R P (9433)

Admission Details for Patient: R P (9433)

Gender: Male Age: 60
Marital Status: Widowed Religion: Church of England
Occupation: General carter
Address: Bala, Merionethshire

Date of Admission: May 6, 1920
Date of Discharge: December 29, 1920
Discharge Category: Recovered

Disease: Mania
Supposed Cause: Previous insanity

Medical Certificate:
Says that he is the direct representative of the Almighty. His chest is full of eels and horses. E J J, Bala, sister: Has talked incessantly day and night for last 3 days. Preaches and prays to imaginary congregations.

Approximate duration of present attack: Nothing entered

Number of Previous Attacks: 6

Number of Previous Admissions: 5

Number of Subsequent Admissions: 1

Total Number of Admissions: 7

Relatives affected: Mother died at Denbigh Asylum about 32 years ago

Number of Previous Attacks: 6

Epileptic: No

Suicidal: No

Dangerous: No

Clean Habit:

Food Refusal:

Sleep Habit:

Destructive Habit:

Disposition:

Education:

Physical/Mental State at Examination: Poor health and condition. Noisy, talkative and restless. Conversation rambling and he is not able to give a coherent account of himself.

Current Diagnosis: Bipolar disorder (F31.1)

Case Notes

1920 May 10 (copy) - Suffering from Mania. Very talkative and noisy since admission, alternately preaching, praying and singing.

He is a man of low intelligence and simple minded and childish. States that he has sensations of things inside him creeping about him and eating him.

14 - Quieter and answers questions fairly well but memory much clouded. Has no subjective sensations of "creeping" etc. but talks vaguely to himself a good deal.

25 - Restless and noisy.

Does not improve.

June 5 - isq.

13 - isq. July 13 - Much better mentally. Works out.

Aug 6 - Suffering from mental excitement.

Oct 1 - Has now calmed down and working in the laundry.

Dec 29 - Discharged recovered.

Medications/Treatments:

Additional Notes

Previous admissions:

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

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.

J P, his brother, states that he refuses to do his work, going out at midnight through public streets, blowing a trumpet and imitating a preacher.

Discharged relieved on 2nd July 1895.

3rd March 1900 (No. 5656) with a diagnosis of Melancholia. The Medical Certificate reads: I (a) 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 (b) By Mr Wm Jones, Master, Union House, Llanrwst: R P 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.

J I J, 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) with a diagnosis of 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 K E, 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, W M W, 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.

Again discharged relieved on 22nd March 1905.

7th December 1905 (No. 6672) with Acute Mania.

The Medical Certificate reads:

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.

S P, 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. E R of Bodafon, Penmachno, saw R P catching hold of S P by the throat and heard him swearing at her and saying he would kill her.

Discharged recovered on 23rd November 1906.

Readmission:

4th April 1922 with Mania (No. 9960), his occupation now given as 'agricultural labourer'.

The Medical Certificate reads: Very incoherent, mixing the subjects spoken of, especially on religious subjects, praying loudly etc.

Mr T R J, 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 M J said he left the horse and cart on the middle of the road and praying loudly.

R P died in Denbigh Asylum on 9th June 1930, after a fall in the airing court, and an inquest returned a verdict of Accidental Death.

Events leading up to his death are recorded in his case notes:

On May 28th this patient was pushed over by another patient unintentionally whilst rushing past him on the airing court, and he sustained a cut on the thumb.

Owing to his bad mental state at the time he was put in bed and fomentations applied. On the 5th inst., when I left for the week-end the wound was progressing satisfactorily.

Two days afterwards he developed symptoms of Tetanus.

Large doses of Anti-Tetanic serum were given frequently, but he died on the 9th.

(The death register gives "Chronic Interstitial Nephritis and Mycardial degeneration" as the cause of death).