Admission Details for Patient: Robert Phillip Hughes (504)
Gender: Male Age: 22
Marital Status: Single Religion: Calvinist Methodist
Address: Bangor, Carnarvonshire
Date of Admission: May 3, 1890
Date of Discharge: December 21, 1891
Discharge Category: Recovered
Disease: Acute Mania
Supposed Cause: Previous attack and Masturbation
I. (i) Attitude occasionally watchful, sometimes lying down on floor of bedroom, sometimes lolling up against chair or bed. Behaviour changed from being courteous, attentive and matter of fact, he is rude, neglectful and fanciful. Now when addressed he refuses to answer or refers to something else. I asked him in English how he felt, he replied in Welsh "Thus a Frenchman would do it". I offered to shake hands; after long hesitation and repeated offers he bent down, touched the tips of my fingers with his and said "Like a Frenchman". Then he would relapse into silence or low muttering and gesticulating. (ii) Hugh Hughes of 342 High Street, Bangor, his father, states that he cannot now converse at all. He
talks nonsense, cursing and swearing, laughing heartily without cause, waving his hands about as if making a speech and frequently without reason assuming a fighting attitude. Emyr Owen Price, Bangor.
2. (i) While sitting on the edge of the bed and able to speak he maintained during twenty minutes an attitude of suspicion and refused to say a single word in reply to many questions put to him by me but continually laughed and gesticulated quite irrationally. (ii) To his father and mother his whole disposition is altered; he often uses the worst possible language in his father's presence, while before his behaviour was in every way good; a day or two ago he struck his brother in the mouth because he thought the food he was then receiving from him was alive with snakes. Rees Rowland Jones, Bangor.
Approximate duration of present attack: 6 weeks
Number of Previous Attacks: 1
Number of Previous Admissions: 1
Number of Subsequent Admissions: 1
Total Number of Admissions: 3
Number of Previous Attacks: 1
Clean Habit: -
Food Refusal: -
Sleep Habit: -
Destructive Habit: -
Physical/Mental State at Examination: Health moderate. Patient since his discharge has lived at home where he has looked after the books of the establishment. Is said to have been very well until about a month ago when he (unfinished sentence).
Current Diagnosis: Schizophrenia (F20.1)
1890 May 5 - Patient's general condition differs but little from that seen upon his last admission. Free from bruises etc.
Mod. well nourished but is anaemic and looks haggard and worn.
Is quite incoherent and is at times noisy and excited.
Has not slept since admission and has to be spoon fed.
9 - Taking sufficient food. Bs have been well opened and is sleeping better. Out all day and looking better.
June 3 - This patient has undergone no material alteration or improvement since last entry.
Language perfectly incoherent and meaningless. Habits restless and frequently destructive and dirty to his clothing.
Constantly gesticulating and muttering disjointed sentences and pays no attention to what is going on.
21 - Has improved very much and is now nearly convalescent but it would be unwise to foretell a recovery for during his previous admission relapses were frequent.
July 1 - During the last few days has been very unsettled. Reserved and talks and mutters to himself and will not answer when spoken to. Not actually violent.
Sept 10 - Has had another very bad attack. Has broken glass and cut his clothing. Very excited, quite incoherent and masturbates badly.
1891 Jan 3 - Since last entry no real improvement. Has just recovered from an attack differing in no respect from its predecessors. During the intervals he appears to be in a condition of Partial Dementia.
Sits by himself all day.
Never speaking, or taking an interest in anything round him and mutters an unintellig. answer when addressed. Fair health.
Apr 15 - No material change. Had a severe attack of excitement about a month ago a couple of days after his father had been to see him. In the intervals is in a quiet and semi demented condition. Complains of indigestion and many of the other symptoms encountered in quack books but is in fair health.
Is devoid of all energy and cannot be induced to do anything, even read a paper. Sept 10 - Has not had an attack of exmt. since last entry and has been quiet and in a low and semi demented condition.
Mind torpid and apathetic. No inclination to amuse himself or work.
As his parents are anxious, decided to send him to them upon trial, the change may do him good.
29 - Appeared before the Committee on 17th. Spoke sensibly and cheerful. The following day shortly after receiving a letter from his father, he suddenly became more demented and stupid and not a word could be got out of him.
Advised his father not to remove him.
Is now becoming sharper again and can converse.
Dec 21 - Has been home for a month and has been discharged recovered but that he has regained even his former standard of mental rigour is impossible. His health is also far from satisfactory and he will probably ere long succumb to Phthisis.
13th May 1886 (no. 462) with Acute Mania.
Medical Certificates read: 1. (i) He refuses food, is incoherent and rambling in his talk, eg "I am surrounded by devils", "have just come from hell", and confuses these with Gods and Mortals, time and place being confused. Occasionally violent, cries for no cause, and although he has no fixed delusion yet he refers at times to his great strength and power which he does not possess.
(ii) Communicated by his brother Rowland Hughes. Sleepless. Immoderate crying and laughter without cause, sometimes imagines people about at whom he will fling any missile within reach.
Great difficulty controlling him at times.
Emyr Owen Price, Bangor. May 11th 1886.
Excited and violent for no cause.
2. (i) Talked of fighting generals and vaguely of funerals, of fighting with coal, of his strength and of the way in which Welshmen fight.
Uses strong language and has no sequence in his expressions. (ii) Communicated to me by his Father: That he has ever changing delusions: sees devils, which he fights: that he has come from Hell: that he preaches nonsense: that he has changing wants, which he forgets.
John Lloyd Roberts, Denbigh. May 13th 1886.
Robert Hughes was discharged on 28th September 1886 recovered.
28th March 1894 (no. 550) with sub acute mania.
He was transferred from the Private Class to the Rate Aided Class in 1931 and remained in the asylum until 23rd March 1952 when he died from dysentery and heart disease.