Medical and general reports and accounts for the year ended 31st December, 1945 : Present Address: Ash Hall, Bucknall, Stoke-on-Trent (from Swaylands, Penshurst, Kent) / The Cassel Hospital for Functional Nervous Disorders.

  • Cassel Hospital for Functional Nervous Disorders (Richmond, England)
Date:
[1946?]
Catalogue details

Licence: In copyright

Credit: Medical and general reports and accounts for the year ended 31st December, 1945 : Present Address: Ash Hall, Bucknall, Stoke-on-Trent (from Swaylands, Penshurst, Kent) / The Cassel Hospital for Functional Nervous Disorders. Source: Wellcome Collection.

    10/20 (page 7)
    anxious patients and is often associated with pain in classes. These, besides being beneficial and stimu- the back of the neck and shoulders, and with appreci- lating, have a definite re-socialising value. able tension of arms and pectoral muscles when Country Dancing is held once a week during the treatment is being given. At a later stage massage winter Thig ig a more strenuous forra of exercise is gradually replaced by exercises, until, at the end of a than Keep.Fit and reqUires greater concentration, fortmght or three weeks, the patient is able to attend Attendance is voluntary, but the majority of the the Keep-b it class. patients who are fit to do so, take part, and thoroughly These classes are held twice weekly, on medical enjoy an evening’s pleasant entertainment. The stan- prescription. Most of the exercises are of a slow dard of dancing is not very high, but the spirit in rhythmical nature, all inducive to relaxation. Team which it is done and the pleasure obtained compensate games are very popular and are introduced into many for that. ANNUAL STATISTICAL Results for 1945 Ninety-two patients were discharged from the hospital during 1945. Of these, three were dis¬ charged within one month as being unsuitable for treatment in the hospital. These three cases are excluded from Table 2. It should be noted that patients who discharge themselves against advice within this period are counted as “ Not improved,” since it is felt that this represents a failure in treat¬ ment rather than an exclusion on grounds of unsuit¬ ability. There is a preponderance of female patients which is still almost certainly due to the abnormal period in which a large number of men were in one of the Ser¬ vices and therefore receiving treatment in Service hospitals. The ratio between males and females is likely to become more even again within the next year or two. The results on discharge (Table 2) show a very close similarity to those of previous years as shown in Table 3, and the diagnostic groups show an equally close similarity of distribution with those of previous years (not shown in tables). In comparison with the years before the war there has been a slight relative increase in the number of patients admitted with a diagnosis of affective neurosis in comparison with the hysterical reactions and the depressions. For example, in 1939 the affective neuroses totalled 45, hysterical reactions 31, and depressive states 48 (available bed numbers were then 64). This trend may reflect to some extent a change in diagnostic concepts. Nevertheless, there are grounds for believ¬ ing that major hysterical reactions are less common in the hospital than they were. Electric shock therapy has continued to be used with striking success in the treatment of depressive states. In addition to those shown in the table many have been treated as out-patients with equally good results and without any serious complications. A small number of patients suffering from affective TABLES FOR 1945 neurosis have also received shock therapy. For these the treatment possesses in no sense the specific action shown in the depressions. It is, however, sometimes a useful procedure in the course of psycho¬ logical treatment in helping to break up the rut forma¬ tion and chronic invalidism associated with certain affective neuroses. Two patients have been submitted to prefrontal leucotomy. Both presented severe personality dis¬ orders with chronic anxiety and depression which failed to respond to other means of treatment. Both responded excellently to the operation. Among organic and toxic reactions is included a patient suffering from addiction to paregoric of which he was consuming more than a pint a day. He had developed an encephalopathy which appeared to be associated with a Vitamin B deficiency, and his general condition and mental state improved remark¬ ably with the administration of massive doses of Vitamin B. The group also includes two patients suffering mainly from an exhaustion syndrome fol¬ lowing prolonged overwork who responded rapidly to sleep treatment. Follow-Up Tables The number of patients replying to the annual follow-up letter is very high this year, particularly in respect of the 1941 and 1942 groups. It is, for example, quite unusual to get a 50% response at the end of the fourth year after discharge as has occurred this year in the cases discharged during 1941 (Table 3a). This is the more remarkable since many letters were inevitably returned marked “ Gone away, address not known,” and the percentage of replies from those actually reached was very high indeed. The probable reason for this success is that each patient receives a personal letter concerning his own immediate problems, commenting if possible upon his report of the previous year. It is felt that the results wholly justify the extensive work involved. TABLE I Total Number of Patients Discharged from Hospital during 1945 New Patients Re-admissions Total Discharged unsuitable within one month Total in which treatment undertaken 83 9 92 3 89