David Ritchie Sr's condition on admission to the Hanwell asylum

This post deals with the physical health assessment done on David Ritchie Sr when he was admitted to the London County Asylum in 1909. It provides considerably more information than the report supplied by Dr Menzies at the Marylebone Workhouse. As with the notes taken on his personal and family history, I will omit details that are repetitive and summarise sections that are too technical for general interest.

Most striking for me is that David Ritchie weighed just 8 stone or 51,6kg. This is extremely light for a man of 35. No height is given on the report but he must have been fairly small in stature. Then again, he was admitted as a pauper so was probably under-nourished. I expect his mental illness affected his eating habits too, as did his insomnia.

On the plus side, his temperature was a normal 97.8ºF and his pulse was 72 beats per minute. No signs, therefore, of fever as I previously supposed. His thyroid, speech and gait were normal. His coordination and musculature were good. He had normal eyesight and his pupils were of equal and normal size. Both eyes responded properly to light. They were hazel in colour.

On the minus side, he presented with several old abrasions and bruises on his legs and a sebaceous cyst on his forehead. He exhibited slight tremors but no real motor impairment.

Regarding his mental state, the report reads as follows:

"Has marked elation and talks a great deal, lapsing into incoherancy. He is quite happy-go-lucky. has a good idea of his powers, says he is a good singer, also a good runner, and that he believes he could win the marathon race. Has no delusions about wealth. Pharyngeal reflex is quite absent, there are no other definite signs of GP except very slight tremors in fingers, also tongue, and these are not at all definite. Coordination is good, also speech and gait. No Tabes."

According to Judy Lester of Kerrywood Research, one of the main things the asylum doctors would have been looking out for when admitting patients was Syphilis, or any symptoms of it. A common symptom was General Paralysis (or Paresis) of the Insane, often abbreviated to "GP,". Lack of pharyngeal reflex could also be a symptom of syphilis, which is why they tested for it. likewise, the comment "No Tabes" is a reference to Tabes dorsalis, a complication of late -stage syphilis infection in which bacteria attack the spinal cord and peripheral nervous system. hence the doctor's remarks about musculature, coordination, gait, vision and speech.

Given the photographs I shared in my previous post and the above extract from the medical notes, my mental image of David Ritchie Sr. is changing. Originally, I pictured him looking quite a bit like my grandfather—tall, well-built and distinguished. Now, he makes me think of Puck in Shakespeare's A Midsummer Night's Dream. Small and spritely, he exhibits childlike mannerisms and seems capable of both cruelty and charm. I wish I could connect with his brothers' descendants to learn more. Please get in touch if you can help.

Photo credit: "Doctor and Brain" by amenclinicsphotos.