Reception Order signed by: R. J. Biron, Dated: July 9, 1884
Sex and Age: m 38
Civil State: Single
Occupation: Commercial Traveller
Religion: Protestant
First Attack: Yes
Age on first attack: 38
When and where previously under treatment: Claybury Asylum (Crossed out)
Duration of present attack: 15 years
Supposed cause: Hereditary
Epileptic: No
Suicidal: No
Dangerous to others and how: Yes
Any near relative afflicted with Insanity: Yes
Union chargeable to: Mile End
Previous Place of Abode: 20 Cottage Grove, Mile End
Name and Address of Person to whom Notice of Death to be sent: Bro (as below)
Names and Addresses of one or more relatives of the Patient: John Finch, 90 Shandy St., Mile End
Medical Certificate Signed by: Atkins
Facts indicating insanity observed by myself at the time of examination viz.:
He is violent & dangerous to others, suicidal, expressing a wish to do away with himself, says his sister & friends are talking to him from outside, is very incoherent at times.
Facts communicated by others viz.:
Attendant Bonner says that he is very violent, has many delusions & is with difficulty restrained.
Transferred from: Claybury
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.
Very feeble-minded. Cannot answer questions rationally. Does not know how long he has been here or where he came from.