Margaret Parry (2435)

Admission Details for Patient: Margaret Parry (2435)

Gender: Female Age: 63
Marital Status: Married Religion: Wesleyan Methodist
Occupation: Shoemaker's wife
Address: Towyn, Merioneth

Date of Admission: March 12, 1875
Date of Death: May 31, 1875
Cause of Death: Senile decay/Uterine disease

Disease: Chronic mania
Supposed Cause: Unknown

Medical Certificate:
She is suffering from dementia and incoherence, her most palpable symptoms being ignorance of time and place and particularly the use of words. She cannot tell the names of persons nor remember who they are whom she formerly knew. Does not know her own daughter. She is unconscious of impending danger. On one occasion her clothes actually took fire. Her husband found her sitting so near the fire that she would have been burnt had he not made the timely discovery of her impending danger.

Approximate duration of present attack: 4 years

Number of Previous Attacks: 0

Number of Previous Admissions: 0

Number of Subsequent Admissions: 0

Total Number of Admissions: 1

Relatives affected:

Epileptic: Yes

Suicidal: No

Dangerous: No

Clean Habit:

Food Refusal:

Sleep Habit:

Destructive Habit:

Disposition:

Education:

Physical/Mental State at Examination: Very feeble health. Sore on the right arm from accidentally falling against the grate. State of nutrition emaciated. State of digestive system normal. Disease of the mitral valve, veins of neck dilated. Respiratory system normal. Prolapse of womb. Enlarged thyroid gland. Mental state - excited, incoherent, loss of identity of persons around her fancying they are her relations. Sleeps very badly.

Current Diagnosis: Alzheimer's Disease (F00.1)

Case Notes

1875 Mar 18 - Takes her food well. On account of her noisiness she has been kept in bed for the last two days. Chloral at night.

Mar 25 - Little better. Still incoherent but now recognises those that attend to her. Very excited and noisy therefore confined to bed all the week

Eats her food well, harmless, still taking Chloral draughts. Apr 5 - Worse. The noisiest patient in the institution.

Continually yelling and tossing off the bedclothes.

Takes Chloral in large doses.

Perfectly incoherent. Cannot answer questions rationally and is perfectly oblivious of her condition. Still confined to bed. When sent to No 4 continually takes her clothes off. Apr 7 - Was today put to bed in a cell in No 4 Ward in consequence of her noisy behaviour. Takes Chloral occasionally. Apr 14 - Has been up out of bed for the last five days since which she has become very much quieter although still noisy at night. May 6 - Very much enfeebled latterly and cannot walk without assistance.

She was observed to have a Prolapsus Uteri.

Applied a round vulcanite pessary and a perineal band which failed and then tried a Hodge (a Smith-Hodge pessary) which has remained.

May 11 - Pessary has come away but the prolapsus has not returned.

Takes Chloral at bedtime in consequence of her noisy behaviour.

May 13 - Was this morning suddenly called up at 7 o'clock and found her in a state of syncope, quite insensible, cold extremities and fluttering pulse with face of death-like pallor.

She had had Ol. Ricini (Castor Oil) the night previously which operated somewhat severely and was the probable cause of the attack.

Applied hot bottles to feet. Wine in frequent doses.

She soon rallied and was as usual in a few hours. Has been on water bed for last fortnight.

Bedsores forming.

May 30 - Has been gradually getting more feeble.

Very noisy all along though taking Morphia.

Still on water bed, will not last long.

Medications/Treatments: Chloral, Ol. Ricini (Castor Oil), Vulcanite pessary and "perineal band", Hodge*, Morphia, Wine, Water bed

Additional Notes

* Smith-Hodge Pessary - a rubber covered wire rectangle which fits between the pubic bone and the posterior vaginal fornix.