1. The person must be shown to have a general tendency to deep and heavy sleep, out of which he can only be aroused by a violent and convulsive effort.
2. Are there any circumstances which, happening before the individual went to sleep, would produce a train of disturbed thought not entirely composed by sleep?
3. Did the act occur during the usual hours for sleep?
4. Was the cause of the awakening sudden, and does the act bear throughout the character of unconsciousness?
5. What were the subsequent acts of the accused in relation to the deed? Did he try to evade responsibility? This must not have too much stress laid upon it, for the wretchedness of the sudden discovery may so overcome him, that he may seek to shelter himself from the consequences of an act for which he is legally but not morally responsible.
No person can be put under restraint unless the conditions required by the Lunacy Acts are fulfilled. The Acts of Parliament for this purpose are the Lunacy Act of 1890 (53 Vict. c. 53) and that of 1891 (54 and 55 Vict. c. 65). Lunatics may be put under restraint by the following procedures, according to the particular case:—
Reception Order on Petition.—This is usually the procedure for private patients. The order for petition may be obtained from a specially appointed Justice of the Peace, Judge of County Courts, or Magistrate. A petition for the order must be presented to the Judicial Authority by the husband, wife, or relative of the alleged lunatic; if any other person apply, the reasons for this must be given. A petitioner must be twenty-one years of age or over, and must have seen the alleged lunatic within fourteen days before its presentation. A statement of particulars and two medical certificates must accompany the petition. The proceedings are private, and no one except the petitioner, the alleged lunatic, and any one person appointed by him, and the two medical men who have signed the certificates, may be present, unless by permission of the Judicial Authority. If the Judicial Authority be satisfied, he may make the order at once, even without seeing the patient, or he may appoint a time within seven days for inquiries and consideration. He may visit the alleged lunatic.
At the time of consideration of the petition he may adjourn it for not more than fourteen days, or he may make the order at the time. He may summon further witnesses, or dismiss the petition, giving his reasons for so doing in writing.
A reception order is valid for seven days from its date, unless the lunatic is certified by a medical man to be unfit for removal, when the order is extended until a medical certificate of fitness for removal is obtained, which is valid for three days.
The medical men signing the certificates must not be in partnership, as principal and assistant, or have any direct or indirect interest in the patient or his keeping (16 and 17 Vict. c. 96, sec. 4). They must make separate visits at different times for the purpose of examination. Each medical man must have examined the person within seven clear days before the presentation of the petition.
Each medical man must write clearly and in the proper place on the certificate: (1) The facts observed by himself as evidence of insanity, and (2) the facts observed by others as evidence of insanity. The name of his informant must be given.
One of the certificates should, whenever practicable, be under the hand of the usual medical attendant (if any) of the alleged lunatic. If not practicable, the reason must be given by the petitioner to the Judicial Authority.
Neither of the certifying medical practitioners may be the father or father-in-law, brother or brother-in-law, sister or sister-in-law, partner or assistant of the other of them.
Great care should be taken to follow carefully the marginal directions on the certificate form. The most trivial omission will invalidate the certificate. The omission of the name of the street and number of the house is sufficient to set it aside. A medical man should remember that, although his certificate may have passed the scrutiny of the Commissioners, it is liable to be made the subject of discussion in a Court of law, and in cross-examination he will have to support the statements therein made.
The following certificate properly filled up by Dr. Millar of Bethnal House Asylum, is given in his book on Hints on Insanity, and may be taken as an example of a correct certificate at that time, the present form being slightly different:—
MEDICAL CERTIFICATE
PROPERLY FILLED UP
| 1. Here set forth the | I, the undersigned, |
| qualification entitling the | John Millar, being a (¹) |
| person certifying to practise | Licentiate of the |
| as a physician, surgeon, or | Royal College of Physicians, |
| apothecary. | Edinburgh, |
| and being in actual practice as | |
| 2. Physician, surgeon, or | a (²) Physician, hereby certify |
| apothecary, as the case | that I, on the third day of |
| may be. | November, One thousand eight |
| hundred and eighty-eight_, a | |
| 3. Here insert the street and | (³) 600 - Cambridge Road, |
| number of the house (if | Bethnal Green, in the county of |
| any), or other like particular. | Middlesex, separately from any |
| other medical practitioner, | |
| personally examined | |
| James Thompson, sen., of | |
| 4. Insert residence, and | (⁴) 600 Cambridge Road, |
| profession or occupation | Bethnal Green, gentleman, |
| (if any). | and that the said James Thompson, |
| sen., is a person (⁵) | |
| 5. Lunatic, or an idiot, | of unsound mind, and a proper |
| or a person of unsound mind. | person to be taken charge of, and |
| detained under care and treatment; | |
| and that I have formed this opinion | |
| upon the following grounds, viz.:— | |
| 6. Here state the facts. | 1. Facts indicating insanity |
| observed by myself (⁶)— | |
| He is incoherent in his | |
| conversation, violent in his | |
| conduct, and quite unable to | |
| take care of himself. | |
| 7. Here state the information, | 2. Other facts (if any) |
| and from whom. | indicating insanity |
| communicated to me by | |
| others (⁷)— | |
| His son, James Thompson, jun., | |
| informs me that he has | |
| threatened to commit suicide, | |
| and has twice attempted it with | |
| a razor. | |
| (Signed) Name—JOHN MILLAR | |
| Place of abode—Bethnal House, Bethnal Green. | |
| Dated this third day of November, One thousand eight hundred and eighty-eight. |
|
Table relating to “Facts” of Insanity,
(compiled from Millar.)
| Facts offering no Evidence of Insanity. |
| 1. Refuses to take her medicine and resists |
| in every way; closes her teeth; threatens |
| to strike every one near her; obliged to |
| use the strait-waistcoat. |
| 2. Violent in her temper, and very abusive. |
| 3. Moody and irritable temperament, and of |
| weak memory in many particulars. |
| 4. General restlessness of manner; considers |
| himself heavily involved in debt to many |
| thousand pounds; says he has been ruined |
| by the Government, and that he intends |
| prosecuting the Admiralty for £5000 damages. |
| Vague and Irrelevant Facts. |
| 1. She is suspicious of her husband; says he |
| keeps bad company; she is most irritable and |
| jealous, and takes stimulating drinks to a |
| dangerous and exciting extent. |
| 2. Obstinate; has the manner and appearance |
| of an insane person; complained of her head; |
| refused her food, and would not go |
| downstairs; melancholy. |
| 3. He has imperfect sight; good hearing and |
| taste; he is unable to speak; his gait is |
| ape-like, and the skull-bones seem to have |
| fallen together from the want of cerebral |
| development. He will occasionally slap his |
| face and strike his hands; sometimes makes |
| a howling noise. |
| 4. She is very good-tempered; but day and |
| night she talks almost incessantly; |
| occasionally sings. She says she comes from |
| Otaheite, and relates stories of thos |
| around her doing absurd things. |
| Good Facts. |
| 1. She states that she is a lost person and |
| without hope of forgiveness; that she will |
| be taken to prison, and die a miserable |
| death; that the devil whispers in her ear |
| that she has committed the unpardonable sin. |
| 2. Great taciturnity; complete seclusion |
| from society; aversion to cleanliness; |
| wandering about the streets at improper hours. |
| 3. He states that he is a Prince of France; |
| that he possesses a palace, and has recently |
| had two fortunes left him (he cannot tell by |
| whom)—one of £400,000, the other of |
| £600,000; that he is going to Liverpool, a |
| distance of 150 miles, with a horse and |
| cart, which will take him four hours to go and |
| eight to return. |
| 4. Inability to hold any rational |
| conversation; her manner and conduct are |
| totally at variance with her usual habits. |
The following are examples of “Facts” sent back to be amended by the Commissioners—the emendations in italics:—
1. Incoherence, perversion of facts, delusion. Fancies that he possesses large amounts of money which people have secreted from him.
2. Says her sister lives in Chiselhurst, and she fears she is dying. She took great notice of my feet, and remarked that they were very large. Query by Commissioner—Are these delusions? Her sister does not live at Chiselhurst, and is perfectly well; my feet are not large.
3. General restlessness of manner; considers himself heavily involved in debt to many thousands of pounds, whereas his debts do not amount to a few hundreds; says he has been ruined by the Government, whereas he has only been dismissed from his appointment on account of his incapacity; and he intends prosecuting the Admiralty for £5000 damages, he having no real ground of action. (This was twice sent back for correction, the first correction being—By these statements I was satisfied that the patient was of unsound mind, and by his general conduct during examination. Finally amended as given above.)
(a)—a Justice of the Peace for ____, or His Honour the Judge of the County Court of ____, or ____ Stipendiary Magistrate for ____.
(b) Full postal address and rank, profession, or occupation.
(c) At least twenty-one.
(g) Some day within 14 days before the date of the presentation of the petition.
(h) Here state the connection or relationship with the patient.
(k) Full Christian and surname.
53 Vict. c. 5.—Sched. 2, Form 1.
PETITION FOR AN ORDER FOR RECEPTION
OF A PRIVATE PATIENT
In the Matter of_______________________________
a person alleged to be of unsound mind.
To (a)____________________________________
____________________________________
____________________________________
The Petition of__________________________________________
of (b)______________________________________________
______________________________________________
in the County of_________________________________________
1. I am___________(c) years of age.
2. I desire to obtain an Order for the Reception of
________________________________________________
as a person of unsound mind, in the Haydock Lodge Licensed House,
situate at Newton-le-Willows, Lancashire.
3. I last saw the said__________________________________
at______________________________________________________
on the (g)_______day of________________ 19_______
4. I am (h)_______________________________ of the
said________________________________________________
(or if the Petitioner is not connected with or related
to the or Patient, state as follows:)
I am not related to or connected with the said_________________
________________________________________________________
The reasons why this Petition is not presented by a relation
or connection are as follows:
The circumstances under which this Petition is presented by
me are as follows:—
5. I am not related to or connected with either of the persons
signing the certificates which accompany this petition as (where
the petitioner is a man) husband, father, father-in-law, son,
son-in-law, brother, brother-in-law, partner, or assistant (or
where the petitioner is a woman) wife, mother, mother-in-law,
daughter, daughter-in-law, sister, sister-in-law, partner, or assistant.
6. I undertake to visit the said_____________________________
__________________________personally, or by some one specially
appointed by me, at least once in every six months while under
care and treatment under the order to be made on this petition.
7. A statement of particulars relating to the said________________
______________________________________accompanies this petition.
If it is the fact, add: 8. The said_____________________
has been received in the Haydock Lodge Licensed House,
Newton-le-Willows, under an Urgency Order dated the____________
________________________________________________________
The petitioner therefore prays that an order may be made in
accordance with the foregoing statement.
Signed (k)_______________________________________
Date of Presentation of the Petition, this____________
day of___________________ 19_________
53 Vict. c. 5, s. 31.
When neither Certificate is signed by the
Usual Medical Attendant.
(a) Name
of
Patient.
I, the undersigned, hereby state that it is not practicable to
obtain a Certificate from the usual Medical attendant of (a)
__________________________________________________________________
for the following reason, viz.:—
(b) To be
signed
by the
petitioner.
(Signed) (b)______________________________
_______________ 19____________
Form 2.
STATEMENT OF PARTICULARS REFERRED
TO IN THE ANNEXED PETITION
If any particulars are not known the fact is to be so stated.
[Where the patient is in the petition or order described
as an idiot,
omit the particulars marked ►]
| The following is a Statement of Particulars | __________________ | |
| relating to the said | __________________ | |
| Name of patient, with Christian name at | __________________ | |
| length | __________________ | |
| Sex and Age | __________________ | |
| ► Married, single, or widowed | __________________ | |
| ► Rank, profession, or previous occupation | __________________ | |
| (if any) | __________________ | |
| ► Religious persuasion | __________________ | |
| Residence at or immediately previous to | __________________ | |
| the date hereof | __________________ | |
| ► Whether first attack | __________________ | |
| Age on first attack | __________________ | |
| When and where previously under care | __________________ | |
| and treatment as a lunatic, idiot, or | __________________ | |
| person of unsound mind | __________________ | |
| ► Duration of existing attack | __________________ | |
| Supposed cause | __________________ | |
| Whether subject to epilepsy | __________________ | |
| Whether suicidal | __________________ | |
| Whether dangerous to others, and in | __________________ | |
| what way | __________________ | |
| Whether any near relative has been | __________________ | |
| afflicted with insanity | __________________ | |
| Names, Christian names, and full postal | __________________ | |
| addresses, of one or more relatives | __________________ | |
| of the patient | __________________ | |
| Name of the person to whom notice of | __________________ | |
| death to be sent, and full postal | __________________ | |
| address, if not already given | __________________ | |
| ‡Name and full Postal Address of the | __________________ | |
| usual Medical Attendant of the Patient | __________________ | |
| ‡When the Certificate is not signed by the
usual Medical Attendant, the Certificate on the other side must be filled out. |
||
| Signed (a) | |
| Name, with Christian | |
| Name at length | ____________________________________ |
| Rank, Profession or | |
| Occupation (if any) | ____________________________________ |
| How related to, or | |
| otherwise connected | |
| with the Patient | ____________________________________ |
53 Vict. c. 5. s. 7 (4).
When a previous Petition has been dismissed.
(a) Name of
Patient.
(b) Name
of asylum,
hospital,
licensed
house,
or single
charge.
(c) Justice
of the
Peace
for ——,
or Judge of
County
Court
of —, or
Stipendiary
Magistrate
for ——
I, the undersigned, hereby state that a former Petition for
Reception of (a)___________________________________________
into (b)__________________________________________________
was presented to __________________________________________
(c)______________________________________________________
in the month of________________ 19_______, and dismissed.
Herewith is a copy
(furnished by the Commissioners in Lunacy)
of the statement sent to them of the reasons for its dismissal.
Note.—This Copy is to be obtained from the Commissioners
in Lunacy by the Petitioner at his own expense.
An Order for Reception of a Lunatic is to be obtained upon a private application by Petition to a Judge of County Courts, or Stipendiary Magistrate, or Metropolitan Police Magistrate, or specially appointed Justice of the Peace. The petition is to be presented, if possible, by the husband or wife, or by a relative (i.e. a lineal ancestor or lineal descendant, or lineal descendant of an ancestor not more remote than great-grandfather or great-grandmother) of the Lunatic, and is to be accompanied by a Statement of Particulars and two Medical Certificates on separate sheets of paper. One of the Medical Certificates accompanying the Petition must, if practicable, be by the usual Medical Attendant of the Lunatic; if not by him, the reason must be stated (see Form above). If a previous Petition has at any time been dismissed, the facts relating to its dismissal are to be stated in the fresh Petition (see Form above); and the Petitioner must obtain from the Commissioners in Lunacy a Copy of the Statement sent to them of the reasons for its dismissal, and present this copy with his Petition. The Reception Order (which will not remain in force for more than seven days after its date), the Petition, the Statement of Particulars, and the Medical Certificates must be sent to the Superintendent or Proprietor of the Asylum, Hospital, or House where the Patient is to be received.
(a) Insert residence of patient.
(b) County, city, or borough, as the case may be.
(c) Insert profession or occupation, if any.
53 Vict. c. 5.—Sched. 2, Form 8.
CERTIFICATE OF MEDICAL PRACTITIONER
In the Matter of_________________________________________
of (a)___________________________________________________
in the (b)_____________________ of_________________________
(c) _____________________________________________________
_______________________________________an alleged lunatic.
I, the undersigned, ________________________________________
do hereby certify as follows:
1. I am a person registered under the Medical Act, 1858,
and I am in the actual practice of the medical profession.
(d) Insert the place of examination, giving the name of the street with number or name of house, or should there be no number, the Christian and surname of occupier.
(e) County, city, or borough, as the case may be.
(f) Omit this where only one certificate is required.
(g) A lunatic or an idiot, or a person of unsound mind.
(h) If the same or other facts were observed previous to the time of the examination, the certifier is at liberty to subjoin them in a separate paragraph.
(i) The names and Christian names (if known) of informants to be given, with their addresses and descriptions.
(k) Strike out this clause in case of a patient whose removal is not proposed.
(l) Insert full postal address.
2. On the_______________________ day of ________________ 19__
at (d) _______________________________________________
in the (e)___________________ of _____________________
_________________(separately from any other practitioner) (f)
I personally examined the said ___________________________________
and came to the conclusion that ____ he is (g) ____________
and a proper person to be taken charge of and detained under
care and treatment.
3. I formed this conclusion on the following grounds, viz.:—
(a) Facts indicating insanity observed by myself at the
time of examination (h), viz.:—
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
(b) Facts communicated by others (i), viz.:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
4. The said __________________________________________________
appeared to me to be[18] ..................in a fit condition of
bodily health to be removed to an asylum, hospital, or licensed house (k).
5. I give this certificate having first read the section of the
Act of Parliament printed below.
Dated this __________ day of ________ 19__
53 Vict. c. 5, ss. 4, 11, 16, 28, 29.
Extract from section 317 of the Lunacy Act, 1890.
Any person who makes a wilful misstatement of any material
fact in any medical or other certificate or in any statement or
report of bodily or mental condition under this Act, shall be
guilty of a misdemeanour.
(a) A Justice for —, specially appointed under the Lunacy Act, 1890, or the Judge of the County Court of —, or the Stipendiary Magistrate for—
(b) Address and occupation.
(d) Name of petitioner.
53 Vict. c. 5.—Sched. 2, Form 3.
ORDER FOR RECEPTION OF A PRIVATE PATIENT, TO BE MADE
BY A JUSTICE APPOINTED UNDER THE LUNACY ACT, 1890,
JUDGE OF COUNTY COURTS, OR STIPENDIARY MAGISTRATE
I, the undersigned _______________________________________________
being (a) _________________________________________________
__________________________________________________________________
upon the petition of _____________________________________________
of (b) ____________________________________________________
in the Matter of _________________________________________________
a person of unsound mind, accompanied by the Medical Certificates
of _______________________________________________________________
and ______________________________________________________________
hereto annexed, and upon the undertaking of the said (d)
__________________________________________________________________
to visit the said ________________________________________________
personally or by some one specially appointed by the said (d)
__________________________________________________________________
once at least in every six months while under care and treatment
under this Order, hereby authorise you to receive the
said _____________________________________________________________
as a patient into your Licensed House (e).
And I declare that I have [or have not] personally
seen the said ____________________________________________________
before making this Order.
Dated this __________________ day of ________________ 19___
Urgency Orders.—Where it is urgent that an alleged lunatic (not a pauper) must be put under restraint as soon as possible, he may be received upon an urgency order, without petitioning a Judicial Authority, accompanied by a statement of particulars and one medical certificate. The order should be made by the husband, wife, or a relative of the alleged lunatic; if this be not possible, the reasons must be stated. It may be signed before or after the medical certificate, and before or after a petition order has been made. If before, it must be noted in the petition; if after, a copy must accompany the petition. No person may sign an urgency order if under twenty-one years of age, and must have seen the alleged lunatic within two days before the date of the order.
The urgency order remains in force seven days from its date, during which period the procedure for a “Judicial Order on Petition” is carried out. If the petition has been presented and the order is for some reason or other deferred, then the urgency order remains in force. The medical examination for certification must have been made not more than two days before reception, and reasons must be given why “it is expedient” that the alleged lunatic should be put under control “forthwith.”
53 Vict. c. 5.—Sched. 2.
FORM OF URGENCY ORDER FOR THE RECEPTION OF
A PRIVATE PATIENT, WITH MEDICAL CERTIFICATE
AND STATEMENT ACCOMPANYING URGENCY ORDER
Forms 4, 2, 8 and 9.
(a) House, or hospital, or asylum, or as a single patient.
(b) Name of Patient.
(c) Lunatic, or an idiot, or a person of unsound mind.
(d) Some day within two days before the date of the order.
(e) Husband, wife, father, father-in-law, mother, mother-in-law, son, son-in-law, daughter, daughter-in-law, brother, brother-in-law, sister, sister-in-law, partner, or assistant.
(If not the husband or wife, or a relative of the patient, the person signing to state as briefly as possible—1. Why the order is not signed by the husband or wife, or a relative of the patient. 2. His or her connection with the patient, and the circumstances under which he or she signs.)
(f) Superintendent of ____ the ____ asylum, ____ hospital or resident licensee of the ____ house (describing the asylum, hospital, or house by situation and name.)
Lunacy, Nos. 4 & 2.
(33 Vict. c. 5, s. 11.)
I, the undersigned, being a Person Twenty-one years of age,
hereby authorise you to receive as a Patient into your (a)
House (b) _______________________________________________
_______________________________________________________
as a (c) __________________________________whom I last saw at
________________________________________________________
on the (d) __________________ day of_______________ 19______
I am not related to or connected with the Person signing
the Certificate which accompanies this Order in any of the
ways mentioned in the Margin. (e) Subjoined (or annexed)
hereto is a Statement of Particulars relating to the said ____________
Name and Christian Name _______________________
at length_______________________
Rank, Profession, or Occupation ___________________
(if any)_______________________
Full Postal Address _____________________________
How related to or connected _____________________
with the patient___________________________
Dated this _______________ day of __________ 19____
Form 2.
STATEMENT OF PARTICULARS REFERRED
TO IN THE ANNEXED ORDER
If any particulars are not known the fact is to be so stated.
[Where the patient is in the petition or order described
as an idiot,
omit the particulars marked ►]
| The following is a Statement of Particulars | __________________ | |
| relating to the said | __________________ | |
| Name of patient, with Christian name at | __________________ | |
| length | __________________ | |
| Sex and Age | __________________ | |
| Married, single, or widowed | __________________ | |
| ► Rank, profession, or previous occupation | __________________ | |
| (if any) | __________________ | |
| ► Religious persuasion | __________________ | |
| Residence at or immediately previous to | __________________ | |
| the date hereof | __________________ | |
| ► Whether first attack | __________________ | |
| Age on first attack | __________________ | |
| When and where previously under care | __________________ | |
| and treatment as a lunatic, idiot, or | __________________ | |
| person of unsound mind | __________________ | |
| ► Duration of existing attack | __________________ | |
| Supposed cause | __________________ | |
| Whether subject to epilepsy | __________________ | |
| Whether suicidal | __________________ | |
| Whether dangerous to others, and in | __________________ | |
| what way | __________________ | |
| Whether any near relative has been | __________________ | |
| afflicted with insanity | __________________ | |
| Names, Christian names, and full postal | __________________ | |
| addresses, of one or more relatives | __________________ | |
| of the patient | __________________ | |
| Name of the person to whom notice of | __________________ | |
| death to be sent, and full postal | __________________ | |
| address, if not already given | __________________ | |
| Name and full Postal Address of the | __________________ | |
| usual Medical Attendant of the Patient | __________________ | |
| Signed (a) | ____________________ | |
When the Petitioner or person signing an Urgency Order is NOT
the person who signs the Statement, add the following particulars
concerning the person who signs the Statement.
| Name, with Christian | |
| Name at length | ____________________________________ |
| Rank, Profession or | |
| Occupation (if any) | ____________________________________ |
| How related to, or | |
| otherwise connected | |
| with the Patient | ____________________________________ |