Elizabeth Williams (2444)

Admission Details for Patient: Elizabeth Williams (2444)

Gender: Female Age: 50
Marital Status: Widowed Religion: Independent
Occupation: Washerwoman
Address: Llandystumdwy, Carnarvonshire

Date of Admission: April 26, 1875
Date of Death: April 28, 1875
Cause of Death: Pneumonia

Disease: Melancholia
Supposed Cause: Ulcers on the head

Medical Certificate:
She is suffering from an ulcer on the forehead and from choreic twitching of the right side, also she refuses to take food, occasionally saying that it is dirt and excrements. She is very dirty in her habits. She is very gloomy and pays no attention to what is going on around her. She doesn't know what she had for breakfast this morning. By Ellen Jones: That she attempted to open her bedroom window saying that she was going to fetch water and she had a poker in her hand and that she thought that she threatened to strike her. She several times came downstairs naked. John Roberts MRCS LSA MD.

Approximate duration of present attack: About 6 weeks

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: Yes tried to jump through the window

Dangerous: Not as far as is known

Clean Habit: No

Food Refusal: Yes, stomach pump has been used

Sleep Habit: Bad

Destructive Habit: No

Disposition: Industrious, quiet and kind

Education: Bad

Physical/Mental State at Examination: Upon admission the patient was in a very feeble condition exhibiting the choreic twitching mentioned in the certificate. She was quite incoherent and somewhat sulky and taciturn but she appeared quite harmless and, as the young woman said, had no intention of injuring anyone with the poker. Exciting cause seemed to have been indignation after having been asked by medical man who was treating her for the frontal ulcer whether she ever had syphilis. (Syphilis is pencilled in under ‘Supposed Cause’). It preyed very much on her mind and culminated in the present attack. She was at once taken into the infirmary ward. She refused her food and was obliged to be fed.

Current Diagnosis: Mental disorder due to brain damage/physical disease (F06.9)

Case Notes

1875 Apr 27 - About 5 o'clock this afternoon she was attacked by severe dyspnoea which increased in intensity until about 7 or 8 when after a Sinapism (mustard plaster) to the chest and the exhibition of Ammonia (smelling salts) to her it gradually subsided. Hardly any cough or rales.

Apr 28 - She slept fairly during the night, the night attendant looking in frequently.

This morning about 10.30 the dyspnoea returned with increased intensity accompanied by very little cough.

Amm. Carb. and Squill (an expectorant) exhibited every two hours with Sinapisms to the chest.

Wine also was given.

The clergyman saw her in the morning to whom she talked very rationally wishing him in return for his kindness every success in life.

Moist rales audible throughout the chest.

Difficulty of breathing rapidly increased although she was sensible nearly to the last.

She died at 8.15 pm.

Medications/Treatments: Sinapism (mustard plaster), Ammonia (smelling salts), Amm. Carb. and Squill (expectorant), Wine