case of measles and detailing the treatment he received. The doctor was Dr Alfred Talbot Rogers, M.B., B.S. London with Honours in Surgery. Dr Rogers was part of a group of doctors working in Bromley near to Philip’s public school.

Blyth Lodge,
35, London Road,
Bromley, Kent.
Ravensbourne 4084

 

Re Anthony Titheradge

 

This boy fell ill on July 21st and by July 24th the rash of measles was well out. On the 25th his left eardrum was red but painless. On the 26th (still without appreciable pain) it was bulging, and on 27th as there was no sign of subsidence of the trouble an anaesthetic was given and the drum was punctured. The ear discharged freely but in spite of this tenderness developed in the mastoid and the bone was opened and drained by Mr R J Cann on July 29th. 

Two days after the operation a pleuritic rib developed in the left axilla, and subsequently practically the whole of the left lower lobe showed signs of consolidation. During the following week inflammation and suppuration developed (again without pain) in the right middle ear, there was however no mastoid tenderness or oedema and in view of the danger of a further anaesthetic in the presence of a lobar pneumonia the ear was left to discharge by itself which it has done freely since August 12th.

He was seen by Mr Cann on August 15th. Mr Cann advises that the mastoid wound should be dressed with eusol dressing (only packed lightly into the wound) that the discharge from the right ear should be carefully frequently cleaned away and spirit drops instilled.
If this ear continues to discharge for three or four weeks in spite of this treatment the mastoid bone may need to be opened. 

The pneumonic area gradually diminished, the temperature fell by lysis and by August 15th I could no longer find any area of bronchial breathing. I was a little anxious at one time that following on what must have been a streptococcal pleurisy – an empyema might develop but fortunately he seems to have escaped this complication.

A Talbot Rogers 
MB 
17.8.1935

His daughter, Penny, sent me this additional information:
“This letter contains details of an operation for mastoiditis for Philip Titheradge, August 1935. This took place at school and the operation was on the kitchen table! Philip was almost totally deaf in his left ear from this time on (he was not quite ten when this took place) and had a deep cavity behind his left ear.”

Healthcare in 2020

Today it is unlikely Philip would have caught measles since most children are given their MMR vaccine, to protect them against Measles, Mumps and Rubella, at 1 year old and this is followed by a second dose of vaccine at 3 years old.

The mastoiditis which Philip developed is a known complication of measles. The mastoiditis is a secondary bacterial infection of the mastoid process and today would be treated with antibiotics. Most bone infections are now treated conservatively with antibiotics, opening them up often makes things worse. It should be noted how ill poor Philip was, as at one time mastoiditis was a leading cause of childhood mortality.

The pneumonia which Philip developed was probably an anaesthetic/surgical complication, as it is quite common after anaesthesia to get a build-up of fluid in the lungs, which increases the risk of infection. Today this pneumonia would also be treated with antibiotics.

As for the operation on the kitchen table at school – well, words fail me!

Hopefully reading this article makes us grateful that we live in an age of the National Health Service, vaccines and antibiotics.

Our thanks to Penny for sharing this letter with us and giving us an insight to life in the 1930s.

The image above shows Philip just a couple of years later being presented with an athletics cup. The effects of his illness and operation did not prevent him having a lifelong love of and prowess in sports in general and swimming in particular, though he was prone to ear infections.