Thomas Thomas Williams (2463)

Admission Details for Patient: Thomas Charles Williams (2463)

Gender: Male Age: 41
Marital Status: Married Religion: Calvinist Methodist
Occupation: Plasterer
Address: Llandyfnan (admitted from Workhouse), Anglesey

Date of Admission: June 4, 1875
Date of Death: December 9, 1876
Cause of Death: GPI

Disease: General Paralysis
Supposed Cause: Fall upon his head

Medical Certificate:
He has a vacant look but beyond that and a general failure of memory I can elicit very little from him to indicate insanity. In fact his condition seems to be that of an imbecile from brain disease following probably an attack of cerebral haemorrhage from which it appears according to his account he suffered some years ago. By others: He was found making bedclothes into a rope to go out of the window. He will say he has not had his meal immediately after he has partaken of it. He will get out of bed shortly after getting into it saying it is morning. He will claim the bed of another person who sleeps in the same room with him and throw his bedclothes on the floor etc. William Evans, MRCS, LRCP Edin.

Approximate duration of present attack: 1 year

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: Yes

Clean Habit: No

Food Refusal: No

Sleep Habit: Badly

Destructive Habit: No

Disposition: Industrious and religious

Education: Bad

Physical/Mental State at Examination: Bodily condition on admission feeble. Above middle size and stout. Phlegmatic temperament. Eats his food well and digestive functions normal. Heart sounds normal, pulse somewhat feeble. Respiratory murmur rather prolonged, chest resonant and lungs emphysematous. Partial paralysis of left side of body. Patient has been an inmate of Llanerchymedd Workhouse for about a month during which time the chief indication of insanity has been a great failure of memory. Some time ago - I could not discover the exact period - he had a fall upon his head which is the supposed cause. He has also had a paralytic stroke for which he has been under treatment in the Bangor Infirmary. The left arm is slightly paralysed but the corresponding leg is but very slightly afflicted. Speech is thick and tremulous. Under the impression that he has been brought to Denbigh to see the Asylum and Howell's School, having been employed at the erection of the latter. Veins of leg slightly varicose. Irides green, pupils equal. Quiet and free from excitement. Talks rationally.

Current Diagnosis: General Paralysis of the Insane

Case Notes

1875 June 5 - Slept well during the night.

Calm and conversing freely with Edward Parry the joiner, they discussed the different orders and styles of architecture in which he displayed considerable powers of memory. Incoherent. Fancying himself a visitor and very loquacious.

Sleeping in padded room.

June 6 - Delusions. Thought that he had been visited this morning by the Master of the Workhouse while in bed.

Drags his leg after him in walking.

Slight delusions of wealth. Placed in No 8 Associated room.

June 7 - Just the same, walking about in the yard, eats and sleeps well, quite free from excitement.

June 14 - Quite imbecile. Fancies that he and his brother have sold a farm for £140 of which he has had half and which is now in the bank. June 21 - Tongue is very tremulous and speech is considerably affected.

Memory is very much impaired.

Says that he is quite happy and contented and very much better attended to here than at home. Cleanly in his habits. July 5 - Muscular tremor more marked if possible.

Aug 5 - Speech more affected and tongue more tremulous. He has also delusions of wealth, that he has £600 in the bank.

Says that he is as happy as can be and that he is much better off here than at home.

Always good tempered and never excited.

No loss of identity and knows where he is.

1876 Jan 13 - Is confined to the sick ward but is sitting before the fire all day. Converses fairly but hesitates considerably in pronouncing his words.

Feb 26 - Patient says he had a fit last night but was not heard or seen by the Night Attendant. He seems altogether much more feeble today.

Very unsteady on his feet.

Apr 20 - Cannot now walk.

His mind is more feeble also.

May 17 - Cannot now stand without assistance. Very cheerful persisting that he is quite well. Aug 5 - He continues to become more feeble, is wet and dirty in his habits, but takes his food well.

Frequently shouting out in the night.

Sept 17 - Sinking slowly and is now confined entirely to his bed. Dec 3 - He has bedsores on each hip and over the sacrum. Has had several attacks of apoplectic convulsions.

Has become perfectly unable to form any word although he seems to a certain extent to appreciate what is said to him.

Dec 5 - Has had more of the fits and much weaker. Dec 7 - Is becoming more feeble and has great difficulty in swallowing.

Dec 8 - Is lying unconscious in bed breathing sterterously.

Medications/Treatments: