Reception Order signed by: F. G. Bedford, G. W. Hall, Dated: June 21, 1895
Sex and Age: m 28
Civil State: Single
Occupation: Soldier
Religion: Ch. of Eng.
First Attack: Yes
Age on first attack: 28
When and where previously under treatment: Bermuda Royal Naval Hospital
Duration of present attack: 3 months
Supposed cause: Not known
Epileptic: No
Suicidal: No
Dangerous to others and how: yes
Any near relative afflicted with Insanity: Unknown
Union chargeable to: Poplar
Previous Place of Abode:
Name and Address of Person to whom Notice of Death to be sent: Bro., R. Mason, 20 Periera St., bethnal Green
Names and Addresses of one or more relatives of the Patient: Mrs Mason, 4 Rugg St., Limehouse, E.
Medical Certificate Signed by: Hewlett
Facts indicating insanity observed by myself at the time of examination viz.:
Dr. Maslen. Expression of intense sadness & melancholy, takes no notice of surroundings & maintains one attitude. Is absolutely silent refusing to reply to questions addressed to him. On a recent occasion he attempted to stab himself with a table knife. Frederick Saunders says he is usually quiet but occasionally talks to unseen persons. Will not take his food unless it has first been tasted.
Facts communicated by others viz.:
Dr. Hewlett. He is sullen looking & refuses to answer questions but looks about furtively & appears to be listening to imaginary voices. William Smith Steward Haslar Hospital states that on one occasion he tried to stab himself with a table knife, also, that he is violent at times & throws the furniture about. He has a sullen demeanour & will not join in the conversation or amusements of the other men. Patient was an inmate of Bermuda Hospital.
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.
Demented. Cannot converese rationally & makes incoherent answers to questions. Does not know his age, or date of year or what month it is.