In the final episode of Downton Abbey season 5, Lord Grantham experiences chest and abdominal pain, tells Cora his doctor wants to do “some tests”, and comes back with a diagnosis of ulcers.
What sort of diagnostic tools would have been available to a physician in a reasonably large city (I think Downton has him going to see his doctor in Kent) in England in 1924? What about a specialist in a state-of-the-art medical facility elsewhere in Europe or the US?
I always assumed that there were no tools for the definitive diagnosis of gastric problems like ulcers prior to the development of the endoscope/gastroscope or advanced radiographic methods like a barium swallow (with or without a tilt table). Did either of these tools exist by the mid-1920’s? Or would the aforementioned “tests” consist of a Q&A session and logical deduction, e.g. “You say your chest doesn’t hurt all the time, it’s worse with exercise but you have no shortness of breath, the pain is worse after you drink alcohol or eat cream sauce… sounds like an ulcer to me”?
They were doing barium x-rays in the 1920s, and that’s probably what the doctor would have used. And also, btw, he was seeing a doctor in York. Downton Abbey is apparently somewhere near Ripon, which means York is about 30 miles away. Maidstone, the county town of Kent is about 250 miles away.
I had no idea they were doing barium x-rays that early.
I apologize sincerely to anyone I may offended either with my abysmal knowledge of English geography (really, I couldn’t look at a map before I posted that?) or my embarrassing inability to remember recurring details from a show that I’ve followed for several seasons (*how *many times does a character go to York for something or other?).
Barium would have been used as a contrast medium even earlier than the 1920s. All kinds of things were tested, often with dire consequences (look up Thorotrast for an excellent example of this).
Yes, he would have had a barium swallow, and possibly a gastroscope.