Has to be
restrained to prevent violence to himself and others. Frequently
suspicious when food and drink are offered him. At times noisy when he
desires food and it is not given to him at once. Probable cause
unknown. There is a vague history of head injury aboard ship in the
tropics. Homicidal tendencies were present when the disease first
became manifest."

Patient was admitted to this institution June 15, 1912, at 10.30 A.M.
On admission he was carried in by two employees. His legs were
shackled and he had wristlets on his hands. He was apparently unable
to stand unassisted, and, when support was removed, fell to the floor.
Pupils were widely dilated; internal strabismus of the right eye was
present. Facial musculature was distorted, and he mumbled to himself
in a low, indifferent tone of voice, over and over again, "Give me
something to eat. I can't do it. Give me something to eat," etc., in a
rapid monotone. He appeared to be in a deep stupor. He did not seem to
realize his whereabouts, and attention could not be gained. He was
totally inaccessible. When put to bed he became quite restless, rolled
out on the floor, and was unable to assist himself back into bed.
Musculature of legs was in a constant mild clonus, and the right foot
was kept in position of talipes equinovarus. Pins pushed deeply into
the skin all over the body caused no reaction. When food was brought
to him he leaped upon it and finished the meal with extreme rapidity,
stuffed his mouth full, never taking sufficient time for mastication
or swallowing, and food was frequently expelled forcibly, probably
from irritation of the air-passages. Questions addressed to him
remained unheeded, but he kept up a constant mumbling in a low
monotone, as described above. He was totally unable to stand on his
feet unsupported, but when lying down his legs were moved about quite
freely in an indifferent manner. When alone in the room he remained
quietly in bed, head and face covered up with a blanket, but as soon
as the room was entered he became restless, grabbing to those about
him and holding on tenaciously. During his first night in the
institution he slept well and was clean in habits. The following
morning he was still inaccessible. He ate his breakfast quite
voraciously, mumbling to himself all the time, "Give me something to
eat" or "Give me something to drink." When water was brought t