6282-14-1 Folio 01

Name: Francis Stevens,

Aged: 53,

Reg. No. 1,

Admitted: August 15, 1899.

Copy of Statement of Particulars

Reception Order signed by: J. P. Burgess, Dated: October 5, 1889

Sex and Age: m 43

Civil State: Widower

Occupation: Clerk

Religion: Protestant

First Attack: Yes

Age on first attack: 43

When and where previously under treatment: Colney Hatch Asylum (Crossed out)

Duration of present attack: 12 days

Supposed cause: Unknown

Epileptic: No

Suicidal: No

Dangerous to others and how: No

Any near relative afflicted with Insanity: Unknown

Union chargeable to: Camberwell

Previous Place of Abode: 36 Rommer St. Westminster

Name and Address of Person to whom Notice of Death to be sent: Bro. J.W. Stevens, 33 Cratcington Pk, Paddington

Names and Addresses of one or more relatives of the Patient: A. Smith, Bro in law, 150 Commercial Rd, E

Medical Certificate

Medical Certificate Signed by:

Facts indicating insanity observed by myself at the time of examination viz.:

Francis Stevens wanders about in a dazed condition. He has various hallucinations. he hears voices which he calls phonetic communications from the spiritual world. He complains he is called the Whitechapel fiend. He is now projecting his head forward in a strange manner and cause he is under the influence of a "galvanic battery". He says this galvanism will kill him. He is constantly miserable and dejected and takes no interest in anything.

Facts communicated by others viz.:

Robert Gould, Attendant, states that Francis Stevens does not stay in bed at night, that he mutters to himself nearly the whole of the day and night and that he complains of galvanism.

Transferred from: Colney Hatch

Condition on Admission

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.

Denies aural hallucination and all delusions of persecution including electric ones. Can detect no sign of dementia.