A 57-year-old mental patient who wandered away from St. Elizabeths Hospital earlier this month has spend the last four days in jail in Culpeper, Va., while officials here and in Culpeper jockey over who will arrange transportation for him back to the hospital.

The patient, Leo Lewis, left St. Elizabeths on Sept. 4. A few days later he turned up in Culpeper, where he was arrested on a charge of trespassing on private property and was jailed.

Officials at the hospital say their rules forbid them from going out of the District to pick up a patient.

The Culpeper County sheriff says officials in the District should go there to get Lewis.

And the U.S. marshal's office here says they would be willing to pick up Lewis at the District line if Culpeper authorities would bring him that far.

"It's a horrible mess," said Ed Lewis, the patient's brother.

"It's a very difficult thing," said James S. Gardiner, an official with the city's Commission on Mental Health. "Everybody [involved] has different regulations."

"We have to follow what is laid out in our procedures," said Harold Thomas, a special assistant to the hospital superintendent.

Thomas, said the hospital rules do not allow the staff to travel across state lines to pick up a patient. If the patient were committed to a state facility in Virginia, however, then he could be transported back to the area by state officials under an interstate agreement.

Yesterday, officials from the hospital and the city's Mental Health Commission obtained a D.C. Superior Court order to have Lewis returned to the District by U.S. marshals.

J. Jerome Bullock, U.S. marshal for the District of Columbia, said he normally does not cross District lines in civil matters, as in the Lewis case.

"It's a sticky legal issue," he said.

Bullock said he would prefer that the Culpeper officials bring Lewis to the District line.

Robert Peters, Culpeper County sheriff, said, "It's not a practice for us to take him to the state line. If we're holding someone for another jurisdiction, they normally come and get him."

Peters said he has talked with Lewis. "He wants to get back up there . . . We will hold him until we hear from them [District officials]."

Peters said if the U.S. marshal comes to get Lewis, the patient would probably be released on his personal recognizance. "We would have to get a magistrate to come down and handle it," he said.

He said the trespass charge against Lewis would not be dropped unless the prosecutor decides not to process the case.

Peters said Lewis has appeared in court on the trespass charge. "He doesn't want to get out on his own. He wants somebody to take care of him."

Gardiner of the District's mental health commission said Lewis' rights have not been violated. "If he is charged with an offense, it's not illegal for them to hold him," Gardiner said.

Lewis' problems began on Sept. 4, when he was allowed to walk around the hospital grounds. He was reported missing when he did not return later that day.

Around 3 a.m. last Monday, Ed Lewis received a telephone call from a Culpeper police officer, who said Leo Lewis had been picked up for trespassing.

"He was apparently trying to seek shelter," Ed Lewis said.

"He's not a violent person. He's never done anything to anybody. It's just whenever he gets sick, he will talk an awful lot of nonsense."

Lewis said his brother was committed to the hospital under a court order in 1969.Prior to 1969, Lewis said his brother had been in and out of St. Elizabeths since 1950.

Lewis received a bachelor's degree in mathematics from the University of Washington in 1946. He transferred there from Cornell University.

In 1972, Lewis said, his brother wandered away from St.Elizabeths and was picked up in North Carolina. A state trooper picked Lewis up on a highway one night, and he was committed to a North Carolina state mental hospital. Later, the hospital transported Lewis back to St. Elizabeths.

In September of last year, Lewis said his brother wandered away again to New York, where he was eventually picked up by the police after a month.

Lewis said his brother became very sick in New York and had to be treated in a hospital, which returned him to St. Elizabeths in May.