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History of Psychiatry in Bristol (4)

Bristol Psychiatry after 1918

The Bristol Lunatic Asylum at Fishponds returned to its old routines after the war.  The first out-patient service was established in Bristol General Hospital in the early 1920's.  On March 10th 1924, Dr E Barton-White Medical Superintendent.  He immediately gave notice in a firm, quiet way that change was intended.  He set about equipping a new research laboratory.  The lab was capable of routine examinations and of original research entailing histological tissue examination of organs including endocrine glands.  In Dr White’s time, many articles were published in the medical press and research results were presented e.g. to the Annual Spring meeting of the Royal Medico Psychological Association (R.M.P.A.) held in Fishponds on 10th February 1928 and at the South West Divisional Meeting of the R.M.P.A on 16th October 1928.  The clinical work in Fishponds was supported by a lengthening list of consultants in pathology, surgery, gynaecology, ophthalmology and in medicine by Dr Carey Coombs.  More complete notes were made on admission, routine special tests were readily available. Attempts were made to assign the principal contributory causes to presenting clinical conditions but these had a limited horizon eg. insane heredity, alcohol, syphilis and general stress.  By 1926 the changes in hospital activity were so noteworthy that the Commissioners praised the standard of professional work especially the character of clinical records and of autopsy examinations.

 

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Dr Barton-White, his Assistant I.T.O.’s and Male Staff

Nursing Staff

Up to the 1930’s there were few physical treatments available for mental illness apart for those employed for symptomatic relief. Malarial treatment which was introduced by Wagner-Jauregg in Vienna in 1917 for General Paralysisof the Insane (G.P.I ) was first used in Fishponds in 1927.  Two male patients were infected with malaria, one of whom recovered sufficiently to be discharged.  The other underwent the inevitable fate of the untreated case: physical and mental deterioration and death.  A permanently mosquito proofed room was arranged in the male side of the hospital.  If the treatment took place on a female ward, between May and October temporary mosquito proofing was required.  The treatment continued to be used until the introduction of Penicillinin the 1940’s.  A six yearsurvey from, 1931 to 1936, showed 72 cases treated of which 43 recovered sufficiently to be discharged from hospital, an impressive 60% recovery rate for an illness 100% fatal in pre-treatment days.

No voluntary patients could be admitted to any psychiatric hospital until 1931 when the  'Mental Treatment Act' came into operation.

More beds continued to be needed.  In 1928, negotiations broke down for the near-ideal site at Oldbury Court, Fishponds, a magnificent estate neighbouring Glenside hospital.  In 1930, the City Council purchased 260 acres of land in the Wild Country, (so named in the Ordinance Survey Map) Barrow Gurney, North Somerset.  This was a difficult site, subject to flooding on the south side of Bristol 11 miles from Fishponds.  Dr Barton-Whitein October 1936.

Although not officially opened until 3rd May 1939, Barrow Hospital received its first patients in May 1938. The Visiting Consultant staff was common to both hospitals, but a different approach was immediately apparent in the dissimilar titles accorded to the workaday medical staff. In Barrowthe doctors were appointed as Senior Physician, Assistant Physician and Research Worker. In Fishponds the older appellation of Assistant Medical Officer applied. Soon other inter-hospital difficulties were evident. Whilst Barrowwas being built, the upkeep of Fishponds was neglected.

Cardiazol convulsion therapy was introduced in 1937 and reported on by Hemphill, Gibsonand Coates.  Electro-convulsivetreatment (ECT) was first used in 1939.  Its complete loss of memory of the time immediately before and after treatment, was much less distressing to the patients but Cardiazol was considered to be clinically more effective by staff.  Throughout 1939 and 1940 Professor Golla  and Mr Grey Waltervisited the hospital several times weekly to carry out the treatment using the Ediswan machine they had designed.  Of the first thirty-seven patients treated with ECT, thirteen were reported to have recovered and eleven to have improved.  E.C.T.was “extended to schizophrenics and manic-depressive cases.”  Of the first 75 female patients treated 20 recovered, 22 improved and 33 failed to benefit.  Improvement was marked and most consistent in cases of agitated melancholia.  An example of the Ediswan ‘Electro-convulsere Therapy Apparatus’ used in the Hospital can be seen at the Hospital Museum.

As war loomed the preparations were made at Fishponds. The wards were surveyed with a view to strengthening them and protecting them from bomb blast.  The patients were drilled, gas masks were supplied, Air-raid precaution (A.R.P) lectures given to staff and the hospital firebrigade was re-organised.

By the end of 1938, it was known that Barrowwould be evacuated in the event of war. Nevertheless it was officially opened by Sir Lawrence Brock, CBE Chairman of the Board of Control on May 3rd 1939. Barrowwas a considerable improvement over existing accommodation, as different in its way as Fishponds was from St Peters in 1861.

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Barrow hospital as planned

During its first year of life, almost 50% of admissions to Barrow were on a voluntary basis. Physical standards within the hospital were excellent, but only private patients were allowed to wear their own clothes “because of storage problems.”

On September 2nd 1939 the day before war broke out, those patients in need of continuing treatment were transferred to Fishponds.  On September 3rd, war was declared and the Royal Navy took over Barrow resulting in a loss to the Bristol Mental Health Services of 375 beds and increasing the grave overcrowding in Fishponds.  

World War 2 at Glenside

On the outbreak of war 10 male nurses including 2 senior officers joined the Services as did an assistant baker and an engineer’s labourer.  By the end of 1940, 42 members of the male staff were serving in the forces.  Thirty-nine (39) out of 56 female nurses left the service within 2 months of joining.  Staffing difficulties affected all departments.  The medical situation became very difficult.  

Pre-frontal leucotomy operations were carried out in 1941-1943 by Mr F. W. Willway and by Mr Lambert Rogers at the Burden Neurological Institute.

By the end of the war the staffing situation was close to crisis point.  The male nursing staff numbered a mere 60 for 522 patients whilst the female nursing staff stood at 56 where the pre-war number of 130, was itself inadequate.  The new superintendent had himself barely escaped from convalescent status but his drive and energy immediately became evident.  Even the undertaking of mundane administrative mental hospital duties could not hide his enthusiasm for the newly formed Department of Psychiatry at the B.R.I. Out-patient attendance increased and a new phase in teaching began.

 The absence of an InsulinDepartment was addressed.  Miss Diffleya doubly qualified nurse, was appointed in nursing charge of a newly established Insulindepartment where treatment started early in 1945.  In this treatment patients were put into an insulin-induced coma for a time.  It was seen as an effective treatment.

               

        

 

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Last updated: 01/31/12.