rders, and
when an attempt was made to enforce these, his condition became
noticeably aggravated, and the maniacal attacks more frequent. He
frequently spoke of being frightened at something, of the attendants
plotting against him, and persecuting him. During one of his
depressions he made a superficial cut on his neck with a piece of
glass which necessitated the application of physical restraint. One
day two physicians who examined him spoke in his presence of the
advisability of operating on his head. Following this he constantly
spoke of his fear of being cut up by the physicians, whom he
designated as a bunch of anarchists, and the elaboration of this fear
remained the dominant feature of his mental disorder. He continued,
however, to be profane, vicious and unruly in his behavior. His
periodic outbursts of rage were as furious as formerly, he tore up his
bed-clothing and personal attire during these fits of anger, which
continued to be more or less reactive in character. He is noted as
having had several attacks of convulsive seizures closely resembling
epilepsy. Patient was admitted to the Government Hospital for the
Insane on April 7, 1911. On admission he was very nervous and
apprehensive, would jump and become startled when touched or
approached by anyone and when spoken to became highly wrought up
emotionally. His body fairly shook with excitement, pupils dilated,
face became flushed and he could hardly speak on account of the
emotional upset. He spoke of having come from a hell, from a dungeon
where a bunch of anarchists were persecuting him, and were going to
cut him up and operate on him, that he had heard them talk about it.
He was imperfectly oriented, somewhat confused, and to all appearances
lacked full appreciation of his new environment. He quieted down,
however, at the close of the day and slept well during the night.
Physically he was slightly emaciated. No neurological disturbances
were noted except that he complained of headaches. When an attempt was
made the following morning by a physician to examine him, he flew into
a rage, became highly emotional, profane and threatening, showed
marked apprehensiveness and expressed the fear of being cut up. He
reiterated the persecution of him by the officials at the
penitentiary, that he did not care what happened to him, whether he
went to hell or heaven, etc. He spoke of killing himsel