Dora L (9425)

Admission Details for Patient: Dora L (9425)

Gender: Female Age: 23
Marital Status: Single Religion: Church of England
Occupation: Domestic servant
Address: Brynrefail, Carnarvonshire

Date of Admission: April 28, 1920
Date of Discharge: August 31, 1920
Discharge Category: Recovered

Disease: Mania
Supposed Cause: Worry

Medical Certificate:
She is a pseudo-hermaphrodite. She stares at the wall and speaks to some unknown person who is very hairy. She thinks it is Lloyd George who talks to her continually day and night and prevents her sleep. She pulls faces, waves and quotes scripture to him. She is requested to put the world right (by him). She sings and laughs alternately. K H, Aunt, Brynrefail: That she is very rough, swears and looks wild. She got up at night and told the family that the world was out of order and that there would be daylight no more. She throws the furniture about and smashed a window. She got out of bed and went out a distance of a mile in her shirt, shouting, singing and disturbing the neighbours. She locked her grandmother in the bedroom in case, she said, she would throw her downstairs as she did with the clock. The family are afraid of her and she attempts to get through the window. Signed Dr. John Roberts, LRCS, LRCP Edin., Llanberis. 27th April 1920.

Approximate duration of present attack: Few days

Number of Previous Attacks: 0

Number of Previous Admissions: 0

Number of Subsequent Admissions: 1

Total Number of Admissions: 2

Relatives affected:

Epileptic: no

Suicidal: yes aunt thinks so

Dangerous:

Clean Habit:

Food Refusal:

Sleep Habit:

Destructive Habit:

Disposition: temperate and steady

Education:

Physical/Mental State at Examination: Good health and condition. Under-developed penis, undescended testicle on left side. There is also a rudimentary vagina behind the scrotum. ( A note in the admissions register reads: 'This patient was admitted as a female and after correspondence with the Board of Control was classified as a male'.). Patient is an illegitimate child, born in London. First signs of attack, alteration of speech and temper. Lack of sleep for six weeks.

Current Diagnosis: Acute transient psychosis (F23.2)

Case Notes

1920 Apr 28 - Admitted as a female.

On examination he was found to have but few female characteristics. Application was made to the Board of Control to classify him as a male.

Mentally he is suffering from Mania.

May 1 (copy) - Suffering from Ordinary Mania on admission.

There was considerable loss of control and he was singing and shouting chiefly about religious matters and said he was seeing visions of Christ and was trying to overcome some great trial. His conversation becomes rambling passing rapidly from one subject to another and there was considerable restlessness.

He was also suffering from Insomnia.

18 - Good health and condition but very clouded mentally.

Rambling in conversation but says he is much relieved to be 'classed' as a man. Shows signs of slight mental improvement.

He is a case of complete Hypospadias and partially descended Lt Testis, Rt Testis being fully descended.

26 - Has shown signs of improvement since admission. Works out.

June 2 - Has gone on improving mentally.

13 - More rational than when admitted.

Sleeps better.

Has no delusions about religion now.

July 1 - Much better mentally.

No religious delusions but he still states he saw Lloyd George's portrait on the wall of his bedroom.

Good worker.

Well conducted.

Discharged.

Medications/Treatments:

Additional Notes

Readmission:

3rd June 1936 (No. 12669 and C1095) with a diagnosis of Mania. By 1936 'Dora' was David, a married farmer still living in Brynrefail. The Medical Certificate reads:

(a) On 2nd June 1936 when called to see the above mentioned the man was quiescent and coherent but upon further examination he referred to biblical and political personages incoherently and felt as if his head was boiling and clung to my hands. I saw around me signs of destruction and a man whom he had injured requiring 4 stitches and others showing signs of fear.

(b) Mrs M L, Brynrefail:

He had about 6 wks or 2 mths ago shown abnormal mentality, morose, refusing to carry out his usual vocation.

His wife, Mrs L of the same address: That she is afraid of his violent actions and showed me the effect of it on 2.2.36 - clock destroyed, books thrown into fire.

Incoherent speech and fear of himself. No reference made as to sexual abnormality and man is willing, she states, to receive treatment.

David was discharged recovered on 9th December 1936 after a two month trial.