Medical and general reports and accounts for the year ended 31st December, 1942 : (from Swaylands, Penshurst, Kent.) Present Address: Ash Hall, Bucknall, Stoke-on-Trent / The Cassel Hospital for Functional Nervous Disorders.

  • Cassel Hospital for Functional Nervous Disorders (Richmond, England)
Date:
[1943?]
Catalogue details

Licence: In copyright

Credit: Medical and general reports and accounts for the year ended 31st December, 1942 : (from Swaylands, Penshurst, Kent.) Present Address: Ash Hall, Bucknall, Stoke-on-Trent / The Cassel Hospital for Functional Nervous Disorders. Source: Wellcome Collection.

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    increase considerably. As far as one is able to judge, with 64 beds available and an adequate medical staff, it should be possible for from 200 to 250 patients to pass through the hospital each year. This larger total should add considerably to the scope and usefulness of the hospital and should serve to reduce the waiting list which has always been a bugbear. It would be most satisfactory if a position could be reached so that urgent cases of neurosis could be admitted immediately. At present this is seldom possible and there is often very considerable delay. TABLES OF RESULTS. The annual tables require little comment. The outstanding feature of Table 2, which shows classifi¬ cation by diagnosis, sex and condition on discharge, is a further slight rise in the proportion of depressions in the series. This rise was forecast last year. It is not great but, in our opinion, it reflects the increased incidence of a type of case which appears to be a typical feature of civilian practice in this war. Cases of depression this year account for 37% of all our admissions, in 1942 they accounted for 30% and in 1938, the last year of peace, for 27%. Long hours of work, lack of adequate recreation and misplaced conscientiousness have all played their part in producing this type of reaction in predisposed individuals. Fortunately such cases have responded well to treatment, either to rest and simple psycho¬ therapy in their mildest examples, or to shock therapy in more resistant cases. The results on discharge for the year are at least as good as for previous years and our follow-up data for patients discharged from 1938 onwards are again quite consistent. In the Annual Report for 1941 an analysis of the follow-up data then available was undertaken with a view to discovering any adverse effects which the war might be having upon this predisposed section of the population. With the exception of the forecast of a rise in the incidence of mild depressive reactions already noted, no such ad¬ verse effects were found. These observations are fully confirmed by the follow-up data presented this year. Gloomy suggestions which have been made from time to time concerning the long-term effects of war strain upon the civilian are not substantiated by our findings, derived from that section of the population in which strain might be expected to show most readily. SHOCK THERAPY. Electrical shock therapy has continued to prove of inestimable value in the treatment of depressive states for which we now reserve it almost entirely. We have entirely abandoned its use for such schizophrenic reactions as have come under our care. In our opinion these patients should be given insulin therapy at the earliest opportunity and time spent on electrical shock therapy is valuable time wasted. We have had no complications among female patients under shock therapy. A few male patients have complained of more or less severe pain in the back which has seldom been associated with radio¬ logical evidence of trauma. There has been no long-lasting disability from this cause. Recently we have instituted the plan first used in America of placing the patient upon a rigid mattress with a firm pillow or rolled-up blanket beneath his thoracic spine. Hyperextension is then applied by pressure upon the shoulders and, if necessary, the hips. The jaw is held firmly over a gag to prevent dislocation. With this method, complaints of pain and stiffness have been very greatly reduced and it is hoped that with improvement in our technique they may be almost completely eliminated. 1942. Total Number of Patients Discharged from Hospital during 1942. New Patients Re-admissions Total Discharged unsuitable with in one month Total in which treatment undertaken 98 11 109 7 102