Mary Jones (2468)

Admission Details for Patient: Mary Jones (2468)

Gender: Female Age: 15
Marital Status: Single Religion: Independent
Occupation: Dressmaker
Address: Bala, Merioneth

Date of Admission: June 15, 1875
Date of Discharge: September 20, 1875
Discharge Category: Recovered

Disease: Acute mania
Supposed Cause: Grief after sister's death

Medical Certificate:
General restlessness of manner. Violent excitement without any cause. Inability to hold conversation, incoherence of speech, railing at and threatening indiscriminately everyone approaching her. By her mother: Sleeplessness. Wandering about the country without any apparent purpose. Robert Hughes LSA

Approximate duration of present attack: About a week

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

Clean Habit: Yes

Food Refusal: Yes

Sleep Habit: Bad

Destructive Habit: Yes, breaking windows

Disposition: Religious and good tempered

Education: Fair

Physical/Mental State at Examination: Fair health, short and slender, nervous temperament. Considerably emaciated. At first obliged to be fed. Bowels costive. Tubercular deposit in apices of both lungs. Voice hoarse and tubercular deposit in larynx. The patient when admitted was extremely excited. Clapping her hands and shaking her fists defiantly and quite incoherent in her language. Said she cared nothing for the doctor nor anyone else. Inclined to use bad language, young as she is. Within the last three weeks two of her sisters have died of consumption and grief after them is apparently the cause of her insanity. Her disposition is entirely changed and from being a quiet religious young girl she is a quarrelsome and furious maniac. Incessantly taking unintelligible nonsense. Father died of consumption and she is obviously phthisical herself although too excited to undergo a physical examination. Irides hazel coloured. Pupils dilated and equal. Placed in Padded Room, with great difficulty was given a Chloral draught.

Current Diagnosis: Adjustment Disorder (F43.2)

Case Notes

1875 June 16 - Still excited and noisy.

Quite incoherent and shouting and singing. June 17 - Still very excited although calming down. Sleeping hardly any and gets Chloral at bedtime.

June 18 - Slept very well last night and is much improved.

Removed from Padded Room to sleep in associated room.

June 19 - Improving rapidly and taken to the workroom where she is sewing quietly. Apt to be excited still and talking nonsense frequently.

June 20 - Improving. Appetite getting very sharp, allowed 3oz extra of bread and butter.

Ordered a purgative.

June 21 - Wants to go home very much, says that she has never been ill.

June 28 - Not so well.

Frequent attacks of excitement. Running about laughing without reason.

Sleeps very badly and has had Chloral for the last few nights. Uses very bad language. July 5 - Since the 1st has been placed to sleep in Refractory Ward as she was greatly excited and sleepless during the night and has had night draughts since. This morning broke a window frame in her cell and cut her hand slightly.

July 12 - Has been very unmanageable during the week, destructive and noisy, requiring a tick dress.

Today she is better and has slept for the last two nights. July 28 - Since the 19th or 20th has been very much improved and is quite herself again.

Aug 20 - Has very greatly improved. Quiet and industrious. Well behaved in every way.

Has gained flesh very much and is now quite plump and fat whereas she was very much emaciated on admission.

If she continues well she will be discharged at the September committee.

Medications/Treatments: Chloral, Purgative, Padded room, Tick dress

Additional Notes

This girl was found to have "tubercular deposits" in both lungs on admission.

Two sisters had died of TB.