M H (895)

Admission Details for Patient: M J H (895)

Gender: Male Age: 30
Marital Status: Single Religion: Roman Catholic
Occupation: Poultry Farmer (former soldier)
Address: Llandudno, Carnarvonshire

Date of Admission: October 22, 1920
Date of Death: October 15, 1965
Cause of Death:

Disease: Dementia
Supposed Cause: War strain

Medical Certificate:
MJH was wounded in back in March 1915. He had sunstroke in Lisbon 2 years before war began. While convalescing from wound became moody, lethargic, great tendency to fall in love with every girl. Sent from Hospital here to Maghull (Military Hospital) and then discharged from Army. On examination now his condition is just the same. Thinks things must be done at once such as railway journeys, which could easily wait. Thinks he is quite fit to go and fight again. M H H, father, says his Son has been slightly erratic since Sunstroke but much more so since he was wounded. He makes love to every girl and wants to marry them all. He gets fixed determinations to do things which he considers necessary but are not. Charles Arthur Ashton, Llandudno, 20th March 1917.

He stands alone taking no notice of anyone. He pays little attention to what is said to him. He is dull, apathetic, lethargic and indifferent. M H (sister) states that he makes violent love to women promiscously and with little or no encouragement. Dr Colin Francis Frederick McDowan, Maghull, 21st March 1917. (Thid patient was treated at Haydock Lodge until transfer to Denbigh).

Approximate duration of present attack: Over a year

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: Not to be trusted with women

Clean Habit:

Food Refusal:

Sleep Habit:

Destructive Habit:

Disposition:

Education:

Physical/Mental State at Examination: Fair health. A very tall well built young man becoming bald. His memory is very poor and he does not know where he is. Very dull, simple and childish and masturbates frequently. Papers in the file indicate he served as a bandsman in the Army before his discharge. One brother was killed and another brother seriously wounded in the war. Patient's pensionable disability described as 'neurasthenia' (although it appears he was never transferred to the Service Class which suggests that the Ministry of Pensions did not consider his illness had been been caused by active service).

Current Diagnosis: Schizophrenia (F20.0)

Case Notes

1920 Oct 25 (copy of official report) - Suffering from Dementia. Memory is very imperfect. Although he has spoken to me several times he did not know who I was this morning. He is very dull and slow in conversation.

He does not know where he is but believes it is a War Hospital.

Becoming simple and childish and talks to himself. Given to masturbation. Believes that all women are in love with him.

(Shortly after the above report was written he had an epileptiform seizure and was very dazed and stupid after it).

Nov 8 - In a rather depressed condition and always waits in the same place for me asking when he can have his liberty. Occasionally brighter and is occupied learning Welsh.

22 (copy report) - Suffering from Dementia.

Dec 22 - Somewhat childish and Quixotic. Is often asking when the War is starting so that he can join the Army again.

1921 Jan 22 - Little change. A persistent masturbator. Strikes out at times.

Feb 3 - Has struck an attendant when getting up recently.

On several other occasions he has assumed a threatening attitude.

Mar 2 (copy report) - Suffering from Dementia. Unable to concentrate his mind on anything for any length of time and his memory is defective for recent events. He is restless constantly wandering aimlessly about the ward. Recently he has become impulsive and has attacked both attendants and patients. He masturbates constantly both night and day often in a most shameless manner.

19 - Assumed a threatening attitude on several occasions during the past week, and struck attendants on several occasions. Has quieted down again and was very peaceful this morning entertaining the other patients with vocal selections. 27 - Still adopts a fighting attitude on occasions. Apr - No change.

May 1 - Attempted to strike me without any reason a few days ago, so was placed in a Side Room for a few days.

12 - Evidently taught a lesson by being put in a Side Room for since then there has been no complaint. June 7 - No further complaints re his conduct.

July 1 - Continues to masturbate.

Oct 4 - Is never to be trusted as he strikes out without any warning.

1922 Jan - Every morning waits for me on the round and asks the most absurd things such as whether he will be allowed to sleep with lady Jane and sometimes makes some filthy references.

Has not been actively aggressive for some time now.

Apr - Now very quiet and never approaches me on the Airing Court. Often he stands still on the court listening to voices and shouting answers.

July - Keeps away from everybody and does everything automatically. Becoming very demented. Oct - No change.

1923 Jan - Now very quiet and indifferent and hardly ever speaks.

June (copy report) - Dementia. At present indifferent and self absorbed.

Recently put his head through a window inflicting several wounds of the scalp which required suturing.

He is considered a suicidal patient and is on the Caution Card.

1924 Jan - Liable to attack patients and attendants when the impulse arises.

Quite demented.

Subsequent notes indicate progressive dementia until in Aug 1927 he is described as "too demented to take interest in anything and leads a vegetative existence".

He continued to have "periodical impulsive moods when he attacks anyone in his vicinity" and to masturbate all day.

In Jan 1931 he is referred to as an advanced case of Dementia Praecox.

Jan 1932 - Given a course of Sulphur in Oil in the Autumn.

For some weeks afterwards there was considerably increased restlessness and activity with constant singing and chanting prolonged far into the night.

He has gradually however subsided into his usual state.

A Special Report dated Apr 5th 1956 describes him as a chronic schizophrenic, who is withdrawn and inaccessible and who can give no information about himself or reply to any questions. He keeps up an incessant mutter in which he displays gross incoherence of thought and which it is impossible to follow.

Medications/Treatments: Sulphur in Oil, Nicamide (after a faint), Sod. Amytal, Largactil, Fertazin

Additional Notes

Largactil started 10th May 1960. Dosages - 25mg tds to 13th May, 50 mg tds to 25th May, 75 mg tds to 27th May, then 100 mg tds. Discontinued 4th June, reason "face very swollen".

Another treatment with Largactil 50 mg tds 28th Sept to 11th Oct 1965, reduced to 50 mg bd and discontinued on 12th Oct.

Died 15th Oct 1965.

The patient's father, a retired customs officer, signed an agreement to pay 3 guineas per week for the keep of his son, writing that: "I think all the arrangements are now complete for the transfer of my poor son" (from Haydock Lodge to Denbigh).

A brother, G H, Public Analyst for the County of Monmouth, seems to have taken over financial responsibility at some point and the file contains several items of correspondence relating to the provision of clothing and 'extra comforts' for the patient.

There is no record of a visit, however, and in March 1949 he wrote that: "It is some years since I last visited Denbigh to see my brother, and on the last occasion he found it difficult to remember me and I came to the conclusion that his mind was almost completely gone and that further visits could serve no useful purpose."

Regraded from certified to informal with the 1960 MHA.

Explaining this regrading to the patient's brother, the Medical Superintendentt wrote that patients taken off 'certificate' and made 'informal' are those who are not dangerous to themselves or to others but are not recovered enough to be discharged.