2nd admission this year.

Name of Patient.

Edwin Ernest Howard

Age.

16 years 8 months

Admitted.

July 3rd, 1890

Residence at or immediately previous to date.

96 Queens Road, Peckham, S.E.

Rank, Profession or Occupation.

Clerk

Degree of Education.

Fair

Religious Persuasion.

Church of England

Married, Single or Widowed.

Single

Number of Children.

-

Age of youngest Child.

-

Whether the first Attack.

No

Age on first Attack.

16

Duration of existing Attack.

6 days

How many previous Attacks.

One

Confined in any Lunatic Asylum.

Bethlem Royal Hospital

Where.

Bethlem Royal Hospital

When.

January 17th – June 25th

And how long.

5 months

Supposed cause of Insanity.

Relapse

Exciting.

Predisposing.

Whether Suicidal.

No

Whether dangerous to others, and in what way.

Yes, he at times throws things, on 1st of July he threw a tumbler at his sister

State of Bodily Health.

Good

Whether of sober habits.

Yes

Relatives afflicted with Insanity.

No

Urgency Certificate. (if any).          
a. Facts indicating Insanity observed by myself at the time of Examination, viz.—
The patient rushed about wildly, he said that he could make me into a woman, also that he had freed all the inmates of Bethlem Hospital, also that he could mesmerise anyone; he has a vacant look and stare.

b. Facts communicated by others.
His father, Urban Howard, tells me that on the 1st of July the patient got into his sisters bed because he said he had changed himself into a woman, he also tells me that he is very destructive.
Trevor Augustus Dagg M.R.C.S., L.R.C.P., 1 Camden Row, Peckham Road, S.E.

1st Medical Certificate.        
a. Facts indicating Insanity observed by myself at the time of Examination, viz.—
He wandered about in a wild way, with a very vacant look, he said he could mesmerise everyone, also that he had freed all the inmates of Bethlem Hospital and that he could change me into a woman and into anyone he chose.

b. Facts communicated by others.
His father, Urban Howard, tells me that he is very destructive, breaking things, also that he got into his sisters bed, under the idea that he had changed himself into a woman.
Trevor Augustus Dagg M.R.C.S., L.R.C.P., 1 Camden Row, Peckham Road, S.E.

2nd Medical Certificate.       
a. Facts indicating Insanity observed by myself at the time of Examination, viz.—
The patient is in constant movement and is unable to talk coherently, he tells me that he’s Napoleon and is 20,000 years old.

b. Facts communicated by others.
Urban Howard (patients father) tells me that his son has been altered mentally for the last few days, that he thinks he is a woman and got into his sisters bed, but he cannot talk rationally and is inclined to be violent.
Herbert Pernell Hawkins, St. Thomas’ Hospital, S.E.

Discharged.

Left the Hospital.

Died.

Relation of Informant to Patient:   Mother.

Family History.
Insanity or other Diseases of Nervous System:  
Grandfather is childish 88 years old. All sisters are very nervous and neuralgic, father asthmatical, most have had convulsions when teething.
Phthsis:   No.
Alcoholism:   No.
Diabetes:   No.
Other Diseases:   One sister had rheumatic fever.

Previous History.
Neuroses in Patient:   Always very nervous, headaches and neuralgia.
Acute Rheumatism or Chorea:   No.
Fits – epileptic or hysterical:   No.
Fits – infantile:   Yes.
Fevers, &c.:   Most fevers of childhood.
Syphilis:   -
Other Diseases:   -
Sober:   Yes.
Number and nature of previous attacks:  
One. In Bethlem Royal Hospital. Excited and noisy.
Injuries or shocks:  
Injury to head when 18 months old, and discharge from ear for years, stopped lately.

Present Attack.
Time of earliest symptoms:   June 28th.
Nature of earliest symptoms:  
Seemed restless and excitable, did not sleep, gradually got worse and in 3 days was quite unmanageable, didn’t sleep and wandered about. Thought he could hypnotise people; mistook identities.

Progress of case:

Suicidal or Dangerous (facts):   No.

Tendency to leave home:   No.

Hallucinations (observed before admission).
of Sight:   No.
of Hearing:   No.
of Taste:   No.
of Smell:   No.
of Common Sensation:   No.

On Admission.

Presence or Absence of Bruises:   None.
Tongue:   Clean.
Appetite:   Good.
Bowels:   Regular.
Hallucinations of Taste and Smell:  
Delusions related to Digestion or Food:  
Poison:  
Obstruction:  
Abdominal Viscera:   Normal.
Pelvic Viscera:   Normal.
Genitalia:   Normal.
Urine, sp. gr.:  
Heart, Pulse, etc.:   Normal.

Lungs:   Normal.

Eyes and Sight:   Good.
Pupils:   Equal - react normally.
Hallucinations of Sight:   No.
Irides:  
Ears and Hearing:   Normal.
Hallucinations of Hearing:   No.
Common Sensation:   Normal.
Temperature:  
Hallucinations of Common Sensation:   No.
Delusions, Exaltation:  
Says he was in country for 20,000 years and has slept for 5000.
Delusions, Depression:   No.
Suicidal:   No.

Memory, Recent:   -
Remote:   -
Sleep:   Bad.
Dreams:  
Walk:   Normal.
Reflexes:  
Dynamometer:  
Weight:   7 stone.
Handwriting:  

Diagnosis:   ?? mania.
Prognosis:   Will probably recover from this attack.

Patient is a short and slight youth, hair dark brown, no hair on face. He is very restless rushing about, flinging his limbs about and making grimaces. His expression is dull and stupid; He says that he can mesmerise us all and make us do what he likes; that he was in the country for 20,000 years and has slept for 5000 years. He mistakes identities frequently calling people “Father.” He throws himself on the ground but always on the grass, he pretends to faint and gives one the impression that he exaggerates unnecessarily his symptoms. He interferes much with the other patients.
Jul. 7 – Very noisy and destructive, jumping about and making faces like a monkey. Mistakes identities and is full of fleeting delusions.
Jul. 14 – A little quieter. Is taking sulphonal?? XX and sleeps about 6 hours. Still loquacious and quotes passages.
Jul. 21 – Not so noisy, but is very silly in speech and manner.
Jul. 28 – Improves slowly, is gaining flesh, still very cheeky.
Aug. 5 – Still noisy and very silly in talk and manner.
Sep. 6 – Very much better, is much stouter, is now quiet and industrious and recognises his illness and apologised to those whom he insulted during his illness.
Sep. 30 – To Witley.
Oct. 28 – Returned.
Oct. 29 – Extended 3 weeks.
Nov. 21 – Discharged well.