The new Lunacy Act, 1889 : with index and schedules complete, arranged for the use of medical practitioners and others : being a reprint from the Journal of Mental Science / by T. Outterson Wood.
- Wood, Thomas Outterson.
- Date:
- 1889
Licence: Public Domain Mark
Credit: The new Lunacy Act, 1889 : with index and schedules complete, arranged for the use of medical practitioners and others : being a reprint from the Journal of Mental Science / by T. Outterson Wood. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
38/42 (page 38)
![Form 7.—Notice of Desire to have a Personal Interview. [Address'] Dated I desire to be taken before or visited by a judge, magistrate, or justice having jurisdiction in the district within which I am detained. Signed Form 8.—Certificate of Medical Practitioner. In the matter of A.B. of [1] in the county [2] of [3], an alleged lunatic. I, the undersigned CD., 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. 2. On the day of 18 , at [4] in the county [5] of [separately from any other practitioner] [6], I personally examined the said A.B. and came to the conclusion that he is a [lunatic, an idiot, or a person of unsound mind] 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 [7], viz..:— (b.) Facts communicated by others, viz.:—[8] [/fan urgency certificate is required it must be added here. See Form 9.] $ f If the lunatic is to be received as a single patient in a house belonging to or kept by a medical \ practitioner under the order of a county court judge, magistrate, or justice, add the follow-1 J ing paragraph:— l I 4. I certify that the said A B. is suffering from unsoundness of mind of a temporary character [or from decay ol mind in old age, or is desirous of voluntarily submitting to 1 I.care and treatment, as the case may be]. J 5. The said A.B. appeared to me to be [or not to be] in a fit condition of bodily health to be removed to an asylum, hospital, or licensed house. [9] 6. I give this certificate having first read the section of the Act of Parliament printed below. Dated (Signed) CD , of [10] Extract from Section 23 of the Lunacy Acts Amendment Act, 1889. 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 the Lunacy Acts, or under this Act, shall be guilty of a misdemeanour. [1] Insert residence of patient. [2] City or borough, as the case may be [3] Insert pro- fession or occupation, if any. [4] 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 sur- name of occupier. [5] City or borough, as the case may be. [6] Omit tlus where only one certificate is required. '.7] If t he same or other facts were observed previous to the time of the examination, the certifier la at liberty to subjoin them in a separate paragraph. [8j The names and Christian names (if known) of informants to be given, with their addresses and descriptions. [9] Strike out this clause iu ease of a private patient whose removal is not proposed. [10] Insert full postal address. Form 9.—Statement accompanying Urgency Order. I certify that it is expedient for the welfare of the said A.B. [or for the public safety, as the case may be] that the said A.B. should be forthwith placed under care and treatment. My reasons for this conclusion are as follows : [State them.] Form 10.—Certificate as to Pauper Lunatic in a Workfiousc. I, the undersigned Medical Officer of Workhouse of the Union, hereby certify that I have carefully examined into the state of health and mental condition of A.B., a pauper in the said workhouse, and that he is in my opinion a lunatic, and a proper person to be allowed to remain in the workhouse as a lunatic, and that the accommodation in the workhouse is sufficient for his proper care and treatment separate from the inmates of the workhouse not lunatics [or, that his condition is such that it is not necessary for the convenience of the lunatic or of theother inmates that he should be kept separate]. The grounds for my opinion that the said A.B. is a lunatic are as follows : Dated (Signed) Medical Officer of the Workhouse. Form 11.—Order for detention of Lunatic in Workhouse. I, the undersigned CD., a justice of the peace for being satisfied that A.B., a pauper in the workhouse of the is a lunatic [or idiot or person of unsound mind] and a proper person to be taken charge of under care and treatment in the work- house, and being satisfied that the accommodation in the workhouse is sufficient for his proper care and treatment separate from the inmates of t he workhouse not lunat ics [or, that his condition is such that it is not necessary for the convenience, of the lunatic or of the ot her inmates that he should be kept separate] hereby authorize you to take charge of, and, if the workhouse medical officer shall certify it to be necessary, to detain the said A B as a » This part of the form has evidently been left in the Schedule by an oversight, the ob- jectionable section to which it relates having been expunged.](https://iiif.wellcomecollection.org/image/b22304101_0040.jp2/full/800%2C/0/default.jpg)