Bethlem Hospital Patient Admission Register, October 1888
This record is available on Findmypast
1SURETIES
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.”).
2SEX
AND CLASS
This differentiates between paupers and private patients (“P. P.”) – note that Bethlem stopped admitting paupers in 1857.
3BY WHOSE AUTHORITY SENT
This column provides the name/address of whoever requested admission; for county asylums, this would usually be a Poor Law Union official.
4CONDITION OF LIFE, AND PREVIOUS OCCUPATION
The patient’s occupation is given; other details may be provided such as “reduced circumstances”.
5DURATION
OF EXISTING ATTACKS, AND NUMBER OF PREVIOUS ATTACKS
This reveals how long the patient was ill before their admission, and whether he or she had suffered from insanity before.
6SUPPOSED CAUSE OF INSANITY
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. co.uk) 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 ( nrscotland.gov.uk) has the originals, catalogued under MC7. For patients admitted after 1 January 1858, there are detailed admission forms under MC2. Scottish Indexes ( scottishindexes.com/ 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 nationalarchives.gov.uk/ 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 ( wellcomelibrary.org/ 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. co.uk) 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 ( historytoherstory.org. uk), while the Worcester Medical Museums website has some of the patients’ records for Powick Hospital ( medicalmuseum.org.uk/powickpatients/?rq=asylum). MICHELLE HIGGS
is a social historian and author: michellehiggs.co.uk