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SURGERY - not many years ago - was often rough and ready, especially in and around the battlefields. In the early years of the last century standards were sometimes poor, even in hospitals.
This photograph is of an X-ray on the left leg of soldier John Albert Harwood of Darwen who was shot while serving in the 1914-18 war. And, yes, those are rusting joiner's nails pinning the bones together...
* The X-ray picture of Private Harwood's knee has not been digitally enhanced in any way.
John Albert enlisted in the East Lancashire Regiment and later transferred to the 1st Manchester Regiment. A ship he was on was machine-gunned and he was hit in the left knee.
Back in England a Canadian surgeon named Joyce carried out an experimental operation at a military hospital near Reading, cutting away shattered bone from above and below the knee and fitting the bones together with ordinary nails - a six inch round-headed nail and a four inch countersunk nail. Private Harwood had nearly 200 stitches in the leg and was in hospital for 18 months.
A professional strong man before the war, Mr Harwood set up as a shoe maker and clog repairer in Pitt Street, Darwen, and he and his wife Bertha had a fourth child. However, as the nails rusted away, blood poisoning set in.
John Albert Harwood was a brave and a hard man, but he was in agony in his final months and he died in Grangethorpe Military Hospital, Manchester, in April 1924.
Consultant surgeon Hugh Thomas, one of the foremost authorities on war wounds, examined the X-ray photograph a few years ago and described the attempted fusion as "extremely crude." His "uncomfortable conclusion" was that it would have caused "very considerable pain, suffering and continued infection."
Mr Thomas said he had attempted to discover whether the use of nails in this manner had ever been a feature in our military hospitals "but everyone was reluctant to admit this - very understandably." He said he had never come across a case quite like it.
It's perhaps not surprising that Authority, over the years, has chosen to turn something of a blind eye to the sad story of the experimental operation on Private Harwood's leg. It isn't the sort of image the Army is keen to promote, even now. The Imperial War Museum North in Trafford were very enthusiastic a few years ago but then, suddenly, they lost interest.
Private Harwood left his widow to bring up four children; two boys, Tom, aged 13 and Joe, aged 11 and two girls, Margaret, aged 7 and a baby, Mabel. He was 38 years old.
In his 90s, Tom remembers his father coming home for the first time in his hospital "blues". "On his left leg he wore a boot which was built up several inches and he had to use crutches to get about. We were in very poor circumstances. We didn't have any carpets or lino on the floor, just sand. We used to buy it in a loaf tin for a penny.
"Before he became really bad he managed to get my mother pregnant again. We didn't know, but one day we were sent to a neighbour's house and when we came back we found we had another member of the family.
"My father became seriously ill and he used to have kidney fits and thrash around on the bed. My mother used to run next door for help and two big lads called Hindle would come and sit on him to hold him down because he was so strong.
"We couldn't afford to go and see him when he was finally taken to hospital because his fits had become so bad. We phoned or telegraphed occasionally from the post office and one day I remember watching as the chap on the counter wrote out a note that my father had died that morning. I had to go and tell my mum”.
Tom remembers the funeral well. "It was quite a modern affair because instead of the usual horsedrawn hearse we had a motorcar. I remember all the men at the side of the road doffing their caps as we passed. It was a traditional courtesy in those days”.
John Albert Harwood died of nephritis - inflammation of the kidneys - and uraemia, a serious toxic condition caused by an accumulation in the blood of waste products. It is characterised by violent headaches, vomiting and, in its acute form, convulsions and coma.
His widow lived to be 90 and is buried in the same grave at Darwen Cemetery.
Article by Harold Heys, grandson of John Albert Harwood.