Reception Order signed by: Alfred D. Lewis, Dated: July 31, 1895
Sex and Age: m 30
Civil State: Single
Occupation: None
Religion: Ch. of Eng.
First Attack: Yes
Age on first attack: 30
When and where previously under treatment: Claybury Asylum (Crossed out)
Duration of present attack: 6 months
Supposed cause: Paralysis
Epileptic: No
Suicidal: No
Dangerous to others and how: No
Any near relative afflicted with Insanity: No
Union chargeable to: Paddington
Previous Place of Abode: 53 Moscow Rd., W.
Name and Address of Person to whom Notice of Death to be sent: As below
Names and Addresses of one or more relatives of the Patient: Mrs. F. Palmer, 14 Railway St., Brighton
Medical Certificate Signed by: Dr. Fitzgerald, Geoffrey Hett
Facts indicating insanity observed by myself at the time of examination viz.:
Dr. Fitzgerald, He has a very vacant look & laughs very frequently without any apparent reason. Keeps rubbing his head with his hands & can't tell why he does it. Says he can't & that at one he went 22 days & nights & never slept at all & James Palmer (Father) tells me has had great trouble with his son for a long time, is very violent at times & has assaulted him, is dirty in his habits & wanders about at night & is incapable of doing any work.
Facts communicated by others viz.:
Geoffrey Hett. His memory is defective & his manner slow & unintelligent. He tells me that towards evening he becomes restless & is obliged to go into the St. & wanders about from 1 to 4 A.M. Also that a short time he passed 2 days & nights without any sleep. James Palmer (Father) tells me that is anyone opposed him he becomes very violent & terrifies the household, also that he often exposes himself naked at the window, is very dirty in his habits & comes home with his clothes all unfastened.
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.
Dull & weak-minded. If cross questioned he becomes confused in his answers & continually contradicts himself. His mind seems to be much -----------. Admits self abuse.