John Thomas (2437)

Admission Details for Patient: John Thomas (2437)

Gender: Male Age: 39
Marital Status: Married Religion: Wesleyan Methodist
Occupation: Railway Porter
Address: Carnarvon, Carnarvonshire

Date of Admission: March 24, 1875
Date of Death: January 22, 1876
Cause of Death: Pneumonia/Exhaustion(certified) GPI (in notes)

Disease: General Paralysis
Supposed Cause: A fall upon the head

Medical Certificate:
He is constantly going about amongst our tradesmen giving orders for articles which he cannot pay for - believes he must be off by train to buy cattle. Having a pig of his own he is constantly boiling food for it burning all the coal he can find and last week stole some for the purpose. By others: He talks incoherently. One period he will state he is ill and in an instant he is off to work at a neighbouring quarry stating he will earn £4 or £5 weekly. And his general appearance. His wife states that he sometimes abuses her as well as the children. She has shown one bruises on her arm inflicted this week. She also states that all combustible material he heaps on the fire. T.S. Foster, Carnarvon, Surgeon.

Approximate duration of present attack: 4 months

Number of Previous Attacks: 0

Number of Previous Admissions: 0

Number of Subsequent Admissions: 0

Total Number of Admissions: 1

Relatives affected:

Epileptic: No

Suicidal: No

Dangerous: Yes but not unless provoked

Clean Habit: Yes

Food Refusal: No

Sleep Habit:

Destructive Habit:

Disposition: Temperate, industrious and religious

Education:

Physical/Mental State at Examination: Free from bruises. Undersized. Nervous temperament. Well nourished, tongue foul in the centre, red along edges. Is very much excited, rambles continually and is quite incoherent, now and then he bursts out singing. Does not know that he is in the Asylum and imagines that he is with some friends in Abergele. He fancies himself the possessor of great wealth which he freely offers to all around him but he chiefly boasts of his pig which, he says, is ready to be killed. He has a slight tendency to unsteadiness in his gait and the tongue trembles slightly upon being protruded. Will probably by the victim of General Paralysis as his malady progresses. His habits are cleanly and there is no tendency to suicide.

Current Diagnosis: General Paralysis of the Insane

Case Notes

1875 Apr 1 - No improvement since preliminary report.

Slightly incoherent in his answers to ordinary questions.

Says he has £2,000 in the bank and intends to attend fairs to purchase cattle etc.

There is no excitement.

Sleeps fairly. No religious tendencies.

Bodily health good.

Apr 17 - He is now conscious that he is in the Asylum but is still unable to understand his position.

Must go out in a few days, he says, as he has some potatoes to plant. Wets his bed.

The money in the bank had dwindled into £20 and on being asked if he was still wealthy he replied in the negative.

Still very incoherent. Eats and sleeps well.

(date illegible) - He does not appear in such good health and is getting to look rather haggard and broken down.

May 4 - Getting gradually worse in body and mind, apathetic and listless. Fond of gathering stones, a habit he has learnt from Wm Jones, Carnarvon, both coming from the same place.

June 4 - Worse.

Mother came to see him on the 1st.

Knew her and was considerably affected. Full of delusions.

Feebler in health.

1876 Jan 13 - Has gradually been getting more feeble. He is now very weak and unable to form his words at all.

Has had bedsores which are now healing. He has remained in this state for some months and cannot possibly last much longer.

Takes plenty of fluid nourishment and 3 oz of Brandy daily.

22 - Has been gradually sinking ever since last note, being rather better one day and worse the next but not refusing his food till the last day or two. Has laid on his back without any power of movement for some time, quite unable to speak.

The last two days his breathing has been short and gasping though there have been no physical signs.

He died this morning at 9 am.

Medications/Treatments: Brandy

Additional Notes

Post Mortem: Skull opened.

Cranium rather small.

Large excess of cerebrospinal fluid in membranes.

The convolutions much wasted.

Brain on removal weighed 40 oz.

Arteries in base very brittle but not atheromatous

On section ventricles much distended with fluid.