6282-14-1 Folio 47
Name: John BROCKMAN,
Aged: 65,
Reg. No. 47,
Admitted: August 16, 1899.
Copy of Statement of Particulars
Reception Order signed by: Edwin Austin, Dated: June 20, 1895
Sex and Age: m 61
Civil State: Unknown
Occupation: Clerk
Religion: Ch. of Eng.
First Attack: U.K.
Age on first attack: N.K.
When and where previously under treatment: Claybury (crossed out)
Duration of present attack: few days
Supposed cause: Unknown
Epileptic: No
Suicidal: No
Dangerous to others and how: No
Any near relative afflicted with Insanity: Unknown
Union chargeable to: Islington
Previous Place of Abode: Islington Informary
Name and Address of Person to whom Notice of Death to be sent:
Names and Addresses of one or more relatives of the Patient: Nil
Medical Certificate
Medical Certificate Signed by: Wright
Facts indicating insanity observed by myself at the time of examination viz.:
He is suffering from religious mania. Is continuously praying & writing prayers. He prays for hours at a time. Imagines he is going to be married to an officer here. Imagines she is his cousin.
Facts communicated by others viz.:
Transferred from: Claybury
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 delusional. Says he was sent into an asylum through the jealous spite of the labour master at the workhouse. Is very religious. Prays to God & has his prayers answered. He prayed that he might have a letter from his friends, & as the result of his prayers a letter came the next morning.