Edward Ellis (357)

Admission Details for Patient: Edward Ellis (357)

Gender: Male Age: 67
Marital Status: Married Religion: Calvinist Methodist
Occupation: Shipbuilder
Address: Bangor, Carnarvonshire

Date of Admission: June 15, 1875
Date of Death: July 18, 1875
Cause of Death: GPI/Apoplexy

Disease: General Paralysis
Supposed Cause: Heredity/Speculative ambition

Medical Certificate:
1. Wanders and talks incoherently. Taken up with wild ideas such as arranging the construction of bridges over the sea to Puffin Island and the Isle of Man. Being under the impression of having received improper treatment by the Ry (Railway) Company's Offs (Offices) at Carnarvon refusing to allow him to pass without a ticket, he is continually arranging a law suit against them and engaging all noted barristers he can think of. By M A Ellis: He has several times threatened and once attempted to drown himself and that he goes almost daily to Major Platt's flower garden and takes anything he fancies away claiming them as his own, and if he is at all crossed he gets awfully wild and dangerous. He keeps the family in a constant state of fear night and day although at times he is calm and pleasant for a short while. Wm. Williams, Surgeon, Bangor.

2. His eyes were wild and fiery and rambled much in his talk and had all the appearance of a person under the influence of drink. At times he indulged in wild and impracticable speculations. By his son Edward Ellis: That he attempted to drown himself, said he would not stay at home as all the family were against him and that he would go abroad in order to be by himself. If he could not make a living there he would put an end to his existence. Robert Hughes, MD, Conway.

Approximate duration of present attack: 2 months

Number of Previous Attacks: 0

Number of Previous Admissions: 0

Number of Subsequent Admissions: 0

Total Number of Admissions: 1

Relatives affected: Two cousins of patient insane

Epileptic: No

Suicidal: Yes, threatened and attempted to drown himself

Dangerous: No

Clean Habit: No

Food Refusal: Sometimes but eats fairly

Sleep Habit: Bad

Destructive Habit: No

Disposition: Sober and industrious but melancholy

Education: Good

Physical/Mental State at Examination: Previous bodily health strong but subject to rheumatism. On admission fair health but not strong, tall and slender, nervous temperament. Naturally thin, muscles are firm, no arcus senilis. Eats very badly, tongue large and papillated, not furred, bowels open. Heart impulse somewhat strong, no bruit. Chest very resonant on percussion on both sides. Right subclavicular region depressed with broncophony. Veins of left leg slightly varicose. Was in a state of great excitement on admission and was perfectly incoherent in his conversation. There was complete loss of identity and his mistook me for one of his imaginary customers (he fancies that he deals extensively in steel). His memory is almost completely lost. Some time ago he went as far as Pwllheli and forgot to take a ticket back so when he arrived in Bangor he had not got one. The officials consequently handled him somewhat roughly. This has preyed upon his mind. But his insanity has been coming for a long while insidiously. Irides green, pupils unequal.

Current Diagnosis: General Paralysis of the Insane

Case Notes

1875 June 16 - Slept very badly last night, was continually knocking at the door. He lifted the bed (lying down beneath it) and it fell back on his eyebrow blackening it very much.

Given two draughts of Chloral and Potass. Bromid. and slept from 2 until 8 in the morning.

June 17 - Just the same, incoherent and foolish.

Eats his food very badly. Ordered some beef tea and bread and milk.

June 19 - Sleeps very badly frequently requiring a repetition of the night draught.

Totters in walking.

Is able to sleep for a short while in the afternoon.

June 20 - Slept better last night after draught.

Quite incoherent, very garrulous, is now wishing very much to return home. Omit the Potass. Bromid. from draught. Chloral. June 21 - He eats his extras very well but cannot manage any animal food. Is aware of where he is.

Rep. Haust.

Very restless and as full of delusions as ever. Pupils have been all along dilated and slightly unequal.

June 28 - Very unhappy and crying sometimes. July 1 - This morning he attempted to escape by smashing the day room window with its strong wire frames during the absence of the attendant.

He crept through and let himself fall onto the flagstone area underneath, a depth of about ten feet.

He was found by Mr Robinson (Clerk and Steward), who brought him in. He had cut his face rather badly and bruised his knee cap, the bursa over which was swollen but otherwise he escaped wonderfully. He was extremely excited shouting and crying continually.

He was placed in bed and given a Chloral draught which procured sleep. Draught repeated at bedtime. July 2 - Kept in bed.

Very restless and unhappy, wants to go home very much, eats very badly and requires to be fed.

Rep. Haust. Chloral.

July 3 - More composed.

Has no recollection whatever of what has occurred and cannot imagine how he has been hurt. Was greatly surprised when he was told.

July 4 - Is getting on very well, cuts on the face are healing.

Allowed to come downstairs, knee is quite well.

July 11 - Is quite well again bodily. No improvement whatever mentally and has no recollection of having injured himself.

Says that he is worth £80,000.

July 18 - Last night at 6.30 pm he was sitting down in his parlour chair when he was observed to be suddenly convulsed and his face distorted and he could not speak.

In a short while he came partially to himself but seemed stunned and stupid.

He was then taken upstairs to bed as another attack was coming on.

He did not regain consciousness after the second one and the convulsive attacks gradually increased in number and frequency until they became incessant with very short intervals of rest, the patient being profoundly comatose. He gradually became more profoundly comatose and died this morning at ten minutes to six, nearly twelve hours after the initial attack. The left was the side exclusively convulsed. The later convulsions were extremely violent and prolonged. There was anaesthesia of right side of body. The left pupil was much dilated.

Medications/Treatments: Chloral and Potass Bromid, Haust Chloral HS