Treatment

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1880s

Drugs

In the late 19th century a number of drugs were used for treatment of patients. Sedatives such as Chloral Hydrate, Hyoscine/Hyoscyamine and Paraldehyde was prescribed. These drugs often had unpleasant side effects and the term chemical restraint was introduced at this time to describe drugs used to quiet patients. These continued to be used into the 20th century, along with new medications including tranquilisers and anti psychotics from the 1950s. Drugs would arrive in large bottles in bulk and then they would be split up into individual doses in order to be taken onto the ward. Powdered drugs would be measured on the scales and then mixed in a pestle and mortar.

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1920s – 1960s

Syringes

Early syringes were made of glass and metal. Those with spouts on the edge would be used for injecting into a vein and those with spouts in the middle would be used for injections into the bottom or shoulder (intra-muscular injection). Nurses could inject antibiotics if patients were unwell, or sometimes patients would be given medicine to calm them down. Nurses would clean and boil the syringes for 20 minutes after use and then again before they next used them. Syringes were also used to administer insulin shock treatment from the late 1930s. However tranquilising drugs had replaced insulin treatment by the mid-1960s.

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1930s

Leucotomy

Leucotomy was a controversial form of psychosurgery which emerged in the 20th century and involved the use of surgical knives, electrodes, suction or leucotomes to cut or scrape away most of the connections to the frontal lobes of the brain in order to trigger a change in the patient’s erratic behaviour. The black marks on the skull would be where the surgeons drilled. During the leucotomy, a qualified nurse would assist the doctor with holding and passing implements. Unfortunately treatment had a permanent detrimental effect on the individual’s personality and intellect. It was common for some long term patients in the hospital to have a scar on their temple. Psychosurgery of this kind is no longer carried out today.

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1930s

Stone mason and carpenters tools

Asylums in the late 1800s and early 1900s functioned similar to small villages. For example, from 1861 to 1948 patients at Glenside Hospital participated in maintaining the ‘hospital community’ ie. helping in the kitchens, gardens, bakery, sewing room and laundry etc. The hospital employed Stonemasons and upholsterers as well as doctors and nurses. These are wooden block planes which were used for smoothing wood. The carpenter would mend and make wooden furniture for use at the hospital. If chairs or tables broke (they were heavy so they couldn’t be thrown around) these could be mended.

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1930s – 1960s

Laundry

It was common for patients to work in the laundry alongside the laundry workers. The laundry was done on a regular basis and the nursing staff would take all of the nightware off of the beds in the morning. Laundry items would be counted to ensure stock control. There was also laundry of patients’ clothing (general cardigans and knickers which were communal clothes). In some hospitals nurses would try to match the suitability of the clothes to the individual patients, taking into account size, colour, style and matching the patient’s taste if they had a preference. Nurses and other members of staff might donate clothes for the patients, however there was not a system of individual patient clothing.

1940s

ECT machine

The Ediswan Electric Convulsion Apparatus is one of the earliest ECT (Electroconvulsive Therapy) machines in the UK, dating back to the 1940s. In the 20th century, ECT was carried out on a regular basis across the whole of the country. The nurses would be responsible for laying up the trolley (this would be mobile with oxygen, ECT apparatus, syringes, water, and saline solution).  The treatment involved giving the patient an anaesthetic, inserting a gum shield, holding a patient to the bed and then applying electrodes to their temples. ECT is still used today in some cases of severe and prolonged major depression, mania or schizophrenia (if other therapies have not been effective). The procedure remains controversial, in part because some patients describe it as an unpleasant experience, and because of the side-effects which can include severe memory loss.

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1940s

Electroconvulsive therapy

ECT was a routine procedure carried out within mental hospitals which involved  passing an electric shock through the brain to induce a seizure. Early ECT, known as ‘unmodified ECT’ was performed on conscious patients, but later anesthetics were introduced. A patient would be held down by nursing staff by ankles, hips and shoulders and either a doctor or the charge nurse would support the jaw to make sure the patient didn’t swallow their tongue and prevent the jaw from dislocating. The head electrodes would be dipped in salt water and applied to the forehead which were removed straight after the procedure. Afterwards the patient would be placed into the recovery position. As soon as the patient came round they might want to get off the bed and even ask for a cup of tea.

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1940s

Sewing machine

It was not unusual for institutions to have a sewing room with a number of seamstress’s working onsite to repair or adjust patient’s clothing. Patients would work in the sewing room, helping to move materials, folding garments and sorting out bags of clothes. Some would have a regular task and some patients might do a little bit of sewing. Patients could gain practical skills and contribute to the running and upkeep of the hospitals.

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1940s

Dentist’s chair

A psychiatric hospital would have access to dental services. There would be a visiting dentist who would come on a regular basis or attend in emergencies, such as a patient having a very painful toothache. A lot of patients had no teeth. There would be a room equipped as a dental room with a steriliser and it would be quite common for a dentist to administer a very mild anaesthetic. There would be a nurse there with the dentist who could look after the patient, but who probably wouldn’t necessarily have been a dental nurse (it would usually have been a psychiatric nurse). Very rarely did a patient own a tooth brush. Dental health was far less than we would expect today.

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1950s

Drug trolley

The trolley in the picture is a ‘Bristol Maid’ trolley from the 1950s. Before the drug trolley, medicine was kept in a cupboard in the Charge Nurse’s office. The trolley was introduced because it made drug administration mobile and more convenient; medication could be given at the dining room table or in the lounge when the patients were sat down listening to the radio. The trolley had a chain on it so it could be attached to a permanent fixture such as a radiator or pipe, meaning it could not be stolen. The lid could also be slammed down quickly and locked if need be. The person in charge of the ward would hold the keys to the trolley. Every patient had a medicine card with their name and ward they were on and the nurse in charge would make sure every patient received and took their medicine.

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1950s – 1980s

Industrial therapy

Industrial therapy was an important part of hospital life and Glenside Hospital lead the way world-wide on its introduction. Industrial therapy developed locally within Bristol between industrialists, trade unionists and the medical staff of the hospital to enable the patient to receive some financial recompense for undertaking relatively simple industrial tasks, like packing, assembling ball pens and some specific activities, such as a car washing. One such activity was the development of a car wash system in St Phillips, an area of Bristol as shown. There was one member of staff allocated there on a permanent basis, with a team of healthy and active male patients who were paid to provide a service to the local population by hand washing cars.

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