Sarah Sarah Byles (6549)

Admission Details for Patient: Sarah Ann Byles (6549)

Gender: Female Age: 59
Marital Status: Married Religion: Church of England
Occupation: Housewife
Address: Bettws y Coed, Carnarvonshire

Date of Admission: March 27, 1905
Date of Death: August 1, 1907
Cause of Death: Cirrhosis of Liver/Haematemesis & Exhaustion certi

Disease: Dementia
Supposed Cause: Intemperance

Medical Certificate:
I. Delusions, wandering talk and evidence of new clothes torn, using filthy and obscene language and imputing actions and motives in relation to her husband and son which were obviously without any foundation whatever. II. Tearing, destroying and burning clothes, climbing through the window above the glass shelter over the Railway Station at the risk of falling through, secreting knives and forks, tearing up and destroying flowers etc in the garden. Wandering about the village aimlessly, leaving house early and staying out all day by the riverside or in the churchyard, using vile language on the Railway Station platform. Dated 25th March 1905. Signed Douglas Macdonagh, Bettws y Coed.

I. Condition of clothes, all torn and in rags. Believes her husband unfaithful, her daughters of being loose in morality and that one of them has gone away to be confined, accuses her son of having stolen her rings and her husband her money. Her language is really foul and obscene. II. Her husband informs that she takes no interest in her household duties, is out all day in all weather. Tears all her clothes and burns everything she can lay hands on. Her language in the house and the street is most obscene. She accuses him and her grown up family of all kinds of immorality and him in addition of having stolen all her money. Dated 24 March 1905. Hugh Williams, Llanrwst.

Approximate duration of present attack: 9 mths

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: No

Sleep Habit: Fair

Destructive Habit: No

Disposition: Intemperate

Education: -

Physical/Mental State at Examination: Patient, the wife of the Station Master at Bettws y Coed, has been Intemperate for many years and about 9 months ago began to show symptoms of mental disorder, has gradually become worse, and latterly quite unmanageable at home.

Current Diagnosis: Unspecified dementia (F03)

Additional Diagnosis: 10

Case Notes

1905 Mar 30 - A tall bony woman, fairly nourished and with no evident organic disease.

Dark hair and complexion, conjunctivae a little tinged but there are no marked symptoms which corroborate the statement that she has been drinking.

She is perfectly quiet and orderly and her statements are coherent and intelligible but whether they are truthful or the fabrications of an Alcoholic it is not yet certain.

She accuses her husband of many things, one being that shortly before she came here she found him in bed with the servant and that he had had Syphilis.

Her son, who came with her, is also everything that is bad. She is very talkative, eats and sleeps well and gives no trouble.

(Dates of subsequent notes are obscured by the death certificate) - Well conducted and gives no trouble. Quite at home and beyond her statements concerning her home her conversation is quite rational.

- Incurable. Silly, rambling and full of delusions.

- Semi demented and useless but pleasant and good tempered. Might be tried outside if she could be placed in the country away from her home etc, where she would be troublesome.

- No improvement. Memory very defective.

Romances. Useless. Would do outside under suitable care and supervision.

- Notes continue the same to Feb 1907.

Works usefully in Sewing Room. In good spirits.

Aug 1 - Patient died this evening after a short and unexpected illness.

On Monday last, four days ago, just after tea, she suddenly vomited a very large quantity of blood, much of it red and apparently arterial. She was put to bed - Ergot, Morphia and subsequently Adrenaline given together with Ice.

She passed a restless night but did not bring up much blood. After being got to bed she vomited a large quantity three times.

On Tuesday there was a little brought up 2 or 3 times.

She was being fed on Enemata with nothing by the mouth. Most of the time slept quietly.

On Tuesday Acetate of Lead w Morphia. Did fairly well until Thursday morning when she was obviously worse, became gradually unconscious and sank. The actual cause of the Haematemesis can only be conjectured.

Medications/Treatments: Ergot and Morphia. Adrenaline together with Ice. Fed by Enemata. Acetate of Lead with Morphia.

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