438 Colonel George Adami [Feb. 7, 



by taking them in hand forthwith at special hospitals just behind 

 the line. 



It is not possible at the moment to give precise figures, but I 

 believe I do not exaggerate when I say that during the first two years 

 of the war 30,000 cases labelled as shell-shock were on the average 

 returned to England. To repeat, these first were sent to no special 

 hospitals, received no special treatment, and tended to get worse 

 rather than better. It was at the end of 1916 that the British 

 authorities determined to establish a shell-shock centre in each army 

 area. The returns from these are not complete, and here again I 



have to rely upon Canadian figures. That for the army was 



placed under the charge of Captain F. Dillon, R.A.M.C, and this, 

 in the middle of 1017, was transferred to No. 3 Canadian Stationary 

 Hospital in the historic old fortress at Doullens, rendered yet more 

 historic during the war as being the object of a w^holly unprovoked 

 and unforgivable night attack by German aeroplanes in May, 1918, 

 with the death of many patients, medical officers, nursing sisters and 

 orderlies. 



By collecting the cases together, reasoning with, encouraging and 

 persuading them, and above all by the force of example, by the 

 patients seeing daily those around them recovering their good spirits 

 and faculties, an extraordinary change was brought about. At this 

 hospital only a relatively inconsiderable minority was found so 

 affected that they had to be returned to England. According to 

 the report of the 0.0. of the hospital (Lieut.-Oolonel Reason, 

 D.S.O. C.A.M.C), 75 per cent of the cases have been returned to 

 duty, with very few relapses or recurrent cases. Others have been 

 given work along the lines of communication As a result of this 

 system, in place of 30,000 only some 2000 were in the last year of 

 the war returned to England. 



Soldier's Heart. 



Not wholly unassociated with shell-shock is the condition known 

 as irritable or "soldier's heart." This condition had been studied 

 in the American Civil War by Da Costa, and since then by Sir 

 Clifford Allbutt, Sir William Osier, Sir James Mackenzie and others, 

 with at first no clear results. It was left to the Medical Research 

 Committee, at the instigation of Mackenzie, Osier and Allbutt, to 

 offer a special hospital at Hampstead, and later, when this was too 

 small, at Colchester, for the particular study of heart conditions in 

 the soldier, under the more immediate care of a staff of highly- 

 trained expert physicians, with Dr. Thomas Lewis at the head, and 

 the above-mentioned three as consultants. Such progress has been 

 made in the diagnosis and treatment of these cases that, not to go 

 into detail, it may be said that 50,000 men have in one year been 

 saved to the army, instead of being returned to civil life as hopeless 



