PATIENTS' RECORDS: CASE FILES

H64/B/08/01 Case notes: female and male

This incomplete series contains draft notes made on examination with detailed typewritten notes giving 'family history', 'previous history', 'history of present illness', 'on examination' (physical assessment). The case note form changes in circa 1938 giving the following:

- Present illness: onset, last date of employment, previous mental illness, post menstrual history

- Personal history: early development, school, occupation, sexual history, social, religious, personality, present situation - summary of stress factors

- Physical condition: general (including skin, height, weight, complexion), alimentary (teeth, bowels), respiratory, cardiovascular (pulse, blood pressure (BP), cardiac, dullness), renal (urine, specific gravity (Sp Gr), reaction, albumen, deposit), nervous, endocrine (hormone glands) - menses (periods), genital, laboratory

- Summary of abnormal findings

- Family history: brief details of family (number of males and females), whether any alcoholism, criminality, psychopathy (mental illness), psychosis (severe mental disorder in which contact with reality is lost or highly distorted), psychoneurosis (a mental or personality disturbance not attributable to any known neurological or organic dysfunction), twin

- Mental state on admission

- General case summary - including diagnosis, prognosis (prediction about how the case will develop) and treatment.

The notes Include treatment, prescription and diet sheets and incoming letters from patients, their relations and other interested parties and outgoing Physicians' copies of correspondence.

Example:

H64/B/08/01/003 case number 0835 includes the following account written and signed by the Psychotherapist:

Patient: Sir Gerald Maxwell-Willshire, Baronet, aged 44, retired army officer, admitted from home, private doctor: Dr Dewes. Admitted 18 May 1936, Discharged 8 June 1936. Result: 'improved'. Diagnosis: 'Psychopathic personality'.

'Recently the patient has been resorting to undesirable night clubs of late where all forms of perversion are practised and catered for'

'he has long been addicted to various sexual perversions, transvestism has been the most prominent, but it is possible that he has also at times indulged in homosexual practice'.

'he served a term of 9 months imprisonment for an unamiable piece of eccentricity - boot-blacking a girl in Maidenhead. For the past year his life has been continuingly punctuated by long visits, sometimes for a week on end, to a West End Flat kept for the entertainment of perverts, he will remain there in a state of drunken bliss arrayed in feminine clothes and adornments'

'his eyebrows show signs of recent plucking and there is evidence of the wearing of earrings'.

Arrangement: by case number which is given in the catalogue. The date in the catalogue refers to the admission date only and subsequent papers date later.

;H64/B/08/02 Case files: female and H64/B/08/03 Case files: male

Each file includes the form of application for admission of patient giving name, address, age, status, occupation, family doctor, previous illness, when last well, present symptoms, whether the patient is desirous of being admitted, what accommodation desired, payment details, signature of patient and relative. Also includes form of application to the Committee for a grant for a reduction in cost which was usually filled in by a relative and sent to the Secretary. The form includes answers to questions on patient's income, liabilities, savings, and property. Also letters from relations, opinions from doctors and in many cases correspondence from the patient following discharge, and the Assistant Physician's outgoing correspondence, and the Physician's report.

Duplicates some information in H64/B/08/01 but fills gap in that series.

A significant proportion of patients recorded in these files were evacuated from the hospital and letters contained in these files include items from patients sent back to the hospital post-evacuation which may reveal the impact of sudden evacuation in wartime on mental health patients.

Arrangement: by alphabetical order by year. Note that the date given in the catalogue refers to the discharge year, and files contain later dated items concerning each case.;H64/B/08/04 Military and Service patient case notes: female and male

These notes were originally bundled in packets (50 cases per packet) and have been maintained in this way. Unfortunately case notes do not survive for patients admitted March 1943 to November 1945 period.

Each case includes typed notes made by Physician-in-Charge which give the name of the patient, age, admission and discharge dates, and the illness. The notes are divided into the following sections:

- History of Present Circumstance

- Service History

- Previous History, including Family History

- Progress in Hospital

- Discussion and Summary

Also included is correspondence of the Physician-in Charge with the Ministry of Pensions and family members concerning each case, arranging visits and giving reports on case progress.

For example, male case extracts:

Case number: 1867 (see H64/B/08/04/017)

G.E.S. [full name given in case notes] Ex-Lieutenant. Age 22. Admitted 21 August 1946. Discharged 3 October 1946. Psychopathic Personality.

History of Present Circumstance: 'During the fighting in Italy he was captured by the Germans in September 1944, and taken to the Prison Camp at Moosberg. He made an attempt to escape, and was at large for four days in February 1945...His disability was found to be attributable to P.o.W. [Prisoner of War] life'.

Service History: 'He thoroughly enjoyed the fighting and volunteered often for dare-devil tasks...[He] was sent out with his platoon to find the Germans, contact having been lost. They pushed on over the mountains and found the enemy in an Italian village. They underestimated the numbers of the Germans...and started a skirmish by shooting a Sentry...his unit got cut off, and were being fired on by 7 spandaus...[he] gave himself up and they were all taken prisoner. There was a tense moment when the Germans lined them up against a wall, and it looked as if they were to be shot...[he] was brought back on 13.5.45 to England. He webt through the usual reception centre, and then home on leave. He showed some signs of P.o.W. instability: felt bitter against civilians, got across [cross] with his family, kept irregular hours, drank too much, and overate.'

Previous History, including Family History: 'He was brought up in Cardiff as the eldest of four children...his father was inclined to spoil him...as a child [the] patient encouraged his sisters to be tomboys...[at school] he seems to have been outstanding at games, especially football, and this may have turned his head and helped to fix the pattern of his reaction to people in authority.' 'There is nothing of special importance with the family history: they tend to be long-lived, patient's grandfather was a remarkable man, who began life selling newspapers and started the family firm building it up to the point which enabled him to leave £384,000 in his will, according to patient. 4 of patient's uncles were killed in first German War.'

For example, female case extracts:

Case number: 1885 (see H64/B/08/04/017)

Sister C.M.M. [full name given in case notes] Nurse. Age 29. Admitted 22 October 1946. Discharged 10 March 1947. Anxiety state, chronic, mild, unspecified.

Service History: 'She was then sent...near Alexandria. The hospital moved up towards the Western Desert during the fighting all that summer. They were living in tents, and had plenty of excitement with the German advance and with Arab marauders coming into the camp, giving the patient nightmares'.

During the 1930s the hospital dealt with general cases relating to nervous and other conditions. However, in 1939, on the onset of the Second World War, the Ministry of Health sent emergency telegrams to the hospital and most patients were discharged home.

By 1940 the Ministry had taken the hospital over solely for the treatment of Ministry of Service (E.M.S.) servicemen and women patients. Payments for patients were claimed from the Ministry. The hospital's name was changed to Saint Luke's Woodside Hospital for Functional Nervous Disorders. A Military Board to consider cases on a weekly basis and a Military Registrar was appointed. Dr Noel Harris, Physician in Charge, divided cases into groups, including anxiety and exhaustion for example which followed Dunkirk, and where patients could not adjust to service life or suffered from mental conditions previous to the War. Treatments including narcosis which proved successful. Patients who would not accept the impact of the emotional experiences they had encountered during service were often the hardest to treat. In 1944 the hospital received patients who had seen action at D-day in Normandy, France; the majority of the cases were acute exhaustion and anxiety states. Many returned to duty following sedation and narco-analysis.

By 1945, 1705 Service patients had been treated at Woodside, requiring a great variety of treatment. Until 1948, patients were admitted from a wide number of sources which included the following:

British forces: Royal Navy, Army, Royal Air Force, Marines, Merchant Navy, Auxiliary Territorial Service

(ATS), Women's Auxiliary Air Force, Women's Royal Naval Service, WAIMNS, Transport Auxiliary, PMRANS, Civilian Ministry of Service, United Nations Relief and Rehabilitation Administration, Allied Control Commission, National Fire Service and Ex-Service

Dominions: Canadian Air Force and New Zealand Army

India: Indian Army and Navy

Allies: American, Czech, Polish and French Armies and French Navy