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. |