Robert Evans (6480)

Admission Details for Patient: Robert Evans (6480)

Gender: Male Age: 48
Marital Status: Single Religion: Calvinist Methodist
Occupation: Labourer
Address: Pwllheli, Carnarvonshire

Date of Admission: January 6, 1905
Date of Discharge: December 24, 1907
Discharge Category: Recovered

Disease: Mania
Supposed Cause: Religious excitement/heredity/previous attack

Medical Certificate:
Patient (who was known to me as a quiet unobtrusive religious man) stands in his bedroom with only his shirt on, gesticulating, cursing and swearing, he imagines himself a horse, then he gives himself a hard knock to make the horse go. He told me that he had been as big as a mountain, with large wheels revolving inside, but now he was reduced to ordinary size. William Owen, Shop, Pistyll, states that Robert Evans is restless night and day, laughing, shouting and cursing and swearing. Dr. William Thomas, Rhianfa, Nefyn.

Approximate duration of present attack: 14 days

Number of Previous Attacks: 1

Number of Previous Admissions: 1

Number of Subsequent Admissions: 0

Total Number of Admissions: 2

Relatives affected: Mother

Number of Previous Attacks: 1

Epileptic: No

Suicidal: No

Dangerous: Yes

Clean Habit: -

Food Refusal: No

Sleep Habit: Bad

Destructive Habit: Yes

Disposition: Steady

Education: -

Physical/Mental State at Examination: Health good. This man has been very well since his discharge in 1887 until two weeks ago when mental symptoms began to show themselves after he had attended some religious revival meetings. There is no other exciting cause. His mother became mildly insane soon after his discharge in 1887 and she is now dead.

Current Diagnosis: Acute transient psychosis (F23.2)

Case Notes

1905 Jan 12 - A middle aged man with dark hair and beard. Head bald in front. Blue irides, pupils equal and mobile. In good bodily health and condition. Mentally he is suffering from Religious Mania of a Sub Acute type. He is very restless and goes about singing and muttering to himself. He has delusions as to his own identity believing, at times, that he is a horse or a mare. His conversation is disconnected.

He eats well and so far he has not been violent.

Sleeps fairly well.

23 - Is keeping better, quiet and well behaved. Rather incoherent when spoken to.

Mar 8 - Useful and healthy but not much improved mentally.

May 29 - The same.

Sept 30 - Has had an attack of Acute Pneumonia.

Behaved well and made a good recovery.

Better mentally.

1906 Jan 14 - Keeps fairly well, but is not quite well mentally.

June 2 - Still well behaved and useful. Not quite fit for discharge.

Sept 3 - Peculiar behaviour at times.

Dec 6 - The same

1907 July 6 - Quiet and useful, well behaved but not quite recovered. Oct 12 - Improved.

Medications/Treatments:

Additional Notes

Previous admission:

18th February 1887 (No. 3801) with Religious Mania.

The Medical Certificates read:

I. His greatly changed manner and language. Hears footsteps of someone coming, when no sound of any kind is heard by others.

When I asked how he bruised his eye, which I knew he had done with his own hand, said he got a blow from some part of a truck in the quarry. Has delusions, illusions and hallucinations. Said he had killed the two snakes at last. He had the last few days been in constant dread of something in the room.

Again today bruised his face and said the truck had run against him in the quarry. II. Communicated to me by his Mother and brother.

Had been very quiet for more than a week and slept well. Last night got very restless and got hold of his brother and bruised him a good deal, thinking he was the Devil. When he was first noticed to be getting wrong, he used to go about praying, sometimes in the Barn, thinking he was in Chapel.

John Evans Hughes, MRCS and LSA England, Nevin. February 17th 1887.

I. At times there is a want of recognition of those formerly well acquainted with; other times, he believes them to be representatives of the deities, whilst periodically he asserts they are scorpions and devils.

II. His brother, who has been almost his constant attendant, states he has on several occasions attempted to do him injury, because he said his brother had joined the devil against him.

Owen W. Griffith, LRCPh. and S Edin., Pwllheli. February 17th 1887.

He was discharged recovered on 20th March 1888.