Richard Pugh (6672)

Admission Details for Patient: Richard Pugh (6672)

Gender: Male Age: 53
Marital Status: Married Religion: Church of England
Occupation: Driver
Address: Penmachno, Carnarvonshire

Date of Admission: December 7, 1905
Date of Discharge: November 23, 1906
Discharge Category: Recovered

Disease: Acute Mania
Supposed Cause: Previous attacks

Medical Certificate:
He talks incoherently and I cannot get him to answer any questions intelligently, he states that he is going away and that shortly he will return and give me everything I desire as he is to be the head Doctor of the whole country. Sarah Pugh, his wife, states that he caught hold of her by the throat and threatened to kill her. She had to escape from the house by the window. Ellen Roberts of Bodafon, Penmachno, saw Richard Pugh catching hold of Sarah Pugh by the throat and heard him swearing at her and saying he would kill her. Dr. William Michael Williams, Penmachno.

Approximate duration of present attack: 21 days

Number of Previous Attacks: 5

Number of Previous Admissions: 4

Number of Subsequent Admissions: 2

Total Number of Admissions: 7

Relatives affected:

Number of Previous Attacks: 5

Epileptic: No

Suicidal: No

Dangerous: Yes

Clean Habit: No

Food Refusal: No

Sleep Habit: Poor

Destructive Habit: Yes

Disposition: Steady

Education: Poor

Physical/Mental State at Examination: Health poor. Without any exciting cause he has again become subject of an attack of mania.

Current Diagnosis: Bipolar affective disorder (F31.1)

Case Notes

1905 Dec 14 - This man has again returned suffering from Acute Mania and is as bad as ever. He has no control of himself and is singing, talking and moving about all day. Very irritating and annoying to the others. Is much thinner than when last discharged. Eats well but sleeps badly. Dec 24 - No change. 1906 Jan 10 - Very excited and rambling. Full of delusions and looks in poor condition.

Mar 7 - No improvement. June 16 - Now improving steadily. Discharged Nov 23 1906.

Medications/Treatments:

Additional Notes

Previous admissions:

29th June 1894 (No. 4760) with Acute Mania.

Although he had had a previous attack it is noted that he had not previously been treated in an asylum.

The Medical Certificate reads: Incessantly talking in the most incoherent manner, writing up religious matter, quoting passages from scripture. Totally impossible to fix his attention upon any other subject.

John Pugh, his brother, states that he refuses to do his work, going out at midnight through public streets, blowing a trumpet and imitating a preacher. He was discharged relieved on 2nd July 1895.

3rd March 1900 (No. 5656) with Melancholia.

The Medical Certificate reads:

I. He fancies the Millenium is at hand, and consequently acts by, for instance, breaking his clock in pieces and saying "it will not be wanted again". He thinks he has a cleaver which no-one in the world can manage but himself (he seems to be an old butcher).

II. By Mr. Wm. Jones, Master, Union House, Llanrwst: Richard Pugh is at times morose and sullen; at others excitable and wants to go away. He will sit for hours dazed and undecided, and is generally in an absent minded condition.

Discharged recovered on 22nd May 1900.

13th September 1901 (No. 5892) again with Melancholia.

The Medical Certificate reads: I. He tells me that he is depressed and that he wanted to come to me for medicine but that every time he started something pulled him from behind so that he was obliged to turn back. He speaks a lot of nonsense about Lord Roberts etc and I cannot get any sense out of him.

II. Mrs. Roberts, Voelas Hotel, Pentrevoelas, informs me that he was in her employ for a short time until the 12th inst. as an Ostler and occasional driver. She was obliged to part with him as he let the horses out of the stables loose to the yard occasioning one to be seriously injured. He also smashed to pieces a knife grinding machine.

John Ivan Jones, Penmachno, informed me that he saw him on the 12th inst. up to his waist sporting in the Machno River.

Discharged relieved on 20th August 1902.

11th November 1904 (No. 6445) this time with Mania.

The Medical Certificate reads:

I. He is maniacal and cannot give a proper account of himself. He is violent and tried to run away. He cannot talk about anything rationally and is far worse than when he was previously sent to the Asylum. II. Mrs Kate Evans, Gorphwysfa, Penmachno, told me that she saw him on Nov 10 1904 lifting his horses legs over his shoulder and shouting that his horses were horses from heaven.

I, William Michael Williams, in company with the Relieving Officer J C Roberts of Penmachno, found him late on the night of Nov 10th 1904 sleeping in the manger of his stable and when we awoke him he became very violent and abusive.

Discharged relieved on 22nd March 1905.

6th May1920 (No. 9433) he was admitted with Mania from Bala where he was staying with a sister.

The Medical Certificate reads:

Says that he is the direct representative of the Almighty.

His chest is full of eels and horses.

Ellen Jane Jones, Bala, sister: Has talked incessantly day and night for last 3 days. Preaches and prays to imaginary congregations.

Discharged recovered on 29th December 1920.

Richard Pugh's final admission was on 4th September 1922 (No. 9960). The Medical Certificate reads: Very incoherent, mixing the subjects spoken of, especially on religious subjects, praying loudly etc.

Mr. T. R. Jones, Moss Hill (neighbour) said that he told him he meant to bleed the horses and was very violent sometimes with Mr Jones, threatening him.

Miss May Jones said he left the horse and cart on the middle of the road and praying loudly.

He was diagnosed with Mania and remained in care until his death on 9th June 1930.

The cause of death was probably Tetanus although there is no certificate to confirm this.