Robert Thomas (4193)

Admission Details for Patient: Robert Thomas (4193)

Gender: Male Age: 33
Marital Status: Married Religion: Church of England
Occupation: Labourer
Address: The Union Workhouse Bangor, Carnarvonshire

Date of Admission: May 31, 1890
Date of Discharge: April 18, 1898
Discharge Category: Recovered

Disease: Melancholia
Supposed Cause: Not known

Medical Certificate:
I. His attitude - one arm frequently held high, at other times gesticulating, face fierce looking and frowning; spitting and making a pretence of vomiting without cause, continually threatening violence. When asked his age said he was two hundred and thirty five, and when how long he had been in the lunatic room, said "from everlasting, hanging between the world and the devils". He is constantly praying and reaching and is violent and dangerous. II. Samuel Greenley, Master of the Union Workhouse, Bangor, said that force had to be used to put him in the room, reasoning and remonstrance being of no avail to pacify him, and when offered food refused it and threatened the master with his fists. He struck the police constable when he was trying to quiet him and he rushed at the master violently and tried to strike his face, all without any reason. Emyr Owen Price of Bangor.

Approximate duration of present attack: 4 days

Number of Previous Attacks: 1

Number of Previous Admissions: 1

Number of Subsequent Admissions: 1

Total Number of Admissions: 3

Relatives affected: Sister

Number of Previous Attacks: 1

Epileptic: No

Suicidal: No

Dangerous: Yes

Clean Habit: -

Food Refusal: -

Sleep Habit: -

Destructive Habit: -

Disposition: -

Education: Reads

Physical/Mental State at Examination: Health good. Patient was discharged from here in May 1888. Has apparently been doing very well and working steadily up to about 12 months ago when he had a brief attack of insanity lasting about a week. He was able to be managed at home and quickly recovered, resuming his former occupation as an ordinary workman on the Baron Hill Estate. Four days ago while so employed he became suddenly excited and unmanageable; was sent forthwith to the Bangor Workhouse and there became still more troublesome and had to be sent to this Asylum.

Current Diagnosis: Paranoid Schizophrenia (F20.0)

Case Notes

1890 June 3 - Patient appears to be in a somewhat similar frame of mind as when he was admitted previously, tho’ on the whole his Melancholia is associated with a lesser degree of taciturnity and he is more capable of being aroused to attention.

His demeanour and general aspect is restless, wild and nervously agitated, he is in the habit of assuming grotesque and absurd attitudes and frequently mutters and prays to himself in an undertone. When pressed for an explanation of his peculiar conduct he informs me that his body is operated upon by a peculiar instrument and that his stomach is tightly grasped by machinery.

That his soul is all on fire and he is suffering the penalty of his sins and that the Lord will never forgive him. Is fairly quiet and manageable in behaviour and expresses a wish to be actively employed. Physically he is well nourished, muscular and in good bodily health. 20 - In better spirits and out working. Aug10 - Very unsettled. Still says that he is worked upon by a machine etc - cannot be induced to work.

Oct 10 - isq. Is tormented by a machine which he thinks is worked by the engine in Laundry.

Has hooks inside him "working downwards". He thinks his circulation is stopped and also states that he has felt pressed whilst at work on the farm to go in obedience to a voice he heard and drown himself in the river. Health good. Is now confined to the house.

1891 Jan - No change. Apr 15 - Full of hypochondriacal delusions and is quite wanting normal energy and activity.

Is still for safety's sake confined to the house. Good health. (From Sept 1891 to June 1894 notes indicate no change).1894 June - This patient has shown some change of late. Thyroid enlarged with puffiness of face and eyelids. Slowness of speech and a general sluggishness of manner which have suggested myxoedematous changes. Same delusions present. 1895 Apr - Quite devoid of energy. This patient quite changed in appearance, thyroid enlargement has disappeared, puffiness of face and eyelids gone and has lost flesh considerably. 1896 Feb - Rambling in his statements, deluded as ever.

May - Still has the machinery in his chest. Sept - Variable, gets excited and noisy but sticks to his work. Dec - Is looking fat and well. 1897 July - Has suffered a great deal from subacute rheumatism.

1898 Jan - Delusions not apparent and free from excitement. Is very anxious to go home and says he feels very well.

In excellent health. Apr 18 - Was discharged off the books today after being home on trial.

Medications/Treatments:

Additional Notes

Previous admission:

16th April 1885 with Melancholia (no. 3593). Medical Certificate reads: 1. Incoherency in his statements and hallucinations as regards the conduct of others toward him, under the impression that everything is done against him, and even in his food suspects poison. 2. Communicated to me by others:

That he is dying and others are making his coffin and suspects poison in everything he takes and has a great tendency to incendiarism.

Owen Thomas Evans, MRCSE, Mem. of Roy. Coll. of Surg. Lon. and Q. C. Ph. Dubl.

Beaumaris, Anglesey.

April 16th 1885. He was discharged recovered on 25th June 1888.

Readmission:

It was almost 30 years before Robert Thomas was readmitted to the asylum in October 1927, this time suffering from Senile Insanity, with delusions that he had a wireless inside him. He was said to be quite incapable of looking after himself.

He died in the asylum from broncho-pneumonia on 8th January 1940 at the age of 83.