Thursday, August 28, 2008

Gastric Lavages and guinea pigs

Dr Carole Reeves writes:

I think I have discovered the origins of this distressing procedure in an article published in the British Medical Journal, 3 March 1934, entitled ‘A note on the study of pulmonary tuberculosis in infants and children’ by G Gregory Kayne.

Kayne is reporting on diagnostic methods that he observed at the Hôpital Hérold in Paris. In order to check for TB you have to catch your germ. The TB germ is called tubercle bacilli. If it’s in the lungs it can usually be coughed up into sputum pots but young children find this very difficult. They cough but then swallow the phlegm. So now for the nasty part. Here’s how Dr Kayne described gastric lavage à la français:

‘The tubercule bacilli are looked for as a routine in a gastric washout. A suitable-sized stomach tube is introduced in the morning before the first feed, and 80 to 100 of warm water (with a trace of sodium bicarbonate) allowed to run in by holding the container about two feet above the child’s head; the gastric contents are then siphoned out by lowering the vessel …Armand-Delille and Lestacquoy (the French docs) claim eminently satisfactory results from this method, and consider it no more inconvenient to the child than swabbing the back of the pharynx (nose cavity) after a cough, or removing a small piece of mucus during a laryngeal (throat) examination.’ The gastric washout was usually sent to the laboratory to be injected into guinea pigs to see whether they developed TB.

By 1944 it was a very routine procedure at Craig-y-nos. In that year 82 children had a total of 169 gastric lavages. Of the 82 children, TB germs were found in 33, and the Welsh National Memorial Association had its own guinea pig breeding laboratory.

With hindsight, it’s a very traumatic procedure as most of the children who experienced it testify. Many can still recall the smell of the red rubber tubing. So how could medical staff appear so callously indifferent to the children’s obvious distress? Children who lived through the 1930s will often recall having their tonsils out with no anaesthetic – another common procedure. It was believed that children didn’t feel pain to the same extent as adults and that they would forget more easily. In the case of gastric lavage, the end justified the means. It was the best way to catch germs from kids who couldn’t cough.

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