Folio 03

Name: Frederick Bibby,

Aged: 58,

Reg. No. 3,

Admitted: August 15, 1899.

Copy of Statement of Particulars

Reception Order signed by: Charles Collumbell, Dated: August 2, 1877

Sex and Age: m 36

Civil State: Marrier

Occupation: Porter St. Thomas Hospital

Religion: Ch. of Eng.

First Attack: Yes

Age on first attack: 36

When and where previously under treatment: 1877 Bethlem Hospital - 2/3/77 to 15/8/99 Colney Hatch (crossed out)

Duration of present attack: 16 weeks

Supposed cause:

Epileptic: No

Suicidal: No

Dangerous to others and how: Yes

Any near relative afflicted with Insanity: Unknown

Union chargeable to: Lambeth

Previous Place of Abode: 8 Southampton St. J--- E---

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

Names and Addresses of one or more relatives of the Patient: S. A. Bibby, 25 Bonnington Square, Kensington Dual

Medical Certificate

Medical Certificate Signed by: H. Lloyd

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

The patient says he is related to the Queen but whether he is son or son-in-law he is not certain. He has seen her majesty this morning in fact he sees her pass through the wards every morning and sometimes in the evening.

Facts communicated by others viz.:

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.

Quite incoherent in conversation. He's memory is practically a blank. Says he came straight here from Lambeth & has been here four days instead of one. Cannot tell what year or month it is. Admits self abuse.