§ THE EARL OF LYTTON rose to ask the representative of the War Office—
- 1. What provision is being made for the hospital treatment of nerve-shaken soldiers who have been medically diagnosed (after an interval for rest) as "uncertifiables."
- 2. Are any uncertifiable soldiers placed at present under asylum doctors in buildings situated within the grounds of county asylums.
- 3. Are asylums which have been commandeered for the use of soldiers withdrawn during the war from the jurisdiction of the Lunacy "Board of Control" in the same way as the Lunacy "Block D." at Netley has by military custom been always kept apart from it.
§ The noble Earl said: My Lords, the Questions which I have placed on the Paper have reference to a class of men who are, perhaps, more deserving of our pity than any others who have suffered in this war—namely, those whose nerves have been so shaken by their experiences that for a time at any rate their reason has become deranged. Some of these men may probably be permanently disabled, but the majority of them, it is hoped, will ultimately recover. I am sure your Lordships will agree, at any rate in the case of those whose reason is only partially or temporarily deranged, that they should not be subjected to treatment as ordinary lunatics or placed under the ministrations of regular lunacy officials. In the Navy I understand these cases do receive careful consideration and diagnosis, and certification takes place by medical officers belong- 694 ing to the Service and not by asylum doctors; and even in the case of men who are certified as insane, they are placed in special naval hospitals and not in the ordinary county asylums. This principle, I understand, is accepted by the Army also. I fear, however, that owing to the large number of cases which have been created in this war the principle is not carried out in practice. Special provision for hospital treatment has been made for officers, and perhaps the noble Lord who will reply can tell me whether special hospital treatment is also being provided for the men who have suffered in this way. I beg to ask the Questions standing in my name.
§ THE PAYMASTER-GENERAL (LORD NEWTON)
My Lords, uncertifiable nerve-shock cases are treated in the neurological sections of the military hospitals, of which there are twenty-three throughout the country. In addition, accommodation is available at two institutions which were formerly under committees responsible to the Lunacy Board of Control—namely, at Springfield House, Wandsworth, which is situated in the grounds of the Middlesex county asylum although separated by a high fence from the asylum itself, and at the Red Cross Military Hospital at Maghull, near Liverpool, which was to have been opened as an institution for the mentally defective. These are asylums which the authorities have been good enough to lend to the War Department for the period of the war, and are in exactly the same position as Netley as regards the jurisdiction of the Board of Control. Speaking generally, all neurological cases are divided into four classes—(1) cases of nerve injuries caused by wounds; (2) cases of men who are quite insane; (3) cases of a milder character; and (4) cases of epilepsy; and there is special treatment in each of these cases.
695 I should like to supplement my reply by informing my noble friend that in order to obtain information at first hand I have, since the Questions appeared upon the Paper, visited two of these institutions myself—the No. 4 London General Hospital at Denmark Hill, and Springfield House, to which I have alluded. The Denmark Hill establishment is a clearing hospital, where the different classes of patients are sifted; and as for the Springfield House hospital, all I can say with regard to it is that it appeared to me to be an admirably conducted establishment in every sense. There was no sign whatsoever of lunacy treatment of any kind. The only difference I could see between the treatment at this hospital and the treatment at every military hospital was that the diet was on a more generous scale, and that the men were upon the whole considerably mere comfortable. The noble Earl may rest assured that the War Office have no intention whatever of treating these unfortunate men as ordinary lunatics; and if he will avail himself of the opportunity, or if any one else will avail himself of the opportunity, which I know will be gladly granted by the War Office, of visiting these establishments—I should like to add that I visited them without notice—I feel satisfied that he and they will be convinced that there is absolutely no foundation for the allegation which has been made in various quarters—not by the noble Earl himself—against the War Office as regards this particular question.
My Lords, I hope you will excuse me if I detain the House for a few minutes on this matter. My excuse for doing so is that I have been thrown into very close contact with a number of these unfortunate men who are suffering from nervous shock. I am responsible to-day for two hospitals for officers who are suffering from nervous shock, and for a third one for officers who are suffering from organic shock; and we are about to open a fourth for officers who are what we laymen call mad, though we hope only temporarily so. Therefore it has been necessary for me to inform myself as to the best form of treatment for curing these men, and also to satisfy myself that the officers, and the men too, are getting the best possible chance given them for recovery. Therefore I have made myself aware of all the arrangements 696 which the War Office have made for the soldiers under their care, and I ask you Lordships to believe me, speaking with some knowledge of hospitals, when I say that the arrangements made are particularly good, and that they are carried out, I do not like to say with loving care, but at any rate with the most intense desire to do everything possible to help towards the recovery of these poor fellows.
For men suffering from functional nervous injury—men who have lost the power o[...] speech, men who have lost control of their limbs, men who cannot sleep, men who have terrible nightmares, men whom the slightest noise throws into a paroxysm o[...] distress, men who feel the floor is falling away from them, men who cannot go ou[...] into time open air, men who cannot go into a shut room because they see the wall closing in on them—for those men who are suffering from functional nervous disorders the War Office has, as Lord Newton has told us, engaged the neurologic[...] departments of no less than twenty-three general hospitals as special hospitals. I the Men at those hospitals get too bad, i[...] they get into such a condition that they may do harm to other patients, or if they need more care taken to protect themselves from injury, or if, what is so often found, a complete change of surroundings will help them to recover, they are then sent either to the military hospital at Moss Side, Liverpool, called the Maghull Hospital or to the Springfield Hospital at Wands worth. If, unfortunately, they get worse and become mad they are then sent to St. Albans. It is perfectly true, as the noble Earl said, that the Navy have asylums of their own, but it is a questionable point whether they are wise to do so. I know that as a matter of fact it has often been discussed whether it is worth while going on with them at all.
Now, my Lords, what is the supposed grievance? I cannot disguise from you that though the Question is innocent and I believe the questioner himself to be quite innocent, hidden behind this Question there is a grievance which has been agitated about considerably. It has been mentioned in what we call here "another place"; in fact, it would be very difficult to find any place where this supposed grievance has not been mentioned. The grievance is that at Springfield and Maghull hospitals the soldiers are treated by men who have 697 made mental disorders the study of their lifetimes; but it is a complete misconception to try and draw any line between doctors who treat lunatics and other specialists who treat mental disorders. There is no such line to be drawn. It is perfectly true that these doctors who are mainly concerned in treating lunatics are called alienists, out they bitterly resent this agitation that has been got up against them and the representation that because they are alienists every man who goes to them is necessarily mad. If any one that we [...]oved dearly ourselves were mentally afflicted, they are the men in the whole world to whom we should choose to send our own relations, and the soldiers to-day are getting the very best care from these men.
The next grievance is that soldiers are sent to buildings which were formerly used as lunatic asylums, and it is suggested that some stigma attaches to these men because they have been treated in such a building. There is nothing in that grievance at all. Nowadays, there seems to be a sort of breed of persons who discover grievances where none exist. Does a soldier call himself a pauper because he is treated in a Poor Law institution which the War Office have commandeered? Does a soldier think that he has received charity when he goes to one of our civil hospitals when he is wounded because our civil hospitals are supported by voluntary contributions? Do the soldiers think that a stigma is attached to them because they are treated at the large Norfolk lunatic asylum which the War Office have commandeered for the treatment of wounded soldiers? There is nothing at all in such a grievance. But even if there were, I would like to tell your Lordships that the Maghull hospital had never been used at all; though it was built for people of deficient intellect it had never been used before and was a brand new building. With regard to the Springfield hospital, that building had only been used for children. Do the soldiers suggest that they are looked upon as children because they are now in this beautiful building where children were treated before? I could not wish for myself, if I had a nervous disorder, for a more beautiful retreat in which to spend a month or two.
This scheme for treating these poor fellows has been most carefully considered and most properly carried out by Sir Alfred 698 Keogh and his staff—men who have managed the medical part of this war in a way of which it is impossible to speak too highly. Can we not trust them to treat these poor afflicted soldiers properly? What have they done that they should not be trusted? Do your Lordships realise that in this war there has been no dysentery? Do the public know that lock-jaw, which was the great curse of all former campaigns, has been reduced to a negligible quantity? Do the public realise that ever since the war started there have been only 920 cases of typhoid, and that to-day in the whole British Army there are only sixty cases of typhoid? Cannot the men who are responsible for these splendid results be trusted to show sympathy, kindness, and consideration to soldiers who are mentally afflicted?
§ THE MARQUESS OF LANSDOWNE
My Lords, I am sure the House must have listened with satisfaction to the statement made by the noble Viscount opposite. I entirely believe, with the noble Viscount, that there is greet difficulty in drawing a sharp line between medical men who are alienists and medical men who are not, and perhaps also in drawing a sharp line between asylums and institutions, premises which have been used for the treatment of mentally disordered persons and those which have not. But I believe you can draw a very sharp line between the treatment of the two classes of patient, and I am convinced from what I have learned from official sources that it is the policy of the War Office that the treatment of these nerve-shaken men shall in no sense resemble that of ordinary lunatics, or be of a nature which would leave on patients of that kind what is sometimes called the taint of lunacy.