Richard Clarke (2466)

Admission Details for Patient: Richard Clarke (2466)

Gender: Male Age: 24
Marital Status: Single Religion: Roman Catholic
Occupation: Unknown
Address: Holyhead, Anglesey

Date of Admission: June 15, 1875
Date of Death: June 22, 1892
Cause of Death: Pulm. Phthisis

Disease: Melancholia
Supposed Cause: Drink

Medical Certificate:
His general appearance and incoherent answers and very often he will not give any answer when questioned and he seems under the impression that he cannot talk anything but Welsh though an Englishman etc etc. Communicated by Mr Isaac Griffith, Baptist St: That he found him half naked fighting with the wall etc etc. Owen Williams, MRCS Eng.

Approximate duration of present attack: 7 days

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: Doubtful

Dangerous: Doubtful

Clean Habit: Yes

Food Refusal: Yes

Sleep Habit:

Destructive Habit: No

Disposition: A drunkard and a bad character

Education: Bad

Physical/Mental State at Examination: In good health. No bruises. Tall and well formed. Nervous temperament. Spare but muscular. Tongue clean, eats well, bowels open. Was quiet and calm on admission but was taciturn and would not converse freely. Memory is very much impaired. Has been a soldier but while staying at Milford he deserted and was sentenced by Court Martial to twelve months imprisonment which he went through. Has been always a worthless and lazy man and fond of drink. Hazel irides and pupils unequal. Was placed in No 9 Ward and put to sleep in an Associated Room. Knows very well where he is and (says) that they ought not to have brought him here.

Current Diagnosis: Dissocial Personality Disorder (F60.2)

Case Notes

1875 June 16 - Slept well last night and eats his food ravenously. Mental condition is the same.

There does not seem very much the matter with him.

He is a likely man to attempt to escape and was found trying the doors this morning.

Asks if there is no beer to be had here.

(undated) - Is just the same, is watching every opportunity to escape.

(undated) - Speaks English freely here when he does converse although the contrary is mentioned in the certificate.

Has been all along very depressed. Stands in the same place staring vacantly.

Can with difficulty be made to speak and when he does it is only in monosyllables. 1876 Jan - Has improved somewhat. He is now still depressed but rather more cheerful. Does not speak much and is in the Sick Ward assisting the attendant whom he obeys cheerfully and readily.

Feb 2 - Having threatened to stick a knife into another patient he has been sent away from the Sick Ward.

Mar 14 - Today at dinner the patient thrust his knife through his jacket at the right side but did not wound himself.

On being asked why he did so, he replied that it was his only chance of getting out of this place and that he was quite well enough to work for his living.

I do not think he meant anything but bravado by this performance as he knew the knife was very blunt and he also cut the RIGHT side.

May 15 - Rather improved and is more cheerful and intelligent. Bodily health good.

Sept 1875 to Nov 1884 – Silent, silly and very idle.

July 1885 - Has been very useful for some months working on farm.

In good health but mentally the same.

March 3 1892 - Has been losing flesh lately and on examination his lungs are diseased. Very poor hope of recovery.

Temperature high and it is evidently running a rapid course.

Apr 7 - Rapidly going downhill.

Often refuses food as he thinks there is something in it which disagrees with him.

June 17 - Is suffering from diarrhoea, probably tubercular, and will not hold out much longer.

Medications/Treatments: