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Name of Patient.

Hilda Smart

Gender.

Female

Age.

Admitted.

April 5th, 1895

Residence at or immediately previous to date.

27 Claremont Terrace, Fratton in the Borough of Portsmouth

Rank, Profession or Occupation.

None

Degree of Education.

Limited

Religious Persuasion.

Church of England

Married, Single or Widowed.

Single

Number of Children.

Age of youngest Child.

Whether the first Attack.

Yes

Age on first Attack.

Duration of existing Attack.

3 weeks

How many previous Attacks.

None

Confined in any Lunatic Asylum.

Where.

When.

And how long.

Supposed cause of Insanity.

Not stated

Predisposing.

Exciting.

Whether Suicidal.

Whether dangerous to others, and in what way.

State of Bodily Health.

Fair

Whether of sober habits.

Yes

Relatives afflicted with Insanity.

Urgency Certificate. (if any). a. Facts indicating Insanity observed by myself at the time of Examination, viz.— b. Facts communicated by others.
1st Medical Certificate. John Edward Harry Kelso. a. Facts indicating Insanity observed by myself at the time of Examination, viz.— She was dull and stupid in manner. Complained of people trying to poison her especially her sister and an Aunt in London, who sends her tinned food, which is poisoned. She doesn’t go to bed because people are calling out to her and shouting out to her from different parts of her bedroom. b. Facts communicated by others. Her mother Mrs. Jessie Elizabeth Smart of 27 Claremont Terrace, Southsea, tells me she complains of people trying to poison her and that she is very difficult to manage, sometimes refusing to go to bed till 3 a.m. April 1st, 1895.
2nd Medical Certificate. Ernest William Phillips. a. Facts indicating Insanity observed by myself at the time of Examination, viz.— She thinks neighbours want to poison her and frequently refuses food for this reason. Says she is afraid to go to bed because of horrid Things under the pillow. She is morose, restless, excessively obstinate. b. Facts communicated by others. Jessie Elizabeth Smart (her mother), 27 Claremont Terrace, states that Hilda Smart has said she should do injury to herself if at home any longer. That she refuses food for many hours. Will not go to bed or move for hours at night. Refuses to do as she is asked, also has delusions as to the month of year and that her sister wishes to poison her. April 1st, 1895.
Discharged.	Left the Hospital.	Died.

Relation of Informant to Patient:

Family History. Not obtainable.
Insanity or other Diseases of Nervous System:
Phthsis:
Alcoholism:
Diabetes:
Other Diseases:
Age and Sex of Children:

Previous History.
Neuroses in Patient:
Acute Rheumatism or Chorea:
Fits – epileptic or hysterical:
Fits – infantile:
Fevers, &c.:
Syphilis:
Other Diseases:
Sober:
Number and nature of previous attacks:
Injuries or shocks:

Present Attack.
Time of earliest symptoms:
Nature of earliest symptoms:
Progress of case:
Suicidal or Dangerous (facts):
Tendency to leave home:

Hallucinations (observed before admission).
of Sight:
of Hearing:
of Taste:
of Smell:
of Common Sensation:

On Admission.

Presence or Absence of Bruises:   No bruises.
Tongue:   Clean.
Palate and Teeth:
Appetite:   Fair.
Bowels:   Regular.
Abdominal Viscera:
Pelvic Viscera:
Catamenia:
Urine:
Heart, Pulse, etc.:   Apparently normal.
Lungs:   Apparently normal.
Eyes and Sight:   Apparently normal.
Pupils:   Equal and active to light.
Ears and Hearing:   Apparently normal.
Taste and Smell:   Apparently normal.
Common Sensation:   Apparently normal.
Dynamometer:
Handwriting:
Walk:   Normal.
Reflexes:   Knee jerks brisk.
Temperature:   Normal.
Speech:   Slow.
Weight:
Sleep:   Fairly good.
Dreams:
Reaction to questions:   Bad.
Memory, Recent:   Bad.
Remote:
Delusions, Exaltation:
Depression:   Yes.
Delusions related to digestion or food:   No.
Poison:   No.
Obstruction:   No.
Hallucinations of Taste and Smell:   None elicited.
Hallucinations of Sight:   None elicited.
Hallucinations of Hearing:   None elicited.
Hallucinations of Common Sensation:   None elicited.
Suicidal or Homicidal:
Diagnosis:   Influenza ?      Melancholia.
Prognosis:   Fair.

Patient is very depressed and confused. She attributes her depression to menstrual irregularities. She is very suspicious of everyone in the ward. She thinks some day she will not be allowed to get up and out, will be kept in bed for ever. The night she came here she says the hands of the clock went round about twenty times and when it was quarter to seven in the morning she was told to remain in bed for a minute or two but was kept there till the hands of the clock again reached quarter to seven which was in about ten minutes. Thinks everyone here is against her. Does [not] take any interest in her surroundings nor does she talk to anyone. It is very difficult to get her talk. Is very slow in answering questions which frequently have to asked several times. Says her hearing is worse at night and in the morning.
Apr. 12 – Patient is very silent. With difficulty will answer questions. Frequently weeps. Does not employ herself. Is troublesome as regards taking food. Says she does not take food because it is too late. When spoken to she becomes restless moving her head and arms in aimless fashion. Sleeps badly.
Apr. 26 – Still very silent and confused. Has to be dressed, if left alone will simply stand about. Is troublesome with food. Does not interest herself in anything.
May 3 – Remains depressed and silent.
May 10 – Still depressed and confused.
Jun. 5 – Depressed and confused but will answer questions. Will not employ employ herself. Occasionally troublesome with food.
Jul. 5 – Remains depressed. Does not interest herself in anything.
Aug. 4 – Still depressed and anxious to get home. Does not employ herself.
Aug. 12 – Noisy at night. Sleeps badly. Sulphoral ??
Sep. 4 – Still depressed and confused. Impulsive at times.
Sep. 30 – Seems less depressed. Employs herself cheerfully reading books.
Oct. 25 – At times appears to be somewhat depressed. Frequently runs down the gallery.
Nov. 5 – To Witley.
Dec. 3 – Returned.
Dec. 4 – Discharged well.