UCL Queen Square Institute of Neurology


Charles Putnam Symonds

Charles Putnam Symonds (1890 - 1978). His skill in clinical diagnosis and his abilities as a teacher is how he will be best remembered.

Thwarted in his initial aim of entering the Indian Civil Service after an Oxford education, Symonds defaulted to medicine, and trained at Guy’s Hospital from 1912. When war was declared on 4 August 1914, Symonds was three months short of qualifying in medicine, but on 19 August, because there were no vacancies as a pilot – his preferred role - he enlisted as a motorcycle despatch rider. Symonds went to war sustained by a spirit of patriotism and adventure. But, like others, he was soon appalled by the terrible slaughter and suffering in the trenches. On 5 November 1914, he was awarded the Médaille Militaire by the president of the French Republic for gallantry during the operations in August 1914. He was wounded in the leg and after his recovery, Symonds returned to Guy’s Hospital, qualified in 1915, and was commissioned into the Royal Army Medical Corps and appointed as medical officer to the Royal Flying Corps squadron at Farnborough. Symonds returned to the 101 Field Ambulance in 1917 as Captain. His accounts of trench warfare are harrowing. Participating in the Battle of Arras, he established a series of first-aid posts, and was twice struck on the head by bullets. 

On demobilisation, he was appointed resident medical officer at the National Hospital. Symonds was appointed assistant physician at Guys Hospital in 1920, until 1927 when he was promoted to physician. In 1927, he applied successfully to Oxford for a Radcliffe Travelling Fellowship. His intention was to study neuropathology in Paris but Hurst suggested that he become interested in psychiatry and neurosurgery. This led to Symonds working with Harvey Cushing in Boston, and Adolf Meyer in Baltimore.

In 1926 he was appointed to the consultant staff at Queen Square. He delivered two weekly outpatient clinics, seeing 100 patients on each occasion and, subsequently, became responsible for inpatients. 

In 1938 Symonds was invited by Cairns to join him at the Military Hospital for Head Injuries at St Hugh’s College in Oxford, representing the Royal Air Force to which Symonds had been civilian consultant in neurology since 1934. From 1942 he became involved with ‘flying stress’, the equivalent of ‘shell shock’, taking the view that aircrew were being misunderstood. Symonds had a busy war and his contributions were fully recognised. He served on the Flying Personnel Research Committee from 1942 to 1963; was promoted to air commodore in 1942 and air vice-marshal in 1945; made a Companion of the Bath in 1944; and knighted in 1946. He received the Raymond Longacre Award for Scientific Contribution to Aviation Medicine from the Aero-Medical Association of the USA in 1949. As a member of the Brain Injuries Committee of the Medical Research Council which, in 1941, produced War Memorandum No. 4, Symonds had defined hysteria as ‘a condition in which mental and physical symptoms, not of organic origin, are produced and maintained by motives never fully conscious directed at some real or fancied gain to be derived from such symptoms’. Symonds considered the nature of fear as a behavioural and physiological response to real, remembered or anticipated danger, conditioned by prior experience or triggers and not constrained by other emotions such as anger and loyalty. Symonds’ approach to curing hysterical illness used methods, including hypnosis, taught by Hurst, who had himself been trained by Babinski. If compensation failed to cure the complaint, recovery might require escaping from the situation with dignity, even if this involved resorting in one case to a faked religious service of thanksgiving for miraculous recovery, thereby avoiding the assumption that the illness was due to malingering. Symonds’ tactic was to strike a deal with the hysteric: ‘I know that your pretended loss of memory is the result of some intolerable emotional situation. Tell me your story. I promise absolutely to respect your confidence, will give you all the help I can and will say to your doctor and relatives that I have cured you by hypnotism.’

After WWII, now famous as a neurologist, Symonds was Sims Travelling Professor to Canada, Australia and New Zealand, and visiting professor in San Francisco and Montréal.

Reflecting in 1970 on his paper from 1941, in which Symonds argued for a closer liaison between students of brain and mind, he claimed (perhaps with the benefit of hindsight) ‘my conviction that there should be a chair of neurology at the Maudsley Hospital and a chair of psychiatry at the National Hospital, Queen Square, remains unshaken’.

Symonds retired from his hospital posts in 1955, aged 65, but continued to see patients in private practice until his early seventies. Symonds was elected president of the Association of British Neurologists in 1956. In 1966 he was invited to teach on two or three days each month at Queen Square, relishing the opportunity to illustrate what could be achieved through clinical analysis, rather than the use of investigations that were beginning to influence the practice of neurology.

Queen Square: A History of the National Hospital and its Institute of Neurology https://www.nationalbrainappeal.org/product/queen-square-history-book/