Report and accounts for the year ended 31st December, 1935 / The Cassel Hospital for Functional Nervous Disorders.

  • Cassel Hospital for Functional Nervous Disorders (Richmond, England)
Date:
[1936?]
Catalogue details

Licence: In copyright

Credit: Report and accounts for the year ended 31st December, 1935 / The Cassel Hospital for Functional Nervous Disorders. Source: Wellcome Collection.

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    cases of mild depression with parsesthesise of the type commonly called “neurasthenic,” one of which may have been a true nervous exhaustion. Of the re-admissions discharged during the year 5 were cases of depression, one of them with maniac phases, hysteria 5, obsessional states 2, anxiety states 2, “ neurasthenia ” 2, chronic alcoholism 1 (patient re-admitted twice), schizophrenia 1. The Director cannot unfortunately speak personally of several of the cases mentioned as the patients were discharged before he took up duty. The long duration of the symptoms before admission in an overwhelmingly large number of cases is a striking feature, and the virtual impossibility in many cases of forecasting the future of the patient when first seen becomes ever more evident. The seemingly hopeless patient, for many years useless to the community, has achieved a measure of adjustment sufficient to permit him to live again without friction in the world, and in some cases to take up a useful occupation on leaving the Hospital. The patient with a prima facie good prognosis after months of treatment has remained as before and so on. Others who left apparently unchanged were reported later by their relatives to have seemed much improved. Obviously however such reports are of little value until a longer period has elapsed. A word may be said about the selection of cases for treatment. Experience has shown that in many cases the general practitioner’s description could not be relied on as indicating suitability. Nevertheless, and this is a point the Director wishes to stress, such cases even if unlikely to respond to treatment are by no means valueless, as the Hospital has a wider sphere of usefulness to the community than that of merely treating patients, namely that of research. The necessity for detailed clinical and experimental research in this dark field of medical study becomes ever more apparent, and with it the desirability of preserving complete freedom from narrow conceptions of the genesis and structure of these disorders. It is the Director’s earnest hope that such research in which the example was set by his distinguished predecessor will form not merely a side line in the Hospital’s activities but a dominant feature. Unfortunately, as far as the present staff is concerned their time is so fully occupied with their duties that little is left for reflection and for discussion of the problems involved. An all important line of research is that of the hereditary and constitutional relationships of the neuroses, and it is to be hoped that at no distant date it may be possible to investigate the incomparable and in many ways unique material of the Hospital along these lines. Daily experience shows with increasing force the part played in these illnesses by heredity. Indeed it is hardly too much to say that one very rarely finds a family history in these patients which is entirely negative in respect of similar illnesses. But impressions are of little value; what is required is carefully controlled research. With regard to the details of the treatment given at the Hospital it is unnecessary to remind this Committee that first and foremost comes the personal relationship of the patient to the physician ; the question of the particular technique employed is probably second. Indeed without the former no technique will avail.