9, he had murdered a girl in Rochester, N.Y. He described
the murder in great detail, stated that he met the girl in one of the
Rochester cemeteries, attempted a sexual assault upon her, and when
she resisted he choked her to death. He stated that he did not mean to
kill his victim, but that he had inflicted the fatal injury before he
was aware of it. It was remorse, he said, and the desire to expiate
his crime which prompted his confession. He persisted in this
confession until the naval authorities were persuaded to discharge him
and turn him over to the civil authorities of Rochester, N.Y. Upon
arriving there an alibi was easily established, freeing the patient of
all suspicion of the murder, whereupon it took a good deal of
investigation on the part of the authorities to establish the
patient's real legal status. It was finally decided that he belonged
to the naval authorities, and he was accordingly returned to prison
and was given an additional sentence of a year for this fraud, which
he began to serve on December 13, 1909. While awaiting this new
sentence he assaulted a master-at-arms, who he claimed abused him, and
for this offense he received an additional five years' sentence. He
served this sentence until his first admission to this hospital on
July 16, 1913, on the following medical certificate: First symptoms
became manifest in 1910. The patient manifested fixed delusions of
having murdered a girl on August 7, 1909. Present symptoms: Fixed
delusions of a self-accusatory nature, delusions of persecution;
accused a medical officer whom he had never seen before as being among
those who were hounding him. Becomes excited, violent, profane,
incoherent and obscene in speech, and attempted to assault the
officer. He attempted suicide on February 15, 1910, while at Concord,
N.H., State Prison.

During the patient's first sojourn at this hospital he conducted
himself in an orderly manner, and, aside from the expression of mild
persecutory ideas with reference to the prison personnel, he was free
from psychotic manifestations. On only one occasion was he involved in
some trouble while here, which was entirely his own fault. He was
discharged on September 23, 1913, diagnosis "Not insane, psychopathic
constitution," and returned to the U.S.S. _Southery_ Prison Ship. Upon
his return there it was noted that he was suffering from a double
benign, tert