|
Miscellaneous Records, Cont’d . . |
|
Source: Transcribed copy of application to State of South Carolina State Hospital for the Commitment of Milton T. Jones, dated January, 1926
Medical Certificate of Insanity (This certificate shall be filled out by two licensed physicians)
STATE OF SOUTH CAROLINA, COUNTY OF Greenville
HISTORY OBTAINED BY PHYSICIANS
Information furnished by R. W. Jones, 103 Buncomb Rd., Greenville, S. C., who is Son of the patient. Patient is at Number City Hospital Street, Town or County of Greenville. Nativity, State or Country Anderson Co., S. C. If foreign, date of arrival in the United States: Native. (Port of Entry and Steamship or line upon which he arrived marked X as not applicable) Is he a citizen of the United States? Yes. Is he a legal resident of South Carolina? Yes. If so, what county, city or town? Greenville, S. C. How long has he resided in South Carolina? All life.
FAMILY HISTORY
Name of father: Levin Jones Birthplace: Abbeville, S. C. If living, legal residence: Not living. Maiden name of mother: Don’t know. Birthplace: S. C. If living, legal residence: Isn’t living. If parents are dead, state cause and age at time of death: Don’t know. Brothers living: No. Brothers dead: 1. Cause and age at time of death: Don’t know. Sisters living: 3 Sisters dead: 2. Cause and age at time of death: Don’t know. (Questions concerning any insane relatives, institutionalized relatives, addictions of relatives, and criminal relatives all answered “No.”)
PAST HISTORY
Patient’s name in full is Milton Thos. Jones Age 68 Sex M Color W Marital state widower Occupation Textile Worker Religious denomination Baptist (Childhood diseases) Don’t know of any History of other severe illness? No Is there any history of severe injury? Was hurt (on) the head when about 23 years old. Shaden Soen (cannot read) Has patient had syphilis? No. Has patient had epilepsy? No. Has the patient had previous attacks of mental trouble? Give dates and duration of each attack. Yes, 1924—6 weeks Ever in a hospital or sanitorium for mental disease? No. To what extent does he use liquor, tobacco or drugs? Chews tobacco. Ever convicted of crime? No. When did present attack begin? Dec. 1925 Characterized by: excitement, untidiness, delusions, hallucinations, Etc. PHYSICAL EXAMINATION
State fully present physical condition of patient: Poor. Is the patient’s physical condition such that he can sit up and make the trip to the hospital without endangering his life? Yes.
MENTAL EXAMINATION
The conduct of the patient as observed by me has been: Depressed and mild at times. Mental Conditioning comes and goes. Cannot be left (??). The conduct of the patient as communicated to me by others has been: Aggressive and excitable. Threatened to strike daughter-in-law with whom he lives. The patient said in my presence: Nothing definite. In my opinion the patient has the following dangerous tendencies: to become violent to those around him.
We, W. C. Black, M.D., a legal resident of Greenville, County of Greenville, State of South Carolina, and A. White, M.D., legal resident of Greenville, County of Greenville, State aforesaid, being severally and duly sworn, do severally certify, and each for himself certifies, with the exceptions hereinafter noted as follows: 1) I am registered in accordance with the State law. 2) I, W. C. Black, M.D., on this the 3 day of Jan. 1926 and I, A. White, M.D., on this the 3 day of Jan. 1926, have with care and diligence personally examined Milton Thos. Jones (name of patient) now residing or being at Greenville in the County of Greenville and as a result of such examination, hereby certify that he is insane and a proper subject for custody and treaatment in the State Hospital as an insane person under the provisions of the statute. 3) I have formed this opinion from the history of the case and my examination of the patient as given above. |