John Thomas (4205)

Admission Details for Patient: John Thomas (4205)

Name Mismatch: 4205 , 2437

Gender: Male Age: 58
Marital Status: Married Religion: Calvinist Methodist
Occupation: Labourer
Address: (Pwllheli), Carnarvonshire

Date of Admission: July 1, 1890
Date of Death: January 16, 1891
Cause of Death: Acute double pneumonia/melancholia

Disease: Melancholia
Supposed Cause: Poverty

Medical Certificate:
I. Incoherence, fancying himself another person, morose and sullen in his answers. II. Facts communicated by Mr E J Griffith, RO and Eliza Thomas that he was searching for a cord to hang himself with, also carrying a carving knife and a razor in his pocket. Violence to his wife and children. June 30th 1890. Edwin Shelton Jones, Pwllheli.

Approximate duration of present attack: 4 months

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: Yes, attempted

Dangerous: Yes

Clean Habit: Yes

Food Refusal: Yes

Sleep Habit: Badly

Destructive Habit: No

Disposition: Religious and well conducted

Education: -

Physical/Mental State at Examination: Health poor. Dyspepsia. Patient has been in better circumstances and his becoming poor is assigned as the cause of his Insanity. Has attempted suicide by hanging and strangulation and refuses food. No. hered. taint.

Current Diagnosis: Severe Depressive Episode (F32.3)

Case Notes

1890 July 3 - Patient is a gaunt and half starved working man with an anxious and haggard expression. He is suffering from Melancholia and is very miserable and wretched.

Informs me that some time ago he contemplated suicide and attempted the same but that now he is more afraid of others murdering him and is sure that he has been brought here for that purpose. Thinks he is in Chester and tho’ he says he has often heard of this place he will not believe that he is now an inmate.

Is thin and poorly ourished and prob. Has some constr. Of Mitral orifice but is too restless to allow of a satisf. Phys. Examination. Suffers from Chronic Dysp. And have put him on extra diet etc. and issued a special Caut(ion) Card.

(Dates of subsequent notes obscured by Death Certificate).

- Condition variable. At one moment acutely melancholic, crying and shouting and bewailing his unhappy lot, at another calmer and less excited. The idea that he is to be killed however never leaves him and he says he is being fattened up like a lamb for the slaughter. He also thinks that owing to his misdeeds a judgemt. Has fallen on his family. Looking much better and is carefully watched.

- Has become more acutely miserable during the last week. All food has to be forcibly administered. Is very deluded and says his body and soul are dead. Persists in following I. Marjoram whom he says is going to be his butcher and unless watched it may prove to be true for Marjoram has struck him for annoying him. Has lost much flesh tho’ taking 4 eggs and milk etc ad lib daily.

Sept 10 - During the last week much quieter and takes his food readily;

same delusions present.

Oct 12 - Working out on farm, has become stronger but the same delusions are present.

1891 Jan 4 - Declares every day will be his last and cannot be persuaded to the contrary. Is said to be a good labourer. Thinks his family have been murdered on his acct. etc. 16 - This poor old fellow died today somewhat suddenly of Cardiac failure consequent upon Pneumonia of an acute nature. The left lung being apparently completely solidified and the right one much congested. He died at 10 pm and no sudden change had been noticed until just a few minutes before he died.

Medications/Treatments: Extra diet - eggs and milk ad lib daily.

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