CASE II.--R. S. C., a white male, age 48 years, who is now serving a
life sentence for murder. One brother and one sister died of
tuberculosis. Another sister and two maternal aunts were insane.
Father alcoholic. Patient has always been regarded as rather sickly.
Had the usual diseases of childhood and has been subject all his
lifetime to frequent headaches. His school career was very irregular
in character and he never advanced beyond the elementary subjects.
Socially, he belonged to a very ordinary stock of frontiersmen and his
chief occupation consisted of farming and certain minor speculations.
He apparently led an honest and more or less industrious life. Married
in 1886, and his conjugal career is uneventful. In March, 1901, he
moved to Addington, Indian Territory. This was a newly-established
frontier town and he had bought, sometime previously, several lots
there, intending to establish himself in the lumber business. Soon
after this he got into some financial difficulty with a town-site
boomer, and finally, in a fit of passion, shot and killed the latter
and wounded a relative of his own. He was admitted to the Government
Hospital for the Insane, December 13, 1901, from the Indian Territory.
From the medical certificate which accompanied him on admission it
appeared that soon after the commission of the crime the patient began
to show evidence of insanity by incoherent talk, false ideas,
nervousness, and outbursts of vicious excitement. Later, this was
followed by mutism, refusal to eat, and stupor. On admission to this
hospital he was in a deep stupor, absolutely oblivious to everything
about him. Eyes were wide open and staring, pupils dilated, voluntary
movements markedly in abeyance. He was mute except for an occasional
incoherent mumbling to himself. He evidenced no initiative in feeding
himself, but swallowed food when it was placed in his mouth. Habits
were very untidy; involuntary evacuation of bladder and bowels were
present. His mental content could not be determined at the time, as
his replies were indistinct and monosyllabic, and were obtained only
after much effort. He appeared to comprehend what was wanted of him,
although this was not absolutely certain. His perception was very
dull, ideation slow and laborious. His attention could be gained only
after considerable difficulty, and he had to be aroused first from a
more or less profound stupor. Spontaneous speech was almost wholly
absent, but occasionally he would utter a word or two about his wife
and children. No delusions or hallucinations could be elicited.
Physical examination showed him to be quite thin and emaciated. Gait
slow and unsteady. Voluntary movements retarded. Knees trembled and
knocked against each other. No paralyses or pareses noted. Marked
general tremors were occasionally seen. Musculature well developed but
flaccid. All deep reflexes diminished.
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