Reception Order signed by: Charles Collambell, Dated: November 27, 1884
Sex and Age: m 44
Civil State: Married
Occupation: None
Religion: Ch. of Eng.
First Attack: Yes
Age on first attack: 44
When and where previously under treatment: Colney Hatch (crossed out)
Duration of present attack: One week
Supposed cause: Fits
Epileptic: Yes
Suicidal: No
Dangerous to others and how: Yes
Any near relative afflicted with Insanity: Not known
Union chargeable to: St. Saviours
Previous Place of Abode: Lodging House, Blackfriars Rd.
Name and Address of Person to whom Notice of Death to be sent: Mother, Mrs Johns, 3 Ganbrook St., B Green
Names and Addresses of one or more relatives of the Patient: Wife, Mrs Singer, 11 Gurney St., New Kent Rd. - Daughter, Miss Singer, 36 St Georges Bdg, Red Cross St.
Medical Certificate Signed by: H. Lloyd
Facts indicating insanity observed by myself at the time of examination viz.:
The patient is the subject of epilepsy & this morning after an attack became very violent to those about them trying to bite & kick, appears strange & incoherent in manner.
Facts communicated by others viz.:
Nurse Bollard states she has seen the patient in several fits & that he is strange after them.
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.
Dull & weak minded. Has no memory. Cannot tell his age at all & has no idea what year of month this is. Says he has about one fit a week.