J. C. a man, aged fifty, was admitted into the hospital, August 6, 1796.
It was stated that he had been disordered about three weeks, and that the
disease had been induced by too great attention to business, and the want
of sufficient rest. About four years before, he had been a patient, and
was discharged uncured. He was an artful and designing man, and with great
ingenuity once effected his escape from the hospital. His time was mostly
passed in childish amusements, such as tearing pieces of paper and
sticking them on the walls of his room, collecting rubbish and assorting
it. However, when he conceived himself unobserved, he was intriguing with
other patients, and instructing them in the means, by which they might
escape. Of his disorder he seemed highly sensible, and appeared to approve
so much of his confinement, that when his friends wished to have him
released, he opposed it, except it should meet with my approbation;
telling them, in my presence, that, although he might appear well to them,
the medical people of the house were alone capable of judging of the
actual state of his mind; yet I afterwards discovered, that he had
instigated them to procure his enlargement, by a relation of the grossest
falshoods and most unjust complaints. In April 1797, he was permitted to
have a month's leave of absence, as he appeared tolerably well, and wished
to maintain his family by his industry. For above three weeks of this
time, he conducted himself in a very rational and orderly manner. The day
preceding that, on which he was to have returned thanks, he appeared
gloomy and suspicious, and felt a disinclination for work. The night was
passed in a restless manner, but in the morning he seemed better, and
proposed coming to the hospital to obtain his discharge. His wife having
been absent for a few minutes from the room, found him, on her return,
with his throat cut. He was re-admitted as a patient, and expressed great
sorrow and penitence for what he had done; and said that it was committed
in a moment of rashness and despair. After a long and minute examination,
he bewrayed nothing incoherent in his discourse. His wound, from which it
was stated that he had lost a large quantity of blood, was attended to by
Mr. Crowther, the surgeon to the hospital. Every day he became more
dispirited, and at last refused to speak. He died May 29th, about ten days
after his re-admission. His head was opened two days after death. There
were some slight opacities of the tunica arachnoidea, and the pia mater
was a little inflamed: the other parts of the brain were in an healthy
state, and its consistence natural.