# Demographic info and clinical notes

On certificate of:
Drs. Henry Patterson and John Palmer, Jr.

History and clinical notes:
History: Patient has been insane for over three years.  At times becomes quiet and orderly and will do what is said, at other times becomes very much excited and during these excited spells has often wished to kill herself and has threatened to kill her sister-in-law with whom she has been living.  Wanders from her home, sometimes only with her night dress on.  Goes in other people’s houses and demands everything she sees.  At night sleeps but little, tears her clothing and bed and the last week or two is much worse in every respect.  Always had had good general health.

Mar 1, 1898.  Mind is very feeble.  Frequently takes her clothing off and is untidy in her appearance.  Is somewhat dazed and does not appear to understand where she is.
Mar 22.  Has improved but little, wanders listlessly up and down the hall.  General health is good.  Mind quite feeble.
Feb 18, 1899.  Mental condition about same, has to be restrained most of the time or she tears her own clothing and removed the other patients’ things when given her liberty.  General health good.
Mar 15.  Very little change since last note.
Jun 16.  Condition about the same; has very good general health, with an enormous appetite, although she appears very thin; little change in mental condition.
Aug 29.  Very little change in mental or physical condition since last note.  Patient occasionally has to have mitts on to prevent from removing the other patients’ clothing which she fancies to be her own, but has been better in that respect lately.  Good appetite and sleeps well.
Jan 15, 1900.  Very little change in mental condition; general health good.
Jan 1901.  Patient has been in bed for past few weeks, considerable diarrhea at times.  Very feeble.
May 4.  Since last note has only taken liquid nourishment.  This morning pulse hardly perceptible.  Gradually failed and died 4 p.m.
May 4, 1901.  Died of Senile Asthenia.


On certificate of:
Drs. Henry W. Briggs and Thomas A. Hitch

History and clinical notes:
History: Patient believes he has lost all of his money and he has committed some terrible sins and that he will be hung.  Is very much worried over the surrounding people thinking they are all starving and freezing to death.  Patient wanders from place to place and is very noisy at night, sleeps poorly, appetite good.

Feb 20, 1898.  Mind very weak.  Is very noisy at night, sometimes cries thinking that people are trying to get in his room to kill him.
Apr 1.  Is very noisy night and day.  Believes that he will be destroyed every day.  Some times it is by dogs and other by being scalped.
Sep 10.  Fell on floor and hurt left hip, which has confined patient to bed and he is very noisy, believing that he will be destroyed.
Oct 12.  Very noisy, talks on various subjects and says that he will be destroyed by being thrown down a deep hole.
Nov 15.  No improvement; general health fair.
Dec 15.  No change.
Jan 12, 1899.  Very noisy, especially towards evening; general health good.
Feb 12.  No change.
Mar 1.  No improvement.
Apr 16.  Mind feeble; is very noisy about suppertime, health good.
Aug 25.  No change.  All symptoms of senile dementia; general health good.
Apr 16, 1900.  Was allowed to go home on parole.
Sep 20, 1900.  Discharged unimproved.


History and clinical notes:
History: Officer who brings patient knows but little of his history, they state that he is a well-known character about Wilmington.  Patient states that he has been sick for about a month.

Feb 9, 1898.  Is very weak and feeble, general anasarca is catheterized at regular intervals urine examined, specific gravity 1010 & considerable albumin.
Feb 12.  Gradually getting weaker.
Feb 16.  No improvement.
Feb 16.  Patient’s son states that his father’s mind has been affected for the past eight or ten years.  Has retired at times with a hatchet under his pillow, talks peculiar at times, very untidy and would try to seduce little girls.
Feb 17.  3 a.m.  Died.

Additional notes:
Pedophile? Anasarca, also known as "extreme generalized edema" is a medical condition characterised by widespread swelling of the skin due to effusion of fluid into the extracellular space. [1]
 
It is usually caused by liver failure (cirrhosis of the liver) or renal failure/disease and severe malnutrition/protein deficiency. The increase in salt and water retention caused by low cardiac output can also result in anasarca as a long term maladaptive response.
 
It can also be created from the administration of exogenous intravenous fluid.


History and clinical notes:
History: Patient has a sister in this Hospital now who is an epileptic.

Feb 20, 1898.  Patient states that he was addressed in Wilmington as D E Lome (?) and has written a number of letters to be sent to President McKinley.  He also believes that some people have considerable property that belongs to him.
Mar 20.  Patient still states that he was addressed as D E Lome.  Talks about socialists and various other secret organizations.
Aug 25.  Does not express his delusions; is very orderly, mind feeble, general health good.
Aug 24, 1903.  Quiet and orderly.  Is trusted to go about the grounds unattended.  Does a little light work.  Reads a great deal.
Sep 6, 1909.  Has been noisy during day and night, also untidy.
Nov 18.  Some mental improvement since last report.
Jan 5, 1910.  Complains of cramps in muscles of legs and cannot rest comfortably in bed, spends most of his time on a chair.
Jan 7.  Confined to bed, has a prevalent cystitis of urinary bladder, able to void only small amount of urine; bladder is washed out daily with Sol. Acid Boric.
Jan 12.  Rapidly growing worse, unable to retain nourishment and hiccoughs follow ingestion of any fluid.
Jan 15, 1910.  1:30 p.m. died.  Chronic Interstitial Nephritis and Tabes Dorsalis.

Final disposition:
Died of chronic interstitial nephritis and tabes dorsalis (syphilitic myelopathy)

Additional notes:
Syphilitic myelopathy is a form of neurosyphilis, which is a complication of late or tertiary syphilis infection. Syphilis is a sexually transmitted, infectious disease. For information on the disease, see: Syphilis.

The condition called tabes dorsalis includes syphilitic myelopathy and other symptoms of nerve damage.

The infection damages the spinal cord and peripheral nervous tissue.

Syphilitic myelopathy is now very rare because syphilis is usually treated early in the disease. Blood tests can identify the disease in its silent (latent) form. People who donate blood and pregnant women are given these tests.  Newspaper article attached:  “Driven Out by Crazy Man.  [Patient’s name], Insane, Seizes Gordon Heights Hotel.  And Ejects the Caretakers.  Young Emery and His Mother Flee, Invader Ransacks House From Top to Bottom.  “Get to _____ out of here.  I own this place!  Do you hear me?”  The speaker was a man six feet three inches high and about a foot and a half wide and a good fence jumper.  He stood upon the piazza of the Gordon Heights hotel about six o’clock last night and his demand was addressed to young George Emery and his mother, of Wilmington.  Young Emery and his mother are caretakers of the Gordon Heights hotel and are in the employ of the Wilmington Steamboat Company, which owns and controls the property.  The size of the man and his gruffness of his tone were enough to frighten a bull, and of course young Emery got frightened.  So did his mother.  The big man crossed the threshold of the hotel and took immediate possession of the place in his own name.  “Clear out now,” he exclaimed, “I want this whole place to myself.  It belongs to me.”  Emery and his mother were awe-stricken by the big man’s peremptory demand.  They were speechless, and cold tremors stole over them as they surveyed the tall man.  They surveyed him for a minute or two and instinctively sized him up.  They turned toward the door and fled.  They had seen enough to convince them that the invader was a crazy man.  Once inside, the big man proceeded with all the dignity and ease of one who had a right to, to inspect the house from top to bottom.  His inspection had not gone far before he was seized with an impression that as the place belonged to him he had a right to make himself as comfortable as possible.  He shivered as he passed from one room to another and spying a grate in one room he set to work to build a fire in it with paper and wood he found in other parts of the place.  Then, with the calmness and serenity of one who had been used to such comfort, he seated himself close to the fire and dived into a newspaper.  When he had received his fill, he wandered into another room upstairs where he found another fireless grate.  “Ah, me, he chuckled within himhelf (sic), “this is certainly a snap.  Now that I have suddenly become ruler of this handsome mansion, methinks I will celebrate my accession by kindling a fire in every grate.”  So he struck a match and with some paper and wood kindled the fire in the second grate.  In still another room which he explored he built a fire in the grate.  After the kindling of the last grate he took a brief rest during which, as he solemnly stroked his double-chin, he reflected.  In his reflections he discovered himself a stranger in the place which he had only an hour or so before seized as his own home.  A stranger in his own home, what was he to do?  No one was about him.  A sepulchral silence pervaded the place.  In a moment or two he evolved a plan.  The plan was a decision to surrender his right to the house in lieu of the privilege to take what few salable articles he wanted.  Un-stairs (sic) the big man went to carry out the plan.  In the meanwhile young Emery and his mother had boarded a train and came into this city where they sought out Captain Wilson of the Steamboat Company, that they might tell of their ejection.  Captain Wilson was in Philadelphia, but George Greer, Captain Wilson’s assistant listened to their story.  When he had heard it, he summoned Howard Feaster, a special officer, and together they went to the Gordon Heights hotel in a coupe.  Arriving at the hotel they came upon the big invader as the latter was in the act of packing up the articles for which he had decided to sacrifice his ownership of the place.  In the pile he had made up he had a valuable sword belonging to Captain Wilson, who lives at the hotel in summer, a clock, a bible, two vases and other articles.  “What are you during (sic) here? Demanded Messrs. Greer and Feaster, as they came upon him.  “Can’t you see what I’m doing?” replied the big man, “I’m just packing up a few things that belong to me.  I’m going away.”  “You had better come with us,” said Greer and Feaster and with little persuasion they got him Out of the place and hustled him into the coupe, which drove to the police station.  At the police station the big man gave his name as [name redacted] and said that he came down from Perkasie, Pa., yesterday.  The officers at the Hall recognized him as the brother of a resident of this city.  He gave his age as 47, and said he has worked hard for 41 years of his life, the first six years being spent at school.  He was locked up and today the Steamboat Company will prefer a charge of trespass against him.  He will probably be sent to Farnhurst, as the authorities believe he is dangerously insane.  [He] wore a heavy coat, adorned with a broad collar of brown fur.  The collar was turned up close to his ears, giving strength to his gruff appearance.  Young Emery and his mother are slowly recovering from the fright he gave them, and will keep a gun on hand in future for the reception of visitors of his inclinations.”

½ sheet of paper attached:  “Wil Del Jan 16 – 1910.  Received from Delaware State Hospital $1.71/100 from [patient’s name] fund.  Thurston M. Lowe, Trustee.”


History and clinical notes:
History:  Was removed by her husband on parole May 25, 1896.  Was returned to this institution last Sunday, but as the papers did not arrive until today, was not admitted.  Patient had been drinking a great deal before she came here and this, coupled with epilepsy, probably was the cause of the return of the malady.

Apr 12, 1898.  Patient has given no trouble since admission.  At first was a little dazed, but in a few days was herself and since then has been working in attendants’ dining room.  Was allowed to go home today on parole.
June 12, 1898.  Discharged recovered.


History and clinical notes:
History: Has been an intemperate man for a number of years, but about 3 months ago took the pledge and has not drank any for a year.  Has never been a bright man, and has always been considered more or less feeble minded.  About 3 weeks ago began to grow worse; has lost flesh and strength.  Imagines that people are trying to injure him and has lately frequently asked people for pistol (?) to protect himself.

Mar 20, 1898.  Patient states that he would like to leave the Hospital but does not like to return to his home for he fears that he will be killed.
Apr 1.  No improvement.
Jul 20.  No improvement
Sep 20.  Mind some feeble, demands money and ties little piece of red, white, and green cloth to his button holes, which he talks about the most of his time.
Nov 10.  Transferred to Ward 6.
Aug 25 (1899?).  Has delusions of persecution, is noisy at times and obstinant, is restrained most of his time, mutters all the time three cheers for the red, white, and green; general health good.
Aug 23, 1903.  General health good.  Has a quick and violent temper and will fight any one who opposes him.  Mean [ill.] constantly.
Jan 4, 1908.  Suffering from a double pneumonia.
Jan 6.  Some improvement today.
Jan 8.  Has had three hemorrhages (pulmonary) today and is very weak.
Jan 9, 1908.  Died, double pneumonia.


History and clinical notes:
History: Patient states that seven years ago last July he had a sunstroke and mind was affected for two months afterwards and three years ago began having convulsions, and has had as many as eight or nine a day, but says he does not have them as often as he formerly did.  Has been treated by a number of physicians without being benefited.  Dr. Hughes states that the patient is very noisy and violent at times.

Mar 20, 1898.  Has had a number of convulsions since his admission here.
Apr 1.  No change.
Sep 24, 1898.  Discharged improved.


History and clinical notes:
History: Patient states that he has been drinking for the past four months, drinking considerable absinthe; was very delirious lost night when admitted, noisy and violent, was given a bath and the right shoulder and arm are bruised.  Some of his clothes contained vermin and were destroyed.

Mar 3, 1898.  Patient was not delirious since a.m. Feb 26th (morning after admission).  Is on Ward C.
Mar 7.  Went home
Jun 12, 1898.  Discharged recovered.


History and clinical notes:
History: Officer who brings patient state that he knows nothing of his history, but he understood that he had been violent.

Mar 20, 1898.  Has not been any trouble since his admission; has been working on the outside for the few days.
Apr 1.  Has been very orderly since admission.
Apr 15.  Patient believes that he is a wonderful railroad man; stands to the windows for hours watching the trains go by and talk to himself about them.
May 15.  No improvement.
Jun 15.  Some little change.
Jul 10.  Is very much improved, desires to go to work.
Aug 10.  Works around the grounds and apparently is removed; allowed to go home on parole October 4, 1898.
Nov 22, 1898.  Discharged recovered.


History and clinical notes:
History: Patient has been admitted here twice before, see pages (13 and 158).  Mind feeble and for the past two months he has given his relatives considerable trouble.  Gets up during the night and wanders around.

Apr 1, 1898.  Is very quiet and orderly; has been feeble minded for years.
Oct 10.  No improvement mentally, general health good.
Nov 12.  Health good.
Jan 20, 1899.  No change.
Apr 16.  Health very good.  Mind feeble.  Is tidy and works on the wards.
Aug 7, 1899.  Allowed to go home.
Aug 24, 1899.  Returned to Hospital by Mr. Taylor, who states that he wandered from place to place and the people in the community did not care to have him as they feared he would commit some act on their children.
Oct 8.  Has been confined to bed for the past two weeks suffering from rheumatism; is much better now.
Jun 29, 1901.  In good general physical health.  Taken out today on parole.
Jul 13.  Returned.
Aug 22, 1903.  General health good.  No change in mental condition.  Was paroled 2 weeks in June in care of his brother.  Orderly.

Additional notes:
Neighbors were afraid he would hurt their children.


History and clinical notes:
History: Officer who brings patient does not know any thing about him.  

Mar 9, 1898.  Is very orderly and works on ward; mind some feeble.
Mar 15.  Has been quiet since his admission, tongue some tremulous.
Apr 1.  No change.
May 1.  Very much improved.
Jul 15.  Patient is very anxious to go home.
Aug 15.  Went home today on parole.
Nov 22, 1898.  Discharged recovered.


History and clinical notes:
History: Mr. Shannahan states that the patient has been peculiar for the past eight years and two years ago be believed that he was very wealthy and had a number of ways to get rich.  He now has all symptoms of paresis.  Patient has spent a large sum of money foolishly.

Mar 20.  Patient believes that he is very wealthy and often talks about the various ways to make it.  He has been confined to bed since admission, being unable to walk.
Mar 30.  No improvement.  General health good.
Apr 30.  Health good, mental symptoms gradually getting worse.
May 30.  Has been confined to bed since admission, being unable to walk.
Jul 20.  Still confined to his bed and mind very feeble.
Sep 20.  Mind feeble, tremulous tongue, confined to bed.
Sep 25.  3 a.m. Hemiplegia of left side.
Sep 27.  Some little improvement.
Nov 12.  Still confined to bed, has delusions of great wealth and etc.  Has good appetite and fair physical health.
Jan 20, 1899.  Confined to bed.  Gradually getting weaker.
Feb 26.  3 p.m. suddenly became unconscious, tremor of whole left side, eyes drawn to left, pulse very rapid, respirations stertorus.  8 p.m. no change.
Feb 28.  8 a.m. much improved, pulse 84, respirations normal and talks no tremor.
Mar 6.  Had another stroke, unconscious.
Mar 7.  No improvement.
Mar 10.  Very weak since unconscious.
Mar 20.  Some little stronger but very stupid.
Mar 26.  Very weak, appetite very poor, pulse 110, bed sores severe.
Apr 1.  Very weak and losing flesh every day.
Apr 3.  Does not recognize anyone.
Apr 5.  died 5 p.m.


On certificate of:
Drs. Joseph M.R. White and William C. Pierce

History and clinical notes:
History: Dr. White states that the patient suffered a number of years ago with syphilis.  Last Jan, patient had a distinct epileptic convulsion and that he has had 3 since that time.  Dr. Wood of Philadelphia stated that the cause of the trouble was syphilis.  Patient has been steadily getting worse.  Last Saturday, patient was paralyzed on right side but since then has regained the use of his limbs, but has not thoroughly regained use of tongue; talks in a hesitating manner similar to a paralytic dement.  Has a good appetite but does not sleep well.  Has not lost flesh.

Apr 6, 1898.  Very eccentric and mind some feeble.
Apr 15.  Is orderly and very anxious to go home.
May 1.  Nothing noticed except feeble mind.
May 20.  Very orderly.
May 30.  Removed by his wife today.
Sep 24, 1898.  Discharged improved.


History and clinical notes:
History: Patient was taken March 30 from the Western Hotel to Homeopathic Hospital with broken knee.  And insanity developed shortly after.  Many who brings patient states that he knows nothing of his history.  Leg much swollen and cyanotic.

Apr 3, 1898.  Very delirious and cannot keep fracture in position.
Apr 6.  Some improved.
Apr 8.  Very much better, fracture re-set and put in box.
Apr 15.  Recovered mentally.
May 1.  Patient being treated for his fracture.
May 15.  Plaster Paris applied to limb.
Jun 15.  Still in bed.
Jul 15.  Fracture doing as well as can expect.
Jul 15.  Patient allowed to go away on parole today accompanied by friends, as he was entirely well.
Oct 4, 1898.  Discharged recovered.


History and clinical notes:
History: Officer who brings patient knows but little of his history; states that he has several times threatened to kill his children.  His attacks come on at varying intervals and in the interim he is entirely well apparently.  The length of attacks is not known.  Was brought to the institution in handcuffs.  

Apr 8, 1898.  Patient told Dr. Hancker today that his three daughters had been at enmity with him since his wife died about 6 years ago; that they spent all the money they earned; that they bought and bought and that he gave them ten dollars out of the twelve he earned each week and they spent it all foolishly.  They have young men to visit them in the evenings and by so doing they burnt his light and used up his fuel and this he could not afford.  He further states that they never get up until about 9 o’clock in the morning and never paid any attention to getting his meals and then he has to eat at a separate table.  They have locked him out of his house and frequently would not let him in; also state that Dr. Pyle is in league with his daughters, as one of them is a great friend of his wife’s on this account.  Dr. Pyle informed his daughter that they were of age and they can sleep in the mornings as long as they pleased and do any thing they wished irrespective of what their father said.  He also said that three years ago, he fell unconscious while working and was carried home and the next day Dr. Wales was called to see him and since this time has frequently a severe pain in the occipital region and that these attacks come on suddenly at various times.  States that he can’t do hard work.  Patient’s face is flushed and considerable vaso-motor disturbance, pupil extremely small and responds feebly to light.
Apr 10.  Told Supt. today that a Mr. Allen, who was a neighbor, was in league with his daughters against him and that a great deal of his troubles originated from him.
May 19.  Patient trial before jury in regard to his insanity = began today before Sheriff in Wil., Del.
May 20.  Told daughters today before leaving court room that he was going to kill himself.
May 26.  Patient was released today, jury finding him not insane.  Discharged unimproved.

Final disposition:
Discharged unimproved because not insane

Additional notes:
Court document attached (looks like purple mimeograph).  “William H. Hancker, M.D., Superintendent Delaware State Hospital for the Insane (Or any other Officer of the Hospital,) Farnhurst, Delaware.  [a handwritten line of illegible writing, looks like it says “Wm Mickle, Official of Del. _____ _____.”  A jury de lunatico inquirendo, summoned by me, at the command of the Chancellor of the State of Delaware, on the ____ day of May, 1898, to decide whether or not one [name redacted] now confined in the Delaware State Hospital for the Insane, at Farnhurst, be a sane or an insane person, made its return on the 26th day of May, 1898, and found and decided the said [name redacted] to be a sane person, as will appear by the annexed finding of the said jury.  I therefore command that you do forthwith release from said Hospital the same [patient’s name].  Signature: Wm. K. Flinn, Sheriff of New Castle County.”


History and clinical notes:
History: Sheriff states that patient has been an intemperate man for years – that about 6 years ago began to wander away from home, associated with negroes, had no sense of decency and never made his home at any one place but 2 months ago was arrested for abortion* and has been in jail ever since.  Mind is becoming more feeble all the time.  Not insane.  Not insane.  Discharged Sep 24, 1898.

* Patient is a physician.

Additional notes:
Likes to "associate with Negroes" and performs abortions


History and clinical notes:
History: Symptoms of insanity were first noticed about ten years ago.  She became very much depressed after her friend, who she was seriously in love with, married another lady and since that time, she has had frequent attacks of melancholia which began about a month ago.  Patient talk very incoherent, memory at times very good.  Menses very irregular during attack.

May 22, 1898.  No change in patient’s condition since admission.  Is on front ward and is quiet and orderly.  Conversation at times very incoherent and mostly in regard to men and marriage.
Oct 19.  Has steadily improved since last note.  All delusions have disappeared.  Was visited by aunt today who removed her on parole.
Jul 13, 1899.  Discharged improved.


History and clinical notes:
History: Officers who brought patient to Hospt. know nothing of her history.  She is very quiet and say that she dates her history from a fall she received about 3 years ago.  She struck on her head and was unconscious for a time.  Was very restless and has always been so ever since she fell.  Wandered from her home; took her clothes off, and has been a source of trouble to her friends ever since.  Has always enjoyed good general health.

May 1.  Is depressed and melancholic, seldom speaks to any one.
May 22.  Is much improved; is more cheerful, talks freely, and says she knows she has been sick.  Is still somewhat dazed, but much better than at time of admission.
Feb 4, 1899.  No special change since last note; was visited by relatives today and removed on parole.
May 15, 1899.  Discharged today.


History and clinical notes:
History:  Patient has been in poor health for about two years – suffered a great deal from malaria and dyspepsia.  About 3 weeks ago was at an exhibition and while there a riot occurred and several men were shot and she became very frightened and jumped out of a second story window.  From this time until the present she has talked about being arrested and was afraid of every one that came near her.  About two weeks ago became very melancholy and since then she has had but little to say to any one.  Kept by herself, has not ate much and is steadily losing flesh.  Last Monday morning she cut her throat with a butcher knife and has since spoken of suicide.

May 22, 1898.  Wound in throat entirely healed.  At first was very much depressed, but is gradually becoming more cheerful and now recognizes her condition.  Was quite ill week before last, with uremia symptoms.  Urea was found in urine.  This has disappeared and she is steadily gaining.
Oct 8.  Has been up and about some since last note, and although somewhat reticent, was allowed to go home today on parole with husband.
Mar 5, 1899.  Was discharged recovered today.


History and clinical notes:
History: About 1 year ago began to suffer a great deal from indigestion.  About last Aug began to be very nervous and restless; wander around her home, could not sleep.  Complained of a choking sensation.  This continued until about 3 months ago.  Had treatment but with no effect.  Since this time imagines that her own relatives are going to rob her and take all she has.  This delusion is permanent – wants to [ill.] her own [ill.] from the house, says that they are going to steal them.  Has steadily lost flesh for past year.  On bathing, the matron say the following marks of abuse on patient: left eye and ear badly bruised, shoulders and left side and ride (right) arm bruised in stripes as if she had been whipped with a lash.  The back of neck was also severely bruised and the skin broken.  The patient stated that her son-in-law had thrashed her.

May 22, 1898.  Her sons and other relatives have been to see her, but she claims they are strangers.  Wanders up and down the hall, begs to go home, moans and rubs her hands.  Very melancholy at all times.
Jul 28.  Has slowly failed since last note.  Has lost considerable flesh and is very weak and feeble.  Has not taken (food) but seldom during past month and has steadily been fed with nasal tube.  Will not go to bed and still refuses to recognize her friends or relatives.
Feb 18, 1899.  Has improved somewhat, as she now takes her food voluntarily, wanders up and down the hall most of the time and seldom speaks.  
Mar 15.  General condition about the same as before.
Jun 16.  Mental and physical condition apparently unaltered since last note.  Patient is very thin, but has a very large appetite and eats a great deal.  Walks up and down the hall almost constantly.
Aug 29.  No change in mental or physical condition since last note.
Dec, 1899.  Patient had an attack of profuse bleeding, apparently from the nose, attended with dyspnea (shortness of breath), very much frightened.
Jan 15, 1900.  Has had one or two similar attacks since and they come on very suddenly and seem to leave her very weak and much depressed.
Aug 2, 1902.  Mentally and physically about the same.  During the past year had fracture of head of right humerus, which was set with difficulty; results good however; with this exception has been very well.
Jul 20, 1903.  Has been in bed for the last week with heart trouble.  Has refused medicine and nourishment at times and has had to be fed and treated by using nasal tube.  Has rapidly failed and became unconscious this a.m. and died at 3:30 p.m. today.  Jul 20, 1903.  Died; chronic endocarditis, chronic interstitial nephritis.

Final disposition:
Died of chronic endocarditis and interstitial nephritis

Additional notes:
Given #38 for year, even though there was already a #38


On certificate of:
Drs. John C. Fahey and Thomas N. Milliken

History and clinical notes:
History: Officers who bring patient knows nothing of his history except that he has been very violent of late.

May 10, 1898.  Very violent at times and is restrained constantly; says that electricity is running all through him.
May 20.  Has been very weak from being so excited.
May 30.  Still restrained.
Jun 1.  Restraint removed and patient is some improved.
Sep 1.  Is losing flesh, appetite poor, ankles swollen.
Oct 10.  No improvement mentally or physically.
Oct 18.  Muscle of left gluteal region very much inflamed; patient lymphatics involved, wound washed with hydrogen peroxide; patient very weak, appetite poor.
Oct 23.  Wound very offensive, pulse feeble.
Oct 25.  Wound still discharging; opening made along the course of lymphatics and considerable pus discharged.
Oct 30.  Patient some stronger; abscess not as offensive, discharge decreasing.
Nov 2.  Very weak pulse, cold and clammy.
Nov 3.  No change.
Nov 4.  Died 6:35 a.m.


History and clinical notes:
History: A little over three years ago became much depressed and melancholy – neglected her work.  In a short time refused to dress and undress and her relatives had a great deal of trouble with her.  This condition continued for about 6 months when she became a little better.  Became worse and then better at varying intervals.  Was taken abroad with but little benefit.  In July 1896 became so much worse that she was taken to Frankford Asylum.  Was so violent that she could not be cared for at home.  Left Frankford January 1897, considerably improved.  During the last six months has gradually gotten worse.  For about two years has had tremulous tongue and for about two months has also had trouble in walking.  Her gait is staggering.  Her appetite is good but has slept but little at night.  Has steadily gained flesh.  

May 22, 1898.  Has grown worse since admission; want of coordination of the muscular system more marked; cannot understand what she says.  Has an inordinate appetite and is steadily gaining flesh.
Jun 6.  Is very untidy; pays no attention to the calls of nature.  Saturday she fell on floor and cut her lip.  Want of coordination more marked.  Cannot understand what she says.
Feb 8, 1899.  Is stronger.  Want of coordination still marked; talks more than she formerly did.  Takes plenty of outdoor exercise.  Is stronger physically.  Not quite so untidy.
Feb 18.  Patient has improved somewhat in her mental condition; is more tidy.  Still walks in a peculiar way and there is marked hesitancy in speech and only seems to make use of a very few words which she frequently misplaces.  General health very good.
Mar 15.  Physical and mental condition about the same; is growing very fleshy.
Jun 19.  Not much change in mental condition; appear to understand what is said to her, but aphasia more marked; seldom attempts to say more than “yes” or “no” and these are often misplaced; sits about all day with a book, but reads very imperfectly, worse than formerly.  Walks very little; can only go a short distance until strength fails in limbs and back.  General health very good.  Still appears to gain in flesh.
Aug 13.  Is failing rapidly.  Extremely untidy and masturbates so much that it is necessary to restrain her at all times.
Aug 14.  About 8:30 yesterday morning had a hemorrhage from the bowels, not profuse; was given opium and Lead acetate per rectum.  Bowels were controlled and there was no return of hemorrhage.  Patient seemed weaker, but took her nourishment all day.  About 10:15 p.m. night watch visited room and found patient dead.  No signs of struggle.  Supposed cause of death – cerebral apoplexy.  No post mortem examination allowed by husband.


History and clinical notes:
History: Patient has been tramping and was found near Dover and taken to the jail.  Sheriff states the patient was very noisy, violent, tearing his clothes and destroyed every thing that was in his room.

May 15, 1898.  Patient stated that he had been drinking and did not know where he was and wandered to the country.  His home was in Wilmington.
May 17.  Apparently nothing wrong with mind.
May 26.  Has been working on the outside and does good work.  
Jun 4.  Was allowed to go.
Jun 12, 1898.  Discharged recovered.


History and clinical notes:
History: About six weeks ago spent the entire day in her garden.  The ground being very damp, caught a severe cold and had a bad attack of bronchitis.  Would not go to bed.  Lost flesh and strength and gradually became “notionally” (sic) and the elements of hysteria were well marked.  Previously to this time was always a healthy woman.  Was patient was received into Hospt. all the muscles were tense and her friends stated that she was cataleptic.  When she got on the ward became very violent and struck right and left.

May 21, 1898.  When first admitted was very much excited and struck the attendants and said that the Lord had commanded her to do it.  Was placed in bed and has been there since.  Is very restless most of the time.  Has rubbed her face until the skin has come off.  It is with the great difficulty that she can be induced to partake of sufficient nourishment.  Bowels has to be kept regulated by the aid of enemas and cathartics.  Has had a camisole on most of the time and is tied to bed with sheet as she throws herself about and has bruised her limbs.  Everything she does she says the Lord commands her.  This morning temperature was 101 and pulse 120.  Profuse perspiration.  No sign of any organic lesion.
May 22.  Temp and pulse normal today.  Has been fed with nasal tube yesterday and today.
Jun 10.  Has gradually improved, although still at time noisy in the morning, praying and preaching.
Jun 28.  Is much better physically and has improved mentally, although there are times when preaches and is a little boisterous.  Was visited by her daughter today who desired to remove her on parole.  Miss Alcorn, her special attendant accompanied her.
Sep 24, 1898.  Patient has entirely recovered.  Was discharged recovered.


On certificate of:
Drs. Everett Shipley and Robert G. Ellegood

History and clinical notes:
History: Mr. Stewart, who brings patient to Hospt. knows but little history of the child.  He states that when child was four months of age had a convulsion, but does not know the cause (whether it was due to a fall or not).  Convulsions have continued since that time.  At first they were every day or two and they have become less frequent until now they only occur every 6 or 7 weeks.  Has not progressed intellectually and at present time is like a child of a few months old.  Cannot talk.  Physical health is good and eats and sleeps well and appears contented at all times.

Feb 18, 1899.  General health very good; has good appetite and sleeps well.  Not much change mentally; says a few words and occasionally a whole phrase but does not talk connectedly; rather mischievous and difficult to take care of.
Mar 1.  Has had a severe convulsion.  Given Chloral which some quieted her.
Mar 15.  Looking very well, no return of convulsions since.
Jun 19.  Patient in excellent physical health; has good appetite and is growing but there appears to be very little mental development.  Has one or two attacks of convulsions since last note, but not as severe as formerly; controlled by the usual dose of Chloral Hydrate administered as an enema.  Patient appears to understand what is said to her, but makes very little attempt to talk.
Aug 29.  Has a severe attack of convulsions last week.  Was given Chloral gr XXV per rectum but the convulsions were not controlled, so does had to be repeated.  Patient now appears to be in normal condition – appetite good and looks well.  Very little change in mental condition.
Jan 15, 1900.  Very little change in mental condition; can say quite a number of words but makes very little attempt to connect them.  General health very good as a rule, but still has severe epileptic convulsions, which are usually controlled after a time by enemata (?) of Chloral Hydrate.
Aug 2, 1902.  Mentally same.  Physically excellent condition, growing rapidly.
Aug 23, 1903.  Good general health.  Has an occasional attack of epileptic seizures.  This morning has had a series of convulsions.  Chloral has been administered per rectum.
Aug 27.  Patient in usual health again.
Jan 26, 1904.  Had a series of convulsions lasting through night (had Sod. Bromide Enema and Chloral).
Jan 29.  Was sent to tuberculosis hospital with diphtheria.  
Feb 27, 1904.  Has made good recovery from attack of diphtheria.  Seems quieter and better behaved.  Condition good; fits infrequent.
Feb, 1907.  No change in patient’s condition.
Jan, 1918.  Patient getting worse mentally.
Dec 23, 1918.  Patient suffering from an attack of epidemic influenza.
Dec 30, 1918.  Patient died at 1:30 p.m. of epidemic influenza.

Additional notes:
Excellent case study -- not insane, merely had seizure disorder leading to mental retardation.  Lived at DSH for 20 years, survived diphtheria, died during 1918 Spanish flu epidemic.


History and clinical notes:
History: Patient has been drinking very hard for the past month; was arrested and confined in City Hall.  

May 18, 1898.  Is very noisy at times, believes that people are after him to destroy him; talks considerable on religion and various other subjects; also very noisy and hard to control.
May 30.  Very much improved.
Jun 3.  Transferred to (Ward) C.
Jun 11.  Removed by wife.
Sep 24, 1898.  Discharged recovered.


History and clinical notes:
History: Symptoms first noticed about 10 days ago when he was noticed to be acting peculiar and talking incoherent.

May 23, 1898.  Drove his wife away from home and would not allow her to return.  Told the boys to sharpen the knives as he wanted to use them.
May 30.  Patient is quiet and orderly.
Jun 12.  Has been been (sic) any trouble since admission.  [Probably supposed to mean “Has not been any trouble since admission.”]
Jul 20.  Very much improved.
Jul 13.  Returned to his home.  [Note discrepancy in dates.]
Sep 24, 1898.  Discharged recovered.


History and clinical notes:
History: Patient has been drinking hard for one month but worked until last Saturday.  Since then has been drinking incessantly.  Cannot eat or sleep and has been treated to no effect.  Was willing to come to Hospt.  Has been a hard drinker off and on for years and two years ago took the Keeley cure and has been drinking but little lately until the time above stated.  

May 30, 1898.  Very much improved.
Jun 4.  Patient has recovered and goes where he desires.
Sep 24, 1898.  Discharged recovered.

Additional notes:
From Wikipedia: "In 1879 Dr. Leslie Keeley announced the result of a collaboration with John R. Oughton, an Irish chemist, which was heralded as a "major discovery" by Keeley.[3] The discovery, a new treatment for alcoholism, resulted in the founding of the Keeley Institute.[3] The treatment was developed from a partnership with John Oughton, an irish chemist, and a merchant named Curtis Judd.("Fargo, N.D., History Exhibition") The institute attempted to treat alcoholism as a disease. Patients who were cured using this treatment were honored as "graduates" and asked to promote the cure.(Tracy) Keeley became wealthy through the popularity of the institute and its well


History and clinical notes:
History: Patient has been an inmate of New Castle County Alms House for years and mind has been feeble for a long time.  Always was a very hard drinking man and had a brother to died insane (sic) in this Hospt.  He believes that he can’t do one thing unless ordered to do so by Chief Justice Lane.

Jul 30, 1898.  Believes that he can’t do anything unless ordered by the Sheriff or Chief Justice.
Oct 15.  No improvement mentally.
Nov 15.  Still believes that he is influenced by the Chief Justice.
Jan 20, 1899.  Still has delusions, mind feeble, good health.
Apr 16.  Health good.  Mind unchanged.
May 10.  Health good, no change mentally. 
Jun 15.  Same as above report.
Jun 29, 1899.  3:30 p.m. Patient was out on the ball field sitting on a bench smoking his pipe with the male patients; fell from bench on the ground unconscious and died before physician arrived.  Post mortem by order of coroner.  Ruptured heart.


History and clinical notes:
History: Patient has been drinking very hard for the past two weeks and eating very little and all symptoms of Delirium Tremens pronounced.

Jun 4, 1898.  Very nervous and delirious.
Jun 5.  Slightly improved.
Jun 9.  Not so nervous but talks a little incoherent.
Jun 12.  Some improvement.
Jun 15.  Very much better.
Jun 20.  Hallucinations disappeared.
Jul 1.  Has liberty to go where he likes.
Jul 15.  Complains of pains in his head and is benefited by treatment.  Allowed to go home or where he desires.
Jul 28.  Left on parole.
Aug 24.  Patient has been drinking steadily since he left here and came back very nervous and irritable and in much the same condition as he was when first admitted.  Los of coordination very marked.
Aug 25.  Very nervous, rests poorly at night.
Aug 26.  Some improved.
Aug 27.  Allowed the liberty of grounds.
Sep 2.  Removed.
Nov 22, 1898.  Discharged recovered.


History and clinical notes:
History: Patient has always been a hard working woman, but was never seriously ill.  Two weeks ago her first child was born.  Last Sunday a week the first symptoms of the mental trouble was noticed; began to talk irrational, had hallucinations of sight and hearing.  Has gradually grown worse.  Talk is more irrational and last Saturday her child was taken from her and since then she has constantly talked of her child and has tried to get out of the window and out of the house.  Has gradually grown weaker and lately has refused food and nourishment of all kind.  Has suffered from insomnia.  Does not sleep at night.  Last night, slept about 1 hour; has not slept for three nights.  Has gradually grown weaker.  Bowels have not moved for 3 or 4 days.

Jun 6, 1898.  When patient was admitted, temperature 102 and quite a discharge from vagina.  Suspecting that the uterus contained some effete matter, Dr. Stubbs, consulting gynecologist was telephoned for.
Jun 7.  Dr. Stubbs operated at 10:15 a.m. Uterus was very much enlarged.  About 5” deep and free of membranes and clotted blood.  Walls of uterus very soft and flabby.  Vaginal wall debrided in several places.  Uterus was curetted and packed in iodoform gauze.  Examination of urine revealed lots of casts and 10% per ct. of Albumen.  Sp Gr. 1032.  For details see record in laboratory.
Jun 8.  Temperature this a.m. 104.  Dressing and tampons (?) removed by Dr. Stubbs.  Sister visited her this p.m.  Temp had dropped to 101.5 but patient extremely weak.  Has been fed twice daily with nasal tube, egg, whiskey, milk and salt was administered with successful results yesterday morning.
Jun 9, 1898.  Patient began to fail very rapidly during the night and died 1:20 a.m. this morning from septicemia.

Final disposition:
Died of septicaemia as a result of childbirth complications

Additional notes:
Effete in this context meaning waste products, something useless, to be excreted.


History and clinical notes:
History:  Has never been up to average in intelligence, although she has worked about the house and attended to all her duties.  First symptoms were noticed about 3 months ago, became melancholy and depressed as is there was something worrying her.  Kept by herself; neglected her work and would seldom speak to anyone.  Lately, imagines that people are down on her; that they are trying to injure her.  Has spoken of killing her mother.  All these symptoms are gradually increasing.  Eats fairly well and usually sleeps well.  Is slowly losing flesh.  There was a time when she could not be induced to eat.  Does not know whether she menstruates regularly or not.  On admission holds her head down and looks like a dement, would not speak.  On ward, attendants reported that her hands were bruised and excoriated.  Her brother explained it by saying that his mother had tied her hands together with a rope when she was more than usually excited.

Jun 12, 1898.  After getting on ward became very much excited and kicked the door of her room and broken keeper of lock and struck right and left.  Is very obstinate and hard to control.  Yells and screams, was so noisy that 1/100 of Hyoscine was administered hypodermically.
Jan 10,.1899.  No improvement.  Very noisy at times and tears her clothing.  Very difficult to care for.  
Feb 18.  Condition about the same – is very noisy and troublesome and will seldom speak to anyone.
Mar 15.  Patient very noisy most of the time; requiring chloral frequently to quiet her so that she will have sufficient rest.  Looks thinner, mental condition unchanged.
Jun 19.  Not much change in mental or physical condition since last note except that patient appears to be growing thinner.  Is very noisy at night and requires chloral almost every night; sits around stupidly in the day time, seldom appearing to notice anything around her.
Aug 29.  Very little change in patient’s condition.  Still very noisy at night except when under the influence of medicine.  Has a good appetite but is very thin. 
Jan 15, 1900.  Condition just about the same as at time of last note.
Aug 2, 1907 (?).  Degenerating mentally and physically.
May 22, 1908.  Patient had a stroke today, but has rallied somewhat.  Has been growing feeble and emaciated for several months.  
Apr 1, 1909..  Has been in Tuberculosis Bldg. for some time.  Very feeble, confined in bed all the time.  Both apices of lungs are full of cavities.
Apr 14, 1909.  Patient failed and died.  5 a.m. pulmonary tuberculosis.


History and clinical notes:
History: Officers who bring patient know but little in regard to him.  Says the attack is produced by intemperance and that he has worked as cook at Hurley’s Saloon Shipley St. between 6th and 7th.

Jun 12, 1898.  Dr. Hancker saw patient at 11 a.m.  He was restless but pulse was good; had the appearance of verging on attack of delirium tremens; was placed in proper treatment this a.m. by Dr. Hammond.  Treatment usually pursued in cases of this kind.  Dr. Hammond saw patient again at 4:30, was very restless.  Ordered him whiskey at 5 p.m.  At 5:30 p.m. Drs. Hammond and Hancker was summoned to see patient; when they arrived patient was dead.  About 10 minutes before this time patient went into convulsions and as it looked serious the physicians were summoned as above stated.  Immediately after he died Mr. Hurley, with whom patient had worked drove to front door and asked after the patient.  The particulars were given to him and he made that statement that on last Thursday, [the patient] went to the cellar of his saloon and drank a lot of high proof whiskey as high as 118; that was only used to dilute other whiskeys.
Jun 12, 1898.  Died Alcoholism.

Additional notes:
Drank a bunch of high proof whiskey at saloon where he worked


History and clinical notes:
History: Officer who brings patient knows nothing of his history.  Patient states that he was in the Washington Asylum from 1892 to 1894 and returned to Wilmington some few months ago.  He was appointed Pay Master in the Army and was found to be incompetent and discharged.  Believes that he is the greatest man that ever lived, even holding a greater office than the President, and he appointed a number of us on his staff.  Also has plenty of money being worth Five Hundred millions and has also delusions of persecution being afraid to get shaved fearing that his throat would be cut.

Jul 1, 1898.  Talks incoherent on various subjects; at times some what noisy.
Jul 28.  No improvement
Oct 15.  Very noisy at times although very polite, appetite good, patient at times says he is President and at other times senator and etc.
Nov 15.  No change.
Dec 20.  Very much improved; reads papers; does not talk as he did some time ago; is very orderly; has good health and very intelligent patient.
Jan 10, 1899.  Talks on various subjects, takes a great interest in the national and state affairs and discusses them very good.
Feb 25.  Does not cause any trouble on ward; appetite good; is very healthy and talk about various affairs; nothing is noticed now that indicates insanity.
Apr 16.  Same as last report.
Sep 15, 1899.  Discharged recovered.


History and clinical notes:
History: Patient was allowed to leave institution on parole with her husband Jan 29, 1898.  Was improved at that time.  She got along well at home until a couple of weeks ago when she became melancholy.  Her husband’s son, who is a worthless fellow, began to make threats; threatened to hurt her etc. and this is supposed to have caused her trouble at the present time.  On admission, her tongue is tremulous and she walks with a hesitating gait.  Has lost flesh and is much thinner than when she left here.

Feb 18, 1899.  Patient bed-ridden and perfectly helpless; seems to understand what is said to her, but only can say one or two words; speech very slow; tongue tremulous.  Appetite fair.  Bed sores forming over hips and sacrum; dressed daily.
Mar 5.  Large bed sore formed over sacrum in spite of constant attention; dressed daily with Saratoga Ointment after thoroughly washing out with Hydrogen Peroxide.  Surrounding tissue thoroughly bathed with alcohol.
Mar 15.  Mental condition somewhat better – patient seems much brighter and pulse is stronger.  Bed sores clean and granulations healthy, but very little attempt at healing from bottom.  Dressed as before.
Mar 30.  Has failed steadily and died at noon today from General Paresis.

Additional notes:
Buried at DSH, Grave #69.  Her # for the year is listed as #56, but she should be #55


History and clinical notes:
History: Officer who brings patient does not know anything of patient’s history, but [patient] was very noisy, cursing and very abusive.

Jun 30, 1898.  Very nervous and talks to himself at times; mind some feeble.
Jul 15.  Is very anxious to go home.
Sep 10.  Is very orderly, appetite good, rests well at night.
Oct 15.  Mind feeble, somewhat.
Nov 1.  Remains about the same.
Jan 20, 1899.  Same as above report.
Feb 25.  Although quiet he is very hard to get along with; has some delusions; mind feeble and at times a little obstinant.
Mar 10.  Complains of pain around heart, fullness in stomach; given Elixir pepsin bismuth and strychnine with digitalis.
Mar 20.  Some improved.
Mar 29, 1899.  10:30 p.m.  Died suddenly.


History and clinical notes:
History: Officer who brings patient knows nothing of her history.  Patient states that she was sent to New Castle Jail by Judge Ball for forty days and that she was here a few years ago.  Records show that patient was admitted November 26, 1890 and was twenty-five years old, and married.  Was discharged March 11, 1892 as cured of chronic mania.

Sep 22, 1898.  Patient was never very bad; in fact showed but little symptoms of insanity since she came here.  At first was a little restless, but this soon passed away and she became cheerful and assisted a great deal in work of various kinds in the Hospt.  Was allowed to go home by herself this 6:34 p.m. on parole.
Nov 22, 1898.  Discharged recovered.


On certificate of:
Drs. Evan G. Shortlidge and John P. Wales

History and clinical notes:
History: Patient was admitted day before yesterday on irregular papers.  Today proper order came.  Husband, when he brought her stated that the first symptoms occurred about 1 mo ago; that she accused her neighbors all sorts of imaginary things and lately had one arrested and that he had to pay the costs.  Has gradually been getting worse; suffers habitually from constipation and has not had a free movement for two weeks.  Cause is supposed to be due to menopause.  Has not menstruated for 6 months until last week when the flow was profuse and from this time has been gradually getting worse.  Is profane at times.  Will not eat, has been gradually losing flesh.

Sep 22, 1898.  Has gradually improved.  At first had some delusions but was induced to conceal them for past month; these have passed away, and she is gradually more cheerful and lately assists at times in light work.
Sep 28, 1898.  Was allowed to go home today accompanied by her sister and husband.
Mar 5, 1899.  Discharged improved today.


History and clinical notes:
History: Patient was in regular army and discharged in 1889 with rheumatism and for the past three years has been employed at Delaware County by Major Raymond.  About a month ago patient began to tell his associates that he had been left $26,000 and threatened to injure people who he imagined had his money.  Will probably be sent to Washington Asylum as he is a pensioner receiving $8.00 per month.

Jul 20, 1898.  Is very restless; believes that he has been left a large sum of money and very anxious to dress in uniform.
Oct 15.  No improvement mentally; has good health, sometimes obstinant.
Nov 1.  No change; is very restless and anxious to get out to spend his money.
Jan 20, 1899.  All symptoms of paresis well marked.
Feb 16.  Mind feeble, very restless, health not so good.
Apr 16.  Very nervous and restless; extremely wealthy; general health good.
Aug 28.  Symptoms of Dementia Paralytica more pronounced; is very restless, says he is worth millions and wants to get away to spend it.  Health good.
Oct 8.  Same as above report.
Aug 24, 1903.  Very quiet and orderly.  Good worker on ward.  Several months ago had a mild attack of Erysipelas from which he recovered in a few days.  Now in good health.  Quite weak minded.
Oct, 1917.  Patient suffering from heart [ill. – looks like lime] as a result of chronic rheumatism.  Endocarditis chronic.
Jan, 1919.  No change in patient’s mental condition.  Physically getting weaker.
Oct 21, 1920  Patient died very suddenly at 6 p.m.  Chronic endocarditis, continued chronic rheumatism.

Final disposition:
Died of chronic endocarditis and chronic rheumatism

Additional notes:
Note: Spent 22 years in DSH at Farnhurst.  Army Veteran, two years with the Army at Fort Sisseton in the South Dakota Territory under Frederick Mears, Post Commander.  Enlisted through recruiting office on 3/22/1887, assigned to Company I, 2nd Infantry.  Served two years.  Buried at Riverview Cemetery in Wilmington, DE.


History and clinical notes:
History: Patient has been intemperate for the past eighteen years and insanity was first noticed eleven years ago.  She talked incessantly without any meaning and wanted to take her daughter’s children away from home and would get up all hours of the night, open the house, and wander from place to place.

Mar, 1899.  Patient is often quiet noisy and destructive, requiring some slight restraint most of the time, as she will take off and tear up articles of her own clothing and also those of patients around her.  Talks a great deal but without any sense, and usually repeats the same things every day.  General health very good.
Jun 19.  Very little change in patient’s condition since last note.
Aug 29.  No change in mental or physical condition.
Oct 12.  Patient has diarrhea for some little time, which seems to persist in spite of treatment.  Appetite is also very poor and is losing in flesh.  Mental condition unchanged.
Dec, 1899.  Patient has been confined to the bed since time of last note; diarrhea somewhat better; patient quite weak; is kept mostly on liquid diet; no change in mental condition.
Jan 15, 1900.  Condition remains about the same although diarrhea is much less; appetite fair and mental condition about the same.
Feb 24, 1900.  Has been steadily failing since last note, and has been very weak the last few days.  Her relatives visited her.  Died of intestinal tuberculosis this 3 a.m.


History and clinical notes:
History: Was put in City Hall one week ago with Delirium Tremens and still has hallucinations, sees lights, horses, and everything imaginable.  Thinks people are after him to kill him.

Jul 5, 1898.  Mind clear, but some nervous.
Jul 15.  Recovered and works on the wards.
Oct 10.  Works in fire room and should be discharged.
Mar 23, 1900.  Discharged recovered.


History and clinical notes:
History: Patient was admitted May 14 (1896) from Dover Jail, and had wandered from Wilmington in a drunken condition; he was delirious when admitted and discharged recovered June 12, 1896.  Some few days ago he began drinking again; was arrested and taken to City Hall (see clipping); patient is very weak and restless, delirious, cold and clammy and is in a moribund condition.  Gradually became worse and died 8:45 p.m.  Was admitted 6 p.m..  His throat was in a terrible condition, trachea was cut and the tissue was badly destroyed

Final disposition:
Died from suicide attempt (cut throat with glass)

Additional notes:
Newspaper clipping: “Wilmington, Del.  Genii tortured him.  Demons caused [name redacted] to attempt suicide.  Broken glass was his weapon.  Terrific Battle Between the Maniac and Captain of Police Kane – had to be Knocked Senseless with a Chair.  He May Die.  The dreaded hallucination that genii and invisible spirits were eking out his life caused [name redacted], a carpenter, 29 years old, living at Jeremiah Sullivan’s No. 403 Lancaster Avenue, to attempt suicide this morning in a cell at the City Hall.  [He], last evening while in a despondent mood, or an insane fit, from which he suffered, clambered up to the roof of the burned stable of C.B. Dougherty at Front and Orange Streets.  When he reached the gables he took up a position thereon, and, picking up bricks which lay scattered there threw them at what he supposed were the demons which pursued him.  They were torturing him, he said, and as he threw the bricks to the street he clapped his hands in glee, crying that the spirits had all returned to Hades.  And during the bombardment of bricks [he] nearly precipitated himself to the street.  The strange sight of a man on the roof hurling bricks at invisible objects created a great deal of merriment to the passersby, who stopped to see where the enemy was.  The rain of the missiles was terrific at times, and more than one person scampered out of harm’s way.  The collected crowd attracted the attention of Special Officer Frank Kane, and he ascended a ladder and brought the mad man to the ground.  The patrol wagon was sent for, and [he] was taken to the City Hall and locked in a cell.  The Fight for Death.  The cell in which [he] wa confined is the last one to the right of the corridor.  With him were several other prisoners.  In the wall in the corridor is a half window, which lets in the light from the alley, separating the hall from James T. Mullin’s.  It is a small aperture, but sufficient to furnish light for its inmates.  The sash of the window was opened and rested against the iron door of [his] cell.  Just previous to the session of the City Court, when the prisoners were about to be called up for trial, a smash of a window pane was heard.  It came from the cell occupied by [name redacted].  Captain of Police Kane, who was standing near the steps leading to the court room, with Turnkey Ourzzo, rushed to the cell and saw [the man] standing with his head back, stabbing his throat with a piece of glass, which he broke from the pane.  Captain Kane quickly opened the door and pounded upon the would-be suicide.  [The man] who is a big fellow and very strong, rushed at the captain and a terrific fight took place.  Captain Kane, who is a powerful man, grappled with [him], who displayed the strength of an infuriated beast.  Both men fought hard, and the captain struck [him] a terrific blow on the head, but this only enraged him more.  Again did he rush at the captain, face covered with blood, which rushed out of the ugly gash which he made in his throat.  Captain Kane, covered with blood, renewed the fight and knocked the mad man down.  He rushed out of the cell and returned with a chair.  By this time [he] was on his feet again, dashed at the captain, who stepped aside, and struck him on the head, knowing the suicide down and out.  Handcuffs were then brought and placed on him.  The patrol wagon was summoned and he was taken to the Delaware Hospital.  The patrol wagon made quick time, but several bystanders saw fit to pass criticism on taking the man over the rough stones on Markey Street.  Captain Kane said that Market Street is the only fit way to convey prisoner hospital patients, as the railway tracks afford easy transportation.  It was just three minutes after [he] was put in the patrol wagon when he was lying on a cot in the hospital.  Drs. Draper, Joseph Wales and Williamson attended him.  His condition is critical.”


History and clinical notes:
History: Patient was admitted here Oct 21, 1891 and was discharged improved July 9, 1894.  Since this time has been getting along well at home until lately when she has become more willful; wanders from her home and will not pay any attention to what is said to her.  Is cross and irritable.

Feb 18, 1899.  Patient does not show much change mentally, but assists in the work in the dining room.  Has not had a good appetite lately and says she feels weak.  Was put upon Pil. Bland (?).  
Mar 15.  Patient is inclined to be very noisy and somewhat troublesome; writes irrational letters; general health good, appetite improved.
Jun 19.  Very little change in condition since last note; patient is boisterous and often troublesome about the ward, but is a pretty good worker and assists in patients’ dining room; is inclined to be irritable at times and difficult to manage.  General health improved.
Aug 5.  Became so noisy was sent over to back ward for a short time; has been somewhat quieter since her return.  General health food.
Jan 15, 1900.  No change in mental or physical condition.
Aug 2, 1902.  Mentally about the same.  Physically very much weaker and poorly nourished.  Has excited periods in which she cries without cause and at some length.
Aug 24, 1903.  Still quite violent at times.  Constant restraint.
Oct 13, 1907.  Was removed by friends today on parole.
Apr 1, 1909.  Discharged unimproved.


History and clinical notes:
History: About six years ago had attack of meningitis and since then has been depressed, although has worked some little.

Oct 10, 1898.  Works in dining room.
Nov 10.  No trouble; works in dining room and capable of taking care of himself.
Dec 30.  Has steadily improved.  This evening slipped down dumb waiter from 3rd floor to basement and escaped.
Apr 15, 1899.  Discharged improved.


History and clinical notes:
History: Patient has always been a very healthy man until two months ago when he had a sunstroke and since that (time) he has lost flesh rapidly and is very much depressed.  He believes the work is coming to (an) end and thinks everyone is going to hurt him.  Does not sleep very well, appetite poor.  Sometimes refuses to eat.

Sep 12, 1898.  Appetite very poor; at times has to be fed; very much depressed and believes that he will be destroyed.
Oct 12.  No improvement.
Nov 10.  Still sits around very much depressed; at times refuses to eat and very seldom talks; has some delusions believing that he will be destroyed and etc.
Jan 1, 1899.  Some improved; eats, appetite good and seems to notice things about him.
Feb 16.  Very much improved, reads the daily papers, talks on various subjects rationally, health good.
Feb 25.  Is a very nice patient; talks on various subjects and is very anxious to go home.
May 15, 1899.  Discharged recovered.


History and clinical notes:
History: Patient has suffered a great deal from constipation, especially during past 3 months.  Has been treated with but little effect.  First symptoms of insanity was noticed about 8 weeks ago by his peculiar talk.  Says he was sold to the devil.  Has frequently talking of killing himself and has attempted to injure his family.  Lately has been very violent; broke furniture and has had to have constant care to prevent him from injuring himself or others.  General health has been fairly good, but has slept but little at night.

Sep 15, 1898.  Very much emaciated; confined to his bed; sleeps poorly at night; appetite poor and mind feeble.
Oct 15.  No improvement.
Nov 1.  Very weak and emaciated; mind very feeble; appetite poor.
Nov 18.  Diarrhea; weak, pulse feeble.
Nov 20.  No improvement.  Gradually getting weaker.
Nov 25.  Hands cold, rapid respiration, pulse very weak, diarrhea profuse.
Nov 26.  Died 2:20 p.m.


History and clinical notes:
History: Has been ill since her child was born.  Had La Grippe.  First symptoms of insanity was noticed shortly after her child was born.  Said that people were talking about her.  Has often threatened to kill herself and has threatened to kill her father and mother.  Talks irrational very frequently and has steadily grown worse.  Has steadily improved in physical health.  Imagines that her husband is down on her and won’t speak to him.

Feb 18, 1899.  General health has improved very much and mentally seems much better also, as she will converse will with apparently no delusions, but writes most incoherent and insane letters.  Works in attendants’ dining room.
Mar 15.  Patient has seemed somewhat more irritated and less contented than usual; also occasionally talks somewhat irrationally.  Physical health very good.
Apr.  Patient became more irritable, and at times was very saucy to the attendants; threatening to do harm to one of them, so was removed to Ward V.  Physical health very good.  
Jun 15.  Has been quiet and orderly and given no trouble to the attendants; assists in the work of the ward and spends the rest of her time reading.  Talks very rationally, but still writes most irrational letters.  Dislikes her husband and believes that he is unfaithful to her.
Jun 19.  Patient assists in dining room, and seems perfectly quiet and rational, so was returned to Ward A again.
Aug 29.  Has been very well behaved ever since though at times talks a great deal to herself and still continues to write very irrational letters.  General health good.
Jan 15, 1900.  At times was very cross and threatened several of the patients and attendants, so was transferred to back wards.  General health remains very good, and though usually quiet now is very full of delusions at all times, which she freely expresses.
Aug 2, 1902.  Mentally the same, physically in excellent condition.
Aug 5, 1903.  Mental has quite improved.  Has quit writing foolish letters.  For the past few months has been a “trusty” going about as she pleased.
Aug 5, 1903.  Paroled.
Jun 13, 1904.  Discharged recovered.


History and clinical notes:
History:  Was taken to Almshouse with chills and fever on July 15, but has been insane for 7 years.  Has worked hard all her life.  About 7 years ago had saved $2,000 and started a boarding house in Philadelphia, but she lost all her money in this venture.  Since this time has been very melancholy and depressed.  Since she has been in Almshouse has been quiet and orderly, but very melancholy.  Was admitted to Almshouse with malaria; has not had a chill since Aug 10.  Eats good and is in good physical health.

Feb 18, 1899.  General condition unchanged.
Mar 15.  Patient remained about the same.  Physical condition fair; usually quiet and orderly, seldom talks.
Jun 19.  Not much change in patient’s condition since last note.  Is usually quiet and orderly and seldom speaks unless directly addressed.  Has rather poor appetite and sometimes has attacks of faintness; otherwise general health good.
Aug 29.  Mental and physical condition remain unchanged.
Jan 15, 1900.  No improvement in mental condition since last note; but seems to be in rather better physical condition.
Aug 2, 1902.  Failing rapidly.  Remains in bed constantly; no special cause; eats very poorly, sleeps a great deal of time, mentally about the same.
Aug 11.  For past few days has eaten almost nothing.  Whiskey being all she would take.  Failed rapidly last night, dying at 1 a.m. today.


Insane Relatives:
mother and maternal aunt insane; others died of nervous troubles

History and clinical notes:
History: Patient was first admitted August 3, 1893, discharged recovered December 15, 1893.  He countenanced well at home until about 5 months ago, when symptoms of the malady was noticed returning.  Became depressed and thought everything was going wrong.  Continued at his work until about 6 weeks ago, when he became rapidly worse.  For the past 2 weeks has failed physically although he has a fair appetite and usually rests sufficiently at night.

Sep 15, 1898.  Very restless and depressed; at times cries, rests very poorly at night.
Oct 1.  Some little improvement.
Oct 15.  Appetite very much better, sleeps well, gaining flesh and desires to go home.
Nov 1.  Talk about various subjects, cheerful, very much improved.
Nov 15.  Allowed to return home this a.m.
Mar 5, 1899.  Discharged recovered.


Insane Relatives:
sister was here, died insane; brother was here; father died insane

History and clinical notes:
History: Patient was discharged recovered June 12, 1898 and left on parole.  The present attack began about four weeks ago.  Lately has been very violent and noisy at night.  Last night was very troublesome.

Sep 14, 1898.  Has been very troublesome since he came here.  Had trouble with attendants today and bit Mr. Gelson on hand.
Oct (no day).  Is quiet and orderly; works on Ward 4 and is good patient.
Nov 10.  Is very anxious to go home.
Jan 1, 1899.  Apparently has recovered.
Feb 10.  Same as last report.
May 15, 1899.  Discharged recovered.


History and clinical notes:
History: Patient has been weak minded from birth; has a sunny (?) disposition; wanders from home.  His brother [name redacted] is now a resident of this institution.

Nov 1, 1898.  Very much improved mentally although as dyspepsia and palpitations of heart, which worries him.  He worries very much over his physical condition.
Jan 20, 1899.  No change.
Feb 25.  All symptoms of imbecility; has fair health and works in the laundry.  No change.  Apr 16.
Sep 15, 1899.  Discharged improved.


History and clinical notes:
History: Officers who bring patient know but little of his history.  Had some trouble with his son but particulars do not know.  They state that they do not think he is insane.

Oct 8, 1898.  Wife visited him today and states that he began to lose his eye sight about 7 months ago and since that time symptoms of insanity have been noticed.  Says that he has become extremely erotic and that she has caught him playing and fondling little girls with his hand up their clothes; that he has become extremely violent at times and has threatened to kill her and her son until they were afraid to live with him.  Our oculist visited him today and found he had atrophy of both optic nerves and that the prognosis was unfavorable.  That the cause was due to some organic change at back of brain and that the patient would not probably live long.
Nov 2.  Is very hard to suit.  Complains of his board (?) and various other things; talks very rational.  Was allowed to go with his wife, December 18, 1898.
Jun 11, 1899.  Was readmitted this evening; had a black and blue mark on right arm and one on left buttock; stated that it had been made by his son to prevent his going out.  Says he is not insane, that his wife is a brute and is untrue to him.  Says that when he was here before someone came to his room and beat him fearfully before he got up one morning.  Who it was he did not know, nor why it was done.
Aug 1.  Health is very good.
Aug 10.  Complains of pains in abdomen and frequent stools.
Aug 15.  Some better.
Aug 28.  Very much better, but a hard patient to satisfy.
Sep 30.  Health good.
Oct 30.  Complains of neuralgic pains in various parts of his body.
Nov 25.  General health poor; is some jaundice.  Soreness over region of abdomen, pulse increased, rise of temp; clay-colored stools and etc.
Dec 2.  Gradually getting worse.  Very weak.
Dec 5, 1899.  6 p.m.  Died.


History and clinical notes:
History: Patient has been in Almshouse since 1890.  Has been queer ever since she was admitted there and always complained of pain in her head.  At times was very stubborn and would not eat.  For past year has been worse; quarrels with everyone and very frequently struck anyone that came near her without any assignable cause.  Has been gradually growing worse.

Nov 10, 1898.  Has given us no trouble since she came here.  Is quiet and orderly, but mind very feeble.  This morning another patient by the name of [name redacted] pushed her down.  On examination by the officers of the institution, a pubic dislocation of the left femur was found complicated with fracture of the same.  She was placed in bed and proper dressings applied.  
Feb 18, 1899.  Patient is able to sit up for a part of each day in rocking chair.  Complains very little of leg unless it is moved suddenly.  Says that her eyes hurt her all the times.  Seems to dislike the light in them and lies most of the time with her head covered.
Mar 15.  Patient about the same.  Still complains of her eyes, although there is nothing visibly wrong with them.  Patient is noisy and untidy.
Apr 1.  Patient’s condition remains practically unchanged.  Remains in bed most of time, but is up in roller chair for part of every day.  Still very noisy at night.
Apr 13.  Yesterday morning, during early hours, attendants found patient in partially comatose, mumbling condition, with mouth drawn to one side and left leg and arm paralyzed.  They notified Superintendent, who on examination found patient suffering from (partial) left hemiplegia.  Patient does not speak at all and seems quite unconscious of her surroundings.
May 16, 1899.  Has failed rapidly and died this a.m.


History and clinical notes:
History: Patient was first admitted May 20, 1889, discharged March 10, 1890 recovered.  While walking along Fourth and Market Street yesterday he struck an old man and knocked him in the street.  

Oct 20, 1898.  Very noisy and violent, has been restrained since admission; raves on various subjects, mostly religion.  
Oct 25.  So much improved that he was transferred to Ward 6.
Nov 5.  Allowed to go home with his wife today.
Dec 2.  Returned.  Very violent, noisy, and attempted to kill his wife with an ax.  Patient was handcuffed and ankles tied.
Dec 7.  Very noisy, violent, untidy and restrained.
Dec 10.  Some improved.
Dec 11.  Restraint removed and allowed on hall.
Jan 14, 1899.  Was on Ward 6 and became very noisy and violent and was transferred to Ward 5.
Jan 20.  Has been restrained since the violent attack.  Is noisy, talks incoherent and times untidy.  
Jan 28.  Very much improved, restraint removed and allowed the privileges of the hall.
Feb 16.  Very much better, health good and sent to Ward 6.
Feb 28.  Excited and exalted ideas, transferred to Ward 6.
Mar 1.  So violent this morning that he was restrained.
Mar 7.  Restraint removed.
Mar 20.  Very much improved, talks very rational.
Apr 12.  Was allowed to go with wife.
Apr 16.  Returned.
Apr 17.  Very violent, was restrained.
May 1.  Restraint removed, allowed to go to the wards.
May 22.  Has been very well for last ten days.
Jun 10.  Not so well, is very nervous and restless.
Jun 16.  Was noisy and violent and transferred to Ward 6.
Jul 10.  Very much improved and anxious to go home.
Aug 23.  Allowed to go with wife today.
Mar 23, 1900.  Discharged recovered.


History and clinical notes:
History: Patient was first admitted to this institution August 26, 1897.  See page 294 (this book), was removed from the institution against the advice of the Supt. September 1.  Patient states today that her father had been drinking and she got into a general row with her family and when she got to the Hall to obtain justice they arrested her and said she was insane and brought her here.  Demands her instant dismissal.

Jan 1, 1899.  Has improved physically since admission; was very pale and anaemic at first, but is now much better.  Still talks about men and at times uses language unbecoming a lady.  Says she ought to have a man to sleep with her.
Feb 18.  Patient still very anaemic, although she has been taking a preparation of Iron for some time.  Appetite fair, but complains of considerable cough.  Physical examination showed dullness over right lung and feeble respiration.  Examination of sputum showed it to contain pus cells in abundance and very numerous diplococci, but no Tubercular bacilli.  Patient given an expectorant mixture and Iron continued in form of tablets.
Mar 15.  Patient’s physical condition has improved somewhat; says she feels perfectly well.  Mental condition unchanged.
Jun 19.  No change in mental condition.  Patient is quiet and orderly as a rule and a good worker.  Once or twice she has struck another patient, but as a rule gives very little trouble; still morally depraved and writes improper letters to men.  General health improved.
Aug 5.  Patient has a severe attack of dysentery.  Given Calomel, followed by Opia and Lead Acetate.  Stools frequent containing considerable blood.  Liquid diet given and Turpentine Stamps (?) applied to abdomen.
Aug 15.  Patient’s condition somewhat improved, though dysentery still continues.  Bismuth [ill. – looks like ‘submit’] by mouth and suppositories Opia and Phubi (?) acetas (?).
Aug 29.  Patient is able to be up, bowel movements about normal, appetite fair.  Returned to regular diet.  Mental condition unchanged.
Sep 21.  Was removed today by mother against advice of the Supt.  Was placed on parole.
Mar 23, 1900.  Discharged recovered.

Additional notes:
Note attached, standard memo.  “Sept. 21st, 1899.  I Mrs. [name redacted] the mother of Mrs. [name redacted] an inmate of the Del State Hospt. at Farnhurst do hereby remove her from said hospital against the advice of the Supt. and will hold myself responsible for any damage that she might do. [Signature].”


History and clinical notes:
History: Patient has been very peculiar for a number of years and had a severe attack of La Grippe last winter and since that time symptoms of insanity have been more manifested.  Very desirous of leaving home, saying that she was a bad woman and that she and all of her children would be killed.  On October 21st, she tried to destroy herself by cutting a piece out of her left arm and a few days ago her face was very much congested, eyes red, and her daughter believes that she tried to hang herself, and often asked her children to kill her.  

Nov 13, 1898.  Has been failing, imagines that people are trying to poison her; will not eat; has to be fed with nasal tube.
Nov 15.  Quite weak this p.m.  Has been fed twice daily with whiskey, milk, and eggs.  Pulse is very weak and resists all attempts to assist her.  Has bruises on her hip due to falling out of bed – is in protection sheet.
Nov 20.  Has been slowly failing since last note.  Her daughter, Mrs. [name redacted] has been with her nearly every day.  Died at 10:45 p.m. last night.


History and clinical notes:
History: Detective Wilsil stated that patient had been at Hotel Jennings for a couple of days and that he had been acting peculiar.  His mind appeared wandering, but was not violent or troublesome.  Did not know where his people were but that the Hotel people had communicated with them and expected a telegram.

Oct 30, 1898.  Patient believes that he is persecuted, thinks that his attendant is trying to poison him; also believes that there is a plot to destroy him; sleeps poorly.
Nov 12.  Some little improved, not so restless, sleeps better and is much pleased with his treatment.
Dec 12.  Cries at times, get very much depressed and worries over his condition; aphasia well marked.
Jan 12, 1899.  Some little improved.
Feb 16.  General health good.  Is very excitable, cries often and at times extremely depressed.  No improvement in speech (aphasia).
Feb 26.  Is confined to bed today with coated tongue, headache, rise of temperature and increased pulse.
Feb 27.  Some improved.
Feb 28.  Dressed and on the wards.
Apr 16.  General health good; no change mentally.
May 22.  Same as above report.
Jun 15.  Mind feeble; aphasia most prominent, has had some diarrhea for the past day or so.
Jun 20.  Some improvement physically.
Jul 1.  Limbs very much swollen and patient confined to his bed.
Jul 5.  Phlebitis of right limb very pronounced.
Jul 10.  No improvement.
Jul 15.  No improvement.
Jul 22.  Some improvement, swelling gradually reducing, appetite returning, and patient resting well.
Aug 1.  Gradually getting well.
Aug 28.  Patient has been dressed for the past two weeks, out on the wards, rests well at night, appetite good and healthy very much better.
Apr 2, 1901.  Died 12:15 a.m.  Buried at Farnhurst.  Correspondent [names redacted].


History and clinical notes:
History: Authorities at Almshouse state that she was sent there from Newark a few days ago so that she could be examined here as to her insanity.  They do not know her history, or in fact anything about her.

Mar 6, 1899.  Patient became excited and had to be put in restraint.  
Mar 8.  Patient somewhat more quiet, but still inclined to be ugly.  Complains of severe pains in bowels and refuses to eat.  Tongue coated, bowels constipated, some distension of abdomen, but no marked tenderness.  Pulse rate increased somewhat.  Ordered Calomel with local applications (Turpentine Strips)(?).  Calomel ineffectual.  Ordered S.S. enema, after which patient much more comfortable.  
Mar 15.  Patient still very cross and irritable, but general health improved.
Jun 19.  Patient is cross and irritable most of the time, and has several times attempted to fight with the attendants, so is kept restrained.  General health very good.
Aug 29.  Patient has been very quiet and orderly for a considerable time, assisting every day in the work of the ward and as she has been very good natured and quiet has been allowed to go without her customary restraint.  General health good.
Dec, 1899.  At times is very ugly, attempting to injure those about her, so wears wristlets most of the time.  General health very good.
Jan 15, 1900.  Not much change in mental condition, still very irritable most of the time and usually wears wristlets.  General health good.
Apr, 1902.  For past six months has been growing gradually weaker and more irritable.  For three weeks was in bed with attack of peritonitis.  Came on suddenly, without any apparent cause.  This ran an irregular course.  Fever averaging 102 and 103, pulse rapid.  During entire attack, appetite remained good.  Patient did not seem worried about her condition.  Improved gradually but has never been able to do more than sit up a few hours daily.  Markedly emaciated, coughs a great deal, expectorates with difficulty.  Complains of pains all over and cries at slightest touch.  
Apr 29.  Abscess size of large orange immediately (over) her sacrum opened today – contents about 1 pint of pus.
May 5, 1902.  Failed gradually and died today at 1:50 a.m.


History and clinical notes:
History: Patient has been drinking very hard for the past month and a few days ago he became very nervous and wild, talking on various subjects.  Son states that patient has been more or less weak minded for past 9 months, that he has frequently threatened to kill him and has chased him with a butcher knife.  He also states that these attacks come on when he has not been drinking.  For past few months patient has been drinking very hard and has threatened to sell out his place and go away.  His family has become afraid of him.

Nov 15, 1898.  Talks well, no indications of insanity.
Nov 21.  Allowed to go home today.
Mar 5, 1899.  Discharged recovered.

Additional notes:
Died of "uremic convulsions."  Buried at Riverview.


History and clinical notes:
History: 48 years ago had the first attack of epilepsy and has had attacks ever since at various intervals.  Lately they have become more frequent.  Mind has been affected about 5 or 6 months.  Had delusions and hallucinations of sight and hearing.  Said he heard people talking about him and that his family and relatives were down on him.  Last Saturday had four convulsions and after was very violent, so much so that it took several (people) to hold him.  When brought to Hospital was quiet and appreciated his condition.  Has failed physically and mentally.  Suffers a great deal from dyspepsia.

Nov 28, 1898.  Believes that people in the Hospital are talking about him.  Says he hears them talking about whipping him.
Dec 5.  Has convulsions occasionally, is very hard to control at times, believes that people are talking about him.
Jan 3, 1899.  Said this morning that Dr. Hammond was calling him Uncle Levi (Leon?) and that other people around here were doing the same thing and he was very much annoyed.
Jan 20.  No improvement.
Feb (no day).  Has convulsions occasionally and sometimes for two or three days after has delusions of persecution with hallucinations of hearing.
Mar 19.  Very noisy, saying that certain people were putting cats in his room and making it very unpleasant for him.  Was transferred to Ward 6.
Mar 25.  Returned to Ward C.
Apr 16.  Had a number of convulsions and has been very troublesome since believes that people are urinating on him, saying unpleasant things about him.
May 22.  Is quiet, orderly, tidy, and mind good for the past two weeks.
Jun 15.  Very little change at times mind is much improved and lasts for a few days, other times is noisy and hard to control.
Jul 10.  No change mentally, appetite good, health fair.
Aug 25.  No improvement.
Aug 12, 1901.  Fair health, more or less constipated.  Fits continue.  Has had two in past week.  Quiet and tractable.
Dec 22.  Has continued in usual health.  This morning at 6:20 o’clock patient had a fit in bath room and fell backwards, striking head on window seat, causing a slight wound of [ill. – looks like ‘sealf’] on right side just posterior to parietal prominence.  Patient go up and walked to room and laid down on the bed.  At 9 a.m. he was complaining of severe pain at base of neck posteriorly extending out in to trapezii.  Patient held neck stiffly, but no deformity was apparent.  Patient moved about stiffly, stood up and walked about.  At 11 a.m. he moved about room while having head dressed.  He then laid down and remained on bed until again seen at 4 p.m.  Efforts to get patient to move legs and sit up proved futile.  A careful examination revealed the following: complete paralysis and relaxation of muscles of legs and of abdomen.  All tendon jerks absent in legs.  Quadriceps and gastrocnemius jerks fair, reflex of arms normal.  Plantar imitation (?) cause weak flexion of all toes, big toe most, associated with contraction of fascia lata and flexion of knee.  All sensation absent for body below nipple line.  Patient unable to tell position of limbs.  Bladder distended 5” above pubis but patient not aware of same.  Complains of severe pain in base of neck, some soreness of upper chest walls.  Pulse 80, Resp 20.  6 p.m. catheterized, obtaining 18 oz. of clear urine.  Urethra anesthetic.  10 p.m. 100 F, both axilla and in mouth.  Pulse 84, Resp. 20.  Patient complains of “nervous chills” and of fever.  No involvement of arms.  No appetite, constipated by habit.
Dec 23.  9 a.m. Area of anesthesia now reach to a line 1 ½ - 2” below nipple line.  In R iliac region is a 5 cent sized area to which sensation for pain seems present at times.  T.P.R. (in mouth and axilla 99 1/5) 80 – 20.  No change in reflexes.  Pain in neck continues.  No appetite.  8 p.m. No changes in condition, except temperature normal.
Dec 24.  Mental state as usual.  No change in physical condition except that the upper border of anesthesia has descended about to 4 or 5” below nipples.  The determination of border is impossible for the answers vary from one second to another.  At times, he seems to feel pin pricks on ant belly wall down as low as the iliac crest, but locates the point of contact near the nipple or between them on costal margins.  Laterally the same variability is present.  Back not examined because of necessity of quiet (?) and on account of pain caused in neck base in motion.  Catheterized twice, obtaining 45 oz. of clear urine, which showed slight trace of albumin.  Belly slightly distended.  Fractional MgSO4 dose is effective.  T.P.R. 98, 80, 20.
Dec 25.  Mental state unchanged.  Patient’s answers slow and [ill.] certain so that examination is unsatisfactory.  Reflexes and anaesthesia the same as at last note.  Posteriorly, sensation is fair down to 10th rib and mid scapula line.  Sensation to touch slightly less accurate than that of pain.  Anteriorly the point of contact is usually placed at nipple of same side; posteriorly, “just under shoulder blade.  No stoa, belly as yesterday (?).  In left heel is a large water blister.  In lower dorsal and over sacral regions are small discolored areas.  Px fast back aside twice daily with alcohol and alum – pad discolored areas with cotton.  (Makes little sense, but that is what it looks like it says!!).
Dec 26.  Reflexes unchanged.  Sensation apparently now [ill.] to all tests, except slight confused and heat and cold, about a line 1” below nipples.  Below this line on R anteriorly, now a marked hypoaesthenia especially for tactile and thermal sensation, down to Pauxarts ligament (?), below which there is complete anesthesia.  On the left anteriorly almost complete anaesthesia [ill.] below above line.  On both sides, contact is usually referred to just below nipple.
Dec 27.  On water bed.
Dec. 28.  Small stool, dark and liquid as result of glyc Mag enema and [several ill. words] by mouth.  No increase to trophic disturbances.  Physical condition unchanged except that belly is more distended.
Jan 7, 1902.  Patient has been fairly comfortable with no change in subjective symptoms since last note.  Twitching of leg is occasionally noticed but there is no change to the flaccid paralysis.  Tonight there is pain determination of sensation anteriorly down to 6” below ant sup spines.  Catheterization required to prevent incontinence.  Bowels move daily, stools at times soft at other hard.  No trophic change.
Jan 8.  Moderate cystitis.  Slight diarrhea.  Patient can voluntarily move toes of left foot today (?) on right.  Sensation over lower abdomen less acute apparently than yesterday.  Some involuntary twitching of limbs (lower).
Jan 12.  Can move both legs, though cannot lift them from bed.  Sensation fair on right leg down to ankle and on L leg to mid-leg.  K.J.s present but rather weak (knee jerks?).
Jan 13.  Bladder irrigated with 1,000 bichloride.
Jan 17.  Bladder irrigated with 1,000 bichloride; legs as at last note.
Jan 21.  Slight cough raises considerable mucous.  Is very despondent.  Touch and pain tests are positive in almost all parts of legs [ill.] and on belly, though below mid-leg there is moderate hypoesthesia.  K.J.s weak and less on left where reinforcement is necessary.  Shoulder joints quite stiff.  Patient does not voluntarily move them on account of pain.  Moves legs in flexion and extension and rotation but cannot raise them off the bed.
Jan 24.  No change to nervous condition.  Has grown progressively weaker, and died at 6:45 p.m.
Jan 24, 1902.  Post-mortem, 8:30 p.m. In the layer of membranes covering post surface of cord is a rather diffuse linear hemorrhage reaching from 7th cervical to the 5th dorsal spines.  Section of cord shows alteration at or below site of hemorrhage.


History and clinical notes:
History: Patient was admitted first time March 31, 1898.  Discharged improved Sep 24, 1898. (See page 348).

Nov 29, 1898.  Said this morning that he went to look for his wife on a side street; does not seem to recognize where he is.
Jan 2, 1899.  No improvement.  Physical condition good, mind very feeble, tongue tremulous, has delusions and hallucinations.
Jan 20.  Feeble mind, orderly.
Feb 4.  Had a severe convulsion during the early evening.
Feb 16.  Health gradually failing.  Stoppage in speech, mind feeble.
Mar 11.  6 a.m. had a convulsion and still at 11 a.m. unconscious; hands cold and clammy, pulse very weak, respirations stertorus.
Mar 12.  5 p.m. very much improved, talks, but rather stupid; pulse normal, respirations good, although rales over left lung.
Mar 13.  6 a.m. very difficult for him to swallow; pulse getting weak, respirations 24 and rales over both lungs.  6 p.m. No improvement.
Mar 14.  6 a.m. very weak, respirations increasing, pulse 120.  Very stupid.  6 p.m. gradually getting weaker and is very restless.
Mar 15, 1899.  5 a.m.  Died.


History and clinical notes:
History: Officers who bring patient know nothing of her history.

Feb 18, 1899.  General health of patient fair: eats and sleeps well, and usually is bright and cheerful, but at times suffers considerable depression on account of some delusions under which she labors.  
Mar 15.  Patient has complained of pain in back and limbs for past week or so, probably rheumatic.  Mental condition still unchanged; usually quiet and easily managed, but attempts to run away whenever an opportunity offers; occasionally is quite melancholy on account of her delusions.
Jun 19.  Physical health is very good, but is still controlled by the same delusions, and attempts to escape whenever she can.  Is quiet and orderly and gives very little trouble, except that she requires careful watching to prevent her running away.
Aug 29.  No change in mental condition.  General health good.
Jan 15, 1900.  No improvement in mental condition patient is still controlled by many delusions and attempts to escape every time an opportunity presents itself.  General health very good.
Oct, 1900.  Has many delusions and attempts to escape at every opportunity.  As a rule, is easily controlled but sometimes becomes violent and has to be restrained for a short time.  General health fair.
Aug 2, 1902.  Mentally and physically about the same.
Jun 7.  Had an apoplectic attack.  Right side face, left side body, in stupor.
Jun 12, 1902.  Died in coma at 4:30 p.m.


History and clinical notes:
History: Officer who brings patient knows nothing of his history.  3 p.m. daughter says that he has drunk very hard and has been very peculiar for twenty-five years; and about three weeks ago he became very obstinant, wanders from place to place in his bare feet, tried to tear up carpet; upset stove, pull the bed down and various other things about his home.  Threatened to injure his family.  Sleeps poorly.

Jan 2, 1899.  Mind feeble, talks incoherent untidy at times.
Jan 14.  Fell on the floor and bruised right shoulder.
Jan 20.  Shoulder much improved.
Feb 15.  Mind very feeble, talks incoherent at times, also untidy occasionally, but easily controlled.
Apr 17.  No change mentally, untidy at times, health good.
May 22.  Same as above report.
Jun 20.  Mind very feeble and ataxia some marked, appetite fair, health good but untidy habits.
Jul 20.  Same as above report.
Aug 25.  Appetite good, mind very feeble, rests well at night.
Sep 10.  No change.
Sep 25.  So weak that he was compelled to go to bed.
Oct 5.  Very weak.
Oct 6.  Very weak, pulse hardly perceptible.
Oct 7.  Gradually getting weaker.
Oct 8, 1899.  Died 8 a.m.


History and clinical notes:
History: Officers state that he was brought to Ferris Ind. School about 3 days ago from Elmsmere (Elsmere).  They know nothing of his history.

Dec 12, 1898.  Very noisy, talks incoherent and is restrained in chair.
Jan 2, 1899.  Still restrained and violent; says that he is a double engine and etc.
Jan 10.  Quiet and orderly, works on the wards.
Jan 20.  Quiet and good worker.
Feb 16.  Mind feeble, assists on the ward.  General health good.
Apr 17.  General health good; works on the wards and is very useful, very much improved mentally.
May 22.  Good patient, works on the wards.
Jun 15.  Not so well.  At times cries and talks on religion.
Jul 1.  Very much improved and is working on the wards.
Jul 20.  Very noisy and violent, talks on various subjects.
Aug 10.  Some improved.
Aug 25.  Very much improved, works on the wards, appetite very much better and is getting along good.
Oct 8.  Same as above report.
May 23, 1902.  Has been in bed for past four or five weeks.  Temperature ranging morning 99 to 100, evening from 102 to 104.  Has been failing for some time past, pain on pressure over abdomen much marked.  During past week or 10 days tongue coated most of the time.  Every symptom seems to point to typhoid fever and has been treated as disease requires.
Jun 12, 1902.  Has not had any complaint whatever but looks unwell and is losing flesh.  The skin of whole body except face is the seat of a more or less marked dry papular eruption most marked on forearms and hands.  Some tenderness of abdomen possibly greatest on left.  Heart action rapid (140 per minute), but regular, no murmur, position and size normal.  Lung good [ill.] except over left apex anteriorly where [several illegible words] on R.  A few sibilant notes were [ill. words] on labored breathing.  Spleen covered by positive tympany (??).  [Entire illegible sentence.  Looks like “Liar of nappeal decucusion.]  Eyes [ill.] and throat normal.  Under and [ill.] to R angle of lower jaw is a [ill.] walnut-sized tumor of [ill. words] density, not [ill. words].  Eats and sleeps well.  Temp. ranges from a.m. 100 to 103 in p.m.
Mar 3, 1904.  Has been suffering from specific iritis and corneal ulcer but is improving rapidly.  [Ill.] treatment.
Jul 21.  Removed to T.B. (ward).
Jul 2, 1905.  Is confined to bed, suffering from Nephritis.
Jul 20.  Rapidly growing worse, does not respond to treatment.
Jul 23, 1905.  Died due to Acute Tubercular Nephritis.


On certificate of:
Drs. M.L. Cirkman (?) and P.W. Tomlinson

History and clinical notes:
History:  About 4 weeks ago began to neglect her work, did not have the same [ill. – looks like “anoletion”].  About Dec 16 became rapidly worse, began crying and became much depressed, said if she could only stop thinking and drive what was in her mind out of it.  From that time until this had not worked at all and has all the symptoms of melancholy.

Jan 13, 1899.  Has improved but little since she came here.  Imagines that something is going to happen to her.  Has been visited frequently by her family, but after each visit has been much more depressed.  Was removed today on parole much against the advice of the Supt.
May 15, 1899.  Was discharged today unimproved.

Additional notes:
Standard memo attached: Dated Jan 13, 1899.  I [name redacted] have this day removed my wife from the Del. State Hospt. against the advice of the Supt.  He has notified me that she was suffering from melancholia and in a condition to commit suicide.  Knowing these facts I exonerate the Board of Trustees from any injury if she might do herself or others (harm).  [Signature]


On certificate of:
Drs. J. [illegible] and George W. Pleasanton

History and clinical notes:
History: Patient had a sunstroke about 8 years ago while working in the field.  He was delirious and was quite bad for a time, but gradually recovered.  Remained well until about 3 years – nature of this attack not known.  Wife was taken sick last week with a [ill. words – looks like ‘nuss carriage’], and this worried him a great deal and last Friday the present attack began.  He neglected his work and has gradually become worse.  Talks vulgar and profane, while before he was a good, strict church man.  Has been growing rapidly worse and yesterday was very unruly, threw flower pots at several people, threatened to kill others.  Was brought in hand cuffs.

Jan 2, 1899.  Restraint removed and allowed to go on the wards, is very quiet and orderly.
Jan 6.  Talks rational, is quiet and orderly.
Jan 10.  Still improving.
Jan 17.  Was allowed to go with [name redacted] on parole today.
May 15, 1899.  Was discharged today recovered.


History and clinical notes:
History: Patient has been taking morphia and opium for years.  Lately has taken as much as 15-20 gms Morphia a day.

Feb 16, 1899.  Morphia reduced to 4 gms daily and is getting along very nicely.
Mar 2.  Morphia stopped.
Mar 4.  Very nervous; is given celery compound and etc.
Mar 6.  Complains of aches and pains and every thing that a person can have to obtain morphia; is given Trimal at night 
Mar 10.  Very anxious to go home.
Mar 17.  Was out walking and went away; probably gone home.
Mar.  Discharged improved.

Additional notes:
Note:  www.msa.md.gov/megafile/msa/speccol . . . . Vol. 805, p. 133.  Mention of same person in Maryland archives re disposing of another man’s slaves after the man died.


History and clinical notes:
History: Patient was discharged improved August 20, 1898.  Was removed against advice of Supt.  Has not been well since her [ill. – looks like a phonetic spelling of ‘sojourn’] at home.  Lately attempted to burn her mother’s house by building a fire in the attic with kerosene.  Friends do not want her removed.

Feb 18, 1899.  Patient seems quiet and orderly since her return; works about the ward; has slight cold, but otherwise general health good.
Mar 18.  Cold is better, general health now good.  Mental condition unchanged.
Jun 19.  Patient formerly assisted in work around the ward, but for the last month or so has grown very lazy and has refused to do anything.  Appears to be in good general health, but shows no improvement mentally.
Aug 29.  Very little change in mental condition.  Still rather inclined to be lazy, though usually assists in work of ward.  General health good.
Jan 15, 1900.  Patient is quiet and orderly and will sometimes assist in the work about the ward.  General health very good.
Oct, 1900.  Little change in patient’s condition since last note.  As a rule is quiet and orderly and works in patients’ dining room, but at times is irritable and will not work.  General health good.
Apr 10, 1909.  Patient about the same since last note until today when she had a slight stroke of apoplexy, right side affected, speech also very indistinct.
Apr 18.  Another slight stroke today.
May 4, 1909.  Has been very stupid since last seizure, unconscious this morning and comatose; died at 2:30 a.m.  Died May 4th, 1909 Cerebral Apoplexy.


History and clinical notes:
History: Officer who brings patient knows nothing of his history.  Wife visited him today, said that he had been out of work for 3 years and this is probably the cause of his trouble.  First symptoms were those of melancholia noticed about last Christmas.  Wife has not seen him for over 2 years; has supported him.

Feb 14, 1899.  Says that he has no blood and that he is going to die.  Complains that he cannot eat, while he eats enough for any one person.  
Feb 22, 1899.  Was removed to New York today by wife.


History and clinical notes:
History: Officers bringing patient know nothing of his history nor where he lives in Wil.  They state that he is very violent and was brought with hand cuffs on.

Feb 22, 1899.  Is quiet and orderly, but at 8 pm very noisy, also at 12 midnight says that little people are after him to destroy him; was restrained.
Feb 23.  8 a.m. restraint removed, patient composed.
Feb 25.  Has been very orderly and quiet since last report.  
Mar 4.  Was allowed to go home on parole.
May 15, 1899.  Discharged recovered.


Complications:
loss of penis and left testicle and atheroma

History and clinical notes:
History: Officer who brings patient knows nothing of his history.

Feb 24, 1899.  Has been very quiet since admission, mind somewhat feeble, at times refuses to eat, thinking that someone has put poison in his food.
Feb 27.  4 p.m. became very much excited running up the hall saying that the house was falling in on him; was so nervous that he was restrained.
Feb 28.  8 a.m. Restraint removed.  Is quiet and orderly. 
Mar 10.  Very stupid and untidy; gradually losing flesh.
Mar 20.  No improvement; pulse very weak.
Mar 30.  8 a.m.  Died suddenly in the bathroom.

Additional notes:
From Wikipedia: In pathology, an atheroma = “tumor full gruel-like matter”; is an accumulation and swelling in artery walls that is made up of (mostly) macrophage cells, or debris, that contain lipids (cholesterol and fatty acids), calcium and a variable amount of fibrous connective tissue. Atheroma occurs in atherosclerosis, which is one of the three subtypes of arteriosclerosis; atherosclerosis, Monckeberg's arteriosclerosis and arteriolosclerosis.


History and clinical notes:
History: Wife died Oct 26th from Typhoid Fever complication Phthisis.  This worried him a great deal.  The day before funeral he came down with Typhoid Fever and was ill and at times unconscious until about Christmas when he began to improve.  Since that time he has drunk more than he ought to and has had delusions and imagines a great many things that have not existed.  Has been quite [ill.] against his housekeeper.  Has lost flesh and strength.  Patient states that he does not remember any of these circumstances.  Patient has been working for carpenter for PW & B RR (Railroad).  
May 15, 1899.  Discharged recovered.


On certificate of:
Drs. James A. Draper and J. William Springer

History and clinical notes:
History: Officer who brings patient knows but little of his history.  Cut his throat last night.  Has been intemperate lately.  Yesterday jumped from train and tried to commit suicide by butting his head against a tree.  Imagines that he is going to be arrested for killing his wife.  Patient is employed by PW and B Railroad as bridge builder and has been working at Oxford, Md., some time and has drank very hard.  Unexpectedly to his friends, he suddenly tried to cut his throat; was overpowered and put on train to go to Wilmington.  While the train was waiting at a station he broke away from his friends, run out in a peach orchard and beat his head against a tree.  Was caught and put on train again and shortly afterwards he tried to get out car window.  Upon examination his throat was cut on left side, scalp very much contused.  He talked some incoherent and desired to see a preacher.  Was restrained and given 1/50 gr Hyoscine by arm.  8 a.m. (25th) restraint removed.  Quiet and orderly.  8 p.m. has slept most of the day, but restrained at night.

Feb 27, 1899.  Was allowed to retire in room with another patient without restraint.
May 15, 1899.  Discharged recovered.

Additional notes:
Tried to kill himself by jumping from a train, then by smacking his head into a tree.


Form:
psychosis with constitutional psychopathic inferiority

History and clinical notes:
History: Patient has been insane since attack of Scarlet Fever when she was about 7 years old.  Never gave much trouble until lately.  During last blizzard left her home and wandered away from home and went as far as Eden Park.  Became quite sick and was threatened with pneumonia.  Has not lost flesh to any extent.  Mind is quite feeble and has been so as stated above.

May 1899.  Patient has been very quiet and orderly ever since her admission; appears bright and perfectly willing to do anything that she was asked.  Works in attendants’ dining room.  Physical health very good.
Jun 19.  Physical and mental condition about the same as at time of last note.  Patient still assists in the work of Dining Room and appears bright and willing.
Aug 29.  No change since last note.
Jan 2, 1900.  Ran away this morning and was found on Market St. Bridge by Dr. Hammond who turned her over to Mr. McFarland who brought her back to Hospt. 11:30 a.m. 
Jan 15.  Patient has been quiet and has not since attempted to leave the Hospital.  Assists with work in patients’ dining room and seems bright and well.
Oct, 1900.  Talks almost all the time to herself when alone, but speaks quite rationally when addressed; mind weak though; assists in work about the centre.  Has not attempted to escape lately; general health fair.
Feb 1, 1901.  Has been restless for a number of days, walking up and down the hall, talking to herself.  Kept in the ward for few days.  Today is working in the centre again; seems quiet and contented.  Physical condition fair.
Aug 2, 1902.  Mentally and physically about the same.
Jan, 1918.  Patient suffering from chronic nephritis; face and legs swollen.  Mentally getting worse.
Dec 1, 1918.  Mentally and physically getting worse.
Feb 15, 1919.  Patient died at 6:30 a.m.  Chronic Int. Nephritis.

Additional notes:
Was left brain damaged after a case of scarlet fever at age 7.  Brought to DHS at age 24, stayed for 20 years before dying.


History and clinical notes:
History: Has been drinking very hard for the past three weeks.  Is very noisy and says bugs are in him.  Snakes are after him.  

Mar 12, 1899.  Very nervous and restless; hallucinations of various things.
Mar 13.  Is very nervous and delirious.
Mar 15.  Some improved; not delirious but little nervous.
Mar 17.  Very much improved; transferred to Ward 4.
Mar 18.  Doing very nicely.
Mar 24.  Was allowed to go on parole today.
May 15, 1899.  Discharged recovered.


History and clinical notes:
History: Has taken cocaine and whiskey for seven or 8 years.  Came to the hospital of his own accord and is very anxious to stop.

Mar 16, 1899.  Very nervous and restless and poor appetite.
Mar 18.  Some improved.
Mar 20.  Sleeps well at night; appetite improving.
Mar 25.  Gaining flesh; goes out walking with attendant and other patients.
Mar 30.  All the privileges of the grounds.
Apr 2.  Has recovered and is very anxious to go home.
Apr 8.  Allowed to go on parole today.
May 15, 1899.  Discharged recovered.

Additional notes:
Addicted to alcohol and morphine; admitted self to hospital in order to detox and quit.


History and clinical notes:
History: About four weeks ago had stroke apoplexy, was unconscious two or three days and mind some feeble since.  Certificate states paralysis.  Word insanity scratched off.  Has lost flesh and strength.

Apr 1, 1899.  Still confined to bed; mind feeble and occasionally has delusions.
Apr 17.  No improvement mentally; some stronger physically.
May 22.  Very much improved; talks rational and is gaining strength very fast.  Sits in chair every day, can walk some little with assistance.
Aug 25.  Mind clear.  Hemiplegia some improved on the left side; appetite good, rests well at night.
Oct 8.  Same as above report.  
Aug 12, 1901.  Health good.
Oct 17, 1902.  For past few weeks patient has been growing weaker.  Occasionally has swelling of lower limbs and considerable increase to a chronic moderate edema of legs.  For a week past has failed to recognize relatives or attendants.
Oct 27, 1902.  Has continued to fail since last note and died at 6:30 p.m. of general exhaustion.


History and clinical notes:
History: [Name redacted, person who brought patient to hospital] knows but little of patient.  She was at Stainton (??), VA Asylum for 3 years and by some means got to Philadelphia a few days ago and wandered to her brother-in-law’s in Dover last Saturday.  Where she has been talking very incoherently and acting very strangely.  She says the Staunton (??) authorities took her to Phila.

Apr, 1899.  For a week or so after admission, patient was quiet, talking quite well, though undoubtedly with many delusions, but has now become quite incoherent in her conversation and at times gets quite noisy and excited.
Jun 19.  There has been no improvement in patients’ mental condition.  At times she is quiet, but talks incoherently and quite suddenly will become very much excited and very noisy.  Two days ago patient attempted to run away from attendants and fought with her when attempting to bring her back.  General health good; usually quiet at night.
Aug 5.  Very little change in patient’s condition.
Aug 29.  Patient is still controlled by the same delusions and at times becomes quite excited, occasionally hitting those around her when so excited, but is usually quiet and orderly.  General health good.
Oct, 1900.  No improvement in mental condition; in fact, appears to be becoming more noisy, requiring hypnotic almost every night; irrational at all times and at times quite incoherent.  Appetite fair, but patient looks thin and anaemic.
Aug 2 (no year).  Very little change in patient’s mental condition.  Physically about the same.
Aug 23, 1903.  Condition the same.  Very noisy at times.
Oct 1918.  Patient had an attack of epidemic influenza.
Nov, 1918.  Patient suffering from tuberculosis of lungs.  Transferred to T.B. Bldg.
Nov, 1919.  No change in patient’s mental condition; physically getting weaker.
Nov, 1920.  Patient died at 3:30 p.m.   Tuberculosis of lungs.

Additional notes:
Seems to have been sent away from previous asylum, to Philadelphia.  Spent 21 years in DSH.


On certificate of:
Drs. John P. Waples and William G. Winner

History and clinical notes:
History: Has always been more or less weak minded and at times is very stupid.  Is tidy and has good health.  All symptoms of imbecility; at times untidy; has been seen a number of times practicing self-abuse.

May 22, 1899.  Health good, no improvement mentally.
Jun 10.  Feeble-minded, untidy, and masturbates at all occasions.
Jul 10.  Health good, appetite fair.
Aug 25.  No improvement.
Oct 8.  No change except very untidy at times.
Aug 12, 1901.  At times untidy; health good.


History and clinical notes:
History: Officers who bring patient know nothing of her history.  They found her in a very filthy room with some other Negroes at 812 Taylor St.  She was paralyzed and lying on the floor.  They know nothing of her history.

Apr 1, 1899.  Has been very noisy and violent almost incessantly.  Has had hypodermics of Hyoscine gr 1/75 about every second night, alternating with Chloral Hydrate, the latter however seldom being effectual in quieting patient.
Apr 20.  All past week patient has been failing in strength; has been very noisy almost all the time; appetite still quite good, but patient does not speak any now.  Urine and feces involuntary.  Has slight abrasions on chin due to rubbing her face against the bed, as she always turns over onto face or attempts to when left alone; left wrist also blistered and slightly abraded, while whole arm and hand swollen from patient endeavoring to free her hand and arm from the muffs.
Apr 23.  Patient somewhat quieter, but also considerably weaker, refuses solid food, given egg nog; arm and hand better.
Apr  25.  Patient continued to fail, becoming entirely unconscious and unable to swallow even liquid food on 24th; remained in about same condition, gradually failing until today at 3 p.m. when she died.


History and clinical notes:
History: Was admitted here December 28, 1894 and was discharged improved August 21, 1895.  Has been taken care of by his parents; wandered from place to place, is very untidy, mind feeble, tremulous tongue and is very hard to manage.  Struck his mother yesterday.

Apr 17, 1899.  Is very orderly, mind feeble and at times much demented and at times untidy.
Jun 10.  Is untidy; tears his clothes and demented; appetite poor, rests fair at night.
Jul 15.  No improvement; is very untidy, gradually losing flesh, appetite very poor.
Aug 25.  Very feeble minded, tongue tremulous and appetite poor, ataxia very marked; is restrained to prevent tearing his clothes.
Oct 8.  Same as above report.  Gradually getting worse.
Dec 12, 1899.  Died.


History and clinical notes:
History: Has been in the Phila. Hospital for insane twice and admitted here August 27, 1894 and discharged October 4, 1896 recovered.  And about three weeks ago symptoms of insanity returned; she became depressed and was afraid that she would be injured.  Sunday she was very violent and noisy, talking on various subjects, mostly religion, and today she attempted to injure several people.  Has had bad health all winter and worked very hard.

May, 1899.  Patient very noisy and violent when admitted, but was give Hypodermic of Hyoscine, which quieted her and there has been no return of violence since; usually quiet and depressed in her manner; inclined to be disorderly in her appearance; occasionally assists in work on ward.  General health very good.
Jun 19.  Very little change in condition since last note.  Usually quiet and somewhat depressed; sometimes cross and irritable, does not appear to take much interest in her surroundings.  Physical health very good.
Aug 29.  Very little change in mental condition, usually quiet and pleasant but at times become irritable.  Both ears are red and swollen and has a slight discharge, otherwise general health very good.
Jan 19, 1900.  As a rule, patient quiet and orderly and a good worker on the ward; at times become irritable.  Physical health fair.  Patient has been upon Iodide (?) or Mercury for some time, but ear still continues swollen and discharges.  Syringed daily and dressed with antiseptic ointment.  It will improve for a time and then grow worse again.
Jun 6, 1900.  Home on parole.
Sep 20, 1900.  Discharged improved.

Additional notes:
Had only one child, listed as dead on admission form.


History and clinical notes:
History: Officer states that he knows nothing of patient’s history.  Has not lived with his wife for 5 years; sisters of patient say that the cause of the separation laid with her.  Patient has been working in Summit, Illinois and sisters do not know any thing of his history while he was in Illinois.  Was very much depressed, would not talk to any one.

Apr 12, 1899.  Talks some and takes little interest in things around him.
May 1.  Is very obstinant; strikes patients if they disturb him.
May 21.  Struck patient [name redacted] in the mouth this a.m. 
Jun 2.  3 p.m. while out on the baseball grounds, he attacked attendant Marval without any cause and was so violent that he was restrained.
Jul 10.  Still restrained; is very hard to control, appetite good; health fair.
Aug 1.  Is very obstinant and bad patient.
Aug 25.  Still restrained to prevent injury to himself and others.
Jun 16, 1900.  Home on parole.
Sep 20, 1900.  Discharged improved.


On certificate of:
Drs. George W. Marshall and William Marshall

History and clinical notes:
History: Man who brings patient states that the attack began about two years ago.  Mind gradually became feeble and talked incoherent on various subjects; ataxia very marked.

May, 1899.  Very little change in patient’s condition since admission.  Has a good appetite, sleeps wells and is usually quiet; sometimes cross and hard to manage; ataxia still marked.
Jun 19.  No improvement in mental condition and ataxia still marked and patient seems to have very little use of her limbs.
Aug 13.  Patients symptoms above noticed are become more pronounced.  Is failing rapidly in this respect.
Aug 29.  Condition about same as at time of last note.
Jan 19, 1900.  Patient has not improved in any respect.  Can scarcely walk at all, gait very feeble and tottering.  Appetite good and sleeps well, very untidy.
Oct, 1900.  Very little change since last note except that patient has become more helpless, and is not able to walk about at all.  Appetite good and patient quiet as a rule.
Sep 26 (no year).  10 p.m.  Died after having been ailing for some time.  Apparently never complaining.  Seemed to grow weaker and weaker until finally had to be confined to bed constantly.  During the summer felt the heat extremely and had several weak spells but these she got over and apparently seemed as well as ever.

Additional notes:
Not clear what year she died, Sept 26 of some year subsequent to 1900


History and clinical notes:
History: Was committed to New Castle Jail by Judge Ball thirty days work for drink; time expired today, but symptoms of insanity developed and was sent here.

May 5, 1899.  Very orderly, works on the wards, at times very obstinant.
May 22.  No delusions; works on the wards, health good.
Jun 15.  Is quiet and composed, is very orderly, works on the wards, appetite good, rests well at night and is useful patient on the halls.
Jul 10.  No change 
Aug 1.  Mind some feeble, health good.
Aug 25.  No change.
Oct 8.  Same as last report.
Aug 12, 1901.  No change.
Sep 30, 1901.  Discharged improved.

Additional notes:
Was in and out of DSH many times.  Died at NCCH/Almshouse 1/19/1919.  Buried at Cathedral Cemetery.


History and clinical notes:
History: Has had epilepsy since puberty.  Mind is very good during the intervals; is a very good worker and has fair health.

May 1, 1899.  Since admission, patient has been quiet and orderly, working around the ward almost every day, but has had numerous epileptic convulsions.  Usually falls in them, but quickly recovers consciousness and soon appears all right again.  Some times has attacks of petit mal as well.  Has a pretty good appetite and sleeps fairly well, but very nervous.
Jun 1.  Aug 13.  Lately, has been quite stupid – not near as bright as formerly.
Aug 29.  Patient has improved again, being much brighter and not nearly so nervous as formerly.  Has had no attacks of epilepsy lately.  General health fair, complains at times of bad pain in heart; no apparent cause.
Oct, 1899.  Patient continues in fair health; at times has numerous convulsions for a few days and then after a few days appears about as usual.
Dec 1.  Patient has numerous attacks of convulsions, but is usually up and about the ward every day – appetite good and generally rests well.
Dec 29.  Patient has been having very frequent convulsions for the last day or so.  Today had several severe ones, after which she was very much excited, requiring restraints and Hyoscine 1/100 to quiet her.
Dec 30.  Much quieter today.
Jan 10, 1900.  Patient is now in about normal condition.  Has had no epileptic seizures since the last of December and her general health has improved very much.  Appetite pretty good and usually sleeps well.
May 3.  For past 3 days has had an unusual number of convulsions and is quite weak and is compelled to remain in bed; had had as many as 50 convulsions a day.
Jul, 1900.  Patient recovered from convulsion attacks but had a very bad ulceration, resembling bed sore, across the lower portion of back 3-4” in length and 2” broad.  Dressed daily.
Oct, 1900.  Patient in good general health and with the exception of one attack, slight, had had no return of convulsions since last note.  Back entirely healed.
Aug 2, 1902.  Under diet pat. has less convulsions, mentally degenerating gradually, physically well.
Jun 15, 1904.  Has been gradually failing in physical health.  Is now confined to bed.  Urinalysis report states 2 ½ % albumin, hyaline and granular casts.  Eyesight and memory failing rapidly.  Severe pain in back region of kidneys.  Partial lingual paralysis, constant high temperature, pulse rapid and weak.  Pre-systolic heart murmur.  Has had two convulsions during the night.  Given Magnesium sulphate 1/10 gr.  Pilocarp (?) Nur. Hypodermic, and kept on exclusive milk diet.  Glass of hot water ordered every hour.
Jun 16, 1904.  Patient reacted well to treatment, perspires freely, and is much better this morning.
May 16, 1906.  Died, interstitial nephritis.

Additional notes:
Note attached on lined paper: Dated Apr. 5, 1906.  Harrington, De.  April 4, 1906.  Dr. W. H. Hancker, Farnhurst, Del.  Your letter rec’d in regards my sister [name redacted], if any thing should happen please notify me at once.  I could do very good if I was there.  I trust this will be satisfactory.  I remain, yours truly, [name redacted.]


History and clinical notes:
History: Patient lost his wife about five years ago.  Three years later lost his farm, which was sold by the Sheriff.  This worried him a great deal and he began to wander around the country.  Had been very melancholy since that time.  Patient states that he had a paralytic stroke sometime ago but brother does not know anything about this.  Has been losing flesh and is very weak when admitted.

May 5, 1899.  Some improved, talks very well.  No delusions.  Ankles very much swollen.
May 22.  Health some improved.  Mind very much better.
Jun 15.  Gradually losing flesh, mind feeble, limbs oedematous, respirations increased, aortic insufficiency marked.
Jul.  No improvement.
Jul 20.  Compelled to go to bed, limbs and prepuce oedematous, pulse irregular and weak.
Aug 1.  Extremely weak.
Aug 3.  No improvement.
Aug 7.  Friends notified.
Aug 10.  3:30 p.m. died of Bright Disease, accompanied by aortic insufficiency.


History and clinical notes:
History: Patient was admitted to this institution March 8, 1896 and was removed by his mother unimproved, May 11, 1896.  Had had epilepsy since birth; supposed to be due to the constant intoxicating condition his father was in.  One admission now, forehead and nose of patient was quite bruised.  Was brought by officer from New Castle.

May 22, 1899.  Has convulsions occasionally and sometimes very obstinant.
Aug 25.  No improvement, health good and appetite great, rests well at night but at times contrary.
Sep 13.  Had had a number of convulsions; is very much exhausted and stupid. 
Sep 15.  Very stupid and does not recognize his mother who visited him this a.m.
Oct 8.  Very stupid, mind feeble, at times very untidy.
Aug 12, 1901.  No change.
Aug 23, 1903.  Quite demented.  Frequent epileptic seizures.  Notices little of surroundings.  Eats well.
May 2, 1905.  Rapidly failing, great emaciation and frequent epileptic seizures.
May 25, 1905.  Died.  Asthenia and exhaustion from epilepsy.

Final disposition:
Died from asthenia and exhaustion from epilepsy

Additional notes:
Doctors attribute his epilepsy to his father's drinking


History and clinical notes:
History: Officers who bring patient know nothing of the history of the case expect (except) that he had always been an imbecile.  Was arrested on the streets of Wil.

May 22, 1899.  Good health.
Jul 10.  Has good health and is very useful on the ward and out door work.
Aug 25.  No changes.
Oct 8.  Is very useful on the wards, has good health, and sleeps well.
Aug 2, 1901.  Ditto to last note.
Aug 23, 1903.  Good health.  Poor eyesight congenital.  Good worker.  No change in condition.
May 10, 1918.  No change in patient’s mental condition.
Sep 15, 1919.  No change in his condition.
Oct 9.  Patient suffering from lobar pneumonia.
Oct 16, 1919.  Patient died this evening at 1:15 a.m. Lobar pneumonia.


History and clinical notes:
History: Was brought to the institution April 25.  Papers did not arrive until April 27, 8:30 a.m.  Dr. Blackson stated that he had an attack of hemiplegia 4 months ago and has been troublesome and delirious at times since then.  Lately has been inclined to break everything he could lay his hands on and they could not keep him at home.  Yesterday had another slight attack of apoplexy affecting the speech center.  This morning (April 27) friends removed him as they thought they could care for him at home.

Apr 27, 1899.  Discharged unimproved.

Additional notes:
Had been in hospital for 2 days without papers before papers arrived on 4/27; friends came to get him the same day


History and clinical notes:
History: Patient fell down about two years ago and bit his tongue, which has never healed, gives him pain and has worried over his condition; has been drinking very hard since about Dec 1, 1898.  Has been in William Jones private hospital in Wilmington for treatment of tongue.  His daughter believes that his mental condition is due to alcohol.  She visited him there and he told her to look at the ants and spiders on the wall.  He is very nervous, noisy, talks incoherent and has all symptoms of delirium tremens.

May 5, 1899.  Talks incoherent, is not so hard to control, mind very weak.
May 15.  Very much better, rational, talks on various subjects and is gaining strength.
May 25.  Appetite good, rests well at night.  Mind clear.
Jun 6.  Was removed today on parole by friends.
Sep 15, 1899.  Discharged Recovered.


History and clinical notes:
History: Symptoms of insanity were first noticed about the last of December, 1898.  Was despondent, refused to eat, and lost flesh very fast; this condition lasted about two weeks and he improved.  Some time ago symptoms returned; he is very much depressed, rests poorly at night, appetite very poor and at time refuses food, believes that he is to be taken away from his family and destroyed.

May 11, 1899.  Very depressed; will not speak and has to be fed.
May 16.  No change.
May 22.  Since last report, has improved; will speak when spoken to, appetite good and not so troublesome to manage.
Jun 8.  Gradually lost flesh, mind very feeble, refuses to eat and has to be tubed.  Transferred to infirmary.
Jun 9.  Very much depressed, refuses to eat, pulse very weak.
Jun 10.  Gradually getting weaker, is fed with tube, pulse very weak, respirations (26).
Jun 11.  No improvement.
Jun 12.  Visited by wife today, and she was told of his condition.
Jun 13, 1899, 3:30 a.m. died, exhaustion from acute melancholia.

Final disposition:
Died of exhaustion from acute melancholia


History and clinical notes:
History: Officers who bring patient know nothing of her history, but understand she has been insane for some time.  Patient states that she is nervous, has pains in the head and back, but she is not insane.  

Jun 16, 1899.  Patient has been very quiet and gives very little trouble ever since admission.  Sits and reads most of the time, but when addressed answers rationally and to the point.  Is sometimes cross and irritable, but does not appear to have any delusions.  Has a good appetite and sleeps well.
Aug 13.  Is very cross and irritable at times and will not speak when spoken to; will not assist in any kind of work, although she is perfectly able so to do.
Aug 29.  Condition unchanged; general health good.
Jan 19, 1900.  Patient has not improved since her admission, in mental condition.  Is still sometimes cross and irritable, but as a rule is quiet.  Complains of feeling nervous and not sleeping well.  Will not go out for a walk, as she says she is not able and sits almost all day reading.  Appears to be in good general health as she looks well nourished.
Oct, 1900.  Very little change in mental or physical condition since last note.  At times appears quite rational and will talk pleasantly, but again very cross and irritable and difficult to manage.  General health good.
Aug 2, 1902.  Condition about stationary.
Jun 20, 1904.  Transferred to Tuberculosis building.
Jan, 1908.  Patient transferred some time since to Ward B, where she has been all winter.  Gradually failing health.  Eats very little, coughs a good deal and is much emaciated.
Jan 17, 1908.  Patient has refused to eat for 3 days.  Is in bed and complains of weakness.
Jan 20.  Fed patient by tube.  Fought against it.  Coughed up an abundance of yellow caseous matter and vomited feeding.
Jan 21.  Patient again fed by tube, retained.  Says she feels better.
Jan 22.  Patient ate 2 eggs and toast.  Refused to eat at night and very weak.
Jan 23, 1908.  3 p.m. Died.


History and clinical notes:
History: Symptoms of insanity was first noticed about 4 months before her last child was born, and she is gradually getting worse.  She is depressed, very seldom talks, believes that her husband is intimate with other women.  And about two months ago she burned her dress, hat, and corsets.  Some few nights ago she left home, wandered around but was found by her husband and taken home.

May 10, 1899.  Since patient’s admission to the Hospital she has been very quiet and easily managed, except once or twice has said that she must go home to her children and has attempted to go away, so sent to Ward B.  Has very poor appetite and does not sleep well.
May 31.  Patient has improved somewhat, though still very much depressed at times; seems very anxious to return to her husband and children.  Complained a great deal of backache and pain in inguinal regions.  Examined her vagina and found indications of left tubal or ovarian trouble, i.e., tenderness, tension, and some fullness on that side.
Jun 16.  Patients seems to be considerably brighter; complains a good deal of headache; appetite somewhat better; seems to be gaining in flesh.
Aug 13.  Lately has been assisting in light work about the dining room Ward 1.  Is brighter.
Aug 29.  Patient still continues to improve; is much brighter, and appetite has improved very much.  Face and neck still continue flushed; put her on Pil Ergotine t.c.d. (?)
Jan 13, 1900.  Has steadily improved since last note and was taken home by her husband today on parole.
Mar 23, 1900.  Discharged Improved.

Additional notes:
Buried at Spring Hill Cemetery, Easton, MD.


History and clinical notes:
History: Officers who bring patient states that she has been living in a very small house at 609 Dupont St. but they know nothing of her history.  Patient has had delusions of persecution for past 15 years; says that her people are putting things on her, gas, etc. and told the Drs. that examined her that she was going to kill them; that she might as well hang for it.  Policemen found two loaded revolvers in her house.  

Jun 5, 1899.  Was removed today by [name redacted] against advice of Supt.
Sep 15, 1899.  Discharged unimproved.

Additional notes:
Standard memo attached: Dates June 5, 1899.  “I hereby remove [name redacted] from the Delaware State Hospital at Farnhurst with the understanding that I will provide for her at all times and will exonerate the Trustees of the Hospital from all damages that might occur while under my care.  [Signature redacted].


On certificate of:
Drs. George N. Carmichael and Lewis W. Flinn

History and clinical notes:
History: Patient has had epileptic attacks ever since she was two years of age.  Supposed to be due to pulling some teeth about that time.  About two years ago her mind became more feeble and lately she has talked of suicide and after attacks is quite vicious and hard to control.  Her general health has always been good; never was ill to any extent in her life.

May 15, 1899.  Patient seemed quiet and rational on her admission and was placed on Ward A, but attempted several times to go away, so was sent to Ward B.  Has had no epileptic seizures since her admission; seems somewhat depressed, but quiet and rational.
Jun 1.  Patient has been irritable and incoherent in her conversations for last few days, and has once or twice struck at one of the patients, so was removed to back wards.  General condition about same.
Jun 16.  Condition about the same; usually sits quietly, seldom speaking.  She will answer a question directly put to her correctly, but if she attempts to enter into conversation soon becomes incoherent.  Physical health good.
Aug 13.  Is better; talks more rationally, but is still at times subject to attacks of epilepsy.
Aug 29.  Patient has not been so well lately; has had several attacks where she has attempted to hurt herself or others and sometimes becomes very noisy.  When she has to be shut in a room, seldom talks coherently; appetite very poor.
Jan 19, 1900.  No improvement in patient’s condition since last note.; has frequent and very severe convulsions, and remains very much depressed and stupid for some time afterwards; appetite poor and patient very thin.  For last week or so has appeared a little brighter and has had fewer convulsions.  Spends most of her time crocheting, seldom talks to anyone.
Oct, 1900.  Patient has had several severe attacks of convulsions during which she had to be kept in restraints for fear of doing herself injury as she seemed entirely unconscious of her actions for some time after these attacks.  Patient looks pale and thin, has a poor appetite, but at present is eating and sleeping fairly well.
Feb 1, 1901.  On the 21 of January, fell during an attack and cut her forehead open, length of 2 ½ - 3 cm diagonally in the L superciliary [ill.].  Put in one stitch and heated incl. Iodoform [ill.] healed nicely.  Patient has had a number of convulsions lately, consequently has been kept in bed for a number of days.  The convulsions are milder and patient seems more comfortable than when up.  Occasionally ask to be allowed up, but complains little when request is refused.  Physically in fair condition.  Mentally the same.
Jan 1, 1912.  There has been no special change since last note.  Occasionally has a number of convulsions and for a few days after is quite stupid.
Feb 1, 1912.  For past few days has been complaining a great deal.  Examination of lungs reveal cavities in both apices.
Feb 20.  Was transferred to TB and placed in bed.
Mar 1.  Has failed rapidly.
Mar 6.  Died at 10:20 p.m. last night.
Mar 5, 1912.  Died, Phthisis Pulmonary.


History and clinical notes:
History: Was patient in Pennsylvania hospital twelve years ago.  Was discharged recovered after seven months treatment; was admitted here August 28, 1894 and discharged recovered November 30, 1894.  Has been peculiar since the severe storm in February and some few days ago he wandered from home, drove all over the county and picked up his things and said he was going to move; had his gun with him and said he would shoot anyone who attempted to stop him.  Is very restless, noisy at times.  Sleeps poorly.

May 22, 1899.  Much improved; rests well at night, appetite good, reads the papers and is very orderly.
Jun 10.  Is orderly and desires to go home.
Jul 13.  Allowed to go home.
Sep 15, 1899.  Discharged recovered.


History and clinical notes:
History: Officer who brings patient knows nothing of his history.  Patient states that he has lived in Wilmington for about two years.  Hemiplegia of right side, no mental symptoms.  Patients states that he had a chancre some years ago, was put on Prot. Iodide Hydroxy and Potass Iodide (?).

May 15, 1899.  Was bed fast when admitted, says he feels some stronger.
May 22.  Has been dressed and out on the wards.
Jun 2, 1899.  Discharged and sent to Alms House, Wilmington.

Final disposition:
Discharged, sent to Almshouse, not insane

Additional notes:
Died at NCCH/Almhouse 8/31/1916.  First name listed as "Moses" in online records.


History and clinical notes:
History: Patient was brought to hospital last Monday, did not have the admittance papers, although he was put on the ward.  He states that he has been drinking very hard for the past few days.  Drinking a pint to a quart of whiskey a day.  Face cut in various places.  Left tibia or shin bruised and inflamed, also left thigh.  Was very nervous and somewhat delirious, also insomnia and loss of appetite.

May 14, 1899.  Not so nervous; appetite some improved, rests well at night.
May 16.  Very much better but complains of his leg and eye paining him.
May 18.  All mental symptoms have disappeared, but left leg very much inflamed.
May 19.  Desires to go to work.
May 20.  Allowed to go to Wilmington, returned May 22 under the influence of alcohol.  
May 30.  Went home on parole.
Jul 28.  Returned.  Very much under the influence of alcohol.
Aug 11, 1899.  Was allowed to leave today.
Sep 15, 1899.  Discharged Recovered.


On certificate of:
Drs. Thomas A. Hitch and Henry W. Briggs

History and clinical notes:
History: Cause is supposed to be due to domestic trouble.  Husband did not support her and she was compelled to work hard to earn her living.  Was depressed and melancholy at first.  Lately she has been getting very much worse.  Last few weeks has been violent.  Threatened to kill her mother and sister until they were afraid to keep her at home.  Is very nervous at times.  Does at times does not sleep and occasionally will not eat.  Has gained somewhat in flesh.

May 18, 1899.  Patient is quiet and has given no trouble since her admission.  She sits by herself most of the time and seldom speaks unless directly addressed.  Has many delusions and talks quite irrationally at times; has rather poor appetite.
Jun 16.  Condition remains about the same.  Still very quiet and gives no trouble; is very nervous at times, and sometimes for hours at a time keeps up a sort of hiccough, which however appears to be a voluntary act; will seldom shake hands as she says that her hands are not clean.  Physical health pretty good.
Aug 13.  No change in any respect.
Aug 29.  At times patient is very noisy at night and has such attacks of screaming that a hypodermic of Hyoscine gr 1/75 was necessary to quiet; appears as usual the next day after an attack, and in the intervals is quiet and orderly, giving very little trouble.  Still controlled by many delusions.
Jan 19, 1900.  Patient has been more quiet lately; although still suffering from the same delusions and never converses rationally.  General health somewhat better and patient assists in the work of the dining room.  Appetite improved and seems to sleep a little better, although she still talks a great deal at night.  
Oct, 1900.  More quiet than formerly, although still very irrational and troubled with many delusions.  General health fairly good, sleeps better and eats well.
Aug 2, 1902.  Mentally and physically unchanged.
Aug 23, 1903.  Condition unchanged.
Jun 15, 1904.  Patient condition about the same.


Complications:
convalescing from fracture of one of tarsal bones

History and clinical notes:
History: Patient broke one of tarsal bones of left ankle about 1 month ago; and has been in Hospital since that time.  First symptoms of insanity noticed shortly afterwards.  Talked about looking for her mother, wandered about the wards of the Hospt and was so troublesome that they could not keep her any longer.  She says every one else is crazy.  Has a good appetite.  Has lost flesh and is steadily growing worse.

May 18, 1899.  Patient was very noisy and quite violent on her admission, but after a sedative became quiet and has been quite easy to manage since.  Has fair appetite but does not sleep very well.  Has many delusions and is all the time begging to go home to her mother.
May 28.  Patient has been transferred to Ward B as she is so much more quiet; seems somewhat more content but suffers from same delusions.
Jun 15.  Condition about the same, except that she is growing more noisy at night; is quiet and tractable in the day time, although always very anxious to go home, and goes around frequently trying to get out, but is so noisy at night that she requires a sedative.  
Jun 16.  Patient very much disturbed last night.  Gave Sod Brom gr xxx, followed by another dose of gr xx in two hours, but being still very noisy gave hypodermic of Hyoscine gr 1/100.  Patient seems to remember very little of being noisy, the next morning.  Received a blow on forehead, which is discolored; probably self-inflicted; remembers nothing of it.
Aug 13.  Not as noisy as formerly, but is steadily growing more feeble; although she is still up and about the ward each day.
Aug 29.  Patient’s general health has improved, appetite very good and patient is much more quiet at night.
Oct 23.  Has been failing very fast of late.  Since day before yesterday has refused to eat and today is very feeble.  Friends were notified.  
Oct 24.  Died at 3:30 pm.


History and clinical notes:
History: Symptoms of insanity were noticed about 10 days ago.  Left home, wandered around the country and spent considerable money – was noisy, excitable and was very hard to control.  

May 22, 1899.  Is orderly and some improved.
May 30.  Very much improved; is quiet and orderly, read the paper and is very anxious to go home.
Jun 16.  Still improving.
Jul 20.  For the past two or three days has not been so well.  Very nervous and excitable.
Aug 10.  Very much improved.
Aug 17.  Allowed to go on parole.
Sep 15, 1899.  Discharged recovered.


History and clinical notes:
History: Has practiced his profession (physician) in Texas for 18 years.  About 10 years ago had Dengue and has had periods of depression at various times since.  Came north last February one year ago and was admitted to Penna Hospital for Insane.  Remained four months and was very much improved; was taken home to his father’s house and remained until admitted here.  For the past few months has gradually become worse; speech affected, loss of power of arms, very nervous, choreic at times, is unable to feed himself; apparently is worse every other day.

May 30, 1899.  Is very untidy, speech very much affected; some paralysis of the upper extremities, cannot masticate solid food; talks some incoherent.
Jun 10.  Not as nervous, but speech more affected.
Jul 20.  Very nervous; tremulous tongue; at times states that he is worth millions and other times not a cent.  Very untidy, destroys his clothes and is restrained occasionally.
Aug 25.  Has to be restrained to prevent him from tearing his clothes; is very untidy, has (says) that he has millions and told Mr. Leach, his attendant, that he would give him two millions to marry his daughter.  He had a good appetite, rests fairly well at night.
Oct 6.  Very much improved, rests well at night, is quiet, orderly, and tidy.
Oct 20.  General health fine, very orderly, but little weak minded.
Nov 20.  No change.
Dec 5.  Was allowed to go home with his father this a.m. on parole.  Returned 1-1-1900, not so well.
Oct 8, 1900.  Has no delusions now but seems to be simple, is very fat and has good health.
Jun 4, 1901.  At 12:15 a.m. today patient was found apparently unconscious with slight twitching of limbs, especially of right side, head and eyes rotated strongly to right.  Reflect active and equal.  No Babinski.  Right side of face and head were stained by a dark vomitus, apparently blood.  Pulse and respirations fair.  3 p.m. Says he is 49 years old, worth $300,000.  His sister [name redacted] called.
Jun 5.  Around as usual, seems brighter than before attack.  His father called.
Aug 12.  Patient untidy at times.  Delusion doubtful.  Health fair but is failing slowly physically.
Aug 14.  Pupils equal, not well to L.A.C. Gross [ill.] tremor of tongue.  Moderate tremor of right hand [ill.] right foot slightly.  Received K.B. treatment for epilepsy.
Jan 3, 1903.  Died.  Exhaustion from general paresis.

Final disposition:
Died of exhaustion from general paresis (syphilis)


History and clinical notes:
History: Patient states that he is employed by an insurance company in Baltimore and that his salary is fifty dollars a day.  He is very wealthy and is going to buy present for all of his relations.  Went to a store in Wilmington and tried to buy about five hundred dollars worth of jewelry.  When admitted had a bible and is full of religious delusions.

May 27, 1899.  Very much better mentally; is orderly and composed.  Sputum examined today and found to contain the bacilli of Tuberculosis.
Jun 6.  Is some noisy and restless; talks on various subjects incoherent.
Jun 16.  Was so noisy that he was transferred to Ward 6.  
Jun 24.  Gradually losing flesh, coughs considerably, mentally some improved and was sent to Ward D.
Jul 1.  No improvement mentally, gradually getting weaker.
Jul 12.  Very weak and confined to his bed.
Jul 18.  9 a.m. has been extremely weak for the past few days and died this a.m.


History and clinical notes:
History: Was admitted to Delaware Hospital May 18.  Supposed to be affected with rheumatism.  On Sunday night was very noisy, tremelous and delirious, was given sedatives.  Monday night symptoms returned and they were compelled to strap him to the bed; was very restless and noisy.  When admitted here all symptoms of Delirium Tremens were present.  

Jun 1, 1899.  All symptoms disappeared.
Jun 5.  Is very anxious to go home.
Jun 6.  Was allowed to leave today on parole.
Sep 15, 1899.  Discharged recovered.


History and clinical notes:
History: Brother states that she has convulsions occasionally; her brother died about two weeks ago and she suddenly became noisy, talking mostly on religious subjects, refused to eat, and has not slept since the attack; has lost considerable flesh and strength.

May 26, 1899.  Patient seems very weak on admissions, with hot dry skin, lips dry and scaly, also tongue, eyes dull and lusterless.  Pulse weak.  Only says a few words and these are usually incoherent; refused to swallow anything in the way or nourishment, so was given a pint of milk with two eggs and about 3 T whiskey by the nasal tube.  Patient became quieter – soon fell asleep.  Resting fairly all night.
May 28.  Patient is growing in strength and seems more rational, but still refuses to eat, so if fed twice daily with the nasal tube.  Sleeps well.
May 31.  Much improved; has been induced to eat a little and feeding by tube has been discontinued; gains steadily in strength and seems much more rational; sleeps well.
Jun 4.  Patient has steadily improved; eats well, and is able to be up and about the ward; appears perfectly rational, although says she cannot remember some things that happened; remembers and laughs at her former delusions.  Was returned to Ward A.
Jun 9.  Patient seems to be gaining in mental and physical strength; has rather poor appetite; put her on Pepto-Mangan.
Jun 16.  Feels much stronger and goes out for a walk occasionally.  Dr. Tybout examined her eyes, as she had complained of headaches; found no serious trouble, prescribed glasses for reading and sewing, appetite improved, sleeps well.
Jun 20.  Patient had a convulsion this a.m. and fell, burning her hand right badly with hot water, left slightly, while in bath room.  Dressed with antiseptic ointment, absorbent cotton, and bandaged.  Gave Morphine gr 1/8 and whiskey to relieve intense pain.
Jul 1.  Had has been dressed daily as at first; still very painful, but looks clean and healthy, except on back of right hand and one finger, where a portion will slough.
Jul 14.  Left hand is all healed and right very much improved.  Patient’s general health good.  
Aug 5.  Only a small portion of the surface of right hand yet unhealed.  Patient has not had a convulsion since the one in June and is in good general health.
Aug 29.  Hand has entirely healed over; dressings all removed; very little contraction of scar tissue, which looks smooth and healthy.
Mar 23, 1900.  Discharged improved.


History and clinical notes:
History: Patient was tried by the Court of New Castle County for assault with intent to commit murder; was adjudicated insane and ordered to be confined in this hospital.

Jun 16, 1899.  Very orderly, but mind feeble.
Jul 20.  No improvement.
Aug 28.  Appetite good, rests well at night, would like very much to leave the hospital.  Has always been considered by his relatives and friends as a peculiar, eccentric man.
Oct 8.  Has no delusions, but is some feeble minded and is supposed to existed from birth; health good.
Aug 12, 1901.  Patient has a [ill.] able temper, is egotistical and illiterate.  No delusions, remains in room all the time except at meals.  Is very anxious to leave.
Aug 23, 1903.  Right sided hemiplegia.  Quarrelsome.  Fairly good health.
Sep 17, 1906.  Died.  Cerebral apoplexy.


History and clinical notes:
History: Officers who bring patient states that he has been drinking very hard for the past few days; very noisy, delirious, and excitable.

Jun 3, 1899.  Was so much improved that he was allowed to go on parole.
Sep 15, 1899.  Discharged unimproved (sic).

Final disposition:
Discharged unimproved (even though notes say he was all better)


History and clinical notes:
History: About three weeks ago patient began to wander from place to place, neglecting his person, mind feeble.

Jun 16, 1899.  Patient complains of indigestion and palpitations of the heart.  Some improved mentally.
Jul 20.  Mind gradually getting better.
Aug 7.  Was so much improved was allowed to go home today on parole.  
Aug 22.  Returned voluntarily today; said he was too nervous to be away and that he ought not to have gone.
Oct 8.  Some feeble minded, also imagines that he has all the diseases that are known.  He is orderly and works in the dining room.
May 18, 1901.  Patient has been quiet and tractable.  
May 18, 1901.  On parole.
Jun 26, 1901.  Discharged unimproved.


History and clinical notes:
History: Symptoms of insanity were first noticed about one year ago.  He began to wander from place to place.  Speech affected, some ataxia.  Very religious and etc.  

Jun 16, 1899.  Very much demented, very ataxic, speech affected, tongue tremulous; is losing flesh, was order in bed today.
Jun 17.  Very weak; has been fed with tube for the past two weeks.
Jun 18.  Cold and clammy, and very much exhausted.
Jun 19.  No improvement.
Jun 20, 1899.  1:45 p.m. Died.


History and clinical notes:
History: First symptoms was noticed about 4 months ago; began to lose his memory.  Began to refuse to work.  Symptoms of ataxia have been noticed for about 2 weeks.  Can’t talk plain, cannot understand what he says.  It is with difficulty that he can walk.  Supposed cause is some intra-cranial lesion.  Has been treated by Dr. Housekeeper of North East (Maryland) and others with no benefit.  Has steadily grown worse, was ordered in restraint, put to bed in the infirmary.

Jun 8, 1899.  4 p.m. was prostrated, temperature 106, unconscious, pulse 130; given cold bath then put in cold sheets, ice to head, alcohol baths, and etc.  10 p.m. temp. reduced to 99.
Jun 9.  8 a.m. temp. 101, patient very weak.  Suppositories used.
Jun 10.  Temp. 100 at 8 a.m.  Ice to head, alcohol baths.  5 p.m. temp. 99.
Jun 11.  9 a.m. still unconscious, temp. 102.5, pulse 130, respirations 28.  Right pupil contracted, left dilated; is gradually getting weaker.  5 p.m. temp. 105 3/5.  Very weak, all symptoms of meningitis.
Jun 12, 1899.  Died, 3 a.m.

Additional notes:
Treated with ice baths, cold sheets, to bring down temp.


History and clinical notes:
History: Patient has been treated in the Del. Hospital for the last three days; was so delirious, noisy, violent that they had to call in the police.  Was admitted here last night at 10:30 p.m. handcuffed and legs fastened and displayed all the symptoms of acute alcoholism.

Jun 7, 1899.  8 a.m. very much better; restraint removed and allowed to go on the ward.
Jun 8.  Doing nicely.
Jun 10.  Is quiet, composed, and orderly enough to go home.
Jul 7.  Went on parole.
Sep 15, 1899.  Discharged recovered.


History and clinical notes:
Jun 13, 1899.  Very nervous and restless.
Jun 14.  Some improved.
Jun 15.  Very much better.
Jun 16.  Transferred to Ward 4, allowed to go home.
Sep 12.  Returned today very drunk; has been drinking very hard for the past two weeks.
Sep 18.  Allowed to go on parole.
Dec 28.  Returned today; has been drinking for the past week; is very nervous, restless, and etc.
Mar 23, 1900.  Discharged recovered.


History and clinical notes:
History: First symptoms was noticed about 6 months ago; began to lose his memory.  Wandered away from home became very loquacious.  Lately has neglected his work a great deal and has been absent from home for several days at a time.  Has not lost flesh; eats and sleeps well.  No history of heredity of any kind.

Jul 20, 1899.  Mind feeble; some demented; very good; patient appetite good.
Jul 22.  Allowed to go on parole.
Aug 1.  Was returned today by officers.
Aug 28.  Very orderly, but has all the symptoms of dementia.  Appetite good, rests well at night.  Occasionally visited by sister.
Oct 8.  Very much demented, does not realize where he is, is untidy at times, general health good.
Dec 24, 1900.  Left on parole.
Feb 14, 1901.  Discharged unimproved.

Additional notes:
Note attached, standard memo form, dated July 22, 1899.  “I, [name redacted], have this day removed my brother from the Del. State Hospital against the advice of the Supt., he having notified me that he was suffering from dementia.  Knowing these facts, I exonerate the Board of Trustees from any injury he might do himself or others. [Signature of sister].


History and clinical notes:
History: Husband states that she has shown symptoms of insanity off and on for 3 years.  That she has neglected her work and has frequently threatened to kill herself.  Suffer a great deal from habitual constipation.  Husband speaks but little English and cannot get a good history of case.  Was in Del. Hospital for six weeks about two years ago, but did not locate any trouble.  Husband states that she frequently has pains in right pylogastric region.

Jul 23, 1899.  As no symptoms of insanity have been noticed, husband was requested to try her home on parole.
Sep 15, 1899.  Discharged, not insane.


History and clinical notes:
History: Patient’s farm was sold some months ago and he drove people away with shot gun; was arrested and committed to New Castle Jail last May.

Jul 20, 1899.  Mind feeble; some depressed; seldom speaks to anyone.
Aug 1.  General health good, appetite fair, sits in one seat all the time; does not make friends with any of the patients, will not talk unless spoken to.
Aug 28.  No change, still has same seat.  Is very orderly, but mind feeble.
Oct 8.  Health good; mind feeble, is very good patient, no delusions.
Aug 12 (1900?).  Health good.  Reads a great deal.  Sees reflex distinct (?) reads without glasses.
Jan 21, 1902.  Complains of giddiness and pain in back and says he has several such attacks.  Heart action fair.  Rx Mag. Sulfate, to bed.
Aug 23, 1903.  Condition much the same, is stubborn.  Talks in a respectful manner, seems contented.
May 23, 1904.  Has been confined to bed for past few days; is very stubborn and for a time refused to eat.  T.P.R. are normal and he does not complain.
May 1, 1911.  Has been confined to bed for past few days, and refuses nourishment.
May 10.  Rapidly failing and is fed per rectum.
May 27, 1911.  Died, exhaustion from Mania (chronic).


History and clinical notes:
History: On Saturday, patient began acting peculiar and during the evening was very violent, breaking furniture in the house and tearing his clothes, threatening to kill people; was taken to City Hall, Wilmington and was very noisy when admitted here this a.m.  He was restrained both hands and feet and all symptoms of acute mania present.

Jun 26, 1899.  Very noisy, violent, still restrained.  
Jul 1.  Not so violent and noisy, but still restrained.
Jul 15.  Very restless and some noisy at times.
Aug 1.  Still restrained, is noisy and restless, masturbates at every opportunity, sleeps poorly, appetite good.
Aug 28.  No improvement; was visited by father today and talked incoherent.
Oct 8.  Mind very feeble, masturbates at times, is restrained to prevent it, occasionally hard to control.
Aug 12, 1901.  Still restrained.  Physical condition fair, mind feeble.
Aug 23, 1903.  Has failed in health and mind.  Has lost considerable weight lately.  Still restrained as he is quarrelsome.  Scarcely ever speaks.  Notices little of what goes on about him.
Sep 6, 1906 (year probably 1905).  Still up and about ward, but requires restraint, tears his clothes.  Abdomen occasionally becomes very much distended, sufficient to impede heart’s action, no elevation in temperature, tongue always heavily coated and breath foetid.
Jan 3, 1906.  Is losing flesh, untidy in his habits.
Feb 7.  No improvement since last report.
Oct 2, 1911.  Abdomen has been distended for past two days; no temperature or vomiting.
Oct 8.  Condition does not respond to treatment, only a small amount of gas is expelled when rectal tube is passed.
Oct 17.  Abdomen greatly distended and is rapidly losing flesh; regurgitates milk when given to him.
Oct 19.  Passed a foreign substance via rectum; have been unable to ascertain just what it is.
Nov 1.  Abdomen has again assumed its normal proportions, but he is losing flesh rapidly and takes but little nourishment.
Nov 17, 1911.  Died.  Peritonitis and intestinal obstruction.

Final disposition:
Died of peritonitis and intestinal obstruction


History and clinical notes:
History: Officer who brings patient states that he knows nothing of his history.

Jul 1, 1899.  Had all symptoms of acute alcoholism, but is much improved now.
Jul 10.  Works in the dining room and is a good patient.
Aug 1.  Has recovered; wants to return to his home in Baltimore; works in the dining room here every day.
Aug 29.  Has good health.  Still works in the dining room and is very useful.
Sep 15, 1899.  Discharged recovered.


History and clinical notes:
History: Patient has been drinking very hard for one month.  About two weeks ago had sunstroke and was under the care of a physician for a few days and his mind has been affected since; he would wander from place to place, talks incoherent, mostly on religion; fear of police, and etc.

Jul 20, 1899.  Not so noisy, mind feeble, has some delusions.
Aug 15.  Gradually improving; is quiet and orderly, read the papers and is very anxious to go home.
Aug 29.  Transferred to Ward D this a.m. and is improving very fast.
Oct 8.  Is very stupid, pupils unequal, muscles drawn on left side of face; does not recognize anyone; confined in bed and all symptoms of cerebral embolism.
Oct 11, 1899.  Taken home on parole.
Oct 15, 1899.  Discharged unimproved.


History and clinical notes:
History: Symptoms of insanity was first noticed about two years ago.  He would talk to himself, sing, refused to work and father states that he has seen him a number of times at self abuse, and always prefers to be by himself.

Jul 20, 1899.  No improvement mentally, health good.
Aug 25.  Appetite good, sleeps well, mind some improved, is restrained at night to prevent self abuse.
Oct 8.  No improvement, works in the wards.  Masturbates at all chances; is restrained at night to prevent it; health good, mind feeble.
Aug 12, 1901.  Masturbates.  Is untidy about his clothes.  Eats and sleeps well, mind feeble.
Aug 23, 1903.  Good health.  Works about the ward.  No change mentally.  Talks to himself and foolishly to others.
May 12, 1915.  Has been losing flesh; does not eat well and does not have the robust appearance he has always had.
Jul 4.  Dullness marked over entire left lung, temp. ranging from 100 to 103 F.
Jul 18, 1915.  Temp dropped to subnormal this a.m.  Died, pulmonary phthisis.


On certificate of:
Drs. H.V.S. Stout and Thomas O. Clements

History and clinical notes:
History:  Officer who brings patient knows nothing of her history.

Aug 1, 1899.  Has been very quiet and orderly since admission, but rather talkative.  Assists in light work in Ward 1.
Aug 12.  Went into a status epilepticus this evening, which was controlled by an enema of 30 gms of chloral.
Aug 13.  Is about the same as usual this a.m.
Aug 29.  Patient seemed very much depressed for several days after the convulsions she had on the 12th, and had many delusions of seeing and hearing, but has been much better the last few days.  Eats and sleeps well.
Jan 19, 1900.  Patient has failed considerably lately, has had very few convulsions, but seems much depressed most of the time; does not eat very well and has lost considerable flesh; sometimes assists in light work of the wards but usually sits by herself almost all day, not speaking to anyone.
Jun, 1900.  Patient has improved somewhat, has had several light convulsions but not as severe as formerly.  Has frequent twitching of right hand and arm previous to convulsive attack – appetite fair and seems in good spirits as a rule.
Jul 27.  Patient unconscious this morning; heavy stertorus breathing, pulse fair quality, about 60 to the minute, pupils contracted and equal, right side appears slightly more powerless than left.  Towards evening pulse became somewhat weak, was given hypodermic of Strychnine and Digitalis.
Jul 28.  Patient’s condition about the same, was fed with milk, eggs, and whiskey twice through nasal tube – unconsciousness not quite so profound.  Given active cathartic and [ill. – looks like ‘licach’] tonic.
Jul 29.  Paralysis of right side slightly more marked with [ill. – looks like ‘denation’] of eyes to left.  Pulse somewhat stronger, about 80 per min; feed as before twice daily.
Jul 30.  Rise in temperature and increase in pulse rate, with deepening of unconscious condition.  Breathing more labored, feed as usual in a.m.  Patient died at 12:15 p.m.


History and clinical notes:
History: Patient has been a well-known character around Wilmington for years.  When brought to Hospital was almost black with filth, hair matted.  Officers know but little of her history.

Jul 6, 1899.  Was very noisy last night, so much so that it was necessary for Dr. Wilson to get up at 1:30 a.m. this morning to give her a hypodermic to quiet her.  At this time she was walking around and pounding on the doors.  This morning attendants found her lying on the floor unable to stand.  Upon examination, a fracture of head of femur right side was found.  A sand bag was placed along leg to keep it in position.  As patient is very restless, good results cannot be expected.  Patient will not eat, nor will she take water – says that it is all poisoned.
Aug 13.  Is much better.  Still in bed, eats and sleeps well, and does not now express any delusions.
Aug 29.  Patient very quiet as a rule – sleeps well and has a fair appetite, but complains much of the pain in her leg, though she is able to use it to a limited extent.  Is still in bed most of the time, but occasionally sits up in an easy chair.  
Jan 19, 1900.  Patient seems a good deal stronger; eats well and usually rests well at night.  Sits up most of the day in a rolling chair; mental condition unchanged.  Seems quite contented here now, as she imagines herself in her own house.
Oct, 1900.  No improvement in mental condition, but in fair general health, although lately has had more or less trouble with diarrhea.  Appetite fair and is usually quiet at night.  Sits up all day as a rule.
Oct 26, 1901.  For about a month has been in bed – gangrene of left foot (2 small toes).  At first seemed fairly well, but lately has been failing gradually; up to last day or two was easily aroused.  “Auntie Jane glad to see me.” “Mr. Dooley call again, call again.” “How nice you look Auntie.”  “How nice you look Mr. Dooley.”  Was able to distinguish figures, etc. but now seemed (not ?) to recognize anyone.  Ate [ill. words] yesterday.  Last day or two circulation in extremities has been failing gradually and the end came peacefully at 7:30 p.m. this evening without a struggle or sound from patient.

Additional notes:
Buried at DSH, Grave #93.  Note on page says: "Husband died (19011-"  Not sure what that means.  Newspaper article attached to page: “KEPT HIS WIFE A PRISONER.  Mrs. Benjamin [name redacted] locked in her residence, No.1308 [name of street redacted].  WAS FOUND BY CITY OFFICIALS.  The Woman Demented and in Scant Attire.  STRATEGEM EMPLOYED TO REACH HER.  The police and health officials made a shocking discovery yesterday afternoon at the house No. 1308 [name of street redacted], which has been occupied for some time by Benjamin [name redacted] and his wife.  [The husband] is about 74 years of age and his wife about 70, and the neighbors have been under the impression for some time that Mrs. [name redacted]’ mind was affected.
	Last Saturday [she] was found wandering aimlessly about the streets by the police, who took her to the police station and afterward sent her home.  The appearance of the house aroused the suspicions of the health officials and Secretary Wigglesworth of the Board of Health decided to make an investigation.
	On Monday Mr. Wigglesworth, accompanied by Health Officers McKinney and Hignutt, visited the house and made an effort to get in.  They could hear a woman inside.  She was making peculiar noises and screamed several times, evidently being frightened by the approach of the men.  All of the doors and windows were found to be closed, locked and nailed, and there appeared to be no possible way of entering except by breaking in, as the woman inside could not be induced to open a door or window, even if it was within her power to do so.  The health officers could not see the woman and she could not see them.  The men were in a dilemma as to what should be done.  After a consultation they left the place, to return when they could devise some means of gaining an entrance.
	Mr. Wigglesworth sought advice from City Solicitor Conrad, and after the consultation with him it was decided not to forcibly enter the place if they could get in in any other way.  Yesterday Mr. Wigglesworth and the health officers, accompanied by Policemen Todd and Peterson, made two visits to the house.  On the first visit they were unable to get in, but while they were there took occasion to draw some of the nails from one of the doors which had been nailed up.  Last evening they returned and the condition of the house appeared about the same.  They heard [the woman] and going to the door from which the nails had been drawn succeeded in inducing her to open it after they told her the nails had been taken out.
	She was evidently of the opinion that one of the men was her husband, as she was surprised and appeared angry when the men entered the building.  She had no clothing on except an undergarment, which was in shreds.  The men found an old dress about the place and endeavored to put it on her, but she resisted them and they were compelled to overpower her before she could be dressed.  A cab was summoned and she was placed in it and sent to the State Hospital for the Insane, at Farnhurst, after she had been adjudged insane by Police Surgeon Harris and Dr. France.
	After [she] had been sent away the officers made an examination of the house.  They found no carpet and nearly all of the furniture was piled in heaps in the front room.  The sanitary condition of the place was bad.  Cobwebs and filth were found in several of the rooms, and in the kitchen, where the woman lived and slept, ashes to the depth of nearly six inches, had been piled against the door, the object evidently being to keep out the light.  The entire lower part of the house was dark, the shutters, windows and doors, as stated above, being locked and nailed, while a bureau, table and other pieces of furniture were piled against the front door, presumably to keep the woman away from it.  One bed was found upstairs, but the conditions there were not much better than on the first floor.
	After the officers completed their investigation last night they left the house, first closing the doors, but returned this morning, when it was fumigated throughout.  It will be cleaned and put in good shape either this afternoon or tomorrow.
	Nothing was seen of the woman’s husband yesterday when the officers were at the house, but he was seen this morning.  He did not appear to be much concerned about what had happened, but objected when Health Officer Hignutt ordered him out of the house and informed him that he would have to stay out until the fumigation had been completed.  He told Secretary Wigglesworth that he had the windows and doors nailed to keep thieves out and said the ashes were placed against the back door last winter to keep the snow out.
	Just how [the man] and his wife lived has not been ascertained.  There is no water about the place, so far as could be discovered.  [The man] told Wigglesworth that he and his wife were healthy all the time last winter when people were sick all around them.  “It depends on the way you live,” he explained.  [The man] is a butcher by trade, but has not been doing anything lately, so far as is known.  He has been spending most of the time walking about, and, according to the neighbors, when he left the house, he locked his wife inside to prevent her from making her escape.  Some of the neighbors say last Saturday night is the only time they have seen her out of the house for nearly five years.  She is in fairly good physical condition, barring her mental trouble.”


History and clinical notes:
History: Patient has been a trouble to his mother and father for years.  Acts like a degenerate.  Frequently pawns his clothing for a mere song so that he can associate with fast women.  Has been in Ferris Ind. School and was brought here from Elwyn School for Feeble Minded.

Aug 13, 1899.  Has given no trouble whatsoever since he came here.  Allowed to go on parole.
Aug 19.  Has been home several times on parole and does not seem to improve here under treatment.  Allowed to go again on Sep 15, 1900.
Oct 10, 1900.  Returned.
Feb 30, 1901.  On parole.
Jul 10, 1902.  Returned.
Oct 31.  On parole.
Feb 28, 1903.  Was returned today.
Aug 23.  No change in condition.  Very neat in dress.  Eats and sleeps well.
Sep 6.  Paroled today to Col. Moore who came for him and says he will take him to his father’s home in Georgetown.
Nov 18.  Returned to hospital today.
Feb 4, 1903 (should be 1904).  Has been quiet and respectful since admission.
Dec 31, 1904.  Paroled.
Jul 6, 1905.  Returned to institution today.
Apr 18, 1906.  Paroled.
Jul 13, 1906.  Discharged improved.

Additional notes:
Was in and out of DSH many times over the years.  Buried with people named Hitchens at Odd Fellows Cemetery, Milford, Kent County, DE.


History and clinical notes:
History: Officer who brings patient knows nothing of his history.  Patient has always been a little peculiar and odd in his ways.  About 8 months ago first began to accuse his wife of infidelity and acted altogether different from his normal condition.  Imagined that there is a lawsuit against him and had other delusions.  Has spoken of killing himself.  Has been extremely anxious since this attack began.  Wife stated that at times that he has threatened to hurt her and has asked for his revolver so that he could kill his family.  Has not lost flesh or strength.

Jul 25, 1899.  Patient believes that he is persecuted and that he can hear people talking about him.
Aug 23.  So much improved that he was allowed to go with his wife.
Dec 29.  Returned today, has not been very well mentally for the past two months.
Jan 24, 1900.  Has delusions and is very much depressed, appetite poor.
Mar 10.  Some improved physically.
Jun 15.  Is some improved mentally, plays ball and is good patient.
Sep 25.  Does not seem to have any delusions, but some feeble minded; health good.
May 18, 1901.  Says today that before he came here he saw people laughing at him; that here, Myers Landenberg and Heister were having a law suit over his head and having [ill.] cause with his wife.  Has “steam” today (meaning he hears voice over phone).  That Penna RR is obliged to pay $160.000.000 to these men and that Bonsal and Davis are looking out for his interest.  Is in good general condition.  Works, sleeps, eat well.
Aug 23, 1903.  In good health.  Works about the farm and ward.  Plays ball and is contented.  
Dec 8, 1904.  Remains in about same condition as when last reported, excepting he occasionally suffers from dyspnea and pains about cardiac region.
Jan 23, 1905.  Became ill during the night, complained of severe pain in chest, lungs became oedematous and face cyanosed.  Died at 1 p.m., Pulmonary oedema and fatty degeneration of heart.

Final disposition:
Died of pulmonary edema and fatty degeneration of heart

Additional notes:
Form says "Yes" to homicide, but only threats mentioned in narrative


History and clinical notes:
History: Has had epilepsy for years; has been confined to Sussex Co. Alms House for the past three years.  Fits are getting more frequent and mind feeble.  At times is noisy and occasionally violent; talks mostly on religion.

Aug 1, 1899.  Patient has all symptoms of epilepsy; at times he is very noisy and controlled by his delusions.
Aug 26.  So noisy that he was transferred to Ward 6, from D.  
Aug 29.  Returned to Ward D, orderly and composed.
Sep 25.  Occasionally will become very much excited and believes that snakes are going to destroy him and at these times he is very hard to control, often has to be restrained.
Aug 23, 1903.  Has frequent severe epileptic seizures.  Very feeble minded.  General health fairly good, considering.
Mar 8, 1908.  Died, Pulmonary tuberculosis.


History and clinical notes:
History: Symptoms of insanity was first noticed about three months ago.  Has been very much depressed and worried over his condition.  About two weeks ago he attempted suicide by cutting his throat, which required six stitches to close.

Aug 1, 1899.  Gaining flesh.  Appetite good.  Rests well at night.  Cut in throat healed.  Patient complains of pain in left eye.  He is very orderly on wards but mind some feeble.
Aug 29.  Very much improved, likes the Hospital and says he is living the best he ever did.
Sep 28.  General health good; mind some feeble, but no delusions.
Apr 20, 1901.  But little change since last note.  For past few days has complained of feeling very bad.  Has bad murmur over [ill.] of heart.
Apr 24.  Has not improved; is in bed; says he aches all over.  Last night got up and fell over chair and as scrotum is very large due to old hernia was bruised and the superficial skin was denuded in several places.  Tongue very dry.  Appetite poor, friends were notified today.
May 11, 1901.  Patient has gradually failed since last note.  The scrotum has sloughed away and patient has suffered a great deal of pain.  Death occurred at 6:30 tonight.


History and clinical notes:
History: Has had epilepsy since birth; has been in Sussex Co. Alms House for the past two years.  Mind feeble.

Aug 13, 1899.  Has been quiet and orderly since she came here.  Helps in light work on the ward and is apparently cheerful and contented.
Aug 29.  Patient has had several slight convulsions and one or two of greater severity, but general health seems to be good and patient give no trouble about the ward.
Dec, 1899.  Patient has become quite cross and irritable, frequently attempting to strike or beat those around her without any provocation.  General health good and has had no convulsions lately.
Jan 19, 1900.  Patient still cross at times and as she has hit several of the patients at night, is now put in restraint at bedtime.  Has had no convulsions and physical health seems very good; assists in the work about the ward.
Sep 28.  As a rule, patient is quiet, orderly, and a good worker.
May 21, 1901.  Died at 8:45 a.m.


History and clinical notes:
History: Has been peculiar for years and became very much worse about a month ago.

Aug 5, 1899.  Was struck on the right wrist by another patient causing considerable bruising and a severe sprain.  Put on a splint and bandage.  Patient has an enormous appetite and sleeps well but imagines herself to be very sick.
Aug 13.  Patient is recovering the use of hand and arm which does not [ill.] seem to cause her any pain.  General health good.
Aug 20.  Has gained in flesh; has a great appetite and sleeps well, but still has the same delusions with regard to her health.
Jan 19, 1900.  Condition about the same as at last note.  General health very good; great appetite and has gained in flesh.  Still has same delusions about her health and thinks she is badly treated here.
Sep 28.  Patient seems to be in fair general health as she has a good appetite and sleeps well, but always says that she is nearly dead and has some complained about her condition every time she sees anyone; mind is very feeble.
Feb 1, 1901.  Complains constantly about her condition; [ill.] medicine and is quite provoked when one stops listening to her various plaints.  Continually opens windows and throws things out.  Keeps running constantly to the closet and says she “never (?) has a passage.”  Reiterates this statement dozens of times.  Past few days has had granular eyelids and slight conjunctivitis.  Otherwise in good physical condition.  Appetite enormous, sleeps well, mentally no change.
Apr 3, 1901.  Died.

Additional notes:
Buried at DSH, Grave #85.  Record keeps noting that she has an "enormous" appetite.


History and clinical notes:
History: Has been in Sussex Co. Alms House for the past two weeks.  Mind has been feeble for years; at times she is very noisy.

Aug 5, 1899.  Patient has been in bed most of the time since her admission.  Is very noisy at times, when she imagines that people are trying to kill her by smothering her.  She is very nearly blind; a cataract over the left eye completely obscuring the sight, while in the right she has only sufficient sight to be able to distinguish light from darkness.  Hearing also very poor, especially defective in left ear.  Complete [ill. – looks like ‘procedentia’].  
Aug 13.  Patient has improved somewhat in general health, but sill has the delusions that someone is trying to smother her, though upon other subjects she seems very rational and has a good memory.
Aug 29.  Patient is not as noisy as she formerly was, and seems in better general health; sits up much of the time through the day and rests somewhat better at night – appetite fair, complains a great deal of a pain in the side of her face, but does not want to take medicine for fear it will kill her.
Jan 19, 1900.  Patient kept constantly removing her clothing, and as she was rather weak and feeble anyway, has been kept in bed for several months past.  She seem considerably more comfortable and has gained in flesh.  Is not quite so noisy as formerly, but still has the fear almost constantly expressed that someone is going to kill her.
Apr 20.  Patient has been gradually failing, losing flesh and eating very poorly.
Apr 24, 1900.  Died.


History and clinical notes:
History: Patient is employed in the H & F Brewery and has been drinking for years, and a few days ago he became nervous, noisy, and violent, all symptoms of D.T.

Aug 6, 1899.  Transferred to Ward C; very much improved and is anxious to go home.
Aug 23.  Has recovered.  Allowed to go home with wife today.
Sep 15, 1899.  Discharged recovered.


History and clinical notes:
History: Has been drinking very hard for the past ten days, is very nervous, restless, and desires to stop drink.

Jul 30, 1899.  So much improved that he was allowed to go home.
Sep 15, 1899.  Discharged improved.


History and clinical notes:
History: Patient has been drinking very hard for the past six months; is very nervous and delirious.

Aug 12, 1899.  Has steadily improved since his admission.  Was allowed to go home on parole today.
Sep 15, 1899.  Discharged recovered.


On certificate of:
Drs. J. Haney Rile and Evan G. Shortlidge

History and clinical notes:
History: Has been at home for Aged Women for five years.  Previous history unknown.  For past two or three years has been insane.  Is very violent at times and stubborn.  Eats and sleeps good.  Is noisy at times and always wants her own way.

Aug 13, 1899.  Has shown no signs of insanity since admission.  Is quiet and orderly.  Says all the trouble was caused by the matron of the Old Woman’s House who was continually interfering with her and it annoyed her.
Aug 29.  Patient still continues quiet and orderly, giving no trouble whatever since her admission.  Says her general health is much better since her admission, feels stronger and eats well.
Jan 19, 1900.  Has improved somewhat in general health.  Says she feels considerably stronger than she did when she came here.  Is usually quiet and orderly but occasionally becomes quite angry and very much excited.  Spends most of her time reading and sewing; converses rationally and intelligently and expresses no delusions.
Apr 28.  Not much change in mental or physical condition since last note.  General health good; became very much excited a short time ago because she was not allowed to have her own way and was removed from the front ward; has been quiet and orderly ever since.
Feb 1, 1901.  Has been in bed for several days early this week with severe cold and headache.  Up and around again, complains of feeling weak, etc.  Ordered Elix. Quin., Iron, and Strych t.i.d.  Mentally patient shows no change – always answers questions coherently and pleasantly; frequently grumbles about the food that it’s poorly cooked, poorly selected, etc. but otherwise seems quite contented.  On parole to Old Ladies’ Home.
Apr 13, 1903.  Discharged improved.

Final disposition:
Discharged improved to "Old Ladies' Home"


Insane Relatives:
father and sister and 3 maternal cousins committed suicide

History and clinical notes:
History: One year ago had an attack when she neglected her work and was very cross and irritable and wanted to fight with her husband.  She got better and about two months was apparently well.  Last Saturday again showed signs of a return of the malady; talked constantly about religion.  Wanted her husband to stop his work and have prayers.  Since then has been much worse at times and has been noisy, and between attacks is very melancholy.  Has lost flesh and strength; does not sleep much at night.  Does not eat well.

Aug 12, 1899.  Is a little more cheerful and has rested fairly well at night.
Aug 20.  Has been in bed for past few days and has a high fever; is very restless.  Tongue much coated and has symptoms of a Typhoid nature.  Is fed on liquid diet entirely.
Aug 29.  Pulse and temperature normal this morning, with flesh cool and moist.  Patient still talks incoherently, but seems somewhat brighter than she has for the past week.
Sep 5.  Patient unconscious.  Can be roused sufficiently to take food.  Pulse and temperature still high; bowels constipated, abdomen not distended but tympanitic.  Tongue coated and sucks on teeth.
Sep 12.  Temperature still high – more characteristics of typhoid now, [ill. – looks like ‘showing nightly use’], still unconscious, pulse full and strong, but patient can with difficulty be sufficiently aroused to take nourishment.  Bowels still constipated.
Sep 16.  Patient has gradually failed and died this 4 a.m.


History and clinical notes:
History: Officers who bring patient know nothing of her history.

Aug 12, 1899.  Has been very stupid since her admission and is very untidy and hard to care for.
Aug 25.  Is much better.  Works a little on ward and is more talkative and cheerful.
Aug 29.  Seems very much better, but is still inclined to be irritable at times; is clean and orderly and works about the patient dining room.
Sep 13.  Was removed by her mother today on parole.
Mar 23, 1900.  Discharged recovered.


History and clinical notes:
History: Patient has for years been a moderate drinker.  For past five weeks has been drinking very hard.  Is very nervous.  Patient commits himself voluntarily.

Aug 12, 1899.  Has steadily improved and was allowed to go home on parole today.
Sep 15, 1899.  Discharged recovered.


History and clinical notes:
History: Patient was brought from Alms House.

Aug 13, 1899.  Has been quiet and peaceable since her admission – gives no trouble and seems to be happy, mind is feeble.
Aug 29.  Patient has very poor appetite, will eat scarcely anything but milk and bread.  Has had attack of diarrhea but refuses to take any medicine.  Is weak and tidy, giving very little trouble about the ward.
Sep 28.  Appetite has improved considerably and general health is fair.  Patient quiet and orderly and give very little trouble.
Jan 19, 1900.  General health somewhat better, but still has a poor appetite; appears to sleep well and gives very little trouble on the ward.  Her mind is feeble, but appears to have no delusions and always talks rationally.
Jun, 1900.  Very little change in patient since last note in mental or physical condition.
Sep 22.  Patient quiet, does not appear to have any delusions, appetite poor, seems very weak and frail.
Feb 1, 1901.  Has been failing steadily of late; appetite very poor, diet bread and milk only.  Wanders up and down the ward occasionally complains of feeling badly but up to last night refused medicine or rest in bed.  Last evening had diarrhea, seemed in great pain and groaned nearly all night.  Given morphine suppository gr ¼; whiskey and aromatic ammonia at intervals always a little at a time as she resisted considerably.  This morning seems quieter, pulse weak and irregular, resists all examination.  Ordered Strych. Sulph. Gr 1/00 and Tr. Digitalis get X t.i.d., with whiskey and milk at regular intervals; this she swallows only after considerable crying.  Hands very cold, feet beginning [ill.] discoloration but circulation good.  Does not groan as much as during the night.  7:30 p.m. has failed rapidly, was visited by friends at 5:45 and by priest at 6:30.  Died 7:30 p.m.  Senile asthenia, abdominal complications, autopsy not permitted by relatives.

Final disposition:
Died of senile asthenia and abdominal complications


History and clinical notes:
History: Was brought from Alms House.  

Aug 13, 1899.  At times is inclined to resist the attendants when they dress or bathe her.  At other times is quiet and orderly.
Aug 29.  Patient has partial paralysis of the right side and moves about with difficulty.  In inclined to be untidy and removes her clothing unless carefully watched.  General health good; mental power poor and patient seldom speaks.
Sep 25.  Patient’s condition about the same, but is kept in bed all the time on account of her helplessness; appetite good, speech very imperfect.
Dec 4.  During night patient apparently had a slight cerebral hemorrhage, as she was found in the morning with head drawn to right side, mouth also drawn to same side and eyes strongly turned in the same direction.  Pulse fair and patient not unconscious; right arm and leg also contracted.
Dec 20.  Patient has continued to improve since last note and is now in about usual condition; appears to notice all that is going on about her, but can move but little and can only say a few disconnected words.  General health very good, eats and sleeps well.
Aug 20, 1900.  For past week has been growing more feeble; bed sores are breaking out over different parts of body.  Does not eat well and cannot last very long.  Friends were notified of her condition today.
Aug 27, 1900.  Gradually failed and died at 8:30 a.m.


On certificate of:
Drs. Irvine Vallandingham and W.F. Kennedy

History and clinical notes:
History: Patient has had bad health for about one year and 4 weeks ago symptoms of insanity were first noticed when she began talking on religion and various things.  About 5 years ago her husband left here and she talks of seeing him most all the time.  Friends stated that she was taken to Phila and the physicians there stated that she had cancer of uterus.

Aug 13, 1899.  Has been in bed since admission.  At times is somewhat noisy and is thoroughly controlled by her delusions.  Has the characteristic cancerous cachexia, appetite is poor.
Aug 29.  Patient has been a good deal more rational the last few days, but suffers considerably with pain and tenderness in the abdomen.  Discharge from vagina profuse and very foul smelling.  Microscopical examination showed characteristic carcinomatous cells with epithelial cells from vagina and cervix and numerous pus cells.  The walls of vagina infiltrated, giving the whole a board like feeling, is patulous (?), admitting finger easily.  Is given a daily antiseptic douche, and Liq. Opii dead. Gm X-XV t.i.d. to control the pain.  Appetite rather poor, but patient sleeps fairly well.
Sep 25.  Some improvement in mental condition and as a rule patient seems fairly comfortably, although at times she suffers very much from nausea and vomiting, accompanied with rectal [ill. – perhaps ‘tenderness’ or ‘tenusnurs’??].
Sep 26.  Physical condition has improved somewhat lately, appetite a little better, and patient has been sitting up for a part of each day.
Nov, 1899.  Patient has not improved any lately, and suffers more than previously, frequently requiring Morphine to control pain; discharge profuse and very offensive.  Appetite poor; patient usually sleeps fairly well.
Dec, 1899.  Patient has had a great deal of pain, requiring from gr ¾ to gr 1 ½ daily to give her relief, usually bears this well, but at times suffers from nausea and vomiting.  Has lost considerable flesh, but still continues to sit up for a portion of each day, appetite fair.
Jan 19, 1900.  Still suffers very much pain; almost constantly under the influence of Morphine and has suffered also a great deal with nausea and vomiting at times.  At present time feeling somewhat better; discharge still profuse; has incontinence of urine.
Jun 5.  Very weak for past few days.  Died this a.m. at 6:30.


History and clinical notes:
History: First symptoms of insanity was noticed about 6 months ago.  Began to neglect his work and said that people were down on him and were going to murder him.  Frequently complained of severe pain in his head.  Lately has frequently wandered from home and has been away for two or three days.  Has delusions peculiar to melancholia.  Does not sleep at night.  Is steadily losing flesh.  Has always been a hard working man and has frequently worked all night.  Friends think that over work is the cause of his trouble.

Aug 29, 1899.  Very little improvement; sleeps poorly, appetite bad, is very much depressed and complains of a fullness in the forehead.
Oct 1.  No improvement, very restless, refuses to eat at times and very much depressed.
Oct 25.  No improvement, still depressed.
Nov 30.  No change.
Oct 8 (year?).  Still depressed and some feeble minded, works on wards and at times on the farm.  Health good.
Aug 23, 1903.  Health good.  Very feeble minded.  Cheerful.  Good worker on the wards.
Mar 3, 1904.  Condition same as when last reported; always orderly and a good worker.
Jun 24, 1904.  Condition remains unchanged; always respectful and obedient.


History and clinical notes:
History: Patient has been peculiar for 1 ½ years.  Lately has been so much worse that they could not keep her at home.  Took her clothes off.  Has delusions that people are stealing from her.

Aug 13, 1899.  Patient has been quite depressed since her admission.  Says that she has suffered for a long time by people putting electricity on her and otherwise annoying her.  Cries a great deal of the time.  Was so depressed this morning and cried and moans so much that she was transferred from Ward A to B.  
Aug 29.  Patient has improved much since her admission, being usually now quite bright and cheerful; sleeps much better and has a fair appetite.  Has been quiet and well behaved ever since her admission, and her delusions seem to be principally of a religious nature.
Sep 25.  For a time, patient seemed very much better; was bright and cheerful, helped with the work about the ward and with sewing – seldom referred to her delusions, but lately seems to be much more excited and nervous.
Oct 26.  Patient has not improved any with regard to her mental health.  Still suffers from delusions of persecution and has many delusions about electricity as well.  At times becomes very much excited, appetite has improved and patient sleeps fairly well as a rule.
Dec 27.  Patient has improved considerably; has good appetite and has gained considerable flesh.  Sleeps well as a rule and seems bright and cheerful as a rule; employs herself with fancy work or some light work about the ward; talks quite rationally and seldom expresses any delusions.
Jan 19, 1900.  Patient was home for a visit at Christmas and seems very well since her return.  Is much improved in mental and physical health.
Sep 20, 1900.  Discharged unimproved.

Additional notes:
Newspaper article attached: “HER MIND UNHINGED.  Young Woman Too Much Wrought Up Over Sanctification.  Miss [name redacted] of No, 502 [street redacted] was committed to the Delaware State Hospital yesterday because of mental aberration due to excessive religious feeling.
	She was a member of Harrison street M.E. Church and became greatly wrought up over the doctrine of sanctification.  She took a pair of opera glasses yesterday and went to the roof of [man’s name redacted] house, where she has lived for years.  When discovered on the roof she was in a nude state.”


History and clinical notes:
History: Has been suffering from choreic movements, mostly involving the facial muscles, for years.  During the last few weeks her mind has become affected; imagines that people are going to poison her.  Has also suffered from uterine trouble for a number of years.  Patient was brought to institution Aug 7th with illegal papers dated July 13th.

Aug 29, 1899.  Patient has not improved any since her admission.  Was put upon Strychnine, but facial movement still continues and she still suffers from the same delusions of persecution.  Wanders up and down the wards all the time, disturbing the other patients, so had to be removed to a back ward.  Appetite fair; and patient usually sleeps well, though occasionally is noisy and has to be given medicine to induce sleep.
Sep 29.  Patient has been very restless and nervous, restraint being necessary to keep her clothing on her.  Very noisy also at night; had to be restrained to keep her in bed and hypodermic to hyoscine given almost nightly to quiet her and give the needed rest.  Probably due to the irritation caused by the cuffing of the wristlets, a large carbuncle appeared on the right wrist; discharged quite freely, now healing.  Dressed with ointment of oxide and zinc.  Patient also has a bad black eye, bruised during the night.
Oct 12.  Patient still keeps very restless and noisy at night, frequently requiring a hypodermic of Hyoscine to quiet her.  Appetite very poor; is losing rapidly in flesh.  Arm has healed well.
Oct 24.  Patient still very restless and noisy, especially at night.  Medicine frequently required to quiet her, appetite is poor and patient has become very thin.
Oct 26.  Seems somewhat weaker today and has remained in bed all day.  Appetite about as usual.  Was visited yesterday by her brother.
Nov 15.  Patient is growing steadily weaker.  Appetite is very poor, frequently very noisy, requiring hypodermic of Hyoscine frequently to quiet her.
Nov 7.  At lower end of spine, swelling with inflammation, having appearance of carbuncle, discharging from two openings.
Nov 15.  Patient grew weaker all day yesterday, could not retain nourishment.  Died 4:50 a.m. this morning.


History and clinical notes:
History: Friends state that he has always been more or less weak minded, but he has kept at his work and has not been troublesome until about 1 week ago when he neglected his work and would not speak to anyone, although he has once or twice threatened those around him.  Has lost flesh and has not taken much nourishment.  Sleeps good at night.

Sep 1, 1899.  Remains in his room during the day, will not speak to anyone, lies on the bed and occasionally will not eat.
Sep 15.  Still refuses to talk and prefers to be by himself.
Oct 1.  Some little improved, is eating well now, will talk occasionally and is gaining flesh.
Oct 20.  Gradually improving, is getting stronger, rests well at night and very much improved.
Nov 20.  Has good health, [ill.], and very orderly.  Patient has remained about one condition mentally.
Sep 18 (1900?).  While playing with another patient, the other patient through this patient on the floor and fractured the neck of glenoid cavity of scapula.
Oct 8.  Very much improved mentally and shoulder doing well.
Aug 12, 1901.  Patient at times taciturn and morose, at others, grins foolishly and is more talkative.  Speaks of no one every coming to see him and of wanting to go back down there.  At times is irritable.  A month ago having hit the hand of an attendant who was trying to quiet him.
Aug 23, 1903.  About one month ago began complaining of headache and back ache, with other symptoms of Typhoid.  The Widal test confirmed the diagnosis.  Patient has gone through an atypical course of Typhoid and is now well on the road to recovery.  Mental condition no better.  Talks but in an irrational manner.
Feb 11, 1904.  Has been in bed for past two days, complaining of headache, tongue is coated, foetid breath and bowels very much constipated.  Placed on liquid diet.

Additional notes:
Lab slip attached with results of positive Widal reaction (for Typhoid).  Dated 7/28/1903.  From Pathological and Bacteriological Laboratory of the Delaware State Board of Health.  Fredk. D. Chester, Director.


History and clinical notes:
History: Has been peculiar since childbirth.  About 4 months ago began to get much worse.  Has several times threatened suicide and says she has nothing to live for and that she might as well be out of the way.  Very melancholy for past few months and has delusions peculiar to melancholia.  Is gradually growing worse.  Has lost flesh, appetite is fairly good, has had some trouble in sleeping.

Sep 28, 1899.  General health has improved somewhat; patient is not so nervous and sleeps much better; appetite fair.  Does not seem nearly as depressed as she did at first.
Oct 26.  Very little change in patient’s condition; general health fair, does not seem as nervous as at first, but otherwise mental condition appears unchanged.  Appetite fair and sleep fairly well.
Jan 19, 1900.  No improvement in patient’s mental condition and seems very much depressed; keeps by herself and seldom speaks unless directly addressed.  General health fair, although patient complains of feeling weak.  Has been on Tonic. PeptoMangan. For some time.
Apr 14, 1900.  Was allowed to go home on parole.
Sep 20.  Discharged improved.


History and clinical notes:
History: In 1890, four months after child was born, was very melancholy, neglected her work and had delusions of persecution.  For about 5 months she began to get better and has remained well until about 2 weeks ago.  Would not sleep, talked irrational at all times.  Is gradually growing worse.  Is pregnant about 8 or 8.5 months.  Is very restless.  Eats well, but at times neglects her work and will wring her hands, etc.  Has steadily lost flesh.
Sep 25, 1899.  Mental and physical condition very little changed.  Patient eats and sleeps well, but still labors under the same delusions.
Oct 26.  Delivered of a male child at 1:30 am.  Labor very short, otherwise normal.  Uterus well contracted, lochia normal.  Patients is now resting comfortably.
Nov 13.  Was taken home by husband today on parole.
Mar 23, 1900.  Discharged recovered.


History and clinical notes:
History: Hackman brought patient to hospital and knows nothing whatever of patient’s history or condition.
Sep 25, 1899.  Patient is very restless, wandering up and down ward, attempting to get out of every door, frequently requires some light restraint to prevent her removing her own or others’ clothing.  Her physical health has improved, but still suffers with many delusions.
Oct 25.  Patient fell a short time ago, inflicting a cut over right eyebrow, which however healed by first intention (without granulations).  Somewhat improved in general health, appetite good and sleeps well as a rule.
Jan 14, 1900.  Is gradually growing more feeble and tottering although she is up and about.  Still destroys her clothing at times.
Jan 19.  General health fair; has gained in flesh and has good appetite, but no improvement in mental condition.  Still controlled by many delusions.
Feb 25.  Patient much weaker; heart action very poor, confined to bed; appetite remains good; feet, hands, and face considerably puffed; urine highly albuminous; is taking Basham’s mixture.
Mar 5.  No improvement; oedema still very marked; heart action very weak; radial pulse 42-44, weak and irregular.  Mitral murmur marked.  Given Digitalis and Strophanthus t.i.d. and occasional doses Spt. Am. Arom. (aromatic spirits of ammonia).
Mar 15, 1900.  No change in patient’s condition until this p.m. when heart’s action became suddenly very much worse and she died in a few minutes at 2:30 p.m.  Appeared as usual in morning and took a good meal of bread and milk about 1 pm.


History and clinical notes:
History: The friend who brings patient states that the first symptoms occurred about July 4, 1899, but it is only about 1 week since he has got bad.  Has delusions of persecution and imagines that these people are after him and has threatened to kill them, but has mentioned no names.  Does not sleep much at night.  Eats well.
Aug 15, 1899.  No improvement; believes that he will soon be killed and is depressed at times.
Aug 30.  No change.
Sep 20.  Still has delusions of persecution, masturbates considerable.
Oct 5.  No improvement.
Jan 15, 1900.  No change mentally, still depressed with some few delusions.
Apr 28.  Has steadily improved and was allowed to go on parole.
Sep 20, 1900.  Discharged recovered.

Additional notes:
Committed suicide 12/10/1932.  Shotgun wound to face.  Buried in Head of Christiana Cemetery in Newark.


History and clinical notes:
History: First symptoms was noticed about 1 year ago; began to run around after men when her disposition was otherwise.  A short time after this was found to have contracted syphilis – what from and to what extent father does not know.  Has been treated by Dr. Elbert.  Runs away from home and father cannot control her.
Sep 25, 1899.  Patient has been put upon Anti-Syphilitic treatment and physical health has improved.  On admission complained of pain in legs and severe night sweats, both of which have improved and patient says she feels very well.  Is very intractable at times and causes the attendants considerable trouble.
Oct 24.  Patient escaped from the ward tonight about 6:30 p.m. and returned about 8:30 p.m..  Said she had been about the grounds and had spoken to no one, until found by one of the attendants.
Nov 2.  Was removed today by father on parole to attend funeral of her sister Annette.
Mar 23, 1900.  Discharged improved.


History and clinical notes:
History: Symptoms of insanity were noticed about one month ago when be began to wander away, talking on religions and said he was going to build some houses.  Shortly after admission was restrained; very noisy and violent.
Sep 20, 1899.  Some quieter, appetite good and rests better at night.
Sep 25.  Restraint removed, allowed the use of wards and is not hard to control.
Oct.  Very much improved, is orderly and works on the wards.
Nov.  Still improving, health good.
Dec.  Is anxious to go home.
Jan 2, 1900.  Was allowed to go on parole this a.m.
Mar 23, 1900.  Discharged recovered.


History and clinical notes:
History: 1876 Patient was injured on the streets of Phila by a wild steer.  He was picked up unconscious and taken home.  About six months after, epilepsy developed and has had convulsions since.  He is noisy, violent, talks incoherent and tears his clothes.
Sep 30.  Very much improved although still restrained.
Sep 15.  Has convulsions very often and is very untidy (note out of order date).
Oct 1.  No change.
Nov 1.  Very untidy and occasionally very maniacal.
Nov 30.  No improvement.
Jan 15, 1900.  Has convulsions often, is very much demented and obstinant; appetite good.
Sep 18, 1900.  Removed on parole.
Mar 13, 1901.  Returned
Jun 5.  Fits have been more frequent of late with patient correspondingly depressed.  Was given KBr which caused excitement as it has on former occasions.  Occasionally soils clothes.
Aug 12.  Fits [ill.] occurred 2-5 a week; Has been quiet for 6 weeks past.  
Sep 15.  Was given KBr as above; no excitement or other apparent result.
Oct 1.  Unclean at times, very ugly temper, very demented.
Oct 15.  Vomits after each meal, no apparent cause.
Oct 23.  This evening Attendant Brennan called attention to swollen and discolored right arm, which was found with fractures of humerus 5” below acromion.  Swelling and discoloration moderate.  Upper end lower fragment to mine sill and posterior (??).  No crepitus obtainable.  No disturbance of circulation or apparently of sensation offhand.  Tenderness and pain marked at injury site, causing [ill. words] Arm bone dayed to axilla padded with splint and felt, shoulder cap applied and arm bound to body.  Sling to forearm.
Oct 25, 1901.  Plaster Paris cast applied from hand to shoulder, elbow at slight less than right angle, forearm semi-pronated.  Moulded splint on shoulder cap.  Arm bound to body.  
Nov 15.  Patient very stupid and demented.
Nov 27.  Cleaner and quieter.
Dec 2.  Patient untidy and noisy.  Plaster cast reapplied.  Apparently good union with log and callus (??).
Apr 15, 1902.  Good physical health.  Vaccinated.
Jan 25, 1903.  Sulky and at times troublesome.  Cleanly habits, sleeps fairly well.
Aug 21, 1903.  Very stupid.  Takes little notice of surroundings.  Has occasional epileptic seizures.  Very irritable.  Untidy in dress and eats at table by himself.  Sometimes tears his clothing.  Untidy habits at night.


History and clinical notes:
History: First symptoms of insanity noticed about 8 weeks ago.  Began to talk incoherently and frequently became very melancholy and did not seem inclined to talk.  Says she hears people telling her to do certain things.  During last 5 or 6 weeks has been growing worse.  Lately has slept but little and has a poor appetite.  Steadily losing flesh.  Is quite hard of hearing.  Is very violent.
Sep 26, 1899.  Was removed by her son today, who was not satisfied with the accommodations.  Was placed on parole.
Mar 23, 1900.  Discharged improved.


History and clinical notes:
History: Patient has had attacks of depression lasting from a few days to a week, for a number of years and has always drank very hard.  About four weeks ago he attempted suicide by throwing himself down the cellar and would go to bed with a knife under his pillow.  Yesterday he drank some bluing, also tried to drink some ammonia.  He believes that there is someone always talking about him and at times would go to the door saying that there was a man there to see him.
Oct 1, 1899.  Very suicidal and tries to injure himself in various ways.
Oct 15.  Has been restrained and tied to chair for some time past; uses profane language and at times noisy.  
Nov 30.  Curses most all the time, saying “Let me out you S.B.s (sons of bitches??), let me out.”  Alternating with “Cut my throat.”
Jan 15, 1900.  No improvement.  Still restrained, is noisy at times, and handles his privates most all the time.
Jun 10, 1901.  Wears belt and wristlets constantly.  Makes infrequent violent attacks on attendants.  Assists in polishing floor.  Is always quiet at time of rounds.
Apr 15, 1902.  No change.  [Ill.] today.
Aug 21, 1903.  Conduct good.  Obedient and respectful.  Good health.

Final disposition:
Still in hospital; died at DSH 4/11/1932.


History and clinical notes:
History: Has been a very hard drinker some two months; had a fight on the street and was severely beaten, sustained injury to head and has been peculiar ever since.  This a.m. attempted to kill his wife.
Sep 27, 1899.  Very noisy and refused to obey the attendants and was bruised some in resisting to take bath.
Oct 6.  Very much improved.
Jan 15, 1900.  Very quiet and orderly, gradually losing flesh.
Feb 12.  No improvement mentally.  Losing flesh very fast.  Was allowed to go home today.
Sep 20, 1900.  Discharged improved.

Small note on lined paper embossed with “Miami Valley.”  “Aunt Lizzie, Mama wants papa to come home and wants me to go over for him tomorrow.  I wish you could go with me, we are talking of getting a team.  Please answer and oblige, your niece, [name redacted] Wilmington City

Additional notes:
Letter about relatives getting a team to go retrieve him because Mama wants him home.


History and clinical notes:
History: People who brings patient to hospital knows nothing of his history.  Probably weak minded from birth; has good health.
Nov 30, 1899.  Very orderly and quiet, mind feeble.
Jan 15, 1900.  Very orderly, health good.
Jun 10, 1901.  Orderly and quiet; good health; mind feeble.
Apr 13, 1902.  No change.  Vaccinated today.
Mar 31, 1903.  Conduct good.  Does considerable work around the ward.  Mental condition unchanged.
Aug 21, 1903.  No change.  Very weak minded.


History and clinical notes:
History: In 1886 had an attack of congestion of brain.  First symptoms of insanity was noticed about 10 years ago.  Since then, has had five attacks.  The last attack started about 2 weeks ago, talked incoherently, prayed and talked a great deal.  Is steadily growing worse.  Has lost flesh and strength.  Has choked her nephew and threatened to kill him.  Appetite is very poor.
Oct 26, 1899.  Patient has been very noisy and restless ever since her admission, requiring medicine to quiet her sufficient to get any rest and restraint to keep her from injuring herself or others.  Has a very poor appetite but sleeps fairly well.  Talks almost incessantly, mostly upon religious subjects, at times becomes quite violent.
Jan 10, 1900.  Has steadily improved for past month and is now on Ward A.  Is rational and has gained flesh and strength.
Jan 18, 1900.  Was removed today by sister on parole.  [Ledger say ’99, but that is incorrect].
Mar 23, 1900.  Discharged recovered.


History and clinical notes:
History:  Has been drinking very hard for the past few days, is very nervous, restless, excitable, and noisy.  Was given hypodermic.
Oct 26.  Rested well all night, is quiet and orderly.
Oct 27.  Very much improved.  [Ledger say Nov 27, but that is incorrect].
Oct 30.  Transferred to Ward C.
Nov 3.  Was allowed to go home with mother this am.
Mar 23, 1900.  Discharged recovered.


History and clinical notes:
History: Went home on parole 6.24.99 and has been getting along very nicely until a few days ago when he became noisy, violent, and destructable.  
Nov 15, 1899.  Very much improved, quiet and orderly, works on the farm.
Nov 30.  Very much improved, orderly and works on the out side.
Jan 15, 1900.  Very much improved.
Jun 10, 1901.  Quiet, orderly, works on farm, reads paper.
Apr 15, 1902.  No change.  Vaccinated today.
Dec 30.  Some improvement.
Jan 25, 1903.  Quiet temperament.  Cleanly habits.  Sleeps well and is a good worker.  Convalescing from fractured ribs sustained by being his by [another] patient.
Aug 21, 1903.  General health.  At present, patient talks quite rationally.  Has infrequent maniacal attacks during which he is very destructive, restraint being required.  At times talks of the most fabulous amounts of wealth.
Nov 4, 1903.  For the last 2 month has been very quiet and rational.  Today was taken away by son on parole.
Feb 20, 1904.  Returned today, quiet but talk irrationally.
Feb 29, 1904.  Has “delusions of grandeur” advises the M.D.s of DSH to invest in real estate and say he will advance the money.  
Feb 6, 1913.  Is usually quiet, eats and sleeps well.
May 15, 1914.  Has a very rapid and irritable heart, complains of pain and shortness of breath, confined to bed.
Jun 1, 1914.  Rapidly growing weaker, pulse feeble, extremities cold and cyanotic.
Jun 4, 1914.  Died of acute endocarditis.


History and clinical notes:
History:  Has been in New Castle Co. Alms House for the past three weeks; is untidy; can’t feed himself and mind has been affected since birth.  When patient was 4 years of age was hit on head by a baseball bat and from that time until present has had epilepsy.  About 1 year ago had a severe hemorrhage from nostrils and after this was paralyzed.  Brain is gradually failing.
Nov 12, 1899.  Had a number of convulsions and appeared to be dying.
Nov 13.  Some improved.
Nov 15.  Very much improved but confined to bed.
Nov 22.  Still improving.  
Nov 30.  Still confined to bed and is gradually losing flesh.
Jan 15, 1900.  Some improved physically, mind no change.
Mar 10.  Has been failing, steadily losing flesh.  Eats only liquid food.  Is very noisy at night.  Has become so emaciated that bed sores have appeared wherever body presses bed clothes for any length of time.
May 1.  No improvement.  Bed sores extending in spite of care and attention.  Has wasted to skin and bones.  For past few days pulse has been at times as high as 180, temperature at times 103 and 104.
May 8, 1901.  Visited by mother today who removed him by Phoenix Ambulance.
May 8, 1901.  Discharged unimproved.

Note: Seems to be some confusion about the dates, correct date is May 1901.

Additional notes:
According to online Delaware Death Records, he died 5/9/1901 of paralysis


History and clinical notes:
History: Sister states that for the past 8 years has at times suffered from what appeared fainting spells and all muscles were involved – so much so that he has been unable to work.  Has been in Hospital in Baltimore for past 6 years.  Is much more reticent than formerly and is more childish in his manner and actions.  General health is good and usually sleeps good.  Sleeps a great deal during the day.
Nov 10, 1899.  Very quiet and orderly.  Allowed to go where he desires.  No symptoms of insanity.
Nov 20, 1899.  Was allowed to go home today.
Mar 23, 1900.  Discharged improved.

Note: perhaps drop seizures?


History and clinical notes:
History: Had a stroke of apoplexy 1 year ago and has not been able to do much since.  Has been quiet usually but this morning became violent and began to break furniture in his wife’s house.  Officer knows but little of details of history.
Nov 30, 1899.  Mind very feeble, has some delusions on religion.
Dec 15.  Mind some feeble, works on wards, health good.
Jan 10.  No change mentally.
Mar 15, 1902.  Has not improved any since last note, removed by friends today.
Dec 27, 1902.  Discharged improved.


History and clinical notes:
History: Officers who bring patient know nothing of her history.  Patient was first admitted Dec 4, 1897 and discharged recovered June 12, 1898.  Cause at preliminary admission was domestic trouble.
Mar 23, 1900.  Discharged improved.


History and clinical notes:
History: Was discharged from Hospital improved Feb 12, 1898.  About two months ago symptoms of insanity returned.  She is very much depressed at times; desires to leave home.
Dec, 1899.  Patient has been quiet and orderly ever since her admission.  Helps in the patients’ dining room and though quiet does not seem much depressed.  Physical health good.
Jan 19, 1900.  Not much change in patient’s condition since last note; has never given any trouble since her admission and seems in good general health.
Jun 13-16, 1900.  Home on visit.  Became excited and was returned to Hos.
Jun, 1900.  At times, patient seems very much depressed, but as a rule says she is well and seems quite happy; assists in light work about the ward.  General health good.
Sep 22.  Patient has failed somewhat in general health, occasionally complains of feeling tired, seems listless, has a rather poor appetite and has lost flesh.  At times seems very much depressed and at others quite excited.  Sometimes refuses to speak to her husband when he comes to see her, believing he has treated her badly.
Feb 1, 1901.  Pat. is pregnant (8.5 months?) – complains of feeling badly at times; suffers from frequent nausea, vomits meals occasionally, is quiet and orderly; sleeps a good deal and is very biddable.  Ordered [illegible names of medicines and doses, included nucis vomicae] t.i.d.  Occasionally stays in bed a day.
Mar 3.  At 9:30 a.m. Female baby delivered.  Labor normal.  Pat. In pain from 4:30 to 9:30 considerable postpartum hemorrhage controlled by position and Ergot however.
Mar 8.  Baby and mother doing well.  Following confinement mother brightened up considerably – able to resume her work in ward but very feeble minded.  Easily confused and upset.  Baby was taken away early in April by husband, lived until July when died from effects of heat (?).  Mother never asked after it, never seemed pleased to see her husband or father, never expressed least desire to leave.
Apr 17, 1902.  No change mentally or physical since last note – works in patients’ dining room willingly and continuously.  Kind and good with sick patients, feeding them carefully when asked to do so.  Vaccinated April 15, 1902.
Jul 30.  Condition unchanged; helps in head dining room, occasionally singing at top of voice.  When spoken to has difficulty in finding an answer.  Smiles, tries to frame a sentence and ends with a semi-vacant smile.
Sep 23, 1903.  Has occasional outbreaks and has had to be transferred from Ward B to Ward 3 on several occasions.  Has lately lost some weight without apparent cause.  Usually respectful and obedient.
Feb 19, 1904.  Transferred again to Ward III because of lying around on sofas all day, refusing to work or sit up.  Has lost flesh, but otherwise generally physical condition good.  Very quiet.
May 2, 1904.  Condition the same.
Aug 20.  Patient lies around all the time, complains of pain in stomach and nausea.
Sep 17.  Very emaciated.  Color yellowish white, refused to eat or take any exercise.  Nauseate all the time.  Vomits food one hour after eating.  Very dull mentally.
Sep 28.  Patient fed by tube, vomited immediately.  Much mucous and blood.  Washed out stomach, more mucous and blood.  Feeding on predigested [ill.] every two hours, peptonizer milk and whiskey.
Sep 30.  Patient very low.  Mind clear.
Oct 3.  Fr. Campbell summoned administered Sacraments.  Husband, daughter and father visited patient.  Morphia given at 10 p.m.  Patient in intense pain reflected to back.
Oct 4, 1904.  Died at 3:45 a.m.  Carcinoma of the stomach.

Additional notes:
Husband took baby away, it supposedly died of the heat.


History and clinical notes:
History: Officers know nothing of her history.  Husband died at New Castle Co. Alms House, July last.
Dec 7, 1899.  Has been very restless and excited since she came here.  Has been in restraint sheet and has kept her limbs moving so much that she has irritated skin on both limbs.  Will not eat at times and attempts have been made to feed her with tube, but she has regurgitated everything that is given her.  Talks incoherently incessantly.  Brother-in-law visited her today.
Dec 15.  No improvement in patient’s condition.  Is somewhat more quiet but still incoherent in speech; large bed sore on back cause by constant friction; other abrasions are healing well.
Dec 18.  Patient is very weak, [ill.] on teeth, tongue heavily coated, conscious but still incoherent in speech.
Dec 20, 1899.  Has failed rapidly since last note and died this 9:45 p.m.


On certificate of:
Drs. David Stewart and Peter W. Tomlinson

History and clinical notes:
History: Patient has been around New Castle for some time and has been laying out in lots and once in grave yard all night.  A letter from her brother-in-law [name redacted] and Dr. John J. Black asks that she be cared for in this hospital as she is mentally unsound.  He states that she has been in New York for some time giving music lessons and her friends did not know that she had left.  Some years ago was committed to the Trenton Insane Asy. and improved so much that she was removed.  
Dec 2, 1899.  Went to Del. Hospital today to prepare for operation on breast.
Mar 23, 1900.  Discharged improved.

Note: Accompanying letter on note paper with bishop’s miter and the words “Bishopstead, Wilmington, Delaware” printed at the top.  Dated (appears to be) Dec 15th, 1899.  “My dear Dr. Hancker, Referring to my conversation with you this afternoon upon the subject of the removal of Miss [name redacted] from the Delaware Hospital of this city, I beg now to say that, upon the understanding that you give her the ordered parole from the Delaware State Hospital at Farnhurst, I am writing to make myself responsible for her during the continuance of the parole exonerating you and the Board of Trustees of the Hospital at Farnhurst from any blame that may attach to her by reason of her conduct in the meanwhile.  Yours faithfully, [name redacted]”

Final disposition:
Discharged improved -- sent to DE Hosp. for operation on breast.

Additional notes:
Vouched for by someone from Bishopstead in Wilmington, DE following operation at DE Hosp.  According to online Delaware death records, she died at SDH Farnhurst 6/19/1900 of heart disease, specifically aortic stenosis.


History and clinical notes:
History: Officers who bring patient know nothing of her history.  Was brought about 10:15 p.m. with irons on her feet and a camisole on with hands tied behind her.
Dec 3, 1899.  Patient had hypodermic of hyoscine gr 1/75, and rested quietly all night; next day considerably depressed, but no return of excitement.
Dec 15.  Patient very quiet and orderly, assists in work about the ward and seems bright and pleasant; expresses no delusions and converses rationally.
Dec 23.  Taken out by husband on parole.
Mar 23, 1900.  Discharged.


History and clinical notes:
History: Patient was over come with heat while picking tomatoes last September and has been peculiar since that time.  He would wander around from place to place very much depressed and desired to be by himself.
Dec 8, 1899.  Has refused to eat since admission and was fed with tube.
Dec 9.  8:30 am tubed.  Talk incoherent and is very obstinant.
Dec 20.  No improvement, very much depressed, will not talk to any one; is fed with tube three times daily.
Jan 15, 1900.  Losing flesh, still refuses to eat, very much depressed.
Feb 15.  Gradually getting worse.
Mar 15.  Still refuses to eat, very thin and emaciated.
Apr 10.  Very much depressed; still fed with tube, still very thin.
May 15.  No change for better.
Jun 10.  Very feeble and emaciated; still fed with tube.
Jul 15.  So weak that he can’t walk.
Aug 1.  Gradually getting worse.
Aug 29, 1900.  Died this a.m.


History and clinical notes:
History: For history, see case book 3, page 36.  Symptoms of insanity returned about 60 days ago, when he became noisy, violent, and restless, wandering from place to place and talking incoherent.
Jan 1, 1900.  Very noisy, talks incoherent and is very troublesome.
Jan 15.  No improvement, very restless and excitable, talking on various subjects.
Feb 15.  Has improved and was allowed to go home.
Sep 20, 1900.  Discharged recovered.


History and clinical notes:
History: About one year ago patient had La Grippe and has been very peculiar since.  He has attacks about once a month and wanders from place to place talking religion, and will go in people’s houses and pray.  The neighbors are afraid of him.
Dec 25.  Patient is very orderly at times, some depressed.
Jan 10, 1900.  Gradually improving, appetite good, sleeps well at night.
Feb 28.  Was allowed to go home on parole.
Sep 20, 1900.  Discharged recovered.


History and clinical notes:
History: Patient has been drinking very hard and was taken to hall and attempted suicide by hanging.  Was very delirious when admitted.  Given Hyoscine and restrained.
Dec 31, 1899.  Very much improved, talks rational and all symptoms disappeared.
Jan 6, 1900.  Allowed to go.
Mar 23, 1900.  Discharged recovered.


History and clinical notes:
History: Officer who brings patient knows nothing of his history.  Patient states that he has been drinking very hard and is nervous.
Dec 31, 1899.  Had a quiet night, very orderly.
Jan 11, 1900.  Went home today.
Mar 23, 1900.  Discharged recovered.


On certificate of:
Drs. H. Clay Stevens and Henry R. Spruance

History and clinical notes:
History: Patient has been drinking very hard for the past three weeks.  About three days ago, he became nervous and delirious, saying that snakes were after him and some one was in the room to kill him.
Jan 1, 1900.  Had very restless night.
Jan 2.  Not so nervous, rested well last night.
Jan 4.  Very much improved, rests well, appetite good.
Jan 10.  Was allowed to go home with sister.
Mar 23, 1900.  Discharged recovered.


History and clinical notes:
History: About six months ago symptoms of insanity were first noticed when she began tearing her clothes, wandering around, mind feeble, etc.
Jan 19, 1900.  No improvement in patient’s condition.  Mind very feeble, incoherent in speech; is very untidy and destructive and has to have wristlets on the most of the time to keep her from removing her clothing.  Physical health fair; appetite good.
Feb 3, 1900.  There was no change in patient’s condition until this morning, when shortly after breakfast she became very weak, was put to bed and stimulants administered; almost pulseless in a few moments and died shortly afterwards.


History and clinical notes:
History: Officer who brings patient says she has relatives in Dover but that he does not know their names.  He knows nothing of her history.
Jan 19, 1900.  Patient has improved slightly in general health since admission; complained by backache and headache, puffiness about eyes, etc.  Urine contained albumin, no casts found.  Appetite fair.  Patient rests pretty well at night.  Mind feeble.
Feb 15.  Patient has not improved; feet and hands very much swollen; also very marked puffiness about the eyes; complains considerably of backache; has been taking Basham’s mixture, appetite good but says she sleeps poorly.
Mar 15.  Feet and legs very much swollen; albumin abundant in the urine; patient feels weak and complains of pain in back and legs.
Mar 26, 1900.  Has steadily failed.  Face and limbs continue to swell since last note.  Died this morning, unconscious at 10:30 a.m.


History and clinical notes:
History: Has been a prostitute for years; insanity was first noticed about 4 months ago when she began wandering from place to place.
Jan 17, 1900.  Patient has been in miserable physical conditions – has slight cough, with expectorations at times, and since admission has vomited the greater part of nourishment and medicine; is very weak and anaemic; put upon Pot. Iodide and Iron, Arsenic and Strych.  Has many delusions, and at time is quite noisy. 
Jan 19.  [Ill.] to persistent vomiting.  Discontinued Pot Iodide and put on milk diet; patient is feeling somewhat better today and vomiting seems to have stopped; no change in mental condition.
Feb 15.  Patient has improved in physical health.  Was found to has been accustomed to use of Spts. Ether Mixt. morphine and spirits.  Was given malt extract and also allowed Spts. Ether Mixt. t.i.d.  Vomiting ceased and patient commenced to improve.
Mar 15.  General health considerably improved although patient still in bed; has good appetite and gained in flesh; no improvement in mental condition; very restless and noisy, especially at night.
Jun.  Very little change in patient’s condition since last note.
Sep 22.  Patient still very restless and noisy almost all the time, having to be kept constantly in restraint, and requiring Chloral Mixt. almost every night to quiet her and give the needed rest.  General health somewhat better, but patient still very thin and anaemic.
Feb 1, 1900 (1901??).  Health better – has been out of restraint some time; does not tear her clothes, no hypnotics for over a month; occasionally noisy and untidy at night, but as a rule sleeps well and is quiet.  Works on ward.  Answers questions pleasantly but no improvement in mental state other than that noted.
Feb 11.  Transferred from Ward 5 to B.
Mar 8.  Has improved considerably; works on ward, seems cheerful and contented.
Mar 27, 1902.  Visited by friends who give her history as follows: lived in Wilmington only few months, going backward and forward to Philadelphia.  Over four years ago had delusions of grandeur.  Acted in hysterical manner, imagined her father was wealthy; she herself had ten thousand dollars.  Addicted to use of nitre even then.
Apr 17.  Mentally and physically no change.  Vaccinated April 15.
Jul 30.  Condition stationary.  Very irritable to other patients; makes fun of their peculiarities; at times chatters continuously, laughing to herself.  Physically in good condition except callous place on undersurface great toe – this she has caused to become very much irritated by digging at it with a pin on every occasion.  Most of the time on ward 3, as she is so noisy and talkative she disturbs quiet patients.
Sep 23, 1903.  Confined to bed.  Movement incoordinate.  Delusions of grandeur.  Pupils unequal.  General paralysis.
Feb 19, 1904.  Condition unchanged.  Lies in bed all day and is very cheerful.
May 2.  Condition both mental and physical, the same.
Jun 20.  Patient has been failing for some time.  Vomits all she eats.
Jun 21.  Vomiting bile.  Eats nothing; asks for whiskey; cannot speak, breath extremely foul.  Bed sores on back.
Jun 23.  Sinking rapidly.  Unconscious.
Jun 24, 1900.  Died, 9:10 a.m.  Note that two letters were sent to her brother in Norristown; “Written to June 17, 1904 that she was failing fast; second letter sent notifying of death on June 24, 1904.  Both letters returned unclaimed.”

Additional notes:
Buried at DSH, Grave #48.  Two letters sent to brother notifying him of her death were returned unclaimed.


History and clinical notes:
History: Had had epilepsy since he was two and one half years of age and mind has been feeble for the past 15 years; has not done any work for the last eight years.  About nine weeks ago he had a severe fall, cutting his head and face in several places; has lost flesh and is very feeble.  About 10 days ago he began talking very incoherently.  Has not had any convulsions for the past three week.  Pupils widely dilated on admission.
May 8, 1900.  On parole.
Feb 15, 1902.  Discharged unimproved.


History and clinical notes:
History: First symptoms were manifested about 12 years ago and has had about 8 attacks since this time.  During these attacks wanders from home.  Frequently has threatened to kill her husband and children.  Last attack has lasted about 2 years and she has steadily grown worse; wanders from home, neglects her work, threatens those around her.  Very melancholy at times and will not speak to anyone.  Lately has no appetite and will not eat; frequently walks around the room at night.  General health failing.
Jun 9, 1900.  Home on parole.
Sep 20, 1900.  Discharged improved.
Note: Readmitted in December, 1902.  #43411438

Additional notes:
Readmitted in December, 1902.  #43411438


History and clinical notes:
History: Patient was admitted very delirious from alcohol.
Feb 4, 1900.  Very much improved, but has symptoms of phthisis.
Feb 15.  Losing flesh; severe cough and hectic fever.
Mar 1.  Gradually getting worse.
Mar 15.  Night sweats, diarrhea, persistent cough with mucous and pus loaded with bacilli tuberculosis; losing flesh very fast.
Apr 1.  No improvement.
Apr 11.  Removed to friends home in Wilmington.
Sep 20, 1900.  Discharged recovered.


History and clinical notes:
History: First symptoms of insanity were first noticed about 4 weeks ago; and is gradually getting worse, he wandered from place to place and etc.
Mar 11, 1900.  Mind very feeble, has been very untidy for the past few days and confined to bed.
Mar 13.  Still confined to bed.
Apr 6.  Has improved and removed today.
Sep 20, 1900.  Discharged improved.


History and clinical notes:
This man, and next two, seem to be brothers, all MR from birth, all admitted on same day, 10 days after the death of their mother.

History: Patient has been weak minded from birth.
Mar 13, 1900.  No change, health good.
Apr 1.  Good health, is tidy and orderly.
Apr 15.  No change.
Apr 28.  Complains of pain in left side; tongue coated, rise of temperature.
Apr 30.  All symptoms of lobar pneumonia of left lung.
May 2.  Rapid pulse, respirations hurried, rise of temperature, tongue dry and parched.
May 3.  Gradually getting weaker.
May 4.  Extremities cold, pulse 140, respirations 50, tongue thick and boardy (?).
Apr 5, 1900. (May 5?).  Died 1:15 p.m.


History and clinical notes:
History: Has been weak minded since birth; is harmless; can hear but can’t talk.
Mar 13.  No improvement; health good.
Jul 18, 1902.  Has been a diligent worker in the laundry since admission.  Very rarely ill.  Complains at times of a cough.  Today after coughing for two days, developed a temp of 102.2 and was put to bed.  There are some rales throughout of a dry crackling type, most marked at bases posteriorly.
Jul 20.  T.P.R. this a.m., 105-126-40, no dullness; expiration equal throughout.  Noisy throat breathing which obscures breath sounds.  Numerous rassy (?) dry rales all over chest, most marked on [several illegible words] and good throughout.  Takes nourishment well.
Jul 24.  Patient much better today.  Is unruly and will not stay covered.  Very little cough.
Jul 25.  Cough worse, temp and resp. higher.  Is somewhat cyanosed.  
Jul 28, 1902.  Very untidy for two days past, temp varies from 101-104 degrees, breathing rapid, 40-56, and labored.  Numerous fine moist rales throughout.  Slight dullness over several areas.  Died today at 12:45 p.m.


History and clinical notes:
History: Has been weak minded since birth.  Can not talk.
Mar 13, 1900.  No improvement; health good.
Apr 15, 1902.  Has enjoyed good health and been fair worker since last note.  Has complained of sore throat all day.  This p.m. vaccinated.  Temp found to be 104-140-30.  Isolated to Room 3 Ward C.
Apr 16.  Transferred to Ward D, Room 8 and too late to Ward VI (?) having developed pink macules and papules with slight nucleation on forehead and face.  Complains only of throat.
Apr 17.  Papules slightly more numerous.
Apr 18.  Eruption increasing in extent and number of lesions, moderate erythema of face.
Apr 19.  A few vesicles, nucleation marked.  A few vesicles on velar palate.  Patient bright and comfortable except for throat.
Apr 20.  Vesicle small, largely umpilicated (?), most on face, numerous lesions on soft palate.  Patient comfortable.
Apr 21.  Pustulation marked on face, partially on body and limbs.  Cheerful.
Apr 22.  Somnolent, complains of face and forehead.  Face and forehead almost covered by matured pustules in which desiccation is beginning.  On remainder of body rapidly becoming pustular.
Jun 4.  Returned from County Emergency Hospital.  Very weak, unable to walk.  Large sacral bed sore down to periosteum.
Jun 18.  Large cavity containing foul dark liquid containing dark sloughing flesh shreds over blade of left scapula.  Bed sore rapidly peeling [ill.] of normal granulations.
Jun 21.  Left leg swollen.
Jun 24.  Noisy, swallows with difficulty, very weak and emaciated, abscess still foul and discharging.  Swelling of left leg about the same.  There is moderate edema throughout and distension of the superficial view on the upper [ill.] of the thigh.
Jun 26, 1902.  Died at 6 a.m. today.


History and clinical notes:
History: Husband states that she has been married to him 10 years and that she has had attacks of insanity about every two years since that time.  She begins to neglect her work and at times will not speak, will get up at night and go out of the house in night clothes.  All attacks have been characteristic of melancholia.  During attacks will not eat and is steadily losing flesh.
Apr 14, 1900.  Allowed to go home on parole.
Sep 20, 1900.  Discharged improved.


History and clinical notes:
History: Patient was first admitted Nov 1893.  Discharged recovered April 1894, from use of morphia and chloral.  Has been drinking very hard for the past month, pawned his clothes, watch, and etc. and was arrested in New York for drunkenness.
Aug 7, 1900.  Allowed to go home on parole.
Sep 20, 1900.  Discharged recovered.


History and clinical notes:
History: Patient was insane number years ago in Penna Hosp for insane, suffering from melancholia and attempted suicide by cutting his throat, but was not successful.  Discharged recovered after 8 months treatment.  Symptoms returned a few days ago when he became very much depressed, saying that every body was down on him, that he had sinned and etc.
Jun 22, 1900.  Allowed to go on parole.
Sep 20, 1900.  Discharged improved.


History and clinical notes:
History: Has had epilepsy for the past 12 years, at times was very hard to control, mind feeble, appetite good.
Aug 1, 1901.  Left side growing progressively more paretic.
Aug 10, 1901.  Complains of soreness of muscles of body and limbs.  Temp 101.  Pulse 100.  Resp. 24.  No discernable cause.  To bed.  Milk and toast.  [Illegible words – looks like “colored purge”].
Aug 11.  TPR 8 a.m. 100-90-25.  Soreness persists.  No cough or [ill.].
Aug 12.  Complains of sore tongue.  No signs of injury.,  Soreness of limbs and body persists.  Physical exam neg except for left sided paresis.  [Illegible words – some sore of medicine, perhaps?] gr XV tid.  Bed.  Milk diet.  TPR 101-86-28.  
Aug 21.  Dr. Robin reports Widal reaction positive from a several day sample of blood [typhoid].  Patient continues slightly constipated.  No especial tenderness.  Headache is less.
Aug 22.  Temp 100-102.  Patient comfortable; constipated; a few sore spots – hypochondria.  Spleen not palpable.  Patient suffers more from having no tobacco than anything else.  Rx milk diet.  Sponge for temp 102.3 every three hours.  Quinine gr iii t.i.d.
Sep 1.  Temp never above 102.  Always constipated.
Sep 7.  Convalescent.  TPR normal six days.  Milk toast and eggs.  Left side gradually growing more paretic.  Livers (?) fit two days ago.
Sep 18.  TPR normal [ill.] diet.  Has repeated abortive or petit mal attacks.  Has occasional grand mal, one last night.  Is confused, irascible, demented.  Fair physical conditions except for paresis of left side.
Nov 18.  For several months past there has been increasing weakness of left side of body and now there is marked hemiparesis affecting especially the larger muscles of the shoulder and thigh.
Jan 10, 1902.  Marked hemiparesis of left side.
Feb 1.  Complains occasionally of pain in head.  Barely able to get about.
Feb 15.  Kept to bed on account of liability of falling; hemiplegia is marked.  All reflexes exaggerated on left.  No Babinski.
Mar 1.  Complains of increasing head ache.  Except for hemiplegia is in good physical condition, in bed.
Mar 18.  Was in better humor than usual.  Seemingly as well as ever.  
Mar 19.  Patient was heard to fall, apparently from considerable height; watch found him lying on floor with staring eyes and pulseless.  He called physician [ill.] who found patient as above with heart sound [ill. – ‘ofint’] ceasing.  Past not obtained. (?)
Mar 19, 1902.  Died.

Temperature chart for this patient included (40461149).  Dating from 8/12 to 9/13, with temperature, respirations, and pulse recorded several times each day, along with bowel movements.  Patient was diagnosed with typhoid fever.  Chart begins at 9 a.m. on 8/12 with a temperature of 100° F.  Highest temp. recorded was at 4 p.m. on 8/21, at 101.8° F.  Last entry is 7 a.m. on 9/13, with a temperature of 98.4° F.  He was on a Diet of “Milk, one pint, t.i.d.” and Treatment of “Quinine gr iii, t.i.d.


History and clinical notes:
History: First symptoms were noticed about 15 months ago, about eleven months after delivery of first child and it is supposed that she was pregnant at time; she became very religious, laughing in a silly way in the presence of visitors and desired to go to bed with the gentleman who was visiting the house; believing him to be Jesus and wanted to have a holy child by him.  And for the past few months has talked on various subjects.  Has been regular in menses for the past three months.
June 1900.  Patient has many delusions – talks incoherently almost all the time; is very hard to control and at times is inclined to strike those around her; has improved in general health, has a good appetite and sleeps fairly well at night.
Sep 22.  Very little improvement in patient’s mental condition; incoherent at all times, frequently noisy and excited, general health very good.
Feb 1, 1901.  Is restrained all the time.  Seldom talks.  Laughs at times a good deal and apparently at nothing.  Lies on sofa or sits in a corner, staring at those around her.  East well and seems in good condition physically.  
Mar 8.  Unchanged exceptment of restraint – occasionally when she fights wristlets are put on for little while; this is only semi-occasionally necessary.
Mar 14, 1902.  Has required very little restraint since last note – only for a short time then.  At times katatmic-negativism [catatonic-negativism] marked.  Mutism.  Verbigeration of same sentence in a high pitched key; gazes stolidly at those around her and has noted disturbances of extremities, especially hands, which are generally blue and cold.  Eats and sleeps well; has had no medicine for past year.
Apr 15.  Vaccinated.
Jul 30.  Becoming more stupid and indifferent, has to be pushed to meals, etc. by another patient, dragged by the hand.  Sits for hours gazing vacantly ahead of her – occasionally holding hands and arm in a fixed position.  Never or rarely speaks; if so unintelligible sentence and few words only.  At times a disagreeable-angry look passes over her countenance, but as a rule stolid and indifferent.  Physically patient is also failing; circulatory disturbances more marked, skin dry and harsh, occasionally has slight attack of diarrhea.  Appetite and sleep good; never restrained any more and gives little trouble except when necessary to move her from one place to another.
Aug 5.  Fractured radius left arm this morning by falling on floor.  Has a habit of keeping hand lightly clinched which probably accounted for accident.
Sep 23, 1903.  Sits all day in one position.  Takes no notice of anything around her.  Never speaks.  Almost always rigid, usually in state of catalepsy.  Has to be led to and from her meals.
Feb 19, 1904.  Physical condition good.  Mutters incoherently at times.  Remains in any position placed.  Rigid and notices nothing about her.
May 2.  Unchanged.  
Nov 14.  Condition the same.  Never talks rationally, wholly unconscious of all about her.  Very untidy.
Jun 5, 1905.  No change.  Physically in fair condition, although coughs a good deal sometimes.  Appetite good.  No intelligence shown.
Nov 20, 1907.  In fair physical condition.  Mental condition, imbecilic.  
Sep 20, 1909.  No change mentally.  Very silly.  Physically well.

Additional notes:
Well-known Delaware family name.  Was still in Farnhurst at the 1940 US Census.  Husband died in 1913.  Daughter died in July of 1900, several months after mother admitted to DSH.  Son lived until 1961.


History and clinical notes:
History: Symptoms of insanity were first noticed about the age of seventeen, when menstruation commenced; gradually grew worse and has never been rational since.  Patient becomes much more excited and noisy at menstrual period, at which time she will often refuse to eat, does not sleep and walks up and down the room, talking incessantly.  General health good, and as a rule, appetite good.
June, 1900.  Patient has very little intelligence.  Talks incoherently and almost incessantly, sits a great part of the time with her eyes closed; appetite very good and has gained flesh and improved considerably in general health; is very restless and mischievous.  
Sep 22.  Patient continues about the same as at time of last note.  Usually is quite quiet although constantly muttering to herself, but at times become quite excited and tears her clothing.  General health excellent.
Feb 1, 1901.  Negativismus (?) marked at times; sits in corner with her head down a good deal of the time; occasionally muttering to herself.  Physical health good; mentally no change.
Mar 8.  In bed for past ten days and numerous ulcers resulting from scratches made by patient.  Under treatment, some of these are improved some have healed.  Patient seems contented in bed, mumbles to herself, screws up her eyes and wrinkles forehead periodically; occasionally answers questions.
Mar 14, 1902.  During past year mentally and physically unchanged.  Eats and sleeps well.  Sits on bench quietly by herself, does as she is told, her very little to say for herself.
Apr 16.  Vaccinated.
July 30.  Infection of ring finger right hand, patient objected [ill.] to incision.  Mentally condition about same; very stupid and indifferent to her surroundings and calls of nature.  Kept cleanly only by regular practice of sending to water closet.  Appetite and sleep excellent, physically in good condition other than above.
Aug 6.  Finger healed.
Feb 19, 1904.  General condition good.  Sews busily all day (?) and gives no trouble.  She talk incoherently.
Apr 19.  Has had an attack of facial erysipelas.  Now recovering with treatment, Icthyol locally applied, iron and quinine internally, and milk diet.  Pulse and temperature now normal.  
May 2.  Fully recovered.  Mind entirely gone.  Plays organ and piano quite well, and stands in front of Amusement Hall door every morning, waiting to go in to the organ.
Nov 14.  Has been transferred to Ward I because of untidiness.
Jun 5, 1905.  No change. Eats and sleeps well.

Additional notes:
Died 10/23/1907 of tuberculosis at age 59, still living in Farnhurst.


History and clinical notes:
History: Patient has a good position on the B&O Railway as a civil engineer.  For past few years has been intemperate and for past year has been smoking cigarettes incessantly until his health has been undermined and he has become quite nervous.  At times goes to bawdy houses and stays there for two and three days drinking, smoking, and was found there today by his brother.  He committed himself though reluctantly.
Mar 19, 1900.  Brother removed him today.
Sept 30, 1900.  Discharged recovered.

Additional notes:
In 1900 is listed in the census records at being a patient at DSH.  Death records say he died 3/16/1906, but only index, no death certificate.


History and clinical notes:
History: Patient has never been entirely well since she left year.  Last Nov a year she fell and dislocated her hip and she has been a cripple ever since.  Lately, has at times been quite violent and has threatened to injure her family.  Husband who brings her states that he could not keep her any longer at home as it was dangerous to all concerned.  Patient left here June 17, 1897. [See Volume III, Page 244].
August, 1900.  Very little change in patient’s mental or physical condition since admission.  Until just recently when a severe conjunctivitis developed, which failed to improve under treatment and a corneal ulcer appeared.  Treated with Hematropine and Boracic Acid Solution and hot applications.
Sep 22.  Eye has improved very much, conjunctivitis almost disappeared, corneal ulcer healed leaving a small cicatrix.  General health very good, mind somewhat feeble.
Oct 10.  Fainted away today; pulse could not be felt.  Telegraphed to her husband.
Oct 12.  Patient rallied from attack to certain extent although heart action remained poor.  Was kept in bed, given heart tonic and light diet.  Ulceration of cornea again appeared; treated as before.
Oct 22, 1900.  Patient continued about the same until this morning, when found on morning rounds, pulseless at wrists; heart action very feeble; sighing respiration, cold extremities, and etc.  Given hot whiskey and water, strychnine, and digitalis, appeared to improve for a while but about one o’clock died.


History and clinical notes:
History: Patient has been drinking very hard for the past six weeks; is very noisy and delirious; all symptoms of delirium tremens.
Apr 10.  Very much improved.
Apr 11.  Allowed to go home.
Apr 26.  
Dec 5, 1900.  Discharged recovered.


History and clinical notes:
History: Has had La Grippe and mind became affected during the attack about two weeks ago; she became very noisy and violent, wandering from place to place, talking incoherent and etc.
Apr 11, 1900.  Patient can walk but little, gets off chair and lies on floor, so put to bed.  Very noisy at night, refuses to eat, bowels constipated.
Apr 12.  Patient fed twice daily by nasal tube; still very noisy, especially at night; seems somewhat weaker.
Apr 15.  Patient continues to fail; still retains nourishment well, but appears very dull and heavy; does not speak at all coherently, but is still very noisy at times.
Apr 18, 1900.  Patient has continued to fail and died this a.m.


History and clinical notes:
History: Has been in inmate of the Sussex Co. Alms House for seven or eight years and has been simple ever since her admission here, but lately has been subject to attacks when she attempted to injure others and has threatened to burn down the house.  These attacks usually only lasted for three or four days, but the present one has continued for three or four weeks.  Patient has many delusions of sight and hearing, but as a rule is easily controlled.  Has fair general health.
Apr 21.  Patient not eating well and seems weak.
Apr 23.  Had an attack today of heart failure; pulse weak and irregular; patient cold especially extremities.  Put in bed, applied heat and stimulated with strychnine and whiskey.
Apr 24.  Seems considerably stronger today, but refuses to eat; gave milk, eggs, and whiskey by nasal tube.
Apr 30.  Patient continued to improve.  Taken nourishment voluntarily; pulse much improved and seemed considerably stronger until today, when she refused all nourishment, became dull and pulse weaker.
May 2, 1900.  Patient continued to fail.  Respiration rapid, rales all over chest, breathing labored, pulse weak.  Died 2:30 p.m.


History and clinical notes:
History: Patient has had a very intemperate husband, who was very mean to her, and he died about two years ago.  Shortly after his death, she began business and failed, which worried her also.  About two weeks ago she was taken with the Grippe and her mind has been affected since.  She is very noisy at night, calls for her husband, believes that people are going to kill her.  Refuses to eat, and sleeps very poorly.
Apr 17.  Patient slept quietly all night; says very little; appetite poor.
Apr 18.  Very noisy all night; had to be removed to back ward; has convulsion attacks resembling hysteria more than true epilepsy; speaks very little.
Apr 19.  Refuses food and has to be fed with nasal tube; still continues to have convulsive attacks; will remain lying, apparently unconscious, for several hours; breathing normal, heart action fair, will resist any attempts to move her.
Apr 21.  Condition about the same as above.
Apr 22.  Considerably better.  Talks quite rationally.  Takes food voluntarily and sleeps quietly.  Has been confined to bed for several days.
Apr 23.  Patient allowed to get up and sent to quieter ward.  On being moved, patient had an attack of heart failure.  Stimulants were administered and patient revived somewhat but relapsed into unconsciousness and died in about fifteen minutes.


History and clinical notes:
History: Symptoms of insanity were first noticed about two weeks after birth of child and is gradually getting worse.  She believes she is full of cancers and tumors; very noisy and very excitable; rests very poorly.  Complains of pain on top of her head.
Apr 25, 1900.  Patient seems weak and hysterical; complains of globus hystericus, sleeps rather poorly and has very little appetite, but does not express any delusions or appear mentally deranged.  Put on tonic treatment.  
Apr 29.  Patient allowed to go home on parole.
Sep 20, 1900.  Discharged improved.


History and clinical notes:
History: Patient registered at Merritt House a few days ago – was under the influence of liquor and has been drinking very hard since.  Was taken to city hall two days ago and is very much depressed; does not seem to know his name.
Oct 27, 1900.  Left on parole.
Feb 14, 1901.  Discharged recovered.


History and clinical notes:
History: Symptoms of insanity began about 5 years ago when his mind began to fail; is very forgetful and wanders from place to place – is perfectly harmless.
Patient had been healthy and able to conduct his business (commission merchant) until June 1, 1895 when he came home at night complaining of severe pain by vertex and of vomiting.  These symptoms with (fever?); scalp very sensitive, lasted 6 weeks, ate almost nothing, was very thirsty.  Recovered partially but memory remained poor.  Was cleanly in his habits until 1898 from which time until admission his niece did not see him.
May 11, 1901.  Sorts clothes.  Almost too feeble to stand.
May 19.  No improvement.  Is in bed greater part of time.  Noisy at night.
May 30.  Slowly failing; more noisy at night.
Jun 18.  Continues to fail.  Does not recognize relatives.  Noisy.  Superficial bed sores in sacral region.  Urinary and fecal incontinence.
Jun 25, 1901.  Died 1:45 p.m.


History and clinical notes:
History: Officer who brings patient knows nothing of her history.  Wanders around at night without clothes on.
Sep 20, 1900.  Patient has improved very much the last month or so; is quiet and orderly, and a good worker on the ward.  Has very little to say but when she does speak seems quite sensible.  General health very good.
Feb 1, 1901.  No special changes to note.  Works on ward; is quiet and keep to herself.  Sits by the window for hours gazing out across the country; when asked what she is looking at, invariably answers “Oh, nothing.”  Seems in fair physical condition. 
Mar 8, 1902.  Condition unchanged, except more cheerful expression of countenance and that she will do what work she is told to.  One day a week goes to [ill.] in the hospital.  If touched by any one has a great habit of pinching them if she can get the chance.
Apr 16.  Vaccinated.
Jul 30.  Little [ill.] of late.  Working around the ward and in laundry.  Has flashes of anger and pants considerable at times but soon is as bright as ever.  Mentally but little change in her condition.  More or less indifferent to surroundings, never asks to go home or [ill.] any of her people.  Wants paper occasionally, then writes a few sentences, chiefly nonsense, and is satisfied.  Physically in excellent condition.
Feb 19, 1904.  In good physical condition, mental state unchanged.
May 2.  Very lazy, sits in one place all day and says little.  Physical condition good.
Nov 14.  Condition remains unchanged.
Jun 5, 1905.  No change, very lazy, seldom speaks.
Nov 20, 1907.  Mental and physical condition unchanged.
Aug 1, 1908.  Is more feeble.  Is in bed.
Aug 10.  Still in bed.  Temperature running to 105 in the evening.
Aug 15.  Very feeble.  Temperature at times high in the morning and going as low as 97 in the evening.
Aug 21.  Steadily failed since last note and died at 10:30 pm last night.
Aug 20, 1908.  Died at 10:30 pm.  Phthisis Pulmonalis.


History and clinical notes:
History: First symptoms of this attack began about 3 weeks ago.  Has been working out in the sun a good deal cutting asparagus.  Talked irrational, chased men from the field in which he was working.  His condition is about the same is it is at each attack.
Feb 11, 1901.  Patient has been no trouble whatever since he came here.  His wife has been written to in regard to his removal, but she has not paid any attention to request.  Was sent home today on parole.
May 13, 1901.  Discharged.


History and clinical notes:
History: Left this institution Dec 2, 1899 to go to Delaware Hospital to be operated on for cancer of breast.  Operation was performed but she never returned.  Was brought back today as an auto.  States that she can hardly breathe and that she has darting pains in breast and etc.  
Jun 19, 1900.  Since her return has constantly complained of difficulty of breathing and at times was quite cyanotic.  Heart’s action has been frequently irregular.  This morning at 8:45 had another attack of heart failure and in spite of usual remedies, failed rapidly and died at 9:30 a.m.


History and clinical notes:
History: Officers who bring patient knows nothing of his history.  He is very violent and noisy.  Improved and left on parole Sep 15, 1900.
Feb 14, 1901.  Discharged improved.


History and clinical notes:
History: Patient believes that he is very wealthy and has all symptoms of paresis, tremulous tongue, and etc.  
Jul 10, 1900.  Gradually getting worse.
Oct 15.  Appetite good.  Mind feeble.  Still believes that he is very wealthy.
Jun 1, 1901.  Patient quiet, sits around ward, speech and tongue tremulous.  Says little and will not admit delusions of wealth.  Marked myosis – slight light fair A.H. reactions.
Jun 20.  This a.m. attendant first noticed patient seemed weak on Right side.  Was carried up to dinner and fed and later placed in bed.  Examination shows marked paresis of R arm and moderate paresis of R leg.  Reflexes equal and active on both sides.  Face and tongue not affected.  Patient seems to comprehend as well as usual what is said but is unable to talk.  6 p.m. moderate twitching of the R face has developed affecting especially the pterygoids, masseter, and buccinator (muscles).  
Jun 21.  9 a.m. twitching of R face much more marked.  Mental condition and paralysis much anged (?).  Pulse 78, full reg. respirations and Temp normal.  Psoriatic lesions persist, being most marked on thighs and legs.  3 p.m. Temp 100.  Twitching of R face and all of abdomen more marked.  Head turns to right.  Eyes rotated slightly to left and range of motionr small.  Tongue deviates markedly to R, the central raphe being in line with R lower canine.  R arm and leg twitch slightly; are flaccid with BJ and KJ increased.  No Pl reflex on right.  Swallows well.  Is conscious.
Jun 22.  TPR.  R limbs complete paretic.  Head drawn to right.  Twitching of right face and neck marked, whole abdominal wall the seat of an intermittent contraction.  R limbs affect only by continuity.  Reflex KJ-BJ slight and on R on pl reflex.  Tongue and mouth coated and drawn and dry.  Tongue lying slightly to R of central line.  Patient notices shouting but show no comprehension of what is said.  Lower R cornea rough, marked conjunctival discharge.  Obstruct constipation.
Jun 23.  Failing rapidly.  Unable to swallow.  Hiccough 15 min 2 pm.
Jun 24, 1901.  9:30 a.m. Completely unconscious.  Twitching involves frontalis, orbicularis, the right mast., the right face and tongue (the latter deviating to R with raphe at ext incisor.  The Px laty mu mypoides and scalini (??) (head rotated to R).  Abdominal muscles reflexes KJ weak and = no Pl Ref on R.  Light clonus (false) of L ankle and wrist.  R limbs flaccid.  TPR. 104.6, 160, 40.  Died quietly at 1:00 p.m. without regaining consciousness or making any [entry ends here].  

Note: This entry includes a temperature record showing his pulse and temperature for the last few days of his life.  Rises from just below 101° to 106° at 10 a.m. on the day he died.

Additional notes:
Detailed description of what it is like to die of syphilis.  Horrifying.


History and clinical notes:
History: Patient believes that her husband is intimate with other women.
Jun 16, 1900.  Was allowed to go on parole.
Sep 20, 1900.  Discharged unimproved.


History and clinical notes:
History: Patient has been drinking very hard for the past two weeks; is very violent and restrained.
May 28, 1900.  Was sent to Phila on parole.
Sep 20, 1900.  Discharged recovered.


History and clinical notes:
History: Patient was found in a graveyard praying in Wilmington; was arrested and committed here; believes that he has committed some terrible sin and that he will be ruined.
Jun 20, 1900.  Is very orderly but still influenced by delusions.
Jul 21.  No improvement.  Is some depressed; does not speak unless spoken to and is very orderly.
Apr 15, 1902.  Quiet, clearly demented, fair worker; vaccinated today.
Mar 31, 1903.  Very good patient.  Helps around the ward.  Simple minded.
Aug 21.  Very contented.  Think he is an employee of the Hospital.  Good worker.  Never complains.  Good health.
Sep 23.  No change.
Mar 6, 1908.  No mental or physical changes; is well behaved and a good worker about wards.
Jan 8, 1909.  Shows physical decline; has a cough, some expectoration and p.m. rise of temperature.  Transferred to T.B.
May 6, 1909.  Died.  Phthisis Pulmonalis.


History and clinical notes:
History: Patient had severe attack of malarial fever last Sept and has been very nervous, saying that never get well and could not live; at times sleeps very poorly, appetite very bad.
Jun 23, 1900.  Allowed to go home on parole.
Sep 20, 1900.  Discharged improved.


History and clinical notes:
History: Patient was admitted to New Castle Alms House May 2, 1898 and has no friends.
Feb 1, 1901.  Cancer involving right side of nose-cheek and R eye rapidly progressing.  Patient will not allow any treatment for it.  Pulls off all bandages etc.  Does not complain very much, occasionally noisy.  Sleeps and eats well.  Patient is weak minded and gets excited when things do not suit her.  As a rule is orderly and quiet on the ward so long as she is allowed to attend to herself.  Otherwise about the same as when admitted.
Mar 8.  Mentally unchanged, physically same; extension of cancer rapid – spreading not only on surface but internally.  Sleeps and stays during the day in a separate room as the odor is disagreeable and patient picks at herself constantly.
Apr 30.  Cancer has made rapid progress and for past 2 days has been unconscious.
Apr 30, 1901.  Death relieved her of suffering.


History and clinical notes:
History: Patient has had an attack of left hemiplegia about 5.5 years ago.  Since then her mind has been more or less affected.  Is melancholy at times and wanders away from home.  Last Thursday fell out of the window and injured her wrist.  At time will not talk to anyone.  Physical health not failing (?).  Nearly all of her maternal relations died of apoplexy or its sequences.
Aug 19, 1900.  Has been in bed since admission.  Is unable to be up and about, has symptoms of general paresis – hesitating speech, etc.  Physical health good.
Sep 20.  Patient has improved very much during the past few weeks, although at times she is very destructive and has to be restrained to prevent her from destroying the bedding or her clothing.  Generally speaks quite rationally but with hesitating speech.  Sits up for the greater portion of each day in rolling chair.  General health is very good.  
Nov 22, 1900.  Home on parole.  Removed by husband.
Feb 14, 1901.  Discharged unimproved.


History and clinical notes:
History: Patient was sunstruck about 11 years ago and has been peculiar since that time.  About 6 months ago became much worse and during the last week or two has been very violent at times and uncontrollable.  Could not get a very satisfactory history from officers.
Jun 25, 1900.  Is very orderly and works in the dining room.
Jul 14, 1900.  Allowed to go home on parole.  
Sep 20, 1900.  Discharged recovered.


History and clinical notes:
History: Was committed to Dover jail about 10 days ago for trespass to serve 30 days.  Shortly after admitted he became noisy and violent, tearing his bedding and clothes up – talks on various subjects very irrational.  Head severely cut [ill. words] over frontal and parietal suture on right side.  
Jun 9, 1900.  Very orderly and quiet.  
Jun 12.  Still improving, wound much improved.
Jun 26.  Allowed to go.
Sep 20, 1900.  Discharged not insane.


History and clinical notes:
History: Mother was burnt to death about 1.5 years ago and has worried a great about this.  About 4 weeks ago first symptoms of insanity was noticed.  Pulled all his flowers up, said that his mother ordered him to do so; is constantly talking about his mother.  Patient has been masturbation a great deal lately.  
Jul 1, 1900.  Was so noisy that he was transferred to Ward 4.
Jul 5.  12:30 p.m. attempted to escape, struck Attendant [name illegible] and knocked him down.  Ran down the fire escape, fell and fractured the [ill.] maxilla on left side at junction of incisor with bicuspid teeth.
Jul 25.  Fracture doing well, mind not improved.
Aug 10.  No improvement.
Sep 25.  Talks incoherent, has delusions and is controlled by them; at times hard to control, mind not improved.
Jun 1, 1901.  Restraint necessary to keep him from rubbing head.  Is insolent.
Aug 12.  Soils clothes constantly, violent and independent.
Apr 15, 1902.  Quiet and cleanly for several months past, but kept in restraint.  Memory fair, inclined to be violent and lazy.
Jul 30.  No change.
Aug 21, 1903.  Very untidy in dress and habits.  Talks little.  Has one place on bench and will remove anyone forcibly if they occupy it.  Eats well.  Talks a great deal to himself.
May 3, 1905.  No improvement, is very hard to care for, when not restrained he pounds his face with his fist.
May 24.  While exercising on ward patient fell, striking nose against same and producing a fracture of nasal bones.
Jul 18.  Has been placed in bed, is rapidly growing weak.
Aug 1.  Still remains in bed and does not improve.
Aug 6, 1905.  Died.  Asthenia.


On certificate of:
Drs. Joseph H. Chander and F. Honny Day (?)

History and clinical notes:
History: About 14 years ago had attack of melancholia lasting 8 months and apparently recovered until about 4 years when symptoms of insanity were again noticed.  A year after he went to bed and has remained since.  Has some delusions and talks irrational at times; has lost flesh and strength.
Jun 26.  Very much demented and untidy.
Aug 10.  Some improved, has gained flesh.
Sep 25.  Very quiet, will not speak unless spoken to, mind is feeble and is very much run down in health.
Aug 12, 1901.  Quiet, eats and sleeps well.
Apr 15, 1902.  No change.  Vaccinated today.
Apr 20.  Slight take.
Mar 31, 1903.  Patient will sit all day in one position, speaking to no one.  Answers questions in monosyllables.  General health good.  Very dull mentally.
Jan 1, 1914.  Patient has been steadily losing flesh and strength.
Feb 1.  Has been in bed for some time.
May 6.  Was visited by his relatives today who removed him.
May 6, 1914.  Paroled.
Oct 7, 1914.  Discharged unimproved.


History and clinical notes:
History: Officer who brings patient knows nothing whatever of his history.  Has always been a peculiar boy, preferred to be by himself, masturbates, mind some feeble.
Jul 15, 1900.  Some improved, is orderly and good patient.
Aug 10.  Very much improved, has gained flesh, mind much brighter.
Aug 30.  Much improved since last report and is very orderly and good patient.
Sep 21, 1900.  Allowed to go on parole.
Feb 14, 1901.  Discharged improved.


History and clinical notes:
History: Fist symptoms of insanity was noticed about 2 months ago, began to talk on religion.  Would not work.  Would not associate with anyone, kept by himself.  For the past few days has been unruly so much so that he could not be cared for at home.  Has appearance of a masturbator.  Has lost some flesh, does not sleep well at night.
Jul 25, 1900.  No change.  Very much depressed, mind very feeble.
Sep 25.  No improvement.  Very much depressed, will seldom speak when spoken to, would not eat unless forced; has lost flesh, is pale and anemic.
May 15, 1901.  Forced feeding has been necessary at irregular intervals.  Patient is always reticent, can be induced to make short answers only.  Gives almost no history.  For 4 months past has show cataleptic echolalia phenomena which are now less marked.  Right leg from knee down becomes swelled when kept up several days.  At present, says he did some great wrong; had a fever and gastritis for a week.  Reflexes of upper limb and JJ increased.  KJ and ACJ only obtained by reinforcement.  Weak JJ.  Slight tendency to catalepsy.  Nose must be held to make him take solid food.
Aug 12.  Eats and sleeps well.  No restraint at night.  Can be aroused with greater ease than at last note.
Sep 1.  Eats less; is growing thinner, coughs slightly at night.
Sep 19.  Is growing much weaker and thinner, cough more troublesome.  Indefinite signs of consolidation at back apices.
Oct 6.  Continues to fail.  Cough is more constant, raising purulent sputum which shows numerous B’s and staphylococci.  Placed to bed; eats under strong protest.
Oct 11.  Very weak.  Profuse expectoration.
Oct 13, 1901.  Died at 8:16 a.m.  Removed on same day.  No post mortem.


History and clinical notes:
History: Officers who bring patient know nothing of her history.
Jul 3, 1900.  Mother visited her today and said she was not insane, that she was only deaf and dumb.  She asked to remove her.  Was allowed to go on parole.
Sep 1, 1900.  Was returned by mother this p.m.; could not get along at home, yelled out of the window to everyone and had to be returned.
Sep 20.  Quiet and orderly as a rule, but occasionally becomes noisy.  Has a good appetite and sleeps well and general health is very good.
Feb 1, 1901.  Mentally and physically about the same as at last note.  Occasionally has attack of constipation, at which time she seems very much depressed and cries a little.  Works on wards industriously and seems cheerful at other times.
Mar 8.  Condition unchanged.
Mar 8, 1902.  During past year has been very cheerful and contented excepting for short periods of depression whenever she suffered from constipation, digestion trouble, headache, etc.  Took a great interest in the dances and other entertainments.  Learnt rapidly and was very bright and lively.  During past four months has been quite a pet on the ward, understanding that [illegible words] made her very well indeed.  Once in a great while has a fight with one of the other patients after which she has a pouting spell.
Apr 16.  Vaccinated today, while working in laundry, where she has [ill.] once a week for past 7-8 months.  Seemed very much frightened and resisted considerably – afterwards held her arm in quite a stiff position for some time, looking at the site of vaccination, shaking her head and muttering to herself.  This fear lasted all the afternoon, then she pulled her sleeve down and was cheerful as ever.
Jul 30.  No change mentally or physically, works in laundry weekly and is very cheerful about doing what she can.  At times has spells of pouts, sitting with her head down, arms crossed, etc. but these are some dispelled.
Aug 23, 1902.  Mother removed her on parole.
Dec 27, 1902.  Discharged unimproved.


History and clinical notes:
History: Officer who brings patient knows nothing of his history.
Jul 10, 1900.  Very much improved.
Aug 27.  Patient was returned to the Hospt. on certificate of Drs. H.C. Stevens and James L. France.  Has some delusions and is influenced by them; at times a little obstinant, health good.
Jul 12, 1903.  He been in bed for the last month.  Has a large swelling over the lumbar vertebrae, thought to be due to lumbar caries.  Few crackling rales in left axilla.  Patient looks tubercular.  Eats and sleeps well.  Has a frequent afternoon temperature.
Aug 21.  Condition much the same, not quite as strong and has lost some weight since last note.
Jul 21, 1904.  Removed to Tuberculosis Hospital.
Jul 30.  Has gained 3 pounds since admission.
Dec 6.  Developed an abscess (tubercular) of hip, which is constantly discharging pus.
Jan 18, 1905.  Gradually growing worse.
Feb 20.  Sinking rapidly, does not take any nourishment.
Feb 22, 1905.  Died at 4 a.m. of general tuberculosis.


On certificate of:
Drs. I.S. Vallandingham and J.H. Hardcastle

History and clinical notes:
History: Officers arrested patient in Armstrong’s Corner, running up and down the road, crying and noisy, stopping teams, etc.
Jul 20, 1900.  Very good patient, excitement disappeared.
Aug 1.  Plays ball but mind feeble.
Sep 25.  Has confusion of ideas, mind feeble but not noisy, untidy or destructable; works on the ward and is useful.
Apr 15, 1902.  [Illegible words] quiet, cleanly, fair worker.  Vaccinated today.
Apr 12, 1903.  Patient has not been so clear mentally for the last week.  Two days ago began beating his head and has had to be restrained.  Says he wants to be killed.
May 1.  Patient is again quiet.  
Aug 21, 1903.  Very quiet and orderly.  Works some about the ward.  Takes little interest in surroundings.  Spends most of day looking vaguely out of window.  
[No date] Died in hospital.

Additional notes:
Died 4/8/1936.  Buried at DSH, Grave #458.


History and clinical notes:
History: Patient was brought from Frankford Hospital June 31st, 1900, but certificate was not received until today (July 7).  
Aug 1, 1900.  For some time after admission was quite ill; could not eat and vomited every time she partook of nourishment.  Was untidy in her habits, so much so that she had to be transferred from Ward A to Ward 1.
Aug 19.  Since patient has been on (Ward) 1, is much better; obeys the attendants and is tidy and easily cared for; talks some and appears quite bright at times.
Aug 21.  Patient is very destructive, tears clothing, bedding  or anything that is within her reach.  Does not talk at all rationally and appears to have but very little intelligence.
Sep 20.  Has improved somewhat as she is not nearly so destructive, but mental condition otherwise has not improved.  She is quiet, and as a rule obedient, but does not talk or appear to pay much attention to surroundings.  General health very good.
Feb 1, 1901.  Mental condition same; physically very well; is quiet and fairly orderly; does not tear her clothes.  Sits on bench by door a good portion of day, paying little attention to surroundings.  Spells one syllable words when asked to do so.  Responses are slow and somewhat hesitating at times, as though she were uncertain of what she said.  Sleeps and eat well, and is obedient.
Mar 8.  No chance since last note, except that during period of menstruation last week she complained of feeling badly, did not eat and vomited considerably.  Attack lasted 2 days only, now well physically, mentally no change.
Feb 15, 1902.  Has had to be restrained lately for masturbating, exhibits herself at any time and does not seem to realize what she is about.
Apr 16.  Vaccinated today, did not seem to take any interest or object.
Jul 30.  Mentally degenerating gradually, restrained at times for masturbation.  Physically in excellent condition.
Aug 21, 1903.  Has failed mentally; never speaks.  Is untidy in dress and occasionally in habits.  Sits on bench all day.  Laughs whenever physician approaches her.  Eats and sleeps well.
Feb 2, 1904.  On Thursday began screaming, and kept it up at intervals throughout the morning.  Discovered the cause to be an aching tooth.  Tooth removed, but in pieces as it was much decayed.  Gave ¼ gr morphine.  Screaming ceased.  On Friday, there was suppression of urine; patient catheterized, about 2 qt (?) obtained.  Gave sweet [illegible words, look like “sweet spirits titre”] and Saturday normal flow returned.  Patient spoke for first time for months; said “No, I don’t know.”  Sunday occasionally screamed as if in pain, kept in bed in warm room.  Thursday – getting up today.
Feb 19.  Has bad toothache.  Tooth extracted and she felt better.
Feb 20.  Retention of urine for 14 hours.  Catheterized.  No repetition.
May 2.  Patient in good health.  Mental condition the same.
Nov 14.  She remains the same.  Eats and sleeps well.
Jun 5, 1905.  Very simple; quiet, eats and sleeps; is untidy.
Feb 20, 1906.  No change.  Eats well.  Seems in good health.
Nov 20, 1907.  Patient rather run down physically.  Mentally no change.

Final disposition:
Still in hospital.  According to ancestry.com she died in 1945 at age 67 and was buried at home.

Additional notes:
5X8 card -- died 6/7/1945 of cerebral  hemorrhage


History and clinical notes:
History: Patient was brought by G.L. Crook of Wilmington, Delaware on July 1st.  Papers were not received until today (July 7).
Jul 30, 1900.  Very nervous and excitable.  Has some delusions.
Aug 15.  Went away with wife.	
Sep 20, 1900 Discharged improved.


History and clinical notes:
History: Was discharged March 23, 1900 after a parole from Sept 18, 1899.  Has been drinking very hard again and recommitted himself.
Jul 15, 1900.  Very much better.
Jul 20.  Recovered and allowed to go home.
Sep 20, 1900.  Discharged recovered.

Note:  Multiple admissions to DSH for drinking problem.


History and clinical notes:
History: Has smoked about 3 or 4 packs of cigarettes and masturbated 3 times a day for the past five or six years, and has lost flesh; appetite poor, complains of loss of memory and pains in his head.
Jul 25, 1900.  Very much improved.
Aug 10.  Very good patient, likes to talk, has no delusions and mind much stronger.
Sep 20.  Not so well, believes that electricity controls his movements and that he is under some peculiar influence.  Masturbates whenever he gets a chance.  Has lost flesh and strength; rests well at night.
Nov 24, 1900.  Left on parole.  
Mar 28, 1901.  During absence has not been very well.  Frequently has threatened and struck his mother.  Smokes constantly, talked about working but never made any efforts to obtain any.  Grew gradually worse and was returned to Hospital by Officer.  On the way did not seem to want to come, but to physician said the reason he came so early was that he had made up his mind to come and wanted to be on time.
Apr 15, 1902.  Good physical health.  Occasionally masturbates to excess if not muffed.  Has frequent outbreaks of temper.  Will not study or work and evidently [ill.] on troubles.  Vaccinated today.
Apr 20.  Fair take. 
Jul 30.  No change.
Dec 30.  Condition the same.  Masturbates at night.  Physical condition good.
Jan 25, 1903.  Condition the same.  Has restraint at night.
Aug 21.  General physical condition good.  Has spells of depression during which he cries at little provocation.  No restraint.
Sep 23, 1903.  Muffs ordered at night as patient masturbates.
[No date]  Died in hospital.

Additional notes:
Died 5/12/1942.  Buried at DSH, Grave #532.  Listed in census at being a patient at DSH in 1910, 1920, 1930, and 1940, and as dying on 5/12/1942 and being buried in the cemetery on the grounds of the hospital.  Grave #532.  Cause of death was heart disease.


History and clinical notes:
History: First symptoms were noticed about 2 years ago; forgot everything that was said to her.  For past 8 months has been steadily growing worse; once she attacked her husband and threatened to kill him with a garden rake.  During this time has continually talked irrational.  Has steadily lost flesh; usually sleeps well at night.
Aug 19,1900.  Was very restless when first admitted, walked up and down the hall incessantly, removed her clothing and was very hard to care for.  Lately is less restless and has gained physically.  Conversation very irrational.
Feb 1, 1901.  Mentally and physically about the same; complains occasionally of feeling badly, sometimes answers rationally but some breaks out in tears.  Wanders up and down the ward; spends a good deal of time looking through key hole.  Give very little trouble to attendants excepting in this respect.
Mar 8.  No change since last note.
Oct, 1901.  During summer has continued about as follows up and around the ward for several weeks.  Walking around a good deal, rattling the door knobs, looking around for imaginary objects, whispering to herself, occasionally moaning and crying.  Appetite excellent, sleep fair, occasionally walking around bedroom or making and remaking bed.  Alternative with this condition were periods during which she remained in bed suffering from diarrhea brought on by indiscretions in diet.  When feeling sick was always very much depressed, inclined to tears readily and picking at bedclothes.  For past few days has seemed somewhat weaker, gradually failing mentally and physically.
Oct 13, 1901.  From last note sank peacefully and quietly and died 11:15 a.m. Oct 13, 1901, just as her son visited her room.


History and clinical notes:
History: Had severe attack of La Grippe in March, and mind has been affected since.  Mind feeble, believes his wife is intimate with other men and is afraid he will be destroyed.
Aug 10, 1900.  Believes that his wife is familiar with other men, mind feeble, appetite good.
Sep 25.  Still has delusions about his wife, mind is some feeble and he is very nervous, appetite good.
Jan 15, 1901.  Is growing more feeble and childish all the time.  His gait is staggering and he has to be helped from place to place.
Jan 31.  Has been placed in bed, is quite weak and unable to care for himself.  Cries a great deal of the time.
Feb 3.  Steadily growing more feeble and although up and dressed in rocking chair is unable to move around unassisted.  Does not seem to realize what is said to him and continues crying and sobbing a good deal of time.  Appetite still good, eats well and somewhat inclined past few days to constipation, requiring enemas to relieve him.
Feb 12, 1901.  Has been in bed for past 4 days.  Has failed very fast.  Has been unconscious since the 10th.  Friends were notified of his condition.  Diet at 3 a.m.  Senile asthenia.


On certificate of:
Drs. J. Willard CrossAn and James H. Morgan

History and clinical notes:
History: Has been ill for the past two years – mental disease.  About three weeks ago, symptoms of insanity were noticed.  He believed that he was being robbed and that every thing he owned was stolen; mind feeble.  Very easily controlled.
Jul 28, 1900.  Suddenly became comatose.
Jul 29.  Some little improvement.
Aug 1.  Very weak, diarrhea.
Aug 3.  Very weak and unconscious.
Aug 5, 1900.  Died.


History and clinical notes:
History: Attack began about 3 years ago – has many delusions and at times very noisy, lasting about 2 weeks at which time she is very destructable.  Gradually getting worse.
Aug 19, 1900.  For a time after admission would not eat and had to be fed by tube.  Lately takes food voluntarily.  Is destructive and has to be kept in restraint most of the time.  Is very incoherent in her conversation.
Sep 10.  Patient has continued to improve; is quiet and orderly and has become quite  rational in her conversation.  General health has also improved.
Sep 20.  Patient seems perfectly ration and has improved very much in general health.
Feb 11, 1901.  Patient complains of pains in neighborhood of breast, of great distress, etc.  Is always anxious when examined.  At other times sits quietly on bench and does not want to talk.  Examination: valvular murmur, mitral.  Tonic treatment ordered.  Patient seems poorly nourished, occasionally works a little on ward.  Mentally condition about the same.
Mar 8.  Was in bed a week with attack of bronchitis; up and around the ward on tonic treatment now, says she feels well; is very quiet and orderly, sitting most of the time on a bench near the window.
Feb 14, 1902.  Gynecological examination today.  Excessive leucorrhea, erosion slight of os uteri, small caruncle just within vaginal opening on the right posteriorly, slight prolapse of anterior vaginal wall.  Daily douche ordered.  
Apr 16.  Vaccinated today.  Made great fuss about it – felt she was being killed, etc.; said her heart was too weak and she could not stand losing any blood.  This statement unnecessary as no blood was to be seen on the excoriation made (???).
Jul 30.  Mentally about the same.  Physically somewhat stronger than last fall.  Eats and sleeps well, rarely vomits dose of medicine for constipation.
Jan 8, 1903.  Has been losing flesh steadily; marked amount of albumin in urine.
Aug 1.  Has been in bed for some months, limbs are constantly swollen; eats but little, only liquid food, is steadily failing.  Has an uncontrollable diarrhea.
Aug 18, 1903.  Was removed by friends today so that “she could die at home.”  Parole 3 p.m.
Patient died about a week after removal.

Final disposition:
Discharged in order to die at home.  Died about a week after removal.


History and clinical notes:
History: Officer who brings patient knows nothing of his history except that he has been drinking very heavy lately and has attempted suicide.  Has two cuts about 2 in. long below left mammary and a small one center of neck.  Says he attempted suicide while he was drunk, but don’t now the reason why.
Aug 10, 1900.  Very much confused and is anxious to go home.
Aug 25.  Very good patient and is OK.
Sep 10.  Allowed to go on parole.
Feb 14, 1901.  Discharged recovered.


History and clinical notes:
History: Was committed to New Castle Jail from St. George’s for Larceny and shortly after admission symptoms of insanity were first noticed.  Very much demented, untidy, talks incoherent and etc.  
Aug 25, 1900.  Mind some improved, works on the wards, but masturbates very often; appetite fair.
Sep 25.  Some demented; is tidy and useful as [ill.] on Ward 6.
Nov 2, 1902.  Patient has a severe cough and is failing.  Expectoration shows numerous TBs.
Feb 1, 1903.  Patient has been in bed for past month.  Is losing flesh rapidly.
Feb 20, 1903.  Is quite low this a.m. and is gradually sinking.  Died at 1:45 p.m. of pulmonary tuberculosis.


History and clinical notes:
History: Has been a drinking man.  Began to drink about 3 years ago and has stopped several times.  Began to drink again about 2 weeks ago, drank very hard.  Has not taken any intoxicants now for 3 days; began to get weak, could not walk.  Is irrational in his conversations.  Does not eat as well as formerly.  Appears to be growing more feeble.  First symptoms of insanity was noticed last Monday and has steadily grown worse in this particular.
Aug 20, 1900.  Has steadily improved since he came here; was visited by brothers today who removed him against the advice of the Supt.
Sep 20, 1900.  Discharged recovered.
Note attached: Hospital memo form.  Dated August 27, 1900.  “I hereby removed Mr. [name redacted] from the Del. State Hospt. At Farnhurst against the advice of the Supt., as he recommends allowing him to remain for a time longer.  We will be responsible for his care in all particulars while absent from the hospital.”  Signed by two brothers.


History and clinical notes:
History: Parties who bring patient know nothing of his history.  He was arrested at Newark for creating a disturbance and his head had several cuts that were found to be almost healed.  He is very incoherent and nothing can be gleaned from him at present.
Sep 25, 1900.  Is still full of delusions and is controlled by them, talks incoherent at times and occasionally is little troublesome; appetite good; rests well at night.
Apr 15, 1902.  Treacherous.  Has twice assaulted the attendant when alone.  In good general health [ill.] vaccinated today.
Sep 23, 1903.  No change in general condition.
Aug 29, 1907.  Removed to TB, suffering from tuberculosis.
Aug 29, 1907.  Died, Phthisis pulmonalis.


History and clinical notes:
History: Patient has not been in good health lately; no serious trouble but run down and weak and has had some love affair that but (?) troubling her.  Has always been a good and hard worker.  Last Friday first signs of insanity was noticed, wanders away from home and was lost for some time.
Sep 19, 1900.  Has steadily improved and went home by herself on parole.
Feb 14, 1901.  Discharged improved.


On certificate of:
Drs. George W. Marshall and J.S. Prettyman, Jr.

History and clinical notes:
History: First symptoms of insanity was noticed about 3 months ago; began to complain of different diseases and was very melancholy.  Neglected her household duties.  About six weeks ago became worse, drank a bottle of niter.  2 weeks ago again attempted it by drinking a bottle of medicine.  Today tried to buy some laudanum; says she wants to die.  Today friends found her in the cemetery.  Says she wants to die, imagines that her child is very ill and that her friends won’t send for a doctor for her.  Has lost flesh, eats well, but sleeps but little.  Husband does not live with her and has not for a year past.  Says that she has syphilis, but this is not so.
Aug 30, 1900.  Was removed by her husband today against the advice of the Supt.  Parole.
Sep 12.  Was returned by husband today, who stated that he could not get along with her, that she needed constant watching, etc.
Sep 20.  Patient does not seem as much depressed as she did after her admission.  Complains considerably of nose and throat – was examined by Dr. Tybout, who prescribed for her.  Appetite has improved and general health seems better.  Is being treated twice weekly for cervical ulceration.
Nov 5.  Visited by her husband today who removed her on parole.
Feb 14, 1901.  Discharged improved.
Note attached: Standard memo form, dated Aug 30, 1900.  “This is to certify that I [name redacted] remove her from the Del State Hospt at Farnhurst against the advice of the Supt. and will assume all responsibility in regard to her actions after she leaves said Hospt.”  Signed [name redacted].

Additional notes:
I[Not Tamsey].  In 1910 census was living with husband and two children.  In 1930 census was widowed and living in Philly with daughter.


History and clinical notes:
History: Mr. Mears knows nothing of the history of the case; certificate states that he is violent at times.  Very feeble, probably due to old age.  Probably cause family troubles.
Aug 28, 1900.  Very excitable and noisy, destroyed his clothing and bedding, refuses to eat.  Talks incoherent.
Aug 30.  Gradually getting weaker, very delirious.
Sep 1.  Does not recognize his friends; pulse feeble and mind gone.  Refused to eat; has been fed with tube all along but stomach will not retain the food.
Sep 2.  No improvement.
Sep 4, 1900.  Died 3 p.m.


History and clinical notes:
History: Patient had La Grippe about two years ago and has had severe headaches since.  She believes that she is persecuted by her neighbors and that her husband has hired them to do so.
Sep 10, 1900.  Patient still has many delusions and is controlled by them; refuses to take any medicine.  Is a good worker on the ward and does not give any trouble.  Has a rather poor appetite and looks anaemic.
Sep 20.  Mental and physical condition almost the same as at last note.  
Mar 8, 1901.  No change since above notes.
Apr 15, 1902.  Vaccinated today; said she would have the law on the hospital; hoped we were conscious of what we were doing; she was [ill.] when we were doing; she was willing to have it done rather than fight but she wished to enter her protest.  Told the doctor she knew nothing of medicine; that all she did was to kill the patients; that it was time someone resisted her and she meant not to have poison put in her food.  That she would not allow herself to be touched; all the time making no resistance and watching attentively every move.
Apr 17.  Taken walking today; first time in many years.  Always had her airing on the [ill. – bridge?] as had threatened to run away.
Jul 30.  Condition about the same.  Once in awhile [ill.] out on ward and berates doctor, especially if some other patient is being disciplined.   Says she knows “you all want to kill that,” that the medicine is poison, that the surgery is only to cut them up, etc.  that you all [ill.] be consigned to hell fire if you continue such ways etc.  Has gone out walking [ill.].  since April – violent objection.  Once in a while has been sick.  Sitting in her room, complaining of headache; did not want the doctor – would not take her medicine; wanted her to stay away, etc.  But when medicine was sent her, she took it without objection.  When asked if she felt better her answer invariably was “Much you care.”
Feb 19, 1904.  Very quiet, condition good physically.  
Nov 14.  Is able to walk to table now; for a long time labored under delusion that she was paralysed.
Dec 17.  Patient has had incontinence of urine for some time.  Bad odor about body any breath offensive.
Dec 26.  Patient became ill, complained of chills and weakness, face flushed.  Temp 98.8 F.  Pulse weak and irregular.
Dec 27.  Patient still in bed.  Temp normal.  Says she is weak, but has no pain.  Eats well and takes medicine.
Dec 28.  Asks to be bolstered up in bed, can’t breathe well, no pain.  Eats heartily, bowels open.
Dec 29, 1904.  Died suddenly and quietly.


History and clinical notes:
History: Has been somewhat despondent for some time past, purchased a hotel in New Castle and lost everything he had and came here voluntarily.
Sep 28, 1900.  Is somewhat improved, has his liberty and goes where he desires.  Sleeps and eats well.
Apr 15, 1902.  Always quiet, cleanly, gentlemanly and cheerful.  Complains of nagging neuralgic pain [ill.] which interfered with quiet sleep.
Jun 4.  Had a mild attack of [ill. – looks like ‘vanolaid’] which was accompanied by a typical prodromal [ill.] or filliform rash.
Jul 30.  Under electric treatment back has much improved .  In bed past two days from an acute cold.
Dec 24, 1902.  Discharged recovered.


History and clinical notes:
History: Last child was born on July 25th and died 5 days later.  Five days after this puerperal insanity manifested itself.  For a time was a little better.  For past 8 or 10 days has been much worse and is very violent, extremely incoherent.  Eats and sleeps well.
Sep 20, 1900.  Patient has had to be fed ever since admission; very noisy and difficult to control requiring a hypodermic about every night.  Has to be kept restrained in bed, for fear of her injuring herself, incoherent at all times.
Sep 20.  Patient has improved somewhat the last few days; sleeps better at night; has commenced to eat voluntarily and at times talks more rationally, general health good.
Jan 25, 1901.  Patient very noisy and restless.  Hypodermic gr 1/100 hyoscine at 10 p.m., slept until 5 a.m.  Then noisy, but not as excited as before hypodermic.  Wears wristlets almost constantly; still talks incoherently at times and is very restless and disturbed.
Feb 3.  Past few days has seemed better; talks more rationally; quieter at night; [ill.] a little at times; is aware of all that goes on around her and notes changes in attire of physicians, etc.  Still continue to wear wristlets.  Is very cheerful and approachable.
Feb 11.  Transferred to Ward 3.
Mar 8.  Still very talkative, at times noisy, frequently necessary to restrain hands, at times cross and irritable; these attacks of short duration and [ill.] easily dispelled.  Physically much improved.
March 1902.  Since last note has been about as follows: quiet and agreeable and tractable for several days, helping the attendants, attending dances etc. with pleasure, then for a day, sometimes entire (?) again only few hours, very excited, screaming at the top of her voice when disturbed, incoherent at times; full of delusions, very aggressive and with slight cause flies into a rage and hits right and left.  During these attacks of rage has to be restrained.  Afterwards has no recollection of attack except to say she thinks she used language she should be sorry for as she [ill.] she must have been anyway.
Apr 16.  Vaccinated today.
Jul 30.  Has been somewhat better of late.  Attacks of excitement of short duration, controlled by short seclusion; has helped attendants on the wards with other patients and is very anxious to learn.  Says she knows she is not right at times, that she should talk and act differently, but that she cannot help it.  Very rarely requires any medicine – appetite and sleeping good.
Aug 4, 1902.  Home on parole.
Dec 27, 1902.  Discharged recovered.

Additional notes:
Child born July 25, 1900, died after 5 days.


History and clinical notes:
History: Officer who brings patient knows nothing of his history.
Sep 28, 1900.  Will not speak when spoken to; desires to be by himself; does not know where he was bound and is very incoherent when talked to.  Mind is extremely feeble, does not realize where he is.  Has good health and appetite and does not cause any trouble on the wards.
May 22, 1901.  Became violent last night and attacked Attendant McGonigle.  Today is quiet and taciturn as usual.
Aug 12.  No change.  No more outbreaks.
Apr 15, 1902.  No change.  Vaccinated today.
Aug 21, 1903.  Patient in good health.  Seldom speaks.  Always surly.
Jul 17, 1930.  Died in hospital.  Buried at DHS [from death certificate].

Final disposition:
Still in hospital.  But note that he died 7/17/1930 and was buried at DSH.

Additional notes:
Buried at DSH, Grave #393.  Was at DSH during 1910, 1920, and 1930 census.


History and clinical notes:
History: Dr. Pyle states that for last 6 months he has neglected his work and has talked of writing a book upon socialistic problems, while he is really an ignorant man.  He does not consider him a safe person to be at large.  Has separated from his wife.  They have had a good deal of trouble with her.
Sep 28, 1900.  Has been very orderly since admission, rests well; appetite good and is very good patient.
May 10, 1901.  When playing ball was struck on back by ball fracturing 8th rib about 16 cm from spine.  Adhesive strips applied.  
May 11.  About as usual, no pain.
Jun 12.  No further trouble with rib.  Today denounces many of our political customs, says McKinley is a tool.  Says fever passes off at finger and toe tips and back of head.  Is in good general health, quiet and tractable.  
Aug 10, 1901.  On parole with brother.
Feb 15, 1902.  Discharged unimproved.


History and clinical notes:
History: Was discharged from this institution recovered May 15, 1899.  Officer who brings patient knows nothing of history.  Says he has been drinking a great deal lately.
Sep 20, 1900.  Not so nervous.  Mind clear.  Appetite good; sleeps well.
Sep 28, 1900.  Allowed to go home this a.m.
Feb 14, 1901.  Discharged recovered.


On certificate of:
Drs. Henry R. Spruance and Henry W. Briggs

History and clinical notes:
History: Patient was struck by train about 9 years ago and symptoms of insanity began slightly after.
Sep 28, 1900.  Is very orderly, complains of pain in his head, mind some feeble, appetite good; rests well at night.
Feb 9, 1901.  Has been in bed for some time.  Is unable to get around and mind is becoming much more feeble.  Has failed considerably of late.
Feb 22.  Today patient is much worse.  Has been unable to take any nourishment.  This p.m. pulse much more feeble, extremities cold.  Is unconscious and cannot be aroused.  Stimulants are being administered at short intervals.  Friends were notified of his condition.
Feb 23, 1901.  Died at 1:30 a.m.

Additional notes:
According to death certificate, he died of chronic myelities


History and clinical notes:
History: Patient was admitted to Del. Hospital Aug 27 with a contusion over left temporal region and unconscious.  He is now very destructive to bed, clothing, and is very noisy at times.
Sep 28, 1900.  Still talks incoherently, but not noisy, is easy controlled; appetite good.
Nov 5, 1900.  Left on parole.
Feb 14, 1901.  Discharged improved.


Complications:
right inguinal hernia and enlarged prostate

History and clinical notes:
History: Has been feeble minded for three or four years – and has been very troublesome for some time; wanders from home, refuses to eat at times, very untidy and noisy.  Has enlarged prostate and urine drain with catheter for the past six months.
Sep 20, 1900.  Very restless and noisy, refuses to eat.  Is very untidy.
Sep 22.  Albumen in urine; bladder inflamed; patient is very weak.
Sep 23.  Gradually getting weaker, have notified people of his condition and advise removal.
Sep 25, 1900.  7 a.m. died.


History and clinical notes:
History: About two years ago patient had an attack of paralysis, quite severe, and for some time afterwards was hemiplegic and aphasic, but gradually made a good recovery.  Since last May, however, he began to lose in flesh and fail mentally and has continued to grow steadily worse.  At times is very destructive to his personal clothing and bedding.
May 15, 1901.  Five years before admission, patient had a right hemiplegic stroke which much reduced his mental power, although his motor symptoms largely disappeared.  Patient was never able to transact any business after stroke.  Two and a half years ago, patient had a second stroke affecting his whole body and much more his intellect.  Patient improved slowly and was able to get about a few months.  For past two years patient has been bed ridden.  Two days age superficial discoloration of R elbow and hip were noticed with slight edema and redness around R elbow.  Patient has been kept in cage for several weeks on account of constantly falling out of bed. The swelling of R elbow has increased reaching elbow and wrist became [ill. words], except [many illegible words] portion where it seems entirely fluid.  Yesterday, a similar process began on L elbow.  For two days patient has grown weaker [ill. words] has been moderate diarrhhora (sic).  
May 14, 1901.  Died 11 p.m.  Senile asthenia.


History and clinical notes:
History: Patient has been drinking man all his life and his mind is very feeble, and a few days ago he had several fits; he is very nervous and excitable.
Sep 28, 1900.  Very much improved, mind clear, rests well, appetite good.  9:30 a.m. left on parole.
Feb 18, 1901.  Discharged recovered.


History and clinical notes:
History: Patient was admitted here Dec 2, 1899 and discharged recovered March 23, 1900.  A few days ago she became very noisy and violent.
Feb 3, 1901.  Up to past few days has been quieter and more biddable; worked on ward and answered questions coherently and pleasantly.  Condition the last day or so has altered; she wanders around the wards, mumbling to herself, struck one of the patients and attacked an attendant; had to be restrained.  Seems dazed and does not answer questions unless repeated a number of times.  Physically in good condition.
Mar 8.  Condition unchanged.
Mar 15.  Up and working about ward again.
Mar 1902.  Same as at above note – attacks of excitement have been mild, patient desires to get out; always asking how soon, when refused does not seem to understand that she is refused.  Works occasionally on ward, takes an active interest in all that goes on around her excepting during attacks of excitement, when she is very ugly and disagreeable, inclined to bite and hit those who interfere with her.
Apr 16.  Vaccinated today against her will.
Jun 4.  Home on parole.
Jul 7.  Returned by friends, maniacally excited, required restraint for 48 hours and repeated doses of chloral.  Very erotic, irritable, talkative and [ill.] alternating by period of crying and sobbing.
Jul 30.  Since return has gradually quieted down, now about the same, asks to go home.  Says she is all right now, wants to write letters all the time to her friends.  Helps a little with work on the wards, but sits chiefly on a bench doing nothing, or talking to those around her.
May 2, 1904.  Is cheerful and quiet, asks to go home often.  Health good.
Nov 14.  Is increasingly worse, and threatens violence.
Jun 5, 1905.  Patient quieter and more amiable.  Eats and sleeps well.
Sep 20, 1909.  No change.  In good physical condition, works in laundry.
Feb 20, 1933.  Died.

Final disposition:
Still in hospital, but died in hospital 2/20/1933.

Additional notes:
According to death certificate, she died of an acute intestinal obstruction (autopsy was performed).


History and clinical notes:
History: Patient’s mind has been affected for the past six years; began gradually with loss of memory and has continued to get worse.  He undresses himself very often through the day but is very tidy.
Nov 10, 1900.  No improvement; mind very feeble at times, noisy and very untidy.
Dec 18.  Has had a number of convulsions and is very little improved.
Dec 19.  Still unconscious.  
Dec 20.  Unconscious and getting weaker.
Dec 21.  Gradually getting weaker.
Dec 22, 1900.  1 p.m.  Died.  Cerebral embolism.


History and clinical notes:
History: Has been at the Home for Aged Women for 10 months; was weak minded there. Has had prolapse of uterus for about 10 years.  Lately has imagined that the building was on fire and has tried to jump out of the window and they could not keep her at the Home.  Imagines that she sees smoke etc. and has delusions and other hallucination.  Eats fairly well, sleeps good at night.
Feb 3, 1901.  In bed constantly; eats and sleeps well.  Suffers from diarrhea at times.  Is somewhat deaf but answers questions where she hears them.  Tonic and diarr. mixt.  
Mar 8.  Same as at last note except suffering from slight bronchitis; takes her nourishment with difficulty and as several small bed sores [ill.] over trochanters.
Mar 11, 1901.  For past few days has failed rapidly.  Throat very markedly inflamed, coat on tongue is very thick; impossible to remove.  Patient keeps mouth open all the time and swallows with great difficulty small quantities of liquid.  Does not pay any attention to what is said to her; has not spoken; holds head in fixed position and groans when she is turned from side to side.  Respirations rapid, numerous rales.  Pulse fair.  Markedly emaciated.  Bed sores look a little better, but still need care.  This morning, back of R eat and extending down side of red (head?) bright red discoloration of skin.  Temperature slightly higher than surrounding surface.  [Ill.] of compresses applied.  By afternoon patient had entirely ceased swallowing any liquid; respirations shallow and labored and continued so until patient passed away quietly at 8:30 p.m.


History and clinical notes:
History: Has been well up to few days ago, has had some financial trouble which is supposed to have caused mental disturbance; was very noisy last night.
Feb, 1901.  Very violent for number of days after admission, restrained constantly; [ill.] unclean as to faeces and urine.  Screamed and cried all the time.  Had to be fed twice daily for some time.  Was extremely difficult to manage.  Cried that her house was open, she must go home, that she had several houses.  Later became quieter and quieter until she commenced to work on wards, assisted attendants, then transferred to better ward where she was cheerful and pleasant.  Willing to assist in work; occasionally said she wanted to go home, at present time is one of the best workers on Ward 1.  Sleeps and eats well.  At times seems little drowsy.
Mar 8.  For past three days very nervous and irritable; full of delusions of pains in different parts of her body, marked hyperaesthesia, never in same place twice.  In bed and treated for swollen hand, apparently rheumatic.  Cries on slightest provocation.  Says she is very sick, etc.  
[No date]  On parole.
Nov 25, 1901.  Discharged improved.


History and clinical notes:
History: Was discharged September 20, 1900 recovered and has been drinking very hard for the past ten days.  He is very nervous and restless and all the symptoms of delirium tremens.
Oct 1, 1900.  Left on parole.
Feb 14, 1901.  Discharged recovered.


History and clinical notes:
History: Patient has always been feeble minded and about 8 weeks ago she became noisy, wandered from place to place, talked incoherent, and attempted to drown herself.  Appetite poor, has not eaten since 20th of this month (nine days).
1902 (When note was written, but talking about 1901).  Since last spring condition has been about as follows: worked in attendants’ dining room only after being told that her friendships (?) would be cut off, cried and expostulated a good deal at first, afterwards seemed to like the work and stayed faithfully by it except that she whined and complained a great deal that she did more than the others.  Finally getting tired of this she had one of her ‘spells’ – these are [ill.] hysteric; she pants, holds her heart, says she has awful pains, is very weak, cannot get up, won’t eat, in fact is perfectly apathetic and in response to all remarks says she ‘cannot help it’, ‘no one knows how she suffers.’  During these attacks, her pulse is as good as it ever is and there are no positive symptoms of any kind.  A few doses of ammonia in asafoetida bring her around all night, but then she is too weak to work and begs not to be sent back to work.  Is really very lazy unless constantly eyed.  Later in season was sent to sewing room.  This pleased her better and the only trouble here was that she objected to her daily work.  Patient is very shy.  Never looks at anyone directly; is very neat in her personal attire and about the ward a ready helper.  Everything she does though is done very slowly and sometimes she has spells when she [ill. – looks like “want life a prayer”].  Patient is inclined to adiposity – is an enormous eater and fond of extra food.  Objects to attending entertainments, in fact tries to get out of doing anything that is expected of her.  When made to do as she is told goes ahead willingly and cheerfully as a rule.  On December 6, fell on ward floor and fractured radius of left forearm.  Dressed by Dr. Hancker.  Although repeatedly told to move fingers and exert herself and to do so constantly, patient has not done so, with the result that when dressings were removed January 17 (1902?), the wrist was stiff and markedly swollen and there was little or no movement of fingers.  Joint apparently fixed; elbow and shoulder joint also stiff.  Patient whined and cried at every attempt to touch her – said it was not her fault, that the floor was to blame.  After the doctor manipulated her she scolded in the wards for a long time, calling them all sorts of names and saying she would not let them touch her, etc.  
Mar 16, 1902.  During past month was on Ward S for several days discipline as she was very disagreeable and impertinent when her arm was massaged.  Had always to be hunted up, would hide away behind doors and in closets.  Then would whine and cry before she was touched almost – kept saying it was the fault of the doctors that her arm was stiff.  That she would never be able to use it again, that she knew it was not set yet.  Had just as severe pain and screamed loudly when shoulder joint was rotated.
Apr 16.  Vaccinated today.  Since last note is a little better, back on A, tries to sew and work some, although she takes great pains to [ill.] left hand as little as possible.
Jun 28, 1902.  Home on parole.  Left on parole today.
Dec 27, 1902.  Discharged improved.


History and clinical notes:
History: Had stroke of apoplexy some time ago and since that time his mind has become feeble and paralysis of left side; but is much improved and can walk very well; is very untidy at times.
Dec 20, 1900.  No improvement; is very untidy at times.  Mind feeble.
Feb 20, 1901.  Same as above report.
May 1.  Patient untidy.  Large scrotal hernia on R which occasionally becomes incorcerated.  Hernia is not completely reducible.
Jul 1.  Patient noisy at night, is failing in strength.  When hands are free is tearing his clothes or picking constantly at his hernial protrusion.
Aug 12.  Patient failing slowly.  Must be restrained to prevent picking at scrotal tumor.  Eats and sleeps fairly well.  Was placed on floor on mattress today on account of inability to keep in chains (?).  
Jan 1, 1902.  Very little change since last note, except for gradual failure of strength.
Feb 9.  Has been in bed for past 3 days.  Today developed Cheyne Stokes breathing.  Cycle averages 45-60”.  Is rapidly failing.
Feb 17, 1902.  Cheyne Stoke breathing has continued since last not and up until time of death.  Died Feb 17, 1902, 3:35 a.m.


History and clinical notes:
History: Has been drinking very hard for the past two weeks; is very nervous and some delirious.
Oct 6, 1900.  Left on parole.
Feb 14, 1901.  Discharged recovered.


History and clinical notes:
History: Had typhoid fever when about 13 years old and has morose (?) peculiar since and about one month ago symptoms of insanity developed.  He believes that he is going to be killed, attempted suicide by hanging.  He is very much depressed and will seldom speak.
Nov 15, 1900.  Still in same condition; will not talk to anyone and is very much depressed.
Dec 16.  No change.
Jan 15, 1901.  Still in same condition.
Feb 20.  No improvement.
Aug 15.  Two months ago developed haematomous auris (“Cauliflower Ear”) on right side; same subsided leaving ear slightly deformed.  Patient stands constantly.  Feet become much swollen at times, necessitating placing patient in cage.  Soils his clothes, occasionally refuses to eat for a meal or two.  Will talk to no one.  Face always congested and expression semi-threatening.
Apr 15, 1902.  Stands almost constantly.  Feet often become swollen.  Vaso-motor dilation moderate, will not converse.  Occasionally curses because he is kept here.  Eats and sleeps fairly well.  Looks as if we were his persecutors but never offers to strike.  Is quite negative.
Jul 12, 1903.  Patient is a total dement.  If not prevented would stand all day in one place and position.  Never speaks.  Takes no interest in anything.  Is untidy.  Has to be encouraged to eat his meals.

Additional notes:
Still in hospital.  Note: from census records, he was still a patient at DHS in the 1920 census, but not the 1930 census.  No entry for his death could be located.


History and clinical notes:
History:  The first symptoms was noticed about the first of September; was very ill shortly before this time caused by working among acids.  After this was very disagreeable, swore and cursed his wife; this was not like himself.  Has neglected his work and several times has threatened to kill his wife.  Has lost some flesh.  Eats well and at times does not sleep well.
Feb 20, 1901.  Very anxious to go home.  Cries at times.
Aug 12.  Fairly clean in habits.  Often fills pockets with odds and ends of paper, food, etc.  Is religious.  Slight tendency to lochry motion (??). 
Apr 15, 1902.  On 3 occasions has bent a piece of wire into key shape and attempted to escape.  Is very untrustworthy.  Wears badges on coats (?).  Vaccinated today.
Apr 20.  Good take.
Jul 30.  Is untrustworthy.  Often is found making a key by which he may escape.
Dec 30.  Somewhat hypochondriacal, moody, and invariably tries to effect a way of escape.
Jan 20, 1903.  Patient had a severe convulsion this morning; epileptic in character; no other history of epilepsy.  In the course of day patient had nine convulsions.
Jan 24.  Has remained in an unconscious condition for past four days; has seizures almost constantly.  Bowels have been inactive.  Had to be catheterized.  Rectal feeding.  A gradual loss of flesh and strength.  Patient died this morning, 5:45 a.m.  Status epilepticus.  Autopsy, brain only, removed.


On certificate of:
Drs. William C. Pierce and Samuel G. Elbert

History and clinical notes:
History: When he was 2 years old fell from the 2nd story window and struck on his head; was unconscious for about ½ hour.  Has never been right since that time.  Has been weak minded and silly, but at times is rational for a short period.  His health has failed some.  Has learned to talk but not to read. 
Feb 20, 1901.  Mind feeble.  Works on the wards and is orderly.
Mar 11.  On parole.
Jun 26, 1901.  Discharged unimproved.


History and clinical notes:
History: Patient had some property and was cheated out of it and about a year ago symptoms of insanity were noticed.  He believes that he is in everybody’s way, thinks people does not want anything to do with him.  Talks incoherent, cries at times, and is very restless.
Dec 20, 1900.  No improvement.  Still noisy, restless, cries at times, refuses to eat.
Feb 20, 1901.  No improvement.
Jan 6, 1902.  Demented.  External piles.  [Ill.] feeble.  Always touchy and quarrelsome.
Feb 15.  Failing mentally (if possible), and physically.  In bed.
Apr 15.  In bed, failing slowly.  Vaccinated.
May 1.  Has been failing rapidly of late.  Is in bed.  Appetite is not as good as it was.  Steadily losing flesh and strength.
May 15.  Very noisy, day and night.  Rapidly failing.  Friends have been notified of illness.
May 26.  Maniacal excitement has continued until yesterday evening when he slowly became quiet and has failed rapidly since.  Died unconscious at 1:15 p.m. today.
May 26, 1901.  Died, exhaustion from maniacal excitement.

Final disposition:
Died of exhaustion from maniacal excitement.  Bruied at DSH. #107


On certificate of:
Drs. George R. Carmichael and S.C. Frederick

History and clinical notes:
History: Was taken from here by her husband July 22, 1900, but has never been well.  Wanders from home, breaks furniture, etc.  Is gradually getting worse.  Has had several attacks of angina since she left here.  See page 66.  
Feb 1, 1901.  Patient vomits all nourishment of late.  Treated in bed with liquid nourishment in small quantities.  Restraint necessary as patient masturbates excessively; at times talks rationally and appears brighter.  Again has spells of crying and worrying her hands.  Complains of pains in her legs.  Patient markedly emaciated, very anaemic.  Heart action at times feeble and irregular.  Of late on [illegible names of medicines] t.i.d. with occasional doses of Spt. Ammon. Arom. (spirits of aromatic ammonia).
Feb 11.  Past few days patient has been brighter; vomiting has almost ceased; was on solid diet for several days last week – commenced to vomit again so was placed on predigested beef and milk and lime water again.  Patient sits up nearly all day.  Restraint still necessary at times.  Patient very unclean [ill.] urine and faeces.  Smears with latter.  Still has spells of crying at times.
Mar 8.  Has not vomited for some time; for past three days uncontrollable diarrhea.  Patient on milk, predigested meat and chopped meat.  Sleeps well, says she feels find and although still very anaemic looks better than she has for a couple of months.
May 15.  Grew gradually weaker and emaciated until finally kept in bed constantly; in straight jacket until too weak to move as she masturbated excessively and constantly when unrestrained.  Also ate her excretions.  Diarrhea continued until the 1st of this month; had an attack of peritonitis brought on my eating bits of her bedding which she chews off when unwatched.  Heart grew intermittent and feeble toward the end, cough was persistent and some expectorations which she smeared around on wall or bed.  But [ill.] that she coughed up she swallowed.  Visited by her friends and husband, seemed to know them fairly well.  Death was peaceful at the last.  Due to great prostration and emaciation, as for the last two days she was unable to retain any nourishment at all, even vomited the smallest quantities of liquid.  
May 15, 1901.  Died.


History and clinical notes:
History: Has been insane since Tuesday night from incessant drinking.  Has always been a hard drinker, but since election has drunk harder than usual.  Has several times fell unconscious without any assignable cause.
Nov 18, 1900.  Left on parole.  Was apparently all right up to past week, since which time he has been drinking hard.  Friends could do nothing with him as they returned him to the hospital on Jan 26, 1901.  As a boy and young man very popular with his companions, ‘middling’ good scholar.  Married at 20 years.  Wife is careless housekeeper, fond of gossip, and etc.  When patient is drunk, curses and gets angry at his wife, but never hurts anyone.  When he starts to drink does not seem able to stop; not satisfied with a few drinks.  Eats well, appetite excellent.  Sleep disturbed, toward morning would get up and want a drink.  Last summer for [ill.] period was very much still down, slept poorly, eat very little and then started to drink hard for the first.
Feb 2, 1901.  Patient improved very rapidly under treatment; left today on parole with father, perfectly well.
Feb 16.  Patient returned by father this evening; had been drinking and was unfit to be out.
Feb 20, 1901.  Has improved, removed by father today on parole.
Mar 11, 1901.  Discharged.


History and clinical notes:
History: First symptoms was noticed about 10 days ago.  Began to talking about dying and talked incoherently.  Has gradually grown worse.  When she was admitted was very violent and incoherent, etc.  Suffering a great deal from hemorrhoids.  
Nov 14, 1900.  Patient put at once in bed, hypodermic of hyoscine gr 1/75 administered.  Slept quietly for the afternoon and took a fair amount of nourishment.  Became very noisy and excited again at night, requiring restraint and another hypodermic of hyoscine in the night.  Seems somewhat better today.
Nov 15.  Patient more quiet, took some nourishment voluntarily in the morning, but later in the day became very much excited and had to be fed by nasal tube.
Nov. 16.  Rested quietly through the night and appeared about as usual on awakening, but about 9 a.m. had a convulsive attack somewhat resembling an epileptic convulsion.  Following this, patient appeared very much exhausted.  Heart action very poor, extremities cold, profuse sweat.  Hypodermic of digitalis, strychnine, atropine, etc. given and later fed with milk and eggs and whiskey.  Condition improved and in afternoon appeared about as usual.
Nov 17.  Heart action continues very poor.  Whiskey and strychnine administered in the usual feeding.  About 6 p.m. patient became worse, cold extremities, very feeble heart action, unconscious.  Hypodermic of Heart Tonic administered.  Cardiac action somewhat improved, but still unconscious.  Friends came about 9 p.m. and removed her to her own home.
Nov 17, 1900.  Patient discharged unimproved.

Final disposition:
Discharged unimproved; in a coma.  Died two days later of heart disease.


History and clinical notes:
History: Officer who brings patient knows nothing of his history; he talks incoherent and does not seem to understand what is said to him.  He is hard to control though not noisy.
Jan 20, 1901.  Has been in bed for past few days; cannot stand, acts as if he was paralyzed, has all the symptoms of cerebral embolism.  Tongue is partly affected and cannot articulate well.
Jan 31.  Still in bed, but weaker.  Had another attack today.  Is growing more feeble.
Feb 7.  Is much worse today; is unconscious and is gradually failing.  Is unable to swallow and cannot talk; friends were notified of his condition.
[No date].  Has not taken nourishment since last note; that administered by mouth and rectum poorly retained.  Patient has been in comatose state ever since admission.
Mar 30, 1901.  Died at 9:45 a.m.


History and clinical notes:
History: Was discharged Sep 20, 1900 from parole.  And few days ago he began drinking very hard.  He is nervous and tremulous and has all symptoms of D.T.s.  See p. 86, no. IV; see p. 458, no. iii (Case books).
Nov 30, 1900.  Left on parole.
Feb 14, 1901.  Discharged recovered.


On certificate of:
Drs. Irvin Vallandingham and J.H. Hardcastle

History and clinical notes:
History: Patient has practiced self-pollution all her life; she is very nervous and attempted suicide by choking herself about two weeks ago.  She has gradually become worse and has delusions and complains of severe headaches.
Jan 29, 1901.  Sleeps at night in camisole; says otherwise she ‘can’t stand it.’ It referring to the burning pains which she feels in her pubic region that gradually ascend to her head and which then, as she says, make her unconscious of what she does.  During the day complains about her condition.  Wants to talk with every one on the subject of her tendency to masturbation, etc.  It is almost impossible to get her to talk about anything else, if allowed to do so.  Some days [ill.] remain in bed with her camisole on.  Internal examination shows pelvic organs in fair condition; external genitals somewhat anaemic but macroscopically nothing of note.  Patient general health poor, very much emaciated, appetite poor.  Sleep poor.
Jan 29, 1901.  Allowed to go home on parole.

Final disposition:
Discharged, but readmitted 2/9/1903.  Died in DSH in 1937 after 34 years.

Additional notes:
Same as person #43571454.  Shawl pin found imbedded in front wall of vagina in 1903, removed with difficulty.  See #43571454 for details.


History and clinical notes:
History:  Patient mind has been affected forty years; she is feeble minded and is restless, she has always been kept at home.  The attack began just before child birth and has been continuous.  On the 6th of this month she had slight attack of hemiplegia.  Left side of face and speech center very much affected.
Jan, 1902.  For past year has been in and out of bed – very stupid and dull, eats light food only as has a tendency to choke.  Incontinence of urine, at times marked.  When up and dressed sits quietly on bench, occasionally chuckling to herself or laughing without a cause, again makes angry faces and gives series of grunts.  Talks a few words occasionally.
Apr 14.  Early part of this month moved to Ward B and put to bed in Infirmary so she could have more care.  Had another light stroke that paralyzed her Left side for a time.  Incontinence of urine and faeces marked.  Fed with difficulty.  On the 12th had moderate fever (101), seemed to be suffering from an attack of indigestion; constipated, coated tongue, foul breath, etc.  Given Cal. and Soda every ½ hour on the 13th.  Few macular spots of heightened color noticed on face and scattered [ill.] on chest.  On the 14th, the case was diagnosed as one of small pox and patient was transferred to small pox ward where she died on the 21st and was buried here.
Apr 21, 1902.  Died of smallpox, buried at Farnhurst.

Final disposition:
Died of smallpox; buried at Farnhurst, Grave #98


History and clinical notes:
History: Patient was discharged May 15, 1899, recovered.  Present attack began about two weeks ago.  Lately he became very noisy and violent, talking incoherent and hard to control.  
Dec 20, 1900.  Very noisy and violent at times; has to be restrained; general health good.
Feb 20, 1901.  No improvement, he is still noisy and talks incoherent.
Apr 15, 1902.  For a year past has been a rational good worker on farm and trusted to do many independent things.  Vaccinated today.  
Oct 13.  Left today on parole.  Returned Oct 25, 1902.  For the last 8 months has been quiet and trusty.  Works about the farm with the team.  Good worker.  Is allowed to go to town alone occasionally.  Splendid health.  Mentally clear.
Jul 1906.  Is employed on farm, is a good worker, and physical health remains good.
Nov 28, 1906.  Eloped.
Dec 10, 1907.  Discharged recovered.

Additional notes:
Could not find any further information about him.


History and clinical notes:
History: Has had epilepsy for the past 4 years and at times be becomes excitable; eats and sleeps well.
Feb 20, 1901.  Works on the wards; has convulsions occasionally, is orderly and has good health.
Apr 15, 1902.  Has enjoyed uniformly good health for past year.  Fits infrequent.  Feeble minded.  Vaccinated today.
Apr 22.  Head ache, temperature at 2 p.m. 101.3.  Mild take.
Apr 25.  Moderately profuse papular eruption on face, forehead, scanty elsewhere.  To VI for smallpox.
Apr 27.  Eruption vesicato papular.
Jul 30.  Recovered with moderate [ill.] from smallpox.  Has fits at irregular interval, often being free for weeks.
Aug 20, 1903.  General condition unchanged.  Has infrequent epileptic seizures.  Is “tricky” – very weak minded.
Sep 16, 1904.  Is very vicious during epileptic seizures and has frequently kicked physicians and attendants.
Nov 24, 1906.  Difficult to manage and requires restraint.

Additional notes:
Died, in DSH, 9/28/1908 of status epilepticus.


On certificate of:
Drs. William G. Winner and John J. Jones

History and clinical notes:
History: Has been an inmate of the Alms House since Nov 13, 1900.  Previous history is not known by person bringing her here.
Feb 11, 1901.  Complains of pelvic pains and neuralgia.  Last few days on Tr. Digitalis Tr. Ergot fl. t.i.d..  Much better.  Last week internal examination showed uterus was enlarged, as irregular, somewhat patulous (?), considerable leucorrhea and bleeding.  Bimanual exam uterus irregular in outline, very firm, especially at sides, slight retroflexion.  Patient is very pleasant and affable with doctors, gives information as to her pains and feelings very willingly; is constantly asking for medicine.  Discusses condition of other patients, says she is not crazy herself, was only sent here for uterine treatment.  Will not attend entertainments, but interests herself as to who is going, etc.  Is very disagreeable with attendants on ward and objects to every little thing; acts as a perfect busybody and talk disgracefully about the other patients, etc. to visitors or anyone going through ward.  Answers back and is extremely impertinent at times, especially when she receives no medicine; at other times fawns over patients and physicians if they let her, calling everyone her “dears” and praising them to the skies.  Physically in fair condition, eats and sleep well.  Is cleanly about her person and room.
Feb 13.  Has refused to eat for two days, disagreeable and fighting; fed by tube this morning for discipline.  During feeding was hysterical, alternating quiet, fighting, and complaining.
Feb 18.  Since feeding has been quiet and pleasant, eats meals well and tries to be more agreeable.  Transferred today to Ward A.
Mar 8.  Same as above.  Constantly utters complains connected with her delusions as to her pelvic diseases, etc.; variable every day; when she finds no notice is taken of these she changes to being truly polite and complimentary; will not work except a little on ward in the morning.
Jun 25, 1901.  Failed, so she was kept in bed almost constantly, refusing to eat at times; hysterical attacks frequent; seemed to delight in frightening the patient.  Finally true convulsions came on and patient sank rapidly until the 25 of June; she passed away in one (?).  During last week of life suffered from incontinence urine and faeces – seemingly perfectly indifferent to calls of nature, visits of friends, or surroundings.  Died at 2 p.m.


History and clinical notes:
History: Officers who bring patient know but little of his history.  Certificate states that disease is gradually increasing; was brought to Hospt in restraint; conversation incoherent.
Feb 20, 1901.  No improvement; is restrained and at times violent, appetite good.
Aug 12.  Quiet for 3 months past, eats and sleeps well.  On one occasion simulated death to frighten attendant.  Talks very little, is clean and orderly, desires to wear restraints, which he is still do.  (sic)
Apr 15, 1902.  No change.  Vaccinated today.
Sep 22, 1903.  No change.  
Apr 4, 1932.  Died in hospital.


On certificate of:
Drs. John P. Waples and Evan G. Shortlidge

History and clinical notes:
History: Has been nervous for years and about a year ago she began to have delusions; believed that people were going to take her life.  She is very much depressed and worries all the time; sleeps poorly at night.
Feb 1, 1901.  Has not improved.  Has a poor appetite, seldom has a good night’s rest.  Says she is going to die and that we are trying to kill her; that the food is poisoned.  Keeps by herself most of the time and does not wish to associate with any one [ill.] carry on a conversation.
Feb 11.  Was visited by husband today who removed her on parole against the advice of the Supt.
May 13, 1901.  Discharged improved.
Note attached: Standard form, dated Feb 11, 1901.  “I, [name redacted], has this day removed (name redacted) my wife from the Del. State Hospital at Farnhurst against the advice of the Supt and do hereby exonerate the Trustees of the said institution should the said [name redacted] do harm to herself or others or commit any depredations that are interdicted by law.”  Signed [name redacted].


History and clinical notes:
History: First symptoms were first noticed 2 weeks ago, 4 weeks after birth of child.  Got up too soon after birth of child and did not get on very well.  Was not able to do her work.  Two weeks ago began to talk foolishly and incoherent.  Has gradually got worse until lately when she swears and curses and is hard to control.  Does not sleep very well and eats but little although she has taken milk; drinks a great deal of water.  She has lost flesh and strength. (Father says patient was up on second day after birth of child and did a day’s washing).  Patient large-framed, strong woman.  Was covered with vermin and very dirty.  Eyes markedly suffused and very bright – pupils dilated, respond poorly; cheeks flushed.  [Ill.] on mouth, tongue coated.  Skin dry and harsh.  Pulse accelerated.  Had to be kept in bed with hands and feet restrained, very violent, thrashed around, tried to bite attendants, etc.  Slept poorly.  Took nourishment badly; fed by tube until 23rd, then [ill.] to obstruction in naso-pharynx; this was discontinued and food was given her by spoonful at frequent intervals.  During the night talked and laughed, quieter during the day.  When restraint removed, masturbated excessively, pushed off clothing, drew herself up in bed and was in every way very restless.  On the 24th attack of heart failure at 11 a.m., pulseless and very weak.  Reacted after Tr. Digitalis [ill.] x, Spt Ammon Aromat ℥ (ounce) ii whiskey ℥ (ounce) ii and hypodermic of strychnine sulph 1/30 and etc.  Hot water [ill.] [ill. – looks like ‘sinaprisus’] etc.  Following this took nourishment a little better.  Disturbed a good deal by collection of mucous in throat and nose.  With exception large bronchi lungs clear (exam. owing to restlessness of patient incomplete).  Bichloride douches which were being administered daily were discontinued as patient was menstruating. Clysinas (?) to keep bowels open.  Also saline enemas (four oz. at a time) given three times daily.
Feb 3, 1901.  Another attack; called to patient, found her almost pulseless, heart action feeble and irregular.  Breathing sighing.  Extremities cold, eyes sunken and anxious.  Reacted after 2 hours work and administration of Strych Sulph gr 1/60; Digitalin 1/100; Nitroglycerine 1/100; Strych Sulph 1/30 gr. Strop 1/250 gr – Aromat Ammon ℥ (ounce) ii and Whiskey ℥ (ounce) ii in water teaspoonsful at a time every few minutes.  Hypodermic of whiskey.  Patient swallows with difficulty; obstruction in throat and Cayer (?) bronchi seems extending; auscultation over lungs revealed only harsh breathing.  Percussion note clear all over grad (?) reacted.  At 2 p.m. last rites of Catholic Church administered.  Following this, patient grew stronger; took little nourishment every little while during the afternoon.  Beef juice malt, milk and whiskey being alternated.  Strych Sulph 1/60 every 6 hours.
Feb 5.  Fed by [ill.] twice in the morning, retained very little, at night did not regurgitate food.  [Ill.] milk, 3 eggs. ℥ (ounce) ii whiskey and ℥ (ounce) ii of meat juice.  All through day patient seemed brighter, was restless and fought attendants.
Feb 6.  Drank food herself through the day; seemed stronger, recognized physician and nurses, seemed milder and more amenable to requirements.  Bowels moved copiously following enema, 8 p.m. R ear commenced to run – considerable quantity creamy white fluid.
Feb 7, 1901.  Seemed stronger.  Asked for coffee, given some, seemed to relish it.  Enema at noon followed by good evacuation.  Quiet and apparently lucid.  At 2:45 doctor called, found patient dusky blue color.  Respirations labored.  55 per min.  Pulse rapid – weak – dicrotic mucous nothing in throat and over chest anteriorly numerous rales heard.  Percussion note anteriorly clear.  Patient appears conscious at first, muttered a little in Polish, same treatment as before, but failed to react.  Ammonia and [ill.] nitrite inhalations of no avail.  Patient could not swallow to [ill.] to hypodermics.  Gradually grew worse and died at 5 p.m. in presence of Drs. and nurses.  See urinalysis for albumin and casts.

Final disposition:
Died of complications following childbirth

Additional notes:
Probably an infection from childbirth.  Could not find anyone else of this name or variations on the spelling -- no husband Frank, no child.  Death certificate says she died 2/6/1901 of oedema of lungs as a complication of puerperal mania


History and clinical notes:
History: Officers who bring patient know nothing of history.  Certificate states that the disease is of 2 weeks standing.  That the patient has had syphilis and that this is the probable cause.  At times is violent.  Patient has a hesitating speech.  Tendon reflex not absent.
Apr 3, 1901.  Removed today by wife.
Apr 3, 1901.  Discharged unimproved.


History and clinical notes:
History: Father died in this institution.  Patient lost 2 children 5 years ago (twin boys), worried a great deal about it, imagined that Dr. Hitch killed them.  Delusions only appeared about 1 year ago.  Has threatened to kill different people because “they are working on [ill. – looks like ‘feice’] with electricity and has repeatedly threatened to injure people around him.  At times he is very melancholy and will not speak for a month or two and then breaks out in violence.  Reads the Bible a great deal since he lost his children; previous to that time was an infidel.  Disease is increasing.  Had steadily losing flesh and strength.  Appetite has been fair.  Sleeps fairly well at night, although there are times when he is very restless and walks the floor.
May 16, 1901.  Believes [ill.] McMullin Joseph and McGonigle are his enemies and when any one speaks loudly it goes through him like electricity.  Says there are good and bad spirits in him, which seem to wander over the world and when they come near bad people in groups he feels as if he were being pulled backwards.  Claims to sleep and feel well.  Is very slow in his reflexes.  Has a dreamy ‘mystic’ appearance.  Is in fair physical condition.  Quiet and tractable.
Jun 20.  Fulfillment period of 4 years ended today.  Is now Jesus Christ and can walk about.  
Jun 25.  Attempted to strike Mr. McMullin today because he was asked to do something.  Transferred to Ward VI.  Says the Spirit makes the pupils (of eyes) large or small by drawing on them.
Feb 1, 1902.  Is going to be King of America.  Gave us all positions.  Is quite hysterical in actions.
Mar 15.  Says he is not going to be King.
Apr 15.  Quiet and cleanly, moves slowly.  Much preoccupied.  Vaccinated today.
Apr 20.  Good take.
Jul 30.  In good physical condition, but mentally the same.
Jul 12, 1903.  Good worker about the ward.  Talks little.  Emotional, crying frequently.  General health good.
Aug 20.  No change in condition.  Voracious appetite.
Jul 11, 1907.  Removed to TB today.
Aug 2.  Failing rapidly, refuses nourishment.
Aug 10, 1907.  Died.  Phthisis Pulmonalis.


History and clinical notes:
History: Officers who bring patient know nothing of history.  Certificate states that disease is of two weeks standing, gradually increasing, of emotional character, religious.  Patient says that people talk to her all the time and want to prevent her communicating with the Lord.  Just wants to lie down and be alone.  Does not want to eat; could give very little information herself.  Stopped working after the New Year.  Wanted to save her soul; did not want everyone to bother her.  Wanted the Lord for herself and did not wish to give anyone else any of his time.  On the ward patient went quietly to bed, drank glass of milk, answered a few questions when persistently asked, but as shortly and irrevelantly (irrelevantly) as she could.  Said she knew the reason she was asked questions was that everyone wanted to make out she was insane but she was not.  Said she had never been an ‘osmary girl’ (?? – perhaps ‘ornery’); had attended Revival meetings, etc.  One sister living (in) Philadelphia.
Feb 11.  Patient has slept quietly since admission.  During the days sits most of the time on a bench with head bent, gazing in front of her; occasionally jumps up and walks up and down the ward; once in a while stands still and jumps up and down on her toes a dozen times or more, as high as she can, muttering to herself all the time.  Patient somewhat negative, only answers questions when one insists; since yesterday has refused to eat.  Fed this morning by tube; never talks to other patients, does not work or show any interest in her surroundings, occasionally shows fight when attendants want her to go to meals.
Feb 19.  After three feedings, patient went to table to eat; for past week has been more approachable, works on the ward willingly; does not talk so much about the Lord; says she knows that she had too much religion and feels better now.  Visited on the 16th by a cousin who said that last fall [patient] had a severe attack of illness and that she prayed and sang with her until [patient] ‘got religion’.  Since then has been peculiar, talking about the Lord, etc. 
Mar 8.  Has been working on ward periodically very well; eats and sleeps properly.  At times has periods of depression and mutters to herself.  Sits idly on bench staring ahead of her or else wanders up and down hall.  These attacks last a day or so only.
Jul 30, 1902.  Mentally and physically unchanged.
May 2, 1904.  Condition about the same.  Works on ward occasionally.  Health good.
Nov 14.  Mentally and physically the same.
Jun 5, 1905.  Remains about the same.  Works on ward.  Eats well.
Feb 20, 1906.  Physical condition fairly good.
Jun 6, 1909.  Patient very stupid; being treated for otitis media.
Sep 22.  Complains of pain in head, discharge of blood from left ear; passed blood in urine.  Exam. heart rapid and feeble, pulse 136, temp. 103.  Skin clammy, moans in sleep.  Lies with head drawn to left side, no appetite, pupils dilated, patient delirious.
Sep 23.  Condition same, considerable quantity blood and pus passed from ear.
Sep 25.  Patient unconscious, blood still oozing from ear.
Sep 25, 1909.  Died 1:30 p.m., cerebral abscess secondary to purulent otitis media.

Final disposition:
Died of cerebral abscess secondary to otitis media.  Buried at DHS #177.


History and clinical notes:
History: Has been drinking heavily for more than a year; only confessed to doing so in Aug ’00.  Has been in the habit of leaving home for days and weeks at a time; on his return can give no account of himself.  Money which he took with him all spent and he is always in more or less of a dazed condition for some time.  Has not worked for over a year; appears nervous and excitable.  Says he has pains in his head all the time.  Wife said they had been married 16 years and that up to a year ago last November that he was always sober and industrious.  Was cheated out of considerable money then and it seemed to prey on his mind.  Habits up to that time good in all respects.  Patient’s father was a heavy drinker; died of ‘stroke’ at age of 73 years.  Patient’s mother still living, perfectly well now, a few years ago was insane for a few years.  Age at present 70 years.  Other than typhoid fever as a young man and repeated attacks of [ill. – looks like ‘quincy’], patient has always been healthy.  During the past year has been treated for nervousness, etc. by Drs. Patterson, Bereus, and others.  Yesterday was the 7th time he absented himself from home.  Came back in intoxicated, dazed condition and confessed to use of Absinthe as well as Alcohol, expressed desire to be treated and was brought to Hospt. today by his wife very nervous and complains of pains in head and contusions of left eye, coordination slightly impaired, tongue tremulous, speech thick, appetite has been better since he drinks than before.  Does not sleep well at times.  First absence from home Nov 1, 1899, 4 weeks; 2nd March 20-Apr 7; 3rd Aug 27-Sep 4; 5th Dec 12-17; 6th Jan 6-9, 1901; 7th Jan 21-29th.  During intervals he is at home he will attempt to work, but cannot.  Gets nervous, walks up and down some and finally says he has some errand or other to attend to that takes him out.
Feb 23, 1901.  So much improved that he was allowed to go home with his wife.  Discharged.

Additional notes:
Mother was insane for a few years, some time previously.  Died 8/12/1907 of accidental poisoning.


History and clinical notes:
History: First symptoms of mental deterioration was noticed about 2 years ago, characteristic of senility; wandered away and did not know where he was.  For past six months has been very hard to care for – wandered about at night and was at times destructive.  His relations were too poor to care for him longer.  Has usually a good appetite but seldom rests well at night.  Five weeks ago his wife died, but patient never realized it, nor has he asked for her for some months.  
Jan 21, 1901.  Slept but little last night and destroyed some of his bed clothes, wanders around aimlessly.
Apr 16, 1902.  Demented; recognized no one; must be tied to bed at night.  In fair health, occasionally has boils or will scratch back badly.  Vaccinated today.
Aug 30, 1902.  Circulation poor, nose cold, extremities often cold and cyanosed.  Is unable to retain solid food.
Aug 31.  In bed.  Very weak.
Sep 2, 1902.  Unconscious.  Died this morning.

Additional notes:
"Relations were too poor to care for him any longer."


History and clinical notes:
History: Has been drinking since last Thursday, he is very nervous and delirious and untidy.  This is third attack in 9 months.
Feb 22, 1901.  Much improved, talks coherent, eating very good and sleeps well.
Feb 23.  Still improving.
Feb 25.  Allowed to go home this a.m.
May 13, 1901.  Discharged.


History and clinical notes:
History: Had La Grippe 4 years ago and mind has been affected every since; gradually getting worse, wanders from home and friends were afraid that he would be injured; at times he is very helpless.
Feb 26, 1901.  Certificate did not arrive until this a.m.
May 1.  Has steadily grown more feeble.  Has to be dressed and undressed by nurse.  Articulation affected so much that he cannot be understood.  Heart action very irregular.
Jun 1.  No change; cannot walk without assistance; breathing very difficult at times.
Jun 30.  Became very weak this evening, could hardly breathe; weather has been extremely hot.  Temperature only 99.  Heart’s action irregular.  Ice bags applied to head and sponged off with alcohol.  Strychnia and cardiac stimulants given hypodermically.  In a few hours was much better.
Jul 7.  Has been dressed every day and placed in a rocking chair in cool part of hall.  Dr. Hancker saw patient at 5 p.m. and was about the same as previous notes, except that he has steadily grown more feeble since June 1st.  At 6:30 p.m. Mr. Brennan and Mr. McGonigle, attendants on ward, spoke to patient and Mr. McGonigle went to dining room to get patient supper.  Returned at 6:35 and found patient had died in the interim, apparently without pain.
Jul 7, 1901.  Died, organic disease of the heart.  6:35 p.m.


On certificate of:
Drs. James L. France and J.B. Steele (?)

History and clinical notes:
History: Complains of rheumatism and pains in his head.  States that women are sending for him all the time and write him postal cards to call and have been at it for the past 14 years.  Says he has plenty of money, and owns a livery stable and various other things; has a tremulous tongue and many other symptoms of paresis.
Aug 1, 1901.  Marked tremor of voice, fibrillary twitching of facial muscles and tongue.  Very demented, is quiet and cleanly, eats and sleeps well.
Dec 15.  Still more demented and stupid.
Dec 26.  Untidy and restless, slight swelling of right side of face.  Temp 101, pulse 120, respirations 18.  Refuses to eat.
Dec 29.  Is about again but often refuses food, cries when made to eat.
Jan 5, 1902.  Is in bed again, very stupid.  T.P.R. normal.  Eats poorly.  Is untidy.
Jan 7.  No improvement or change.
Jan 12.  Continues in bed.  Eats and sleeps fairly well.  Very demented.
Jan 18.  No change.
Jan 19.  Out of bed.
Apr 16.  In bed for six weeks past.  At times noisy.
May 2, 1902.  Has been failing rapidly of late; patient nourishment badly; died this a.m. 10 o’clock from gradual exhaustion of general paresis.


On certificate of:
Drs. J. Paul Lukens and James L. Nance (?)

History and clinical notes:
History: Officer who brings patient knows nothing of history.  Patient somewhat excitable – anxious to talk, is violent at times.
Mar 8, 1901.  Very talkative, restless, occasionally singing, says she wants to do just as everyone wants her to, does not see why people lied to her in bringing her here.  Everyone is her ‘dear friend.’  Says the reason she went and asked police protection was that a man has been following her on a bicycle for a number of days; that she was not well, but certainly not insane.  On the 3rd was so excited that she had to be transferred to (Ward) 5 and restrained for the day.  Then returned to B and since has been better and more amenable to discipline.
Jul 30, 1902.  Since admission patient has been in stationary condition.  Great worker on ward; anxious to help; if anything, has to restrained from working.  At the same time she complains that the attendants make a slave of her – that she has all the work to do, that they are lazy, but they treat her badly.  That they beat and abuse the patients, that she wants to do right but she cannot in this h---- (hell) of a place.  The one moment she is fawning all over the doctors, the next berating them as thieves, liars, etc. at the top of her voice and with great rapidity.  Her voice is of a peculiarly penetrating rasping character that it grates on one’s nerves.  This she seems to realize and when excited or angered there is no stopping the [ill.] that flows of vile language.  She also has a complete vocabulary and uses it extensively.  Patient is obliged to live on back ward as she became too obnoxious in the manner she greeted everyone passing through B Ward that her transfer was necessary.  Her acquaintance in Delaware was extensive and her memory [ill.] more than ordinarily good; the result was she buttonholed everyone with whom she came in contact.  Once in a great while her excitement is sufficient to cause her transfer to Ward 3 for the time being.  If she likes an attendant etc. there is nothing she won’t do to help them.  If she does not there is nothing she leaves unsaid.  Her memory of people and faces is excellent; for past events etc. not quite so good.  She is a great church woman, being able to recite whole pages of the services, but her manner in attending church is so pronounced and her answers too loud that she disturbs the others.  [Ill.] is only allowed to go occasionally.
Jun 1, 1903.  Very abusive and violent at times.  Talks incessantly at the top of her voice.  Disturbs the entire ward.  Sedations frequently necessary.
Jul 30.  For past week, patient has complained of headache and backache with T. 100-104, P. 90-100, R. 20-25.  Constipation.  No rash, no splenic enlargement.  Enteric fever suspected and verified by Widal test.
Aug 20.  Patient better.  Temp ran an atypical course.  No rash or palpable splenic enlargement at any time.  Sitting up some now.  (see p. 155)
Sep 23, 1903.  Has completely recovered from Typhoid.  During the course of and the recovery from the fever she was quiet and tractable, but now is again noisy and at times violent.
Feb 19, 1904.  Uses very foul language, is quarrelsome and unruly.  Losing flesh, but otherwise in good physical condition.
Mar 16, 1904.  Rapidly losing flesh and strength.  Breath very foul. Mental condition unchanged.  Coughs and expectorates profusely, sputum examined, no tubercle bacilli found.  Patient sent to bed and put on milk diet.
May 2.  Patient better, growing thinner.  Eats well.  Is up and about ward, sometimes works.
Nov 14.  Physically well, has wild outbursts of passion very frequently.
Jun 5, 1905.  Patient vulgar and noisy, great nuisance on ward, physical condition somewhat better.
Nov 20, 1907.  Physical condition, much emaciated.  Eats well.  Mental condition unchanged.
Sep 20, 1909.  Physically [ill. – looks like ‘rarlur’] good; mentally no change.  A good worker.
Apr 5, 1929.  Died


History and clinical notes:
History: Left here July 13, 1899, was fairly well until about last Christmas, when he began to neglect his work and wandered from home.  For past month or six weeks has been carrying pistols and guns and has threatened to kill any one that comes near him.  Is in fairly good general health.
May 10, 1901.  Has been violent since last admission and often under restraint.  Is vindictive, quarrelsome.
Jun 15.  Restraint off most of time.  Occasionally will play with spittoon contents.  
Aug 15.  Quiet except at times at night; cleanly; no restraint.  Very incoherent.
Apr 16, 1902.  Incoherent, demented.  Quiet, cleanly, helpful, vaccinated yesterday.
Jul 30.  No change.
Jan, 1919.  No improvement in patient’s mental condition, physically getting worse; suffering badly from chronic interstitial nephritis.
Feb 22, 1920.  Patient died this morning at 6 a.m. of chronic interstitial nephritis (3 years).


On certificate of:
Drs. Francis L. Durrilap (?) and J.W. Delbitt (?)

History and clinical notes:
History: Patient had apoplexy in August and has been paralyzed; on right side, since mind is feeble; is very nervous and falls very often, perfectly harmless.
Mar 12, 1901.  Has been in bed since admission.  Has not been able to take solid food, has to be fed with liquid nourishment.  Has all symptoms of general paresis.
Mar 18.  Patient is unconscious today; has not been able to swallow since yesterday.  Cannot last very long; friends were notified.  Failed rapidly and died 9:30 p.m. on March 18, 1901 of general paresis.


On certificate of:
Drs. John P. Wales and Evan G. Shortlidge

History and clinical notes:
History: Has been admitted a number of times for drink; is nervous and excitable.
May 13, 1901.  Discharged recovered.


History and clinical notes:
History: None.
Mar 27, 1901.  Visited by friends who have known her for many years; who say she was always insane, mania for stealing anything, terrible temper, flying into a passion at slight provocation.  Three years ago this May threw herself into Brandywine; had a little money saved, supposed to have been stolen from her, grew very despondent and tried to drown herself.  Afterwards [ill.] work for a little while, then steal something and leave.  Afterwards traveled around for awhile; in New Castle Jail for beating her mother.  History of bad treatment, even from a child in part of her family – mother drinks hard; father fell down stairs and killed himself while drunk.  Has history of [ill. – perhaps ‘having’] a child many years ago.  Taken home by this friend who has given her a shelter whenever she needed it.  Used to run around a great deal, with any and everyone.
Jul 30, 1902.  Since admission has been on violent ward, occasionally in restraint for short time, as she has periods of excitement in which she imagines that people are talking about her, saying she is no good, etc.  Her face is suffused, she is very incoherent and confused during these attacks and the least remark will occasion great anger on her part and unless carefully watched and restrained she is apt to strike the patients or fight with the attendants.  She works on the ward at other times a little, but sits chiefly in a rocking chair singing and humming to herself.  She takes great pride in the arrangement of her hair and does it up no end of times a day.  Half the time she only gives one finger to the doctor – at others she is approachable and affable, answering all questions.  Her memory is poor, or else she will not remember, but the [ill.] questioning at various times has failed to elicit much history.
Sep 23, 1903.  Has outbreaks in which she is very violent and restraint is required.  Talk at times is profane and obscene.  Good physical condition.
Feb 19, 1904.  Condition unchanged.
May 2.  Is quiet, except on rare occasions.  She is well physically.
Nov 14.  Very noisy at night.  Is disgustingly obscene in her language.
Jun 5, 1905.  Vulgar and noisy.  Eats and sleeps well.
Feb 20, 1906.  No change in any way.
Nov 20, 1907.  Very much run down physically, very violent at times.
Feb 2, 1924.  Died.


History and clinical notes:
History: Has been attempting to obtain money to buy poison this past week, has been hysterical with husband, hitting him, scolded, etc.  Does not want anyone to come hear her; at other times very demonstrative.  Sleeps well, appetite poor.  Hears buzzing noises in her head; says she is very nervous and fears she is going insane.  Has globus hystericus, nervous indigestion, etc.  At times excitable, again easy to manage.  In this hospital April 24-29, 1900.  Did very well for a while; past three months been getting gradually worse.  In Delaware Hosp. for couple of days; annoyed patients and husband had to remove her.  Patient wants to be treated for trouble in head.  Came willingly with husband; is very fond of children; had to be driven to see her father to say farewell before she came here.  Following day after sexual intercourse always more excitable and nervous.  No bad habits.  When patient was 3 years old, she was run over by horse and carriage, head hurt.  According to father, patient’s condition very similar to her mother’s.  Latter was very excitable and hysterical.  Died in convulsions following miscarriage occasioned by accident to [this daughter – when she was run over by horse and carriage].  During residence in hospital had several hysterical attacks; would throw up her hands and run shrieking down the ward, or cry noisily, saying that no one understood her case.  Invariable acted for the benefit of lookers on – one night summoned the Doctor, had a regular seizure heart ‘cramps’, groans, pain in epigastrium, etc., lay moaning in bed.  Immediately relieved following administration of asafoetida.  At other times was friendly and kindly on the wards; took care of a baby belonging to one of the patients, was smiling and agreeable.  Again would talk in a disagreeable way relative to the other patients.  Would try and get letters mailed by visitors for other patients.  Was very untruthful at times.  Always smiling and fawning on the Doctors.  Afterwards criticizing everything they did severely.  All the time anxious to get out – ‘she was not crazy’ – her people could afford to pay for her in a private hospital.  She was only nervous, would not act that way if they would only try her again.  Removed by husband on parole, April 1, 1901.
May 13, 1901.  Discharged improved.
Note:  same as patient number 40561159.
Note: The “epigastrium” is the upper middle portion of the abdomen, above the navel, directly over and above the stomach; the region of the esophagus.

Additional notes:
Same as 40561159.  Could not track down in online resources.


History and clinical notes:
History: Patient was sick following birth of child; treated for womb trouble at Presbyterian Hospital, better afterwards.  Again became pregnant; at 7 months labor induced – child lived a day and a half, six years ago following (sic).  Since admission has been on Ward A.  At first complained greatly of being unable to walk, wept and moaned at slightest excition (sic).  Claimed she had lost all power over her extremities.  Had one or two semi-hysterical attacks in the night relieved by [ill.] Valerian.  Palpitations, pain in chest, sense of approaching death, etc.  Heart all the time regular if slightly accelerated.  Worried a great deal over her pelvic troubles, said she knew she had to have another operation, etc.  When she found no attention was paid to this, she ceased.  By suggestion firmly administered patient improved so she was able to walk out to meals, then finally was gotten out to walk around the grounds.  If watched, would sway from side to side and shake all over, but if commanded to [illegible words] try to do as she was told.  Ultimately improved so she dusted her room, made her bed, etc.  Very particular about her personal appearance and neat about her surroundings.  When visited would resort to her old cries and whines, making the life of her family wretched by her doubts and worries.  Sleeps well and eats [ill.] given to using a great many endearing terms; has a habit of holding a person or a chair, etc., as though she needed support.  Facial expression generally one of typical [ill.].  Cannot be gotten to sew.  Claims eyes are [ill.] or that she shakes too much, etc.  Only attends entertainments and church on compulsion and then looks as though she were a martyr.  In April had a light attack of small pox, which frightened her nearly to death.  She did not feel she had sufficient attention from the nurses, the others had more than she, etc.  After release from small pox ward in June was somewhat more lazy than formerly, claiming she was weak, etc.  When this was found not to be the case and no attention was given to her plaints, she ceased and is now in about the same condition mentally and physically she was before the attack.  
Sep 23, 1903.  During June, patient ran a typical course of Enteric Fever.  At present, condition is good physically and quite clear mentally, but indifferent to surroundings.  Visited often by family.
Sep 26, 1903.  Paroled.
Jan 21, 1904.  Discharged improved.
Note attached, typical pathology report.  “Pathological and Bacteriological Laboratory of the Delaware State Board of Health, Fred’k D. Chester, Director, A. Robin, M.D., Bacteriologist and Pathologist.  Newark, Del., June 12, 1903.  Dr. Mr. H. Hancker, Dear Sir, The examination of the specimen of blood, Laboratory No. 3158, submitted to the Laboratory June 10, 1903, does show the presence of the Widal Reaction.  The case is therefore one of Typhoid Fever.”


On certificate of:
Drs. James L. Crossmore and Luther S. Conwell

History and clinical notes:
History: Was brought to Kent County Alms House last May by parties that he was living with; wandered away from his work.  Since he came to the Alms House was very restless, has slept but little, could not keep him there as they had no accommodation.
Jun 1, 1903.  Patient is a very poorly developed man physically.  Talks but little and then can scarcely be understood.  Is an imbecile.  Has tuberculosis of lungs.  Transferred to TB.  
December 4, 1926.  Died in hospital.


History and clinical notes:
History: Patient has been in Del Hospt for some time suffering from Rheumatism.
Apr 5, 1901.  Has been in bed since admission.  Very noisy and troublesome at night.  Has a large scar about 6” long inner aspect of left thigh.  Complains of a great deal of pain in this limb.  Cannot talk English.  At times, especially when dosing, has slight choreic movements.  Was visited by friends today who stated that he was injured by cars about 4 months ago and that he has not been well since then.  Has been at Alms House, at Farnhurst, but was discharged from there April 15th.  Has been very restless and has been so weak that he has to be kept in bed and in restraint; tosses restless about from side to side.  Both conjunctivas intensely congested, pulse full and rapid; complains constantly of pain in head.  Cold applications on head produce no relief.  Is much weaker.
Apr 28.  Is much weaker today, although still noisy.
Apr 29.  At 5:30 this a.m. attendants noticed that he was failing fast and died in a few moments.
Apr 29, 1901.  Died.


On certificate of:
Drs. John Palmer, Jr. and James L. France

History and clinical notes:
History: For past two years has been little feeble in intellect – given to wandering around, especially at night.  Talks to herself at night.  Has been living with daughter and talks continually of going home, but has no other.  Sleeps very poorly.  Appetite very good.  Takes very little interest in her surroundings.  Misaprises that her grandchildren are her own children.
Apr 5, 1901.  Did not sleep much last night.  Seems to have very little realization where she is.  Does not recognize the doctor or attendants a second time.  Walks around the wards a great deal, continually chattering, will talk to anyone who listens or else to herself.  Answers questions readily but information not accurate.  Has no knowledge of time or place.  This morning was untidy, not withstanding that she was on the closet a few minutes before.  Appears sometimes to desire to go home but readily sidetracked on another subject.
Apr 6, 1901.  Left on parole with a friend of family.
May 13, 1901.  Discharged unimproved.


History and clinical notes:
History: Patient has had epilepsy since birth, but never showed symptoms of insanity until about one week ago, when she became very violent, attempted to strike Mrs. [name redacted, same as patient’s].  Had to be restrained at that time.  Has been living with Mrs. [n.r.] at Harrington for about 14 years and has always been a faithful servant.  Has delusions of persecution that are well marked for past few days has not ate anything and has slept but little.
Aug 1, 1902.  Since admission has been practically stationary, working at times industriously both on wards and in laundry.  At other periods sitting around and doing nothing unless constantly urged.  Has frequent epileptic attacks but these are not severe and only inconvenience patient for the time being.  Is very angry if any of her belongings are disturbed.  Very desirous of decorating herself with ribbons, etc.  Neat in habits and personal appearance.  Eats ravenously, sleeps well, and seldom requires medicine except for constipation.
May 2, 1904.  Physical condition good.  Works daily in laundry.
Nov 14.  Works all the time.  Is good natured, good physical condition.
Jun 5, 1905.  Has epileptic convulsions frequently, otherwise in good health.
Feb 20, 1906.  Mental and physical conditions unchanged.
Nov 20, 1907.  Has frequent epileptic convulsions.  Works on ward every day.  
Jun 3, 1909.  Condition not improved, coughs a great deal.
Sep 20.  Tubercular area in both apices.  Coughs and expectorates a great deal.  Very cheerful and amiable.  Transferred to T.B., has epileptic convulsions, but not frequently.
Jan 31, 1910.  Had several convulsions today and feels very weak.
Feb 1.  Rested poorly, quite talkative in the morning, grew much weaker in the evening.
Feb 2, 1910.  Died this morning at 4 a.m. in status (epilepticus).

Final disposition:
Died of status epilepticus; buried at DSH #181


On certificate of:
Drs. James L. Crossmore and L.S. Conwell

History and clinical notes:
History: Patient has been sick off and on all winter, chiefly grippe.  Has been very violent, destructive, knocked on other doors, broke out windows, had to be restrained.  Tied with rope.  Mother high grade imbecile, has always managed to make her living, husband was fairly educated.  Several other children – these all seem bright except daughter who is somewhat feeble minded.  Last Friday patient attempted to pull his own tongue out.  Appetite enormous.  Wanders around the country, has only been capable of minding [ill. – could be ‘cows’], etc.  Answers questions slowly; does not always comprehend what is asked.  Cries and moans occasionally.  Physical condition of patient good, prognathous face, small head, vacant expression.  Skin abraded all around the waist, objected to taking bath, tried to bite and kick.  
Aug 26, 1901.  Has grown fat and happy since admission.  Is quiet, helps polish floors.  On parole with brother.
Sep 2.  Returned by brother.  Was well for 3 days then began to refuse to eat, took off his clothes, crawled on floor.  Is quiet now, but depressed and frightened and more stupid than when he left.
Sep 17.  Quiet.  No longer confused.  Gaining in weight.
Nov 18.  Fat and strong, eats and sleeps well.
Jan 12, 1902.  No change.
Apr 16.  No change.
Jun 10.  More stupid today.
Jun 13.  Brighter.
Jun 24.  Very stupid, would take no nourishment or medicine today.
Jun 25, 1902.  Refused food and medicine this a.m.  Was given Mag Sulphate, milk and eggs by nasal tube at 8:15 a.m.  Regurgitated about ½ of same at once.  Vomiting twice during morning and seemed very weak and stupid.  Died suddenly at 12:20 p.m.  At post mortem, no gross cause was found.  Cause of death reported as post dementia exhaustion.  Buried in hospital cemetery.  Grave 108. [Ledger says #107, but Cemetery Book says #108].

Final disposition:
Died of "post dementia exhaustion."  Buried at DSH

Additional notes:
Buried at DSH, Grave #108 (says 107 in ledger book, but this is a mistake, according to cemetery records).  One sister and one brother also described as MR.  Sister was still living with their parents as an adult.


On certificate of:
Drs. Frank Roop Smith and P. Isenscheid (?)

History and clinical notes:
History: Patient has always been a temperate man, has had kidney and bladder trouble for 3 years.  Suffers from incontinence at times.  3 ½ months ago had a stroke; all right side paralyzed at time, speech indistinct.  About six weeks before began to improve, gradually regained use of leg and arm, but has not perfect control of them yet.  For past few weeks has been trying to get out of bed at night – did so occasionally and fell several times.  Talking incessantly, kept family awake nights.  Appetite excellent and sleeps some through the day time; hardly two hours straight.  No increase of irritability.  Has not recognized his daughter since the stroke.  Patient very feeble, thinks he is in the poor house.  
May 1, 1901.  Out of bed.  Sits in chair all the time during day; is feeble in every respect.  Complains but little.  Appetite good.
May 14.  Tears clothes if not restrained.
Jun 7.  Is failing in strength.  Eats and sleeps well.
Jun 9.  Several bed sores over sacrum and crack.  Unable to get up.  Heart weak.
Jun 13.  Has an irregular temp, 99-102, pulse 100-130.  Heart sounds of poor quality.  No murmur detected.  Lungs clear.  Eats well.  Urinary and fecal incontinence.
Jun 20, 1901.  Is unconscious this a.m.  T.P.R. 100-128-36.  Some pulmonary oedema at bases posteriorly.  Died, 4:35 p.m.


Complications:
blind in right eye; kick of horse when a boy

History and clinical notes:
History: Has been failing for some time.  Wanders away from home, does not know where he is.  Talks to himself, chiefly at night.  Tries to get out at night, sleeps poorly.  Appetite good.  Has no memory.  Continues to work well at simple things – originally a good hard worker.  Hit on head by young colt when 8 years, very ill following injury.  History given by 2nd wife, who knows little of his previous history, only married 4 years.
Dec 30, 1902.  Condition the same.
Jan 20, 1903.  Condition the same.
Jun 1.  Patient quite contented and comfortable.  Works some about the garden and ward.  Physical condition unchanged.  
Jan 16, 1904.  Vision of left eye totally destroyed, vision of right failing rapidly.
Apr 24.  Vision entirely gone, failing rapidly physically.
Jun 12.  Confined to bed, emaciating rapidly.
Jun 19.  Very much worse today.
Jun 29, 1904.  Died, senile dementia.


History and clinical notes:
History: About 2 years ago both ovaries removed on account of organic trouble.  Shortly after this, symptoms were noticed that were peculiar.  She began to detest her husband and his family while formerly she thought a great deal of them.  This has continued until lately she imagines that they are all in league against her and that they are trying to rob her of property.  For past few weeks has wandered from home a great deal until her friends were alarmed against her.  At times sleeps well while again she is very restless.  Appetite is good.  Has lost considerable flesh since operation.
Jun 4, 1901.  On parole.
Feb 15, 1902.  Discharged unimproved.


On certificate of:
Drs. Edgmont T. Negendauk and T.C. Frederick

History and clinical notes:
History: Patient has been with Uncle Tom’s Cabin Co. [occupation listed as actor].  Lately disbanded at Wilmington.  He states that he has been drinking a great deal and for past few days has been on verge of delirium and has slept but little.
May 29, 1901.  On parole.
Jun 26, 1901.  Discharged recovered.

Additional notes:
Not able to track him after discharge. Uncle Tom's Cabin Co. was a travelling troupe of actors who put on shows based on the book, for audiences.


Insane Relatives:
father died insane (recurrent mania, 3 times)

On certificate of:
Drs. Samuel C. Elbert and Henry Clay Stevens

History and clinical notes:
History: First symptoms were noticed about 3 years ago.  Father died insane, suffered from recurrent mania, had several attacks.  At first could not sleep and after this became incoherent in his conversation.  Had delusions in regard to his wife – said that she went out at nights.  Lately he has neglected his work and has threatened to kill his wife and has several times threatened to cut his throat.  Lately has wandered from home and his friends have been unable to care for him.  General health has been fairly good.
May 24, 1901.  Physical exam shows fairly well nourished slender white male of about 65 years.  Speech clear.  Memory rather poor.  Tongue corrugated, straight, no tremor (tobacco stained).  Pulse irregular, about 110.  Eyes neg.  At upper outer angle of R scapula is a hemispherical tumor 6” to diam., almost smooth, semi-solid, moveable, not tender, with [several illegible words].  Just below R Poupart's ligament is a slightly larger tumor of similar appearance.  Except that mass 2/3 is fluid with numerous dense pea-to-thumbnail-size rigid “kernels” which are more or less attached to tumor base.  Over fifth rib about nipple line on the R is a small 2” X 1” X ¾” tumor, slightly moveable but similar in character to one on shoulder.  Heart: position and size normal.  1st mitral rough.  Lung: Expiration slightly prolonged with a few sibilant rales.  Abdomen negative.  Limbs negative except for contraction of poleus (?) fascia of 4th and 5th finger of R hand.  
May 26.  Was very noisy all night and rather violent.  This a.m. says he was disturbed and did not sleep well.  
May 28.  Slept well last night (no changes).  Give a coherent history this morning.  Memory poor, says he has two children.  Admits to domestic trouble.
Jun 8.  Was restless and slightly noisy last night.  Complains of indefinite pain in forehead.
Jul 15.  Patient would tear all his clothes off if not restrained.  Has a traumatic (cuff) ulcer on R wrist over styloid process.  Is incoherent; at times is noisy at night.  
Oct 1.  Has been transferred to Ward VI on account of being noisy and for constantly tearing clothes.  Has an abscess of concha of R ear extending along post [ill.] and canal.
Oct 20.  Ear recovered.  Growing much worse, very demented.
Oct 26.  Transferred to Ward (looks like empty square box).  Bare able to walk, restraint constantly necessary to keep from tearing clothes.  Superficial bed sore sacrum.
Note: last line of notes worn away at bottom of page, which sticks out below other pages, is much worn away.  
Nov 6, 1901.  Died.  8:25 a.m.


On certificate of:
Drs. Frank F. Pierson and Harrison W. Howell

History and clinical notes:
History: History given by his son.  Father of patient died of senility.  No history of severe illness.  Has been a hard drinker for 10 years past, except for an 18-month period beginning 2.5 years ago during which he took no alcohol, in obedience to a pledge.  One year ago he returned to his old habits.  He does not go on periodical spree but keeps nearly tipsy all of the time.  He would occasionally be sober over Sunday, but no other time.  Has never been violent and is always rational and wishes to give up the habit when sober.  December 10, 1900 while tipsy was struck by a street car sustaining a lacerated scalp wound in left occipital region which necessitated 5 sutures.  Was unconscious 4 days with a temp 106-107, delirious and violent.  Recovery was gradual.  Was attended by Drs. Ogle and Wales at hospital for one week.  Went home and was back to old habits in 3 weeks.  Damages of $250.00 was allowed by company.  There has been no change in character of patient since accident.  Has never had D.T.s.  Troubled some with insomnia.
Present condition: Large, 5 ft 11.5” well nourished (206 lbs), white male of about 50 years.  Temper irritable, face flushed, moderate tremor of limbs, none of tongue.  Heart, lungs, limbs show no gross change.
May 25, 1901.  Rx Tincture Capsici and Nux Vomica aa ℨ  (dram) xv every 3 hours with ℥ (ounce) vi of hot milk.  Chloral Gr xv once and repeat if restless.  Patient quieter.
May 28.  Now taking solid food.  Sleeps fairly well.
Jun 26.  On parole.
Aug 5, 1901.  Discharged recovered.


History and clinical notes:
History: History of being restless, tearing clothes for several months past.  From New Castle County Alms House.
Jul 24, 1901.  Visited by wife for first time.  In County Alms House for 1 year, 4 mos.  Two years ago hurt in steel plant (head/ sick in house at [ill.] by doctor.  Never able to work after accident, always been kind and considerate.  Drank little but never to excess.  Good worker, used tobacco, was always a hearty eater, good sleeper.  After accident became feeble in mind, talked a great deal to himself, wandered around a great deal, did not seem to know what he was doing.  Always knew his family, sometimes failed to recognize other people.  Had hallucinations of sight and hearing.  Delusions that someone was coming after him, thought people had objects in their hands and were going to hurt him.  Wife hated to hear him declared insane, therefore had him put in Alms House.  First wife had 11 children, 9 are dead.  2nd wife one child, 11 years old.  
Aug 12.  Very incoherent.  Tears off all his clothes if not restrained.  Eats and sleeps well.  Fair physical condition.
Oct 13.  Very stupid this a.m.  Given Mag Sulph and put to bed.
Oct 17.  Bright again though incoherent as usual.
Oct 21.  Slightly stupid.  Put to bed and purged.  Rx Predigested Beef Σ every 3 hours.  Milk (different weird symbol) with meals.  Whiskey ℥ (ounce) ss as directed.
Nov 1.  Right ankle swollen anteriorly.  Same punctured and considerable pain experienced.  Hg Cl2 and cotton dressing.
Nov 8.  Ankle much better.  [Ill.] round 10 cent piece sized clear-cut deep ulcers on right leg just above ankle.  Takes liquid food only.  Noisy at times.
Nov 12.  Has continued to fail since last note and died at 1:30 am today.
Nov 12, 1901.  Died.
Note: Sounds like something bit him on the ankle?


History and clinical notes:
History: Was admitted to the Hospital July 28, 1893 at which time he talked a great deal of loss of property.  Patient says he was here at a later date but record has not been found.  Patient now talks of his property losses and says also that he had been treated unfairly at the Alms House, his law books and some papers having been destroyed.  Talks clearly, memory fair, physical condition good.
Jun 9, 1901.  Slept well.  Appetite good, is orderly.  
Jun 11.  Transferred to Ward C.  Was in Alms House off and on for the past 7-8 years.  Married twice, eldest child 28 years.  Had a little property which he lost giving security for his friends.  Had a violent disposition, easily upset, made considerable noise.
Aug 4.  Feels weak and dizzy.  Some diarrhea.  Bed.
Aug 12.  About wards as usual.  Is weak however.  Reads papers, is tractable.  
Jan 12, 1902.  Is troubled with chronic papular eczema, for which carbolic acid solution seems to give best results.  Is quiet, cleanly, and fairly well contented.  Has been on parole with son several times.
Nov 19, 1902.  Went on parole.  Feeble minded, condition the same.
Jan 18, 1903.  Patient returned to Hospital, being brought by his son, who says that he is feeble minded, annoying persons.  Reads the papers and afterward talks of shootings, etc.  Said after reading of a man shooting another for $50,000, “I don’t think it’s wrong to shoot a man, do you?”  Says this to every one he meets.  Appetite has been fair.  Bowels irregular.  Sleeps poorly.
Aug 20.  Complains a great deal about things in general.  Worries about his lost wealth.  Good health.
Jun 17, 1904.  Discharged.  Not insane.


History and clinical notes:
History: Brought by officer.  Unmanageable for past 4 days, wandering around [ill.], noisy.  Did not eat any.  Slept for an hour or so occasionally, drinking constantly.  In this hospital February 20, 1901, allowed to go on parole Feb 25, 1901.  Discharged Recovered May 13, 1901.  Heart, lungs, and abdomen show no gross lesion.  Tongue –semi-moist, thick white coat, no tremor; breath foul, whiskey laden.  Pulse 90, regular, full, vessels soft, no tremor of hands, but is restless, constantly changing his position.  Rx Tincture Nux Vomica Tincture Capsici aa mix xv, milk ℥ (ounce) vi  every 3 hours.  Give chloral gr xv if restless.  Repeat if necessary.
Jun 11, 1901.  Slight tremor.  Stomach quiet.
Jun 14.  Eats and sleeps well.  Still slightly nervous.
Jun 15.  Was about grounds on parole.  Eloped on 8:36 a.m. train for Wilmington.
Jun 26, 1901.  Discharged recovered.


History and clinical notes:
History: Nephew by marriage said that [patient] had always been mildly imbecilic, never would work, of late has taken to wandering away – at other times sits and worries about a half-sister who was in Farnhurst (Alms House) for poor morals.  Cried and moaned more the past two weeks than before.  Could not get her to take any medicine.  Has always been in poor health; of late has lost considerable flesh; sleeps very little at night; appetite very poor.  As a child, was always ill, did not attend school, was not as bright as other children.  Since admission has been very quiet and [ill.].  Shows very little interest in surroundings.  Does not want to go to bed or get up in the morning.  Has to be constantly urged.  Sits in a corner of ward, gazing without interest ahead of her.  Eats very little except when forced to do so.  Does not make any complaints, does not desire to go home.  When friends visit her takes very little interest either in what they say or what they bring her.  Physically in bad condition, thin, anaemic, etc.  Seems to have delusions as she occasionally whispers to herself but impossible to get these (?) out of her.  
Jul 17, 1901.  Maternal aunt died insane.  [Name of sister redacted] in Alms House.  Also feeble minded.  [Patient] never liked men.  Never would sit at table with them; always said she hated men.  Cousin says [patient] was crossed in love when she was young.  
Jan 8, 1902.  Since last note no change in patient.  Works industriously on the ward, seems cheerful and contented.  Never expresses least desire to return home or see any of her people.
Apr 12.  Remains unchanged.
Aug 1.  No change.
Feb 19, 1904.  Works sometimes, usually sits in corner by door, saying the police are waiting outside to rescue her, and arrest her keepers; physical condition fair.
May 2, 1904.  Works in dining room.  Is surly and refuses to speak to physicians, dropping her work and running away from them.  Physical condition apparently very good.  Eats and sleeps well.
Nov 14.  No change in condition.
Jun 5, 1905.  Good worker in dining room.  Physical condition good.
Feb 20, 1906.  No change.  
May 19, 1933,  Died, bronchial pneumonia.

Final disposition:
Still in hospital.  Died in hospital 5/19/33.  Buried at DSH #415


History and clinical notes:
History: Was in this Hosp. two years ago, has been through four attacks since, varying from week to two.  This attack began June 14, 1901.  For past four days has been eating nothing and drinking constantly.  Unmanageable at home.  Desires to be taken care of.  Wants people to be kind to him.  Very talkative and rather undecided about what he wants to do.  Physical exam: Medium sized, well nourished, white male.  Slightly hilarious (?) and quite restless.  Begging for an hypnotic.  Eyes, heart, lungs, and abdomen show no gross lesion.  Reflexes normal.  Pulse 80, regular, fair volume (?).  Respirations 21.  Tongue semi-moist, gray coated, slight tremor.  Doubtful tremors of hands (extended).  Rx chloral gr xv, hyoscine gr 1/100.  Stat.  Repeat in an hour if necessary.  Tincture Nux Vomica with capsici (odd symbols).  Hot milk ℥ (ounce) vi every 3 hours.  
Jun 14, 1901.  Was given Chloral and KBr (potassium bromide) aa gr xii, no result.  10 p.m. morphine gr ½, hyoscine gr 1/50 under skin, giving two hours sleep during night.
Jun 15.  Nux and capsacin continued.  NoBr gr xx every 3 hours.  Slept all last night.
Jun 17, 1901.  On parole, leaving at 8 a.m. with wife.
Aug 5, 1901.  Discharged improved.


History and clinical notes:
History:  Very melancholy at times, especially last several months, then attends to domestic affairs and becomes very well.  Took a dose of rat medicine two weeks ago; the other night tried to get hold of pistol to shoot herself.
Jun 23, 1901.  Since admission patient has been very quiet on wards, first few days complained a great deal – said she was in agony and misery.  Close questioning however did not bring forth cause.  Said life was not worth living, she had had such troubles.  After a day or two began to work around the wards, expression a little more cheerful.  She asks to return home, says her husband will be broken up if she does not.  Last day or two has been very industrious, sewing, shelling peas, and [ill.] floors.  Eats and sleeps well.  Answers questions more readily and seems to be taking a little more interest in her surroundings.  Physically perfectly well except for slight anaemia.
Aug 4, 1901.  Still very melancholy at times.  Clambers (?) all the time to go home, says a famine will take place if she don’t; she must go home or she never will be well.  Works on the ward very nicely and takes an interest in helping with household affairs in the kitchen.
Jan 4, 1902.  Since last note, little change, continually worrying and crying, asking to go home, to see the Trustees, to be allowed to leave this place.  She never will be better as long as she is here, etc. etc.  Today, against the advice of the Superintendent, was allowed to go home with husband on parole.
Feb 15, 1902.  Mr. Hopkins said that she is doing fairly well at home; husband has an old woman look after her and she herself says she wants to do all she can to keep at home.
Sep 8, 1902.  Discharged improved.


History and clinical notes:
History: Has been drinking for 8 days, but worked until 3 days ago.  Has taken beer, half and half, and some whiskey.  Has been drunk bi-monthly during past year but has only been on 3 or 4 sprees similar to the present.  The night before admission began to see four pictures rats and was unable to sleep (??).  On admission, there was moderate tremor of the tongue and extended hands and patient was restless.  Eyes, heart, lunch, abdomen and limbs show no gross lesion.  The tongue is tremulous, gray brown, coated and moist.  T.P.R. 98.4, 80, 22.  Rx Tincture Nux Vomica, Tincture Capsici aa mix xv.  Sodium bromide gr xx.  Hot milk ℥ (ounce) vi every 3 hours.  Mag sulph ℥ (ounce) at  once.  Bed.
Jun 17, 1901.  Slept well last night.  Tremor persists.  Complains of deafness and pain in each ear which dates back 5 days.
Jun 18.  Out of bed.  Tremor less.  Ears examined, canals found dirty with severe amount of cerumen impacted.  Same removed.  Membranes congested.  On house diet.  All internal treatment stopped.
Jun 21, 1901.  Discharged recovered.


History and clinical notes:
History: Has been intemperate for many years; great man to spend money, and like good company.  No disease of any kind.  Has name of being a good fellow.  Has been married almost 25 years, never had any children.  This attack commenced last week.  Left home (first time) drinking hard, commenced to talk in a peculiar manner, going traveling, to Omaha, everywhere, had imagined he gave a great deal of money away; thought he was [ill.] so much money that he need never work any more.  No hesitation in speech noted by friends.
Jun 25, 1901.  Says he is worth $100,000 to $200,000 dollars.  Believes his wife is a little crazy.  Memory good.  Speech shows no [ill.] though it is rather drawling.  Well nourished slender male of about 50 years.  Eyes gray.  Slight ataxia on extreme deviation, one pupil oval lat 180 degrees 4 mm – O.S. similar but slightly larger.  Doubtful reaction to light, feeble reaction to A&C. [ill.] media clear, never heals, gray in deeper layer.  [Note: I have no idea what this is all about].  Tongue moist, corrugated, slight general tremor.  T.P.R. 98.3, 64, 18.  Heart, lungs, and abdomen show no gross lesion (doubtful prolongation of expirations).  Gross strength of limbs normal.  Slight ataxia of arms.  Reflexes: no Jaw Jerk.  Biceps Jerks normal.  No KJ even with reinforcement of Jendrassick.  No AC J, QJ and GJ feeble.  No Pl reflexes.  Station sway increased, can not stand on one foot with eyes shut.  Sensation normal except for delay in the usual perception.  No asteriognosis.  History of incontinence of urine for six years, or intermittent lateral dip [ill.] of difficulty in walking of quick jumping pain in legs for 4-5 years past.
Aug 12, 1901.  Getting fat.  Mental condition unchanged.
Sep 28.  Good physical condition.  Very [two illegible words] in habits.
Nov 8.  Untidy.  Tears clothes.  Says he is worth $10,000,000 and he held all important offices in state.  Is failing quite rapidly.
Jan 12, 1902.  Believes that purgative salts were put in supper yesterday and claims he had a severe diarrhea past night, but which is not true.  Is very cross and has refused breakfast and dinner.  Continues very untidy and must be restrained to keep him from tearing clothes.
Feb 27.  Quiet, cleanly, feels well.
Apr 16.  No change.  Vaccinated.
Apr 22.  Good take.
Jun 13.  No change.
Jul 30.  Has occasional attacks of weakness and of increased tremor and ataxia.
Aug 30.  Ptosis of O.S. increasing.
Oct 7.  Complete ptosis O.S.  Mounts stairs with difficulty.  Transferred to Ward D.
Dec 30.  Condition the same.
Jul 12, 1903.  Patient has failed rapidly for the past 3 months.  Has been in bed about 4 weeks.  Rapidly losing in strength.  Eats little.  Bed sores.  
Aug 13.  Patient noisy and abusive at night.  Last night he abused a fellow patient and he retaliated by striking him several times in the face, causing several slight abrasions and blacking his eyes.
Dec 8, 1903.  Died at 7:20 a.m.

Additional notes:
Note: The Jendrassick maneuver involves telling the patient to lock his index fingers together and then try to pull them apart.  It distracts the patient and usually results in a stronger knee jerk reflex, though the mechanism for how/why is not well understood.  Astereognosis means the inability to identify objects by touch, which, if present, would indicate some brain lesion or abnormality of function.


History and clinical notes:
History: In this Hospital from Dec 26, 1898 to May 15th, 1899; when she was removed by husband against wish of Superintendent.  Officer who brings patient knows nothing about her.  Wants her own way, makes it uncomfortable for husband, scolds all the time; does not like strangers; likes her youngest daughter but dislikes eldest, who had to leave home on account of disagreement.  Has been better mentally than when here before.  Husband could not make her mind (he is of imbecile grade himself).  
Aug 1, 1901.  Since admission has worked on ward, kept a great deal to herself; always neat and clean and when spoken to plainly has done what was required of her.  Says she is here for a purpose, will not go home, does not want to see any of her people, especially is upset by visits of her husband.  Is sometimes pleasant and agreeable with physician, again does not [ill.] to have anything to say.  [Ill.] shake hands, once in a great while has a short period of depression during which she has her head buried in her hands and won’t say anything to anyone.  Seems to take a pleasure in working, but will only do the kind that suits her.  Physically in good condition.
Sep 30, 1901.  Discharged unimproved.


History and clinical notes:
History: Before husband died (3 years ago), patient signed away her rights to property.  June 2nd of this year, court decided that she was not entitled to any of the property.  This worried her a great deal, and she became very much depressed, did not sleep and wandered from her home, wrings her hands a great deal.  Resists everything that is done for her.  Patient would not get out of carriage and it required considerable effort to get her to enter Hospital.  Patient has a number of bad bruises about her person, arms and limbs.  Sister says patient injured herself by squeezing her arms.  Last Saturday was quite a little noisy, moaned, etc.  Has lost flesh – is very anaemic.
Aug 4, 1901.  When first admitted very hysterical; threw herself around, banged head against wall, tried to strangle herself with her hands, cried and moaned.  Had to be restrained a few times, for a week was constantly watched.  Kept in bed for three weeks, opium and Valinace (?) administered as needed.  Sometimes was clear and tried to collect her thoughts but as a rule moaned and cried.  She had no money.  They had taken her clothes.  She had no place to go.  Was visited by attorney but clutched and cried so that he could get little out of her.  Always wanted to see the doctors.  Was not satisfied to have anyone pass her door without calling them in.  Objected to the treatment she received.  Said everyone was [ill.] with her, kept repeating over and over again.  That she was a lady and should be treated as one.  For past two weeks has been in front ward, only brought there by greatest tact.  When once there she decided/demanded to return to Ward 3.  Told as long as she controlled herself she would be allowed to remain.  First night she pounded on the door, but when threatened with removal ceased and has acted quietly ever since.  Holds herself rather aloof from the other patients.  Still very nervous and readily excitable, but on the whole a vast improvement in her condition.  In October had mild attack of erysipelas beginning around ears and roots of hair, spreading down the outside of face.  Responded to treatment well; during this attack mental ability seemed much duller than usual.  Did not seem to grasp the trouble with her face.  As she improved physically returned mentally to same condition as above notes.  Only once or twice ate her excretions – was very uncleanly in her habits.  Thought the house was on fire, that she saw a crowd of Negroes outside her window.  That everyone wanted to poison her, that she was no good in this ward.  Gradually improved until she was able to be transferred to B, the week before Christmas.  Here she behaves very well on the whole, occasionally worries about herself and moans a little but the mention of returning her to [ill.] wards is sufficient to keep her quiet for a time.  
Apr 12, 1902.  Visited by sister yesterday; was quiet and had little to say for herself.  Of late has not worried quite so much.  Has gained in weight and except to utter a few plaints relative to “she has no clothes”, “Is she to be put in the Colored Ward?”, “I am very naughty, [ill.], very naughty,” has very little to say.  Physically she looks better.  Eats and sleeps well, etc.  
Sep 23, 1903.  Fairly good condition physically.  Thinks she is soon to be normal.  Always says “I won’t be here long.”
Nov 14, 1904.  Condition the same.
Jun 5, 1905.  Begs not to be turned away, “nowhere to go.”  Eats well, but grows emaciated.
Feb 9, 1910.  Fell from a chair on which she was sitting sleeping, and sustained a fracture of the neck of right femur.
Feb 21.  Rests comfortably on a water bed.  Eats and sleeps well.
Mar 4.  Quite pale.  Seems listless when spoken to.
Mar 11.  Semicomatose.  Had a fainting spell today.
Mar 13, 1910.  Died.  Chronic valve disease of the heart.  Exhaustion from intra-capsular fracture of femur.

Final disposition:
Died from chronic valvular disease of the heart and exhaustion from intra-capsular fracture of femur


