{"id":56,"date":"2011-12-14T00:39:31","date_gmt":"2011-12-14T00:39:31","guid":{"rendered":"https:\/\/blogs.bmj.com\/jnnp\/?p=56"},"modified":"2012-03-23T10:42:43","modified_gmt":"2012-03-23T10:42:43","slug":"the-hospital-for-incurables-what%e2%80%99s-in-a-namef","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/jnnp\/2011\/12\/14\/the-hospital-for-incurables-what%e2%80%99s-in-a-namef\/","title":{"rendered":"The Hospital for Incurables: what\u2019s in a name?"},"content":{"rendered":"

 <\/p>\n

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Can semantics get in the way of progress?<\/figcaption><\/figure>\n

<\/strong>By <\/strong>our roving blogger Dr Susanna Park
\n<\/strong><\/p>\n

Directly over the fence from my new home, there lies a complex with an impressive Victorian fa\u00e7ade, proclaimed as the Royal Hospital for Neuro-Disability. It is clear that this facility has been operating here for a long time, probably ever since the Victorian era. What was the history of this hospital next door and how did it come to occupy such a stately building? My interest was further piqued when I found an old map of the area and written in small italic print was \u2018Hospital for Incurables\u2019<\/em>.<\/p>\n

The Hospital for Incurables was founded in 1854 by the distinguished philanthropist Dr Andrew Reed and moved to its current location, a former part of the Lord Spencer\u2019s estate with 25 acres of gardens in 1863.\u00a0 Florence Nightingale advised on the design and the estate was supported by notable personalities of the day such as Charles Dickens, as well as several distinguished royal patrons. At the time, there were very few options for poor patients with so-called \u2018incurable\u2019 conditions 1<\/sup>. Most prominent hospitals of the day were designated as facilities for patients with acutely curable disease and often specifically excluded incurables in their charters 2<\/sup>. The difficulties experienced by incurable patients in obtaining care were commonplace in the 19th<\/sup> century. In the United States, hospitals also routinely excluded patients with incurable diseases from hospital beds3<\/sup>. The term \u2018incurable\u2019 was typically reserved for chronic diseases which required long-term care, such as cancer or tuberculosis 3<\/sup>.<\/p>\n

The Hospital for Incurables became the only facility specifically designed for such patients in London at the time, although there were \u201c270 hospitals and infirmaries for curable patients\u201d in London in 1860 4<\/sup>. Over time the focus of the hospital has shifted towards neurological conditions, perhaps as public consideration of cancer and tuberculosis as incurable, untreatable diseases has changed.<\/p>\n

In his 2009 book Incurable and Intolerable: Chronic Disease and Slow Death in Nineteenth Century<\/em> France<\/em>, Jason Szabo suggests that the development of treatments for chronic diseases in the 19th<\/sup> century was hindered by the widespread belief in their incurability 5<\/sup>. Szabo writes that \u201cA critical early step in this crusade involved questioning the scientific validity and social consequences of the term incurable.\u201d Perhaps in line with this type of thinking, the Hospital for Incurables changed its name to the Royal Hospital for Neuro-Disability in 1995. Currently, the focus is on assessment, treatment, care and rehabilitation for patients with neurological disability.<\/p>\n

The question remains – Can semantics get in the way of progress? As with cancer and tuberculosis, is it possible that our current attitudes as to the incurability and hopelessness of neurological disorders are hampering the fight to convert these into chronic but treatable conditions? Spinal cord injury, traumatic brain injury, neurodegenerative disease \u2013 do these disorders represent the new frontier in the redefining the boundaries of possibility? Perhaps the words of Charles Dickens, in his weekly journal \u2018All the year round\u2019 sum it up best:\u00a0 \u201cWhat is meant by Incurable? A disease called incurable in one generation, is curable in the next. A disease incurable by one man, is curable by another. A disease called curable, ends in a painful death; a disease called incurable, is borne with little suffering through a long life, and after all is not the cause of death\u201d.6<\/sup><\/p>\n

References<\/span><\/p>\n

1.\u00a0 Royal Hospital for Neuro-disability http:\/\/www.rhn.org.uk\/<\/p>\n

2. Cook GC.\u00a0 2004. Caring for \u201cincurables\u201d: the 150th<\/sup> Anniversary of the Royal Hospital of Neuro-Disability, Putney. Postgraduate Medical Journal; 80: 426-430.<\/p>\n

3. Abel EK. 2011. \u201cIn the last stages of irremediable disease\u201d: American hospitals and dying patients before World War II. Bulletin of the History of Medicine; 85:29-56.<\/p>\n

4. Elliot & Cobbe. 1860. Destitute Incurables in Workhouses<\/em>: A paper by Miss Elliot and Miss Cobbe,\u00a0 read at the Social Science Meeting at Glasgow, September 1860: London: James Nisbet and Co.<\/p>\n

5. Szabo J. Incurable and Intolerable: Chronic disease and slow death in Nineteenth Century France.<\/em> New Brunswick New Jersey; Rutgers University Press. 2009.<\/p>\n

6. Dickens C. 1861. All the year round:<\/em> a weekly journal conducted by Charles Dickens. Volume V, March 30 to September 21, 1861 London: Chapman and Hall: 44-45.<\/p>\n

Map segment from Old Ordinance Survey Maps, Putney 1866 London sheet 113, Alan Godfrey Maps<\/p>\n\n\n\n\n
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<\/p>\n","protected":false},"excerpt":{"rendered":"

  By our roving blogger Dr Susanna Park Directly over the fence from my new home, there lies a complex with an impressive Victorian fa\u00e7ade, proclaimed as the Royal Hospital for Neuro-Disability. It is clear that this facility has been operating here for a long time, probably ever since the Victorian era. What was the […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-56","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"\nThe Hospital for Incurables: what\u2019s in a name? - JNNP blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/jnnp\/2011\/12\/14\/the-hospital-for-incurables-what\u2019s-in-a-namef\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Hospital for Incurables: what\u2019s in a name? - JNNP blog\" \/>\n<meta property=\"og:description\" content=\"  By our roving blogger Dr Susanna Park Directly over the fence from my new home, there lies a complex with an impressive Victorian fa\u00e7ade, proclaimed as the Royal Hospital for Neuro-Disability. 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