On March 22, a few hours after Sacco had gone to bed, he complained of a headache and asked the ward attendant for a wet towel to place across his forehead. When the attendant left, Sacco sprang out of bed and struck his head several times against a chair, lacerating his scalp. Wardmen rushed in and seized him, and as they struggled he cried out, “I am innocent! There is no justice!” It took four men to restrain him and put him in a dry pack. Next morning he was again calm and cooperative, and when the director, Dr. C. MacFie Campbell arrived, he said with some embarrassment, “I am ashamed of what I done.” He told the director that he was tired of life and wished to kill himself. Dr. Campbell considered the incident “a transitory condition of emotional tension which was intelligible in view of the emotional strain to which the patient has been subject.” There was no recurrence of any such episode or of the Dedham delusions. At the end of the observation period Dr. Campbell wrote to Judge Thayer that with the exception of that one night Sacco’s “behavior has been that of the ordinary hospital patient. There has been no difficulty in caring for him ... his mood has, on the whole, been equable.” He concluded: “The result of the observation of the patient in the Boston Psychopathic Hospital has been that we have found no evidence of insanity of any type.”
Nevertheless, Thayer extended Sacco’s observation period for another month, and the early days of April presented quite a different picture. Mrs. Evans, visiting Sacco on April 2, was much disturbed by his mental state. She told the doctor in charge “that she knew nothing about medicine but that in her opinion [the] patient was talking like a crazy man.”
She said [the hospital report continued] that the patient insisted he would kill himself.... He said that he had suffered long enough, that he wanted it over with one way or another, that when he went back to jail he would give the judge twenty-four hours to decide the case and that if he did not set him free patient would “take things in my own hands.”
Five days later when Rosina was visiting, Sacco told her that he was going crazy. After she left, according to the report, he
suddenly jumped out of his bed and rushed toward the edge of the open door, with his head lowered in a blind, impulsive manner.... Thereafter, he became excited, somewhat noisy, and struck out violently, requiring considerable restraint. He was given treatment in the form of a dry pack with cold compresses to his head. He was talking and shouting in an excited tone, maintaining that his wife was confined in the ward above him, whence he had been hearing (as a matter of fact), the voices and cries of the women patients, which he believed were those of his wife.
By evening he had calmed down and now said “that he must be going crazy in this place, that his ideas about his wife were all a mistake.” Early next morning he spoke of voices telling him that a bunch of roses had been left for him in the hospital lobby.
On the morning of April 12 he suddenly lunged forward as if he were going to dart out of the room. To Dr. Campbell he later explained that he had thought he heard his wife’s voice call “D-a-a-n-t-e.”
For about a week he seemed calm. Then, on April 19, he became unmanageable. Seven times in the next four days he had to be placed in wet packs.
During these attacks [the ward doctor reported] he shouts and screams that he wants his freedom; he wants to go home to his family. Between the attacks and often during the attack, when he can for a moment be made to control himself, he is rational, clear and oriented, knows the time and the date and the place, and clearly recognizes those about him. During the attacks he at times strikes viciously at those about him, or those who attempt to restrain him, and also hurls all manner of abusive and profane imprecations upon others.
According to Dr. Ralph Colp, in a psychiatric study published in 1958, Sacco was suffering