Recipient of C.Hubert Bond to 'The Chairman', 9th Dec. 1930.
9 Dec 1930
Description:

‘The Chairman.

I have given careful consideration to this matter and to make sure of my facts and of the position I paid a visit when in the neighbourhood on the 5th instant to Horton Mental Hospital and saw Lt. Col. J.R. Lord.

As you say, the malarial treatment of general paralysis has largely gone beyond the experimental stage. I am afraid however that in some areas the position can scarcely be said even to have reached the experimental stage; for instance there are about 20 of the 98 Mental Hospitals that are still without a laboratory; and on more than one occasion I have found that a strong recommendation to use malarial therapy is a useful lever to get a laboratory installed and started. Then apart from the existence or absence of a laboratory, there are still a number of Institutions at which malarial treatment does not seem to be given; thus there was a nil return re 1929 from 42 of the County and Borough Mental Hospitals, from 9 of the 14 Registered Hospitals, and from 49 of the 54 Licensed Houses. So you see there is a pretty considerable field in which we must still peg away. I feel it is worse than useless to exert too much pressure because, if there is not an awakened desire to undertake the treatment, its results may prove poor and even dangerous and bring about a certain amount of disrepute to it. For instance, at Horton, which has caught up the enthusiasm for this line of treatment that in this country arose at Whittingham, a death while the patient is under malarial treatment is practically unknown. The Laboratory and the excellent arrangements set up at Horton are to my mind doing a piece of work that fairly could be called National; one might almost say International; because besides students attending there from this country to watch the modus operandi of the treatment, students sent by the League of Nations also attend for the same purpose. It is of course, Col. Lord’s colleagues and their Technical Assistants, that, with the assistance afforded by the Ministry, actually carry out the work; but, while he himself makes no claim to credit in the matter, I am much impressed by the good service which Lord has rendered, and is still giving, in this work. Without his enthusiasm and pride in the centre which, with the consent of his Committee he has established at Horton, and without the watchful eye he keeps over it and his determination to see that the facilities are thoroughly maintained, this highly useful centre would never have come about.

It is perhaps a little outside my province to say so; but it does seem to me that the Ministry would be wise, through us as agents and through Col. James, to keep a watch and a hold – for the sake of the public health – as long as they can on this line of treatment.

I greatly hope that the Treasury may be persuaded to continue the present arrangement.

Hubert Bond. 9th December 1930.’

Recipient of H.A. Leggett to [Secretary, H.M. Treasury], 20th Dec. 1928.
20 Dec 1928
Description:

‘Sir,

I am directed by the Minister of Health to state, for the information of the Lords Commissioners of His Majesty’s Treasury, that the arrangements for providing adequate assistance for the work in connection with the malarial treatment of persons suffering from General Paralysis of the Insane has once more been under his consideration.

When the work was originally undertaken by the Department the treatment was entirely in the experimental stage and it was, therefore, essential that the supply of mosquitoes and the control of the treatment should be in the hands of the Ministry. It now appears possible that it shortly will emerge from the experimental stage into a definite and recognised system of treatment. This stage has not, however, yet been reached. There is still difficulty in securing that the mosquitoes are infected with the right type of malaria; the treatment, while becoming more and more recognised, is still looked at with some apprehension by certain of the Medical Superintendents of Mental Hospitals, and these Medical Superintendents still need careful instructions in administering the treatment; and it is essential that all the results should be closely watched and studied in order to perfect the technique of the treatment; and it is essential that all the results should be closely watched and studied in order to perfect the technique of the treatment. It is further the case that was this is the only definitely positive treatment for General Paralysis of the Insane that has ever been successfully tried it is vital that, until the technique is definitely settled, the present control should not be diminished.

While, however, the experimental stage cannot be yet said to be over, it is felt that the experiment is sufficiently advanced to justify the consideration of the future to ascertain whether, and if so, by what means full financial and other responsibility for the operation of the system, subject of course, to such central medical supervision as may be necessary, should be placed on local authorities.

The Minister is not yet in a position to give any indication of the date from which the full control now exercised can cease, and though it is clear that the present arrangements are of a temporary nature only and cannot involve the Department in any permanent commitments, it is probably that the present arrangements must necessarily continue for the next two or three years.

The general medical control of this work is exercised by one of the Medical Officers of this Department but, since the latter part of 1927, it has been necessary to supplement this by obtaining the services of one of the Medical Officers of the London County Council employed a the Horton Mental Hospital, the Minister paying for the cost of the substitute of this officer out of the Special Inquiries and Services Subhead of the Vote. This arrangement comes to an end on the 31st March, 1929, and the Minister does not propose to renew it. The duties of the Medical Officer consist partly in the general supervision of the care of the patients and of the laboratory activities at the Horton Hospital and partly in taking infected mosquitoes to different hospitals throughout the country for inoculating patients and giving advice on the care and management of patients.

The London County Council is prepared to allow the Deputy Superintendent at Horton, who is fully cognisant with this work, to perform the necessary supervision of the patients at that institution, without any payment by this Department, and the Minister is now satisfied that, as most of the other hospitals have been visited at least once and the necessary precautions taken and management of cases are more widely known, the work of visiting the various hospitals with infected mosquitoes can in a number of cases now be devolved upon a competent laboratory assistant.

There are at present two Laboratory Assistants employed by this Department on this work; one a permanent officer who is specially qualified, and the other a temporary officer whole employment was sanctioned for a period of one year by Sir H.H. Scott’s letter of the 15th October, 1927. (E.4102/2).

If the work of conveying infected mosquitoes to the various hospitals is in general to be performed by a Laboratory Assistant, it is necessary, not only that the employment of the present temporary laboratory assistant should be continued, but that an additional officer should be appointed, who, having regard to the considerations set out above, the Minister would propose to be a temporary office.

The Minister would accordingly be glad if Their Lordships would be please to approve, for a period of two years,

(a) the continued employment of the temporary woman laboratory assistant sanctioned by Sir R.R. Scott’s letter of the 15th October, 1927.

(b) the employment on a temporary basis of an additional laboratory assistant on the scale applicable to a Second Class Laboratory Assistant, viz. £91.5 - £5 - ££120 per annum plus bonus.

I am, Sir,

Your obedient Servant,

H.A. Leggett.’