Beth­lem Hospi­tal Pa­tient Ad­mis­sion Regis­ter, Oc­to­ber 1888

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This record is avail­able on Find­my­past


Here you can find the names and ad­dresses of friends or rel­a­tives who would vouch­safe for pay­ment of a pa­tient’s fees; some­times a de­posit was left (“Dep.”).



This dif­fer­en­ti­ates be­tween pau­pers and pri­vate pa­tients (“P. P.”) – note that Beth­lem stopped ad­mit­ting pau­pers in 1857.


This col­umn pro­vides the name/ad­dress of who­ever re­quested ad­mis­sion; for county asy­lums, this would usu­ally be a Poor Law Union of­fi­cial.


The pa­tient’s oc­cu­pa­tion is given; other de­tails may be pro­vided such as “re­duced cir­cum­stances”.



This re­veals how long the pa­tient was ill be­fore their ad­mis­sion, and whether he or she had suf­fered from in­san­ity be­fore.


This lists pos­si­ble rea­sons given by the fam­ily for the pa­tient’s ill­ness.

an­ces­tor was in a county lu­natic asy­lum rather than a pri­vate one. Al­though it can be dis­tress­ing to dis­cover that your fore­bear was in an asy­lum, the records pro­vide il­lu­mi­nat­ing de­tails about their fam­ily back­ground, men­tal health and treat­ment.

For Eng­land and Wales, start with the Lu­nacy Pa­tients Ad­mis­sion Reg­is­ters for pub­lic and pri­vate asy­lums, be­gin­ning in 1846. Cat­a­logued un­der MH94, the orig­i­nals are at The Na­tional Ar­chives in Kew but An­ces­try ( an­ces­try. has digi­tised them for 1846–1912. The records’ in­for­ma­tion in­cludes the pa­tient’s name, the in­sti­tu­tion, the date of ad­mis­sion, and the date of dis­charge or death. Be aware that if a pa­tient was treated in more than one asy­lum, there may be omis­sions in the reg­is­ters.

The equiv­a­lent record for Scot­land is the Gen­eral Regis­ter of Lu­natics in Asy­lums from 1858; this lists all asy­lum pa­tients, in­clud­ing those ad­mit­ted be­fore 1858 who were still be­ing treated. The Na­tional Records of Scot­land ( nrscot­ has the orig­i­nals, cat­a­logued un­der MC7. For pa­tients ad­mit­ted af­ter 1 Jan­uary 1858, there are de­tailed ad­mis­sion forms un­der MC2. Scot­tish In­dexes ( scot­tishin­ learn­inghealth.aspx) has in­dexed both record sets. You can search for free and down­load doc­u­ments for a small fee. Once you know where your an­ces­tor was treated, you can find out whether pa­tient files still ex­ist. Most lu­natic asy­lum records are held in lo­cal ar­chives, and you can dis­cover what’s avail­able by search­ing the Hospi­tal Records Data­base at na­tion­ hos­pi­tal­records.

Three main types of record were kept: ad­mis­sion reg­is­ters; dis­charge/ death reg­is­ters; and pa­tient case­books and/ or case files. The doc­u­ments are more de­tailed from the 1840s on­wards. The ad­mis­sion reg­is­ters in­clude the pa­tient’s full name, age and mar­i­tal sta­tus; place of abode and oc­cu­pa­tion; date of ad­mis­sion and so­cial class (pau­per or pri­vate); men­tal and phys­i­cal con­di­tion; the di­ag­nosed men­tal dis­or­der and sup­posed cause; plus reli­gion and ed­u­ca­tion.

Asy­lum pa­tients were bathed on ar­rival, and an ex­am­i­na­tion was made of their men­tal and phys­i­cal con­di­tion. Af­ter­wards, their men­tal ill­ness was di­ag­nosed; this might be melan­cho­lia, ma­nia, de­men­tia or amen­tia (‘id­iocy’ or ‘im­be­cil­ity’). The ad­mis­sion reg­is­ters also state whether the pa­tient was re­cov­ered, re­lieved or not im­proved when dis­charged, or whether they had died. Some­times, more de­tail is given in the rel­e­vant dis­charge reg­is­ters.

If your an­ces­tor’s case­book has sur­vived, then you will find reg­u­lar re­ports about their health, be­hav­iour and treat­ment in the asy­lum. From the 1870s on­wards, there might even be pho­to­graphs of pa­tients. Other use­ful records in­clude an­nual re­ports and vis­it­ing com­mit­tee min­utes.

One in­ter­est­ing case is that of 50-year-old Charles

‘Pa­tients were bathed on ar­rival, and their con­di­tion ex­am­ined’

An­drew Gird­wood (see page 67), who was ad­mit­ted to Beth­lem on 12 Oc­to­ber 1888 suf­fer­ing from melan­cho­lia and sui­ci­dal ten­dency, be­cause of a “be­lief that he has been con­nected with the Whitechapel mur­ders”; by this time, Jack the Rip­per had claimed his first four vic­tims. Charles’s delu­sion had led him to cut his wrists in a sui­cide at­tempt.

His case file states he be­lieved that “men are se­creted be­hind the cur­tains to ar­rest him for the East End mur­ders”. Un­for­tu­nately, Charles con­tin­ued to think that “evil in some form is about to be­fall him”, and was pre­scribed the seda­tive par­alde­hyde. He was sent to Wit­ley, Beth­lem’s con­va­les­cent depart­ment, for a few months but re­turned “very mis­er­able and soli­tary”. Charles was dis­charged “un­cured” on 9 Oc­to­ber 1889. Sadly, he was ad­mit­ted to two fur­ther asy­lums and died at Han­well in Eal­ing on 31 March 1901.

An in­creas­ing num­ber of asy­lum records are com­ing on­line. The Well­come Li­brary ( well­comeli­ col­lec­tions/dig­i­tal-col­lec­tions/ men­tal­health­care) is work­ing with oth­ers to digi­tise records from a range of asy­lums in­clud­ing The Re­treat in York and Gart­navel in Glas­gow. Find­my­past ( find­my­past. has the col­lec­tion ‘Lon­don, Beth­lem Hospi­tal Pa­tient Ad­mis­sion Reg­is­ters and Case­books 1683–1932’; it also has tran­scripts for Prest­wich Asy­lum Ad­mis­sions (1851–1901), South York­shire Asy­lum Ad­mis­sions (1872–1910) and Bex­ley Asy­lum Minute Books (1901–1939).

An­ces­try has digi­tised the Crim­i­nal Lu­nacy War­rant and En­try Books (1882–1898) and some early Crim­i­nal Lu­natic Asy­lum Reg­is­ters (1820–1843).

It also has the Fife and Kin­ross Asy­lum Reg­is­ters (1866–1937) and in­dexes of St Lawrence’s Asy­lum Reg­is­ters, Bod­min, Corn­wall (1840–1900).

The re­search project His­tory to Her­story has digi­tised case­books for the West Rid­ing Pau­per Lu­natic Asy­lum ( his­to­ry­to­her­ uk), while the Worcester Med­i­cal Mu­se­ums web­site has some of the pa­tients’ records for Pow­ick Hospi­tal ( med­i­cal­mu­­ick­pa­tients/?rq=asy­lum). MICHELLE HIGGS

is a so­cial his­to­rian and au­thor: michelle­

This sketch was drawn from life at Beth­lem

Pa­tients’ en­ter­tain­ment at Mid­dle­sex County Lu­natic Asy­lum, 1853

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