Samuel Roberts (4245)

Admission Details for Patient: Samuel Roberts (4245)

Gender: Male Age: 31
Marital Status: Married Religion: Independent
Occupation: Joiner
Address: Pwllheli (admitted from police station, Carnarvonshire

Date of Admission: November 25, 1890
Date of Death: February 9, 1898
Cause of Death: Acute pneumonia

Disease: Dementia
Supposed Cause: Sunstroke

Medical Certificate:
1. Chaotic state of mind, conduct and appearance in general. Has been under my care since his return from America 4 years ago. Suffering from Melancholia with delusions and latterly Dementia. 2. Facts communicated by others, viz. From his wife Catherine Roberts: That he rushed at her and followed her out of the house with a knife. Rebecca Clark (niece): Violently struck his father (who was asleep) without any cause whatsoever. November 25th 1890. Thomas Hunter Hughes, Pwllheli.

Approximate duration of present attack: 4 years

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: No

Dangerous: Yes

Clean Habit: Yes

Food Refusal: No

Sleep Habit: Bad

Destructive Habit: No

Disposition: Sober

Education: -

Physical/Mental State at Examination: Health good. Patient has done no work during the last 10 months. Cause a sunstroke got in America 4 years ago. Has been suffering from alternate depression with elation of spirits. During the last few days became so dangerous that he had to be lodged in Police Station. No Hered. taint.

Current Diagnosis: Bipolar Disorder (F31)

Case Notes

1890 Nov 29 - Patient is a short and strongly built man with slightly bowed legs. Complexion sallow. Irides and hair brown.

He is perfectly quiet and manageable.

Mentally he is in a stupid and confused condition and, with the exception that he thinks his father and people are hostile to him, he has no delusions.

Answers in a hesitating manner and his memory is evidently imperfect. Eats and sleeps well. Muscular and healthy.

Dec 10 - isq. Probably an incurable case. 1891 Jan 3 - Well conducted in every way and is sharper than he was. No delusions but his manner is still slow and hesitating. Does a little ward work.

Mar 17 - i Mildly demented.

Sept 11 - An incurable case but might be tried at home for he is harmless and docile - very good tempered and useful.

1892 Jan 2 - Semi demented and childish in conversation and behaviour. (May 1892 to April 1895 indicate no change).

Aug 30 - Was called up to this patient this morning and was told that he was found with great pain in the stomach and covered with perspiration and throwing everything up.

Examined him, found him pale and complaining of pain very much, quick pulse. Tongue rather dry and large. On examining the abdomen no hernia to be discovered. Abdomen was rather hard, tender but tympanitic all over. Pain seemed to be more or less referred to about the umbilicus and violent peristalsis was felt just above and to the right of the umbilicus.

Was seen again at 10am and the pain was much better but there was a slight amount of distension noticeable. Pulse was extremely quick, 135 to the minute. Could get no history from patient.

No history of constipation.

He also suffered from vomiting and retching which came on in paroxysms. The pain also came in paroxysms and then stopped altogether.

Gave him an injection of soap and water and had a good clearing out and to be fed per rectum.

Went on very much the same the whole day and his face is getting pinched. T. 97.4F.

Evening T. 97.4F.

Aug 31 - Seemed to be about the same. Vomiting still going on and the pain. No more tenderness in abdomen.

Pulse very quick and tongue dry. Had a fairly good night after getting a dose of morphia at 11 o'clock. Still fed on beef tea and the pain seems a little better tonight and the paroxysms shorter.

Sept 1 - Gave him an injection of morphia before going to bed which relieved him for the night. Seems much better this morning. Tongue better. Pulse slower and fuller. Not so much vomiting and griping.

Gave him an injection of soap and water but did not work him.

Sept 2 - Had a good passage last night. A frothy and very foul smelling stuff but nothing was found in it.

Sometime last night before he had the passage he vomited a quantity of pure bile. Today he is practically convalescent.

All the symptoms gone.

Dec 26 - Recovered completely from his illness and now is the same as before. Working in W6. In excellent health.

1896 Feb 23 - No change.

May 13 - Is getting more stupid and refuses to do his work as well

Sept 16 - Since last entry this man's neck has swollen to a large size the swelling being more or less limited to the right side. An incision was made in it, letting out about an ounce of yellow pus. Dressed it, left a sinus behind, which is showing some signs of healing.

Dec 4 - Has gone very lazy and stupid and when made to work was inclined to be violent.

1897 Oct - Has had some tubercular glands in his neck and groin. 1898 Jan - Does not look so well as he used to be, seems to be worse in every way, no apparent sign of any disease, except the tubercular sinuses. Feb - Died last night after an illness of about 4 days, was unconscious for the last 24 hours. Temperature had been up for a day or two and passed into a state of stupor and then into coma.

The probability being that it was Influenzal in origin. Died February 9th 1898.

Medications/Treatments: Morphia

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