Catherine Jones (2521)

Admission Details for Patient: Catherine Jones (2521)

Gender: Female Age: 19
Marital Status: Single Religion: Calvinist Methodist
Occupation: Farmer's daughter
Address: Bala, Merioneth

Date of Admission: December 20, 1875
Date of Death: May 13, 1878
Cause of Death: Chronic peritonitis

Disease: Imbecility
Supposed Cause: Unknown

Medical Certificate:
Roaming about the country without any purpose and not able to assign any reason for doing so. Great aversion to relatives. From her brother William Jones: Refusing to take food, saying she would not mind being starved. Threatening to drown herself. When found on a railway line and told of the danger, saying she would not mind being killed. Roper Hughes, MRCS, LSA, Bala

Approximate duration of present attack: From birth

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: Threatened to drown herself/threatened

Dangerous: No

Clean Habit: Yes

Food Refusal: At times

Sleep Habit: Good

Destructive Habit: No

Disposition: Given to wandering about

Education: Can read Welsh

Physical/Mental State at Examination: Bodily condition good. Father died of softening of the brain. All her brothers and sisters said to be sharp and intelligent but peculiar. She has been much given to wandering about the country away from home then very unwilling to return. She also refuses to have her meals with others, but takes them readily when she is alone.

Current Diagnosis: Personality Disorder (F60.9)

Case Notes

1875 Dec 28 - Continues in good health. Is quiet and inoffensive. Yesterday she tried to escape on the return from chapel but was immediately brought back. 1876 Jan 12 - Remains in the same state, generally quiet and listless, not employing herself in any way. But several times on being let out into the recreation ground she has taken a chair and attempted to scale the wall.

Jan 13 - Managed to get over the rails but was soon brought back. Feb 12 - Just the same idiotic state. Very silly but works well and is in excellent health. Attempts to escape at every opportunity.

Apr 9 - Just the same and makes herself useful in the wards but is not by any means bright.

(Notes to Jan 1878 continue the same).

1878 Jan 5 - The last week she has much lost flesh and there is some distress from swelling in the abdomen but this is partially relieved by a few days in bed.

She is now in the infirmary ward.

Feb 6 - The abdomen continues very much the same but she is in fair health. The distress is present at times.

March 12 - The distress having become urgent she was today tapped under chloroform* and about two gallons of fluid removed.

She suffered no ill effects. The swelling found to be peritoneal.

March 14 - Is much better after tapping. The wound is healing but there are signs of a reaccumulation of fluid.

Apr 12 - The tension has become rather severe but on examination under chloroform the intestines were found floated forwards and the amount of fluid less than anticipated. Tapping deferred.

Apr 15 - During the night a small quantity of serous fluid of faecal odour oozed from umbilicus and has been continuing all day.

Apr 16 - This morning at 4am the hole in the umbilicus enlarged and there poured out a large quantity of sero-purulent matter intensely offensive. The abdomen has quite collapsed. Apr 17 - Abdomen continues draining steadily. Apr 20 - Has become very feeble, abdomen draining constantly.

Mind just the same as ever. May 1 - Has become very emaciated. Takes a fair quantity of milk and 4oz of brandy daily.

Notes May 4, 10 indicate continuing deterioration.

Medications/Treatments: Abdominal surgery under chloroform, Brandy