Philip Owen (514)

Admission Details for Patient: Philip Asaph Norman Owen (514)

Gender: Male Age: 19
Marital Status: Single Religion: Church of England
Occupation: No occupation
Address: Frongoch Vicarage Bala, Merioneth

Date of Admission: October 4, 1890
Date of Death: January 3, 1920
Cause of Death:

Disease: Melancholia
Supposed Cause: Many severe attacks of illness and masturbation

Medical Certificate:
1. (i) I have attended the above named Norman Owen for the last 5 years periodically, he has been all along suffering from Religious Mania and when the attacks come on, conversation with him was nothing but about religious subjects, all other subjects he refuses to reply to and talk about. (ii) Facts communicated by the Rev. Philip Owen, Frongoch Vicarage, Bala: Always running away by himself. Praying aloud at home several times a day, continually reading the Bible and always stopping persons on the road and elsewhere and talking about religion. Refuses to take his meals, has not taken anything for 3 days. Refused to drink milk or any other fluid in my presence today. Owen Richard Pugh Owen of Bala. October 3rd 1890.

2. (i) Patient's conduct generally; would not respond to any question given. Absolutely refuses nourishment for the last three days. (ii) Facts communicated by Mrs Gwen Roberts, Station House, Frongoch, Bala: Wanders about alone night and day, continually conversing with persons about religious topics, whether known to him or not, forced his way into a sick woman's bedroom and questioned her upon religious questions and had to be turned out by force. October 3rd 1890. Evan Williams of Bala.

Approximate duration of present attack: Coming on for 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: No

Clean Habit: Yes

Food Refusal: Yes

Sleep Habit: Fair

Destructive Habit: -

Disposition: -

Education: Good, reads and writes

Physical/Mental State at Examination: Health moderate. Refuses food. The above patient is said to have been of ordinary intelligence and understanding up to about 4 years ago. He then went to a Grammar School at Ellesmere, stayed there about 12 months and on returning it was observed that his habits and disposition had become strange and apathetic. It has subsequently transpired that he had frequently indulged in self abuse and has continued this vicious practice for the past 2 or 3 years. He is said to be low and melancholy in spirits, imagines that he has committed various sins, and shows no disposition to employ himself usefully.

Current Diagnosis: Schizophrenia (F20)

Case Notes

1890 Oct 7 - This is an almost typical example of the Insanity of Masturbation.

Patient is a gawky pale and pasty faced lad with a shambling gait.

He during the first day after admission would at times become somewhat communicative and his conversation was free from delusion but displayed the usual religious sentimentalism and ideas of an egotistical nature which are characteristic of the

disease.

He confesses having practised masturbation and also states that he has some trouble on his mind but will not divulge the same. Requests his discharge as he is not insane and declared he would not eat whilst here.

After the first day has had to be fed forcibly with feeder. He is rather thin, muscles flabby, but organs are sound.

(Subsequent notes are undated, the death certificate obscuring dates).

- Has still to be fed with the feeder but after the first mouthful or two does not offer much resistance. Is in a condition of stupor and stands in the same place or paces about the ward with head hung down and cannot be induced to converse.

If a hand be placed on him will often roughly brush it away.

Is carefully looked after as he is evidently deluded and it may be he has impulses of a self destructive nature.

Is fed with milk and eggs with Cod Oil daily. - Improving in health. Sent out to Airing Court daily when fine. Condition otherwise variable, will take his own food one day and refuse the next and sometimes seems a little brighter and will mutter "yes" or "no" to a question but no more.

- Since last entry patient has been somewhat brighter and until Wed last, 19th, had taken his ordinary food regularly. On Thursday owing to his determined opposition to ordinary feeding prepared to give him Stomach Pump and he then gave in and took it himself.

This afternoon at 2.30 whilst writer was coming down from Sick Ward stopped to speak to Owen who, giving no reply, slouched off down passage. The Attendant who was in bathroom then came out to speak to writer who was in dayroom. When opposite bathroom Owen was seen by myself to half run into room and, suspecting mischief, I ran at once to room. There saw Maude, a Private Patient, on his hands and knees and Owen standing over him his arm lifted to strike down on Maude's uncovered head. Jumped across room and intercepted blow in descent.

Owen then turned on myself, and the Attendant, hearing the struggle, came up and he was secured. Maude was lying on floor bleeding profusely from what turned out to be two severe scalp wounds each about 2 and a half inches in length and extending to bone of the right side of Occipital protuberance.

The wounds parallel, half inch apart, and the occipital artery divided.

The bone corresponding to low incision appeared to have a simple fissure in it.

The wounds had been inflicted through a felt hat in which there was one incision with a heavy flat iron, and had another blow fallen on his head the results would undoubtedly have been fatal.

Tied artery and sewed up wounds. Put patient in bed.

Put Owen in Strong Clothing in Padded Room.

Further enquiry shows that this Homicidal impulse was consequent upon a delusion he has that "all the old men here are devils and ought to be killed".

Nov 23 - In Padded Room. But little to be got out of him. Says he is a devil but his face is not like one's and wishes a knife to disfigure himself to make him like one. This evening made a violent attack upon an Attendant and the writer who were in his room about tea time

Nov 25 - Have got him up and put him in charge of an Attendant and instructions have been given that he is never to be lost sight of. Cannot induce him to say anything except that he is a devil etc.

Has a hangdog expression on his face and casts furtive glances at one when spoken to. Dec 17 - Has become quite loquacious during the last few days. Informed me that his father was a filthy drunkard and hypocrite and compared him to a whited sepulchre.

He says he has also strong suspicions that his mother is no better than she should be.

A strange and incomprehensible lad.

1891 Jan 20 - Improving. Still inveighs against his father but has lately written him a fairly sensible letter in a pacific spirit. Has lately become very anxious to work and is always asking for a job as he calls it. Conversation more rational and his condition is so far satisfactory.

Feb 28 - Since last entry had been out working until a week ago and has stuck to it well.

Has chilled himself and is now in bed with what seems to be Erythema Papulatum.

Consid. febrile disturbance and general malaise.

Mar 20 - Have got him up. Pale and much pulled down and taking Iron regularly. Apr 22 - Is now in fair health and out again. Has improved much in his mind and writes a sensible tho' somewhat childish letter. Anxious to return home and do something for himself and has lost his old antipathy to his parents. Indeed he regrets having spoken ill of them and was very glad to hear I had not posted his letters written when bad.

May 25 - Has become very strange during the last fortnight. Imagines the Patients conspire against him and poison his food and that they accuse him of Witchcraft. Asks me whether I believe he is one etc. General behaviour sullen and peculiar.

July 10 - After improving and becoming more rational, losing his delusions etc, is again bad. States that he is afraid of the night attendant, that he means to murder him but cannot say why.

His letters home are silly and illogical. Habits careless etc. Aug 1 - Very unsettled.

Thinks people accuse him of witchcraft and mean mischief to him. Shouts out "We are all sinners" etc. Says he will be revenged upon anyone who does him harm and will kill without scruple. A very dangerous fellow.

Sept 19 - Certificate sent this day to Commis. in Lunacy stating that his condition showed no improvement and that he was a fit person to detain.

1892 Jan 4 - Quieter and more demented. Incurable.

May 1 - Sits in same place all day with eyes fixed in vacancy. Demented and useless.

Notes from 1893 to 1913 (on average 3 entries per year) continue to indicate little change.

1913 Oct - An untidy, dirty patient. Quite demented and speaks so that no one can understand him. Is in fair health.

Notes after February 1914 continue in Loose Leaf.

Little mental change is noted and he continued to be described "demented", "chronic", "dirty" etc.

Sept 1917 -

He is suffering from Dementia and is quite rambling and incoherent. He repeats the same thing over and over again.

Is restless, dirty and mischievous in his habits and his memory has gone. Poor health and condition.

In Nov 1917 he was confined to bed with Cellulitis of right leg.

He recovered from this but on Dec 31 1919 he was noted to be suffering from symptoms of pneumonia and he died a few days later.

Medications/Treatments: Strong Clothing and Padded Room. Milk and eggs with Cod Oil. Iron.

Additional Notes

A note addressed to "Dear Papa and Mamma" dated 16th Dec 1890 reads:

"Of course you know that I am a devil and that I will go to eternal hell.

Norman Owen"

A pencilled note written by the patient dated 1st August 1891 reads: If Jesus Christ wanted us why did he not look after us. It is Jesus Christ (D) that has brought these troubles on us. Jesus Christ is the devil Beelzebub. He is an enemy to the eternally good God who is without a beginning.

Attached to case book - "Copy of Special Report" dated 3rd April 1912.

Reads:

He is suffering from Dementia. He is lost and demented - rambles incoherently during an attempt at conversation and does not appear to understand anything that is asked him. He is untidy in his habits and dress. He is in fair health and condition.