Looking Back: From TB colony to pioneering heart and lung surgery

Patients beds were placed on the balconies so they were able to have plenty of fresh air.

Patients beds were placed on the balconies so they were able to have plenty of fresh air. - Credit: ROYAL PAPWORTH

In the early part of the 20th Century, the tiny village of Papworth Everard, on the outskirts of Huntingdon, was home to a TB colony. The expertise gained from treating the lung condition attracted the leading lights in the field and eventually led to the creation of a world-renowned pioneering heart and lung transplantation hospital.  

On February 12, 1918, 17 patients arrived at Papworth Hall, many of them were discharged soldiers from the battlefields of France and Belgium. During the First World War, cases of tuberculosis surged and the chronic infectious disease was killing thousands of people each year. In 1915, more than 41,000 people in the UK died of TB.

The Cambridgeshire Tuberculosis Colony – as it was known then – was founded from Dr Pendrill Varrier-Jones’ experimental scheme to deal with what he described as the “aftercare problem” and had been relocated to the village of Papworth Everard from nearby Bourn following a donation of £5,000 from a wealthy philanthropist.

The move allowed Dr Varrier-Jones’ to realise his vision for a long-term approach to caring for not only the patients but his concept of a colony, which would treat, house and employ patients and their families.

The Papworth settlement was more than just a sanitorium and fresh air and light work were believed to be central to recovery. TB patients’ beds were placed on the hospital balconies and wooden huts were also built in the grounds to house patients.

Wooden huts were built in the grounds of Papworth Hall for the TB patients.

Wooden huts were built in the grounds of Papworth Hall for the TB patients. - Credit: ROYAL PAPWORTH

The huts were basic wooden boxes, with a door and a flap, and the flaps were left open all day, all year round and were said to be freezing in winter.

Other early TB treatments involved collapsing the lung, as doctors believed the diseased lobe would heal quicker by resting it.

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Sometimes the lung was collapsed using ping pong balls placed in a cavity under the ribs (plombage), and sometimes by removing ribs from the chest wall (thoracoplasty).

In 1929, the colony was renamed the Papworth Village Settlement, and in 1948 the treatment blocks were passed to the National Health Service and the facility began to expand its services and develop expertise in other areas.

The treatment of TB had attracted some of the best chest and lung surgeons around at that time to Papworth and it was this expertise that drove innovation and over time led to the foundlings of heart and lung transplantation surgery.

The early days of treating people with TB and the pioneering work of Dr Pendril Varrier-Jones laid the groundwork for the hospital to become a centre of world excellence for pioneering heart and lung transplant surgery.

Over the years, the hospital established an international reputation for excellence in research and innovation.
Professor John Wallwork, chairman of the Royal Papworth Hospital NHS Foundation Trust, says: “As surgery started to be used as a treatment for TB, hospitals like Papworth attracted chest surgeons to come and work here, and over time they moved into other types of heart and lung surgery, for example transplantation.”

Professor John Wallwork says the TB colony attracted the best long surgeons to work at Papworth.

Professor John Wallwork says the TB colony attracted the best long surgeons to work at Papworth. - Credit: ROYAL PAPWORTH

He continued: “Once we started performing UK and world ‘firsts’ at Papworth – like the first successful heart transplant in the UK in 1979 and the world’s first heart, lung and liver transplant in 1986 – we became known all over the world.

This helped us to attract more world-class doctors and develop specialist services, not just in transplantation, but also the treatment of pulmonary hypertension, cystic fibrosis and sleep disorders.”

Surgeon Ben Milstein performing surgery at Papworth in 1960.

Surgeon Ben Milstein performing surgery at Papworth in 1960. - Credit: ROYAL PAPWORTH

In August 1979, surgeon Terence English performed the first successful heart transplant in the UK at Papworth Hospital. The patient, Keith Castle, lived for more than five years following his surgery. In 1984 the first UK heart and lung transplant was carried out at Papworth and in 1994 a team of doctors carried out a revolutionary operation on 62-year-old Arthur Cornhill who received the world’s first permanent battery-operated heart.

The hospital remains committed to pioneering new treatments in heart and lung medicine. It is the only UK centre for the innovative pulmonary endarterectomy (PTE) surgery, and successfully pioneered transplants using non-beating hearts, which has increased heart transplantation at the hospital by a third.