6282-14-1 Folio 15

Name: Thomas Herbert NICHOLLS,

Aged: 36,

Reg. No. 15,

Admitted: August 15, 1899.

Copy of Statement of Particulars

Reception Order signed by: J. L. Hannay, Dated: January 12, 1891

Sex and Age: m 28

Civil State: Single

Occupation: Stationers Porter

Religion: Ch. of Eng.

First Attack: Yes

Age on first attack: 28

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

Duration of present attack: 3 months

Supposed cause: Epilespy

Epileptic: Yes

Suicidal: Doubtful

Dangerous to others and how: No

Any near relative afflicted with Insanity: Not known

Union chargeable to: Westminster

Previous Place of Abode: 3 Titchfield St., Soho

Name and Address of Person to whom Notice of Death to be sent: Aunt (as below)

Names and Addresses of one or more relatives of the Patient: Mrs Kennedy, 60 Ebury St., Pimlico

Medical Certificate

Medical Certificate Signed by: D. Axham

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

Very restless at nights, requires attention as to his habits in every way, hesitating in speech, careless about his person, eating voraciously. He has a delusion that his is ??? & nash has been in the insane ward 2 months admitted as subject to epilepsy, shows no sign. Has a vacant look.

Facts communicated by others viz.:

Edwin Goodwin (Attendant) on the insane confirms the above statements. D. matheson, He is in a chronis & demented & mouse state of mind apparently unable & unwilling to speak & answer simple questions. He is dirty in his habits & peculiar in manner. Has certain delusions as to his right name & seems void of intelligence. Edwin Goodwin Attendant states he is restless at night & requires constant watching. He corroborates the above & that he formerly had fits.

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.

He is weakminded & does not appear to understand easily. thinking orms time before answering a simple question. Is delusional says people used to knock him about in the night time, pulling his stomach about & putting a needle in his gums. They said this was a game he had no play.