William Thomas (6508)

Admission Details for Patient: William Thomas (6508)

Gender: Male Age: 56
Marital Status: Widowed Religion: Calvinist Methodist
Occupation: General labourer
Address: Carnarvon (admitted from Workhouse), Carnarvonshire

Date of Admission: February 20, 1905
Date of Death: September 18, 1913
Cause of Death: Endocarditis/Chronic Brights Disease certified COD

Disease: Melancholia
Supposed Cause: Intemperance

Medical Certificate:
States that he lives in fear of people, when fearing people has uncontrollable fits of violence, has been obliged to be put in a straight jacket in consequence. John Parry, Master of the Workhouse, says that he suddenly assaulted several persons without any reason or warning whatsoever, including the above named. Dr. Thomas Roberts, Penywaen, Caernarfon.

Approximate duration of present attack: 28 days

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: No

Food Refusal: No

Sleep Habit: -

Destructive Habit: Yes

Disposition: Intemperate and immoral

Education: poor

Physical/Mental State at Examination: Health moderate. Had marks of restraining anklets on his ankles and a wound on his forehead when admitted. (Straightjacketed at Workhouse). This man is a widower, but has been living with a woman in common lodgings for some time, he has been a steady drinker. He had one child 12 years after marriage; the child died. There is no history of insanity.

Current Diagnosis: Unspecified nonorganic psychosis (F29)

Case Notes

1905 Feb 27 - Bodily healthy fairly good.

Mentally suffering from Delusional Melancholia. He is in a state of great trouble and mental depression.

Subject to sudden attacks of violence, brought on by a sudden fear of some great danger, which he attempts to escape from. Has aural hallucinations. Since admission he has had two attacks of violence, which he says is due to weakness rising to his head.

Eats and sleeps well. Mar 2 - No change.

Apr 8 - Rather better on the whole but will not apply himself in any way. May 28 - The same.

Sept 30 - Much better and works outside. No attacks of violence for some time. 1906 Jan 14 - No further change. June 6 - Has had one attack of violence since last report but now quiet again.

Sept 1 - Quiet and useful at present. Dec 8 - No change.

1907 Apr 27 - William Thomas complained this morning that his side was injured. I found one rib broken.

There was no discolouration or external marks. He said he had had a scuffle with three attendants and that one (a tall man) had kicked him in his side. The attendant referred to, Ebenezer Davies, states that during dressing in the dormitory that morning, William Thomas was very noisy and excited and was throwing the blankets about and he had to send him down. Shortly after he was passing through Ward 3 when William Thomas suddenly attacked him and while he (the attendant) raised his hands to keep him off, William Thomas got his thumb in his mouth and would not let it go.

Ebenezer Davies and two other attendants put William Thomas down and closed his nose to make him open his mouth but he (Davies) had to pull his thumb out by force and his thumb was badly bitten. Att. Ebenezer Davies states that he did not strike or kick the patient and is surprised to hear that a rib is broken.

William Thomas has his side strapped and bandaged and is lying up in the Infirmary Ward.

July, Oct - No mental change.

1908 Jan to 1910 Feb - No change. 1909 June - Demented and useless, very impulsive at times, general health good.

Notes to 1913 indicate no further change.

1913 Sept - Has been removed to sick ward as he was refusing food. He has an enlarged and dilated heart and has oedema of the feet and eyelids.

His urine is 1020, dark in colour, albumen in fairly large quantities, a few casts seen. He is sullen and morose. Has ideas of persecution and is suspicious of everyone.

Sept 8 - Showing signs of failing heart. Oedema is now well marked, breathing is short, has an earthy colour in his face. Murmurs at apex and bases, rough in character. Endocarditis diagnosed 2 days ago.

Mentally much the same.

Sept 15 - Gradually failing, urine still shows albumen. Mentally much the same.

Sept 18 - Died today at 5.25 pm.

Medications/Treatments: