Admission Details for Patient: Margaret Powell (2455)
Gender: Female Age: 46
Marital Status: Single Religion: Baptist
Occupation: Domestic servant
Address: Llandudno, Carnarvonshire
Date of Admission: May 26, 1875
Date of Discharge: November 25, 1880
Discharge Category: Relieved
Disease: Chronic mania
Supposed Cause: Heredity/Gastric fever
Medical Certificate:
She suffers from Religious Mania. Religious Mania confirmed by her sister Sarah Sullivan. Thomas Davies, Colwyn Bay LRCP Edin. MRCS Eng.
Approximate duration of present attack: 6 years
Number of Previous Attacks: 0
Number of Previous Admissions: 0
Number of Subsequent Admissions: 0
Total Number of Admissions: 1
Relatives affected: Uncle died here. One sister maniacal, 2 epileptic.
Epileptic: No
Suicidal: No
Dangerous: No
Clean Habit: Perfectly
Food Refusal: No
Sleep Habit: Good
Destructive Habit: No
Disposition: Kind, religious and industrious
Education:
Physical/Mental State at Examination: Used to suffer from bronchitis. On admission in fair health. Middle sized and spare, lymphatic temperament. Fairly nourished. Tongue clean, eats sparingly but does not refuse food. Bowels open. Heart's action extremely violent. Impulse very powerful. Respiratory system normal except over left apex where it is rather harsh - percussion clearer on right than on left apex. On admission she was very taciturn and talked but very little. Quiet and quite free from excitement. Said that the Relieving Officer was the Holy Ghost. Insanity commenced seven years ago when she had an attack of fever. Since that time she has more or less entirely been a recluse. Shutting herself up in her bedroom and refusing to talk with anyone. Irides are hazel coloured, pupils slightly unequal. She has a slight cough at intervals, unaccompanied by expectoration, but there appears no active disease of the lungs at present. Sister tells me that she has always been a very spare eater hardly touching meat.
Current Diagnosis: Schizophrenia (F20.0)
Case Notes
1875 May 27 - Is quiet and very silent.
Could not get her to speak so as to elicit her delusions.
Slept well last night.
May 28 - States that she sees visions at night and that her relations come to see her.
Very quiet, talking very little.
June 2 - Transferred to the Workroom where she is quiet and industrious. June 11 - Transferred to the kitchen where she gives every satisfaction.
June 18 - Quietly at work in the kitchen.
No improvement mentally.
Full of religious delusions. June 25 - Somewhat excitable at times and must have her own way.
Said there was a £5 note in my coat pocket, took the coat from my bedroom and placed it in a tub of water. Talking incoherently about religion.
July 7 - Quiet and industrious if she gets her own way.
Was found last Sunday by the pond, said she had merely taken a short walk it being Sunday. Had no intention of escaping. Sometimes excited and requiring to be sent from the kitchen to No 3 where, if not in the kitchen, she works.
(Notes to 1879 indicate no change).
July 19 1879 - Talks to herself all day while dusting or sweeping.
Health moderately good.
Sept 3 - Has a scrofulous abscess of considerable size and fluctuating over posterior surface of scapula.
Painted with Iodine and Iron administered.
Sept 25 - The abscess on back was lanced and a quantity of pus escaped. leaving a cheesy mass.
Oct 9 - The cheesy material softened and came away a few days ago, leaving a granulating hollowed surface about size of half-a-crown.
Health moderate.
Sept 29 - A piece of bone 3/4" long and 1/2" wide escaped today.
Wound healing slowly.
Dec - Granulating process going on slowly.
Dressed daily.
1880 Feb 12 - Wound healing and contracting slowly.
Talkative and full of delusions. Health moderate.
March 15 - Two more scrofulous abscesses appearing one over angle of left scapula below the previous one and the other higher up in posterior fold of left axilla.
Health deteriorating.
Delusions strong.
April 26 - Losing flesh. Caries of scapula discharging.
(Notes continue to indicate deterioration).
Nov 25 - The friends being extremely anxious to take her home to die, and she being perfectly harmless and manageable, she was discharged.
Medications/Treatments: Iodine, Iron, dressings
Additional Notes
Removed by friends to die at home.
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