Page:The Modern Treatment of Mental and Nervous Disorders.djvu/28

— 26 — hospitals, for example, have out-patient departments to which these cases may be brought for advice. But, unfortunately, out-patient treatment is necessarily inadequate for patients of this type, and valuable though these departments unquestionably are, they do not afford any satisfactory solution of the problem.

With regard to nervous disorders, the neurasthenias, hysterias, and "nervous breakdowns," the facilities are somewhat greater, but they still fall very far short of reasonable adequacy. The general hospitals have out-patient departments for these cases, but few admit them to the wards, or possess wards in which the necessary treatment is obtainable. Special nerve hospitals are mainly concerned with organic diseases, and although a certain number of "functional nervous" patients are received into the wards, this number is very restricted. Moreover, these special hospitals are naturally few and far between. Here again treatment is available for those who can afford the consultant and the nursing home, but for the great bulk of the population little can be obtained.

The outlook for a certain class of these patients, however, has been radically altered by the experiences of the war. The cases of "shell shock," which are almost all typical examples of nervous disorder in the sense in which the word is employed in this lecture, have been very numerous, and it has been absolutely necessary to provide efficient treatment for them. Many special hospitals have, in fact, been established in which this treatment is obtainable.