Reception Order signed by: George Chance, Dated: March 1, 1881
Sex and Age: m 32
Civil State: Single
Occupation: Whip Maker
Religion: Ch. of Eng.
First Attack: Yes
Age on first attack: 32
When and where previously under treatment: Colney Hatch Asylum (Crossed out)
Duration of present attack: 6 months
Supposed cause: Unknown
Epileptic: No
Suicidal: No
Dangerous to others and how: No
Any near relative afflicted with Insanity: Not Known
Union chargeable to: Lambeth
Previous Place of Abode: 35 Pleasant Place, Brook St.
Name and Address of Person to whom Notice of Death to be sent: Mother, E. Price, 183 Brook St. Lambeth
Names and Addresses of one or more relatives of the Patient: Aunt, E. Price, 35 Pleasant Place, Brook St. Kennington Rd.
Medical Certificate Signed by: Arthur
Facts indicating insanity observed by myself at the time of examination viz.:
He says he hears voices when in bed and is unable to rest, gets up fatigued and is unable to perform his work as usual, that he gets out of bed to find the caused of the voices. Feels a bubbling in his abdomen and down his back and then knows somebody is trying to injure him.
Facts communicated by others viz.:
Mrs Price, Landlady (his Aunt) says; He gets out of bed in the middle of the night & says they are after me, on Friday last he wrote his name & address on a slip of paper & said if I am missing you need not be surprised. Calls me very bad names & says I am not for to live. Talks to the floor as if holding a conversation.
Transferred from: Colney Hatch
Mental State:-
As far as possible under such Headings as:
Attention, Comprehension and Re-action, Cognition of self and surroundings, including mistakes of identity and appreciation of time and place, States of Stupor and Catalepsy, Memory for recent and remote events, Association and flow of ideas, Coherence, Reasoning power, Hallucinations, Illusions, Delusions, Exaltation, Fantasies of dress, Excitement, Depression, Impulses—General, Suicidal, Homicidal, Erotic, Destructive, Obsessions, Resistiveness or Hostility, Restlessness, Self-employment, Attention to personal needs, Religiosity, Sense of propriety, Lewdness of conversation and conduct, Regard for relatives.
He is rambling, irrational & delusional. Says people have been making use of his body & have taken all the strength out of him with flames. Complains that they let other people like him loose in the street, m-ads from his body.