Parkinson's Disease (Treatment)

– in the House of Commons at 12:00 am on 17th July 1952.

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Motion made, and Question proposed, "That this House do now adjourn."—[Mr. Kaberry.]

10.0 p.m.

Photo of Mr Albert Davies Mr Albert Davies , Stoke-on-Trent North

From time to time many hon. Members, I am sure, receive representations from their constituents as to whether anything can be done to assist the unfortunate victims of Parkinson's disease. Naturally, hope springs eternal in the human breast, and when people hear that there are likely remedies available overseas, particularly in America and in Germany, they are most anxious, if they can, to profit by these facilities.

Cases from North Staffordshire have come to the notice of my hon. Friends and myself in which valiant endeavours have been made amongst working men to subscribe sufficient money to enable one or two of their colleagues to go overseas to Germany to see what could be done at a certain clinic in Kassel, the Elena Klinik, which is well known, I think, to the hon. Lady the Parliamentary Secretary. In one case, at least, it is said that great success has attended the visit to this clinic.

I know that there is a division of view amongst informed people in this country about the virtue of what is being done in Germany, as contrasted with what is being done, and what facilities are available, in this country; and my main purpose in raising this matter tonight is to give the Minister and the Ministry an opportunity to tell us at what stage we have arrived in our researches into this disease, and, in the light of the findings of those researches, to tell us what is being done to make the facilities available, as far as possible, throughout the country.

I understand that we are not without hope. Indeed, if my hon. Friend the Member for Stoke-on-Trent, Central (Dr. Stross) has the good fortune to be called, he will be able to cite some correspondence which he has upon this subject with the Minister of Health and will be able to refer to a recent reply which he has received. We should like to know whether the Ministry take the view that our knowledge of drugs is as up to date and as beneficial as the knowledge which is claimed overseas.

Some people take the view that where this disease is not in an advanced stage, and where the person concerned is less than, say, 55, there is a possibility, by some kind of surgical operation, that some remedy may be effected, but from my slight reading on this aspect of the matter, I gather that such an operation, surgical procedure as it is called, is attended very often by other difficulties and other dangers. Similarly, in the use of the drugs which have been used over the years, there are attendant difficulties.

As I have said, when the unfortunate victims of this disease hear of some success, they are apt to conclude that here is just the thing they are looking for. But I think we should all agree that in this matter there are psychological as well as physiological considerations, and it may well be that a change of environment, a change from the occupation which they normally follow, some improved family circumstances in terms of feeding and rehabilitation, might well do much to assist those who are so unfortunately placed.

A few weeks ago I put to the Ministry of Food a case concerning one of my constituents who had recently been to Germany, and, who, as I have said, had come back having had some success. Indeed, it is claimed that he was 90 per cent. cured of his complaint. A request was made to me that some consideration should be given so as to make available to this man—and we will call him Mr. "A" from North Staffordshire—some extra fats. It was said if he could get extra buttter and one or two things like that he would be all the better able to follow his work.

We are glad to know that in this case the man was so much improved for one reason or another attributed to the excellent clinical treatment he got, that he was able to do five days' work at a local colliery—not underground, but on the surface. That is a very good performance, and all his colleagues who collected their shillings and sixpences to provide the money to send him to Germany think it has been a first-class investment to achieve this successful result.

On the other hand, when we have pointed out this instance to the Ministry—as I did as far back as November of last year—because other people were raising the matter and wanting to know if the facilities could be made available to them, the hon. Lady replied on 4th December saying that at the Ministry of Health they … were aware of the claims made by German clinics for the treatment of Parkinson's disease, notably that under Dr. W. Voeller at the Elena Klinik at Kassel. The Minister's predecessor caused the work of this clinic to be investigated by two well-known consultant neurologists and several patients were carefully observed before and after receiving treatment there. Both consultants reported that the treatment followed well recognised lines and consisted primarily of excellently planned rehabilitation and physical re-education together with administration of drugs of the belladonna group. There was no question of 'cure', though some confusion had arisen because the German word Kur meant regime or course of treatment, and had been misunderstood by patients. The Minister has no power under the National Health Service Acts to make any financial contribution for treatment abroad except in the case of pulmonary tuberculosis"— which, of course, is a very different matter— but our advisers are satisfied that there is no necessity for such journeys"— as there were good rehabilitation centres in various parts of this country. Moreover, they took the view that drugs which were being used there were being superseded by new and more effective remedies.

The hon. Lady's contention on that occasion was that no good purpose would he served by encouraging and helping people to get abroad for treatment at Kassel. That may be so. That is a technical matter upon which I am not qualified to judge, but in the letter the hon. Lady referred to facilities being made available for rehabilitation and treatment in this country, and it is upon that aspect that I hope she will have something to say tonight.

I have mentioned psychological and physiological considerations, and I should like to deal for a moment with the physiological considerations. As I said, I have received a request for extra fats to be granted for one of my constituents who had made the request to the Ministry of Health, who turned it down. Today I have received a letter from the Parliamentary Secretary to the Ministry of Health saying that there is no medical evidence to show that extra fats and cheese are now required and that the committee of expert medical men by whom the Ministry is advised had assured him that diet does not affect the progress of Parkinson's disease, although the Department's officers were always willing to give sympathetic consideration to applications from doctors for special treatment in unusual conditions.

I am not proposing to say much more about this because I want others to have the opportunity to intervene. I have had four cases brought to my notice during the last few years, and I am sure that all hon. Members present tonight are satisfied that we should do everything we can for the victims of this dreadful disease. If it is a question of spending money and of providing beds where experimental and curative work can be done, no effort should be spared. I would ask the Minister to satisfy us that this is being done.

While it may be, as the Ministry of Food has said, that certain fats and special foods by themselves would not bring sufficient remedy—we can appreciate that, even as laymen—no doubt the family circumstances of malnutrition and the attendant difficulties of a poor environment must have an effect upon rehabilitation. I hope that the Minister and her Department will keep in touch with the Ministry of Food and will secure their support where it can be shown that they can help these unfortunate people. We must give the maximum evidence to the country that we are alive to this question.

I know a young man who sustained an injury or shock to the nervous system in a bomb incident. He is a comparatively young man and his family were sorely distressed that a man in that comparatively early life should suffer from paralysis agitans. He had no prospects, and they were willing that he should undergo any kind of surgical treatment of a serious nature. He did. Unfortunately in the process he lost his life. The case of a middle-aged woman was brought to my attention. She was most anxious to get into the Maida Vale Hospital for Nervous Diseases. She and her family thought that if they could only get there all would be well, like those people of old who always thought there was some magical quality they could tap to help them over their dreadful disease. All we want to know in an inquiring kind of way from the hon. Lady is what she has done, and that no effort will be spared to help these people.

10.13 p.m.

Photo of Sir Barnett Stross Sir Barnett Stross , Stoke-on-Trent Central

I am happy that my hon. Friend the Member for Stoke-on-Trent, North (Mr. Edward Davies) has been fortunate in the ballot and has chosen this subject. I am very grateful to the Leader of the House. When he was Minister of Health I put this matter to him, and he effected an introduction between myself and his Deputy Chief Medical Officer. I was able to put my point of view to him. I think that he agreed, by and large, with the points I made, namely, that there is no need for any great investment or expenditure to enable us to go forward to solve this problem. We need perhaps more physio-therapists with a specific slant in their training so that they would be able to deal with these patients. They should be trained in groups, a method which is very successful.

I have never found it tolerable that our constituents should have to save up or collect money to send their unfortunate brothers and sisters abroad, having to find something like £300 in each case. They want them to get treatment, being under the impression that it could not be given in this country. We have not done justice towards these people as yet, and I am sure the Parliamentary Secretary will agree that there is room for improvement. A letter which I received today from the present Minister of Health gives me a great deal of hope. Perhaps I may quote one sentence. He says: Shortness of staff is the obstacle in Stoke-on-Trent. I understand that a special committee has been formed there with a view to improving the facilities for the treatment of Parkinson's disease as rapidly as possible, and I hope that the committee will find it possible to produce results by re-organisation within the existing facilities. I am sure it can be done, but it should not be done only in Stoke-on-Trent, although naturally my colleague and I are content that the City General Hospital in Stoke-on-Trent should he one of the pilot schemes. We are conscious of the valuable work being done in Canterbury at present under the guidance of two praiseworthy medical men who are running a group clinic of this type. We want to see this repeated all over the country. I put it to the hon. Lady that there is no reason why every management committee running a group of hospitals should not be able to make use of their facilities, premises and staff so that patients need not move from that area to any other in order to have the type of treatment which will do them so much good.

In these cases the sufferer is always deeply distressed. They are, as it were, human beings locked rigidly in a physical body. Their mentality, their sense of humour, their wit is not impaired at all. This makes it all the more distressing. It needs, therefore, very little ingenuity and assistance at least partially to open the door so that they can get better. It is amazing how they emulate each other when treated in a group, how quickly they learn to dress themselves, feed themselves, become partially active—and in some cases, as my hon. Friend has pointed out, active enough to be able to do five days a week on light work at a pithead when before they could hardly even walk.

There are many of these cases, and in addition to the all-Parkinson cases there are allied ones such as disseminated sclerosis which would benefit equally by a provision of this type. It is with the fond and almost certain assurance that the Parliamentary Secretary will tell us that she will do everything she can, and that her right hon. Friend can, to see that this provision is made wide over the country that we have brought this Adjournment debate before the House.

10.17 p.m.

Photo of Miss Patricia Hornsby-Smith Miss Patricia Hornsby-Smith , Chislehurst

I am grateful to the hon. Members for Stoke-on-Trent, North (Mr. Edward Davies) and Stoke-on-Trent, Central (Dr. Stross) for the realistic manner in which they have approached this important subject and upon which they can be assured of the whole-hearted sympathy of the Ministry.

We are agreed that this tragic affliction is one which, to a large extent, is still defeating medical science. As the hon. Gentlemen know, it is a tragic affliction consisting of increasing rigidity of the muscles which combines with a varying degree of tremor. The rigidity and the stiffness increases, ultimately handicapping the individual from the normal processes of his work, leading to difficulty in his walking and other movements, finally attacking his speech. It generally means that the use of their hands in writing—or in the case of women, in sewing—are seriously handicapped. It affects varying groups. Sometimes it attacks the young, and we find that young people generally get it through being affected by what is colloquially called sleepy sickness. Or it may attack those in middle life as part almost of a senile process.

We are fully in sympathy with the hon. Members about the tragedy of this disease, and we are only too anxious to investigate any method which we believe may mitigate the hardship of the unfortunate people suffering from it. But it would be misleading the House if we pretended that at the present time medical science has any full cure. The essence of the disease is damage to certain areas of the brain that destroys certain of the nervous tissues which cannot be regenerated. The only thing at the moment which medical science can provide is to aim at a treatment which will enable other parts of the nervous system to take on the functions of those damaged cells, as well as to relieve as far as possible the various distressing symptoms of what is known as Parkinson's disease. No remedy, or regime as yet known by medical science can arrest the disease process, much less reverse the damage already done.

I am grateful to the hon. Members for giving me the opportunity—I shall deal in more detail with the two specific points mentioned by the hon. Member for Stoke-on-Trent, North about claims which have been made of cures which are not cures—of pointing out to people, however unhappy may be the circumstances, that as yet there is no known full cure for this dread disease.

It is, of course, an important contributory cause of a patient's disability that he suffers very grave depression. It is characteristic of the disease, when patients know that it is progressive, that it is a gloomy outlook for them, and it leads to great apathy and discouragement. It increases a patient's incapacity. I agree with the hon. Member for Stoke-on-Trent, Central that everything must be done to try to maintain a spirit of hope that patients can maintain what faculties they have, and that everything possible shall be done to develop their alternative faculties.

The treatment which is undertaken in this country falls under four main heads. First, there is the treatment, which has long been in use, of the belladonna drugs, which lessen the stiffness, which counteract certain of the other symptoms of Parkinson's disease, and in some cases help the tremor. But the drug has unpleasant side effects—for example, the dryness of the mouth and the difficulty of reading—and especially bad side effects with the increasingly large doses of belladonna which are applied for this disability.

There is a new field of drugs which are fully in use in this country and which are applied in modern medical science to this disease—artane, lysivane, benedryl and parpanit—all of which have excellent effects on stiffness, and which in out experience have not the same serious side effects as the belladonna group of drugs. Our physicians and neurologists throughout the country are using these in all our centres where Parkinson's disease is being treated. We are fully up to date in these treatments, and these drugs are fully available in all the hospitals throughout the country where patients come for treatment.

So far as diet is concerned—and to which the hon. Member for Stoke-on-Trent, North particularly referred—we have very fully investigated this matter, and, despite all the claims that are made, we are convinced that there is no scientific evidence that diet has any influence on this disease. It is very much a disease of the nervous tissues, and we do not believe that the question of diet, whilst it might have some small psychological effect, has any real effect on the progress of the disease.

The third item of treatment is physiotherapy, in which lies our greatest field of hope and development. One of the main tasks, of course, is in the training of people who will be dealing with those suffering from Parkinson's disease. I welcome the comments of the hon. Member when he said that the people trained to do this work have to maintain the spirit and the hope of the patients, because so much of their disability may be—at any rate, for a time—retarded if we can prevent them from that depression and apathy which grips them when they know that they are sufferers from this disease. Their tendency is to give up the unequal struggle, to lapse into rigidity and, finally, immobility, feeling that it is too much to cope with and that it cannot be overtaken.

Much is being done by trained physiotherapists to encourage patients to use the residual muscle power which they have and to make the best of their disability. That is the guiding principle in the physiotherapy treatment which is undertaken in our hospitals and clinics.

A very great deal is done by physical re-education and rehabilitation similar in principle to that applied to other injuries and other paralytic diseases. But in this disease it would be misleading if we did not admit that it is a long treatment, and a prolonged and laborious process, to maintain the spirit of patients who are suffering from the disease, for which medical science has not yet found a full cure, and to teach them to make the best of their disability. But I can assure hon. Members that there is no encouragement that is not available in centres throughout the country being applied through the physiotherapy centres to those in need of treatment.

The fourth suggestion was of treatment by surgery. Various operations have been suggested, mostly to deal with the tremor resulting from this disease. Up to the present all have been discredited, except one which has proved of some value in rare cases where the tremor was found only on one side of the body. I want to make that clear, because the hon. Members specifically mentioned certain treatments in America and Germany and I think it is fair to deal with this, because I should like to answer them before the clock overtakes me. The Konigin Elena Klinik at Kassel is a clinic specialising in the treatment of Parkinson's disease where they undertake extensive reeducation, and encouragement is combined with the old-fashioned belladonna treatment and a peculiar and, we believe, unnecessarily built-up diet. We do not consider there is any medical evidence to prove that diet has any real effect on the treatment of these patients.

Two years ago the right hon. Member for Ebbw Vale (Mr. Bevan) undertook a very careful investigation of selected persons sent to this clinic. Their clinical records were very fully investigated and the hon. Member will have seen the results of those investigations. There was no evidence whatever to prove that similar and equally efficacious treatment to anything available in that clinic in Germany is not available in this country.

Photo of Mr Ernest Davies Mr Ernest Davies , Enfield East

The hon. Lady will agree that the gentleman who has been to the clinic in Germany and had the extra food is now doing five days work a week and will take a lot of convincing that he has not benefited.

Photo of Miss Patricia Hornsby-Smith Miss Patricia Hornsby-Smith , Chislehurst

The psychological value of treatment in this clinic is acknowledged, but my claim is that equal treatment can be provided in this country, and the benefit the patient receives is mainly from the very strenuous physiotherapy treatment which is equally available in this country.

Great claims were made for certain surgical operations conducted by Dr. Klemme in Minneapolis, where certain brain operations were carried out. It is fair to say that those operations have been wholly and absolutely discredited both in the United States of America and in this country.

It is unfortunate that Parkinson's disease is not uncommon. Most physicians and general practitioners have some cases amongst their patients suffering from this disease. But we believe that best-known drug treatments available for this disease are available throughout the country at the various hospitals and clinics dealing with this disease. We believe that the physicians and neurologists who take a special interest in this disease are well spread over the country, so that treatment can be applied to patients wherever they live.

I can assure hon. Members that any new possibilities, any new drugs, any new suggested methods, are being very fully tested and investigated by neurological centres in this country. Research is continuous and we have certainly not closed our eyes to any treatment, whether it originates in this country or elsewhere. We have tested them and are ever ready to investigate them, but we are convinced that there is no known treatment for Parkinson's disease which, it claimed to be successful, is not in operation in this country. If not successful, it has been fully investigated, and if it is not in operation in this country, then for varying reasons it has been discredited.

With regard to concentration in one centre as was advocated by hon. Members, there are, for example, centres at Birmingham and Canterbury, but we are not wholly convinced of the desirability of grouping sufferers from this disease in special clinics. There is much to be said for the other side—in encouraging them to join with other people getting physiotherapy treatment, but we can assure hon. Members that our mind is open and that everything possible is being done to treat this dreadful scourge.

The Question having been proposed at Ten o'Clock and the debate having continued for half an hour, Mr. SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at Half-past Ten o'Clock.