O E (9540)

Admission Details for Patient: O E (9540)

Gender: Male Age: 45
Marital Status: Married Religion: Calvinist Methodist
Occupation: Baker
Address: Marianglas, Anglesey

Date of Admission: November 12, 1920
Date of Death: May 1, 1922
Cause of Death:

Disease: Manic depressive (II.9.b)
Supposed Cause: (Family trouble and anxiety)

Medical Certificate:
(a) Fancies bowels constipated - not moved for past fortnight, presumed to have swallowed pills which were found in the bed. (b) Eight years ago arrived in Liverpool from overseas, was locked up by police presumed to be under the influence of drink, but was released as soon as it was found that he was "off his head". Since this time he has done no work and is at times very stupid, refuses his food, will not be washed, and at times will not speak to anyone. Dr. Griffith Llewelyn Jones, Llangefni. 11th Nov 1920.

Approximate duration of present attack: About 8 years

Number of Previous Attacks: 0

Number of Previous Admissions: 0

Number of Subsequent Admissions: 0

Total Number of Admissions: 1

Relatives affected: An uncle suffered from fits

Epileptic: No

Suicidal: No

Dangerous: No

Clean Habit:

Food Refusal:

Sleep Habit:

Destructive Habit:

Disposition: Very quiet and stupid

Education:

Physical/Mental State at Examination: Poor health and condition and has rapid heart action. Mitral regurgitation. Said to have had convulsions at three months old after vaccination, but not since. Simple and weak minded, rather cunning and deceiving. Always complained with headaches. First signs: Loss of memory on return from sea voyage. Suggested cause: family trouble and anxiety.

Current Diagnosis: Unspecified organic disorder (F09)

Case Notes

1920 Nov 12 - Very lethargic and depressed in appearance and slowly answers questions in monosyllables and a wan voice.

16 (copy) - Suffering from Melancholia.

Depressed and apprehensive, is very slow in answering questions and at times refuses to answer them at all.

Attributes his condition to bodily weakness. States that he has been in bed for some years on account of his bodily weakness. Poor health and condition.

19 - Reclusive but generally answers questions with a feeble semblance of a smile even.

23 - Had some oedema of the feet and ankles this morning.

Put to bed.

Has a mitral murmur.

30 - Remains very depressed. Lacks any emotional reaction.

Yesterday, he was shown a letter from his sister, urged to write her a few words to say how he was, but would not brace himself to that much effort.

No initiative whatever.

Dec 9 - No mental change. Bases of lungs congested.

12 - No change.

1921 Jan 1 - Lives a vegetative existence.

Feb 1 - Unchanged.

Mar 12 - Owing to cardiac oedema has been in bed this last fortnight but was allowed up again today.

Apr 3 - Mental condition unchanged.

July 1 -The same.

Oct 1 - Was in bed a few days about a week ago with swollen feet. About again once more.

Has been persuaded now to walk about a little, as formerly he resembled plant life.

12 (copy) - Suffering from mental depression and is becoming demented.

Poor health and condition.

1922 Jan - No further change. Apr - Confined to bed.

Cardiac compensation rapidly breaking down. Extremities cold and blue with swelling of feet.

May 1 - Since last report, he improved temporarily on Digitalis and Nux Vomica, but became much worse a few days ago and, gradually sinking, died today.

Medications/Treatments: Digitalis, Nux Vomica