Robert Jones (2476)

Admission Details for Patient: Robert Jones (2476)

Gender: Male Age: 32
Marital Status: Single Religion: Calvinist Methodist
Occupation: Slater and plasterer
Address: Carnarvon (admitted from workhouse), Carnarvonshire

Date of Admission: June 29, 1875
Date of Death: August 25, 1888
Cause of Death:

Disease: Mania
Supposed Cause: Debauchery

Medical Certificate:
His rambling statements with regard to his being brought up a barrister and directed to come to Carnarvon to meet the Prince of Wales's children and to draw his hand across their faces. The master of the house has given the same information as the above to me and informs me that the man has been destroying property. Robt. William Jones, MRCS, LSA, Carnarvon.

Approximate duration of present attack: 1 week

Number of Previous Attacks: 2

Number of Previous Admissions: 2

Number of Subsequent Admissions: 0

Total Number of Admissions: 3

Relatives affected:

Number of Previous Attacks: 2

Epileptic: No

Suicidal: No

Dangerous: No

Clean Habit: Yes

Food Refusal: No

Sleep Habit: Well

Destructive Habit: Defacing the wall

Disposition: Always leading a wild life - spends all his wages

Education: Fair

Physical/Mental State at Examination: In good health. Middle sized and muscular. Lymphatic temperament. Well nourished. Tongue clean, bowels open, appetite good. Heart sound peculiarly sharp and loud. Chest broad and prominent, resonant on percussion. He was found wandering in the streets of Carnarvon by the police on the 21st inst. and taken by them to the Workhouse. He was quite incoherent and had delusions as to having been brought up a barrister. He was working up to last Saturday week. While in the House he destroyed the chamber pot and defaced the wall by tearing the plaster off. On the way from the station he gave the attendant the slip and escaped about 8 miles into the country before he was caught. Has always led a wild and useless life. Sometimes complains of pain over the cardiac region and states that he was struck violently there some years ago. Pupils small but equal, green irides. Placed in No 8 to sleep in an associated room. Thinks that he is a barrister and says that he is a good scholar.

Current Diagnosis: Schizophrenia (F20.0)

Case Notes

1875 June 30 - Slept well last night. Appetite good.

July 1 - Stupid and silent.

Says he never ought to have been brought here.

July 2 - Obstinate and impatient of control. Threw his hat off and would not pick it up again.

July 3 - The same delusions. Will not do any work.

July 10 - Still morose and silent. Has not been excited since admission. July 16 - No improvement except that he is more obedient and tractable. Not so irritable and sulky but labouring under the same delusions. Has commenced working a little with the joiner.

July 27 - Says that he has more than one name, but that he will not tell anyone his real name, that it is the same as the Emperor of Russia's.

(Notes to February 1882 indicate no change except that he worked regularly with the painter for a time).

1882 Feb 16 - Alternately civil and cross. Industrious when civil.

1884 Feb 12 - Works as plasterer and in good health.

Nov 12 - Has been in poor health.

Refusing his food and to work.

Is probably phthisical.

1888 Jan 14 - In poor health. Does a little work at times.

No mental change.

Mar 28 - Found today that patient had strumous disease of right elbow - a sinus thro' which a probe could be passed into joint.

Elbow swollen, tender, discharge abundant. Put arm on splint.

Washed out with Carbol. water and ordered full extras with Cod Oil.

Apr 15 - The same.

Have made counter opening on opposite side of joint and inserted drainage tube. Washing out daily.

Holds his ground pretty well.

Sleeps fairly and spends day in fresh air.

May 3 - Discharge continues unabated and he is slowly losing flesh. Nothing can be done but wash out daily and endeavour to maintain his strength.

Taking food and port wine well. Have endeavoured to obtain his consent to amputation but without avail.

May 25 - Joint not quite so swollen and discharge less. June 20 - Discharge almost ceased. Swelling in joint diminished to half with fair movement. Sinus closing up. At the same time his general condition is bad, the lungs showing signs of fresh phthisical mischief. A couple of sinuses on the chest which had healed have also broken down and are discharging afresh. July 10 - Both lungs tubercular esp. the left. Night sweats and is quickly losing flesh. A large quantity of pus discharging from sinus over sternum.

Will not allow same to be opened up and indeed the same can only be of temporary benefit. Takes fair amount of food and to this must be ascribed the manner in which he holds out

Confined to bed and almost helpless.

Cheerful and contented.

Aug 6 - Very feeble.

Discharge abundant. Diarrhoea at times probably of tubercular origin. Cannot live much longer.

Medications/Treatments:

Additional Notes

Two previous admissions are noted but no dates given.

A Robert Jones of Llannor, near Pwllheli, was admitted on 6th April 1861.

This would mean an age of onset of 18 and is probably the same man.