Insanity in every-day practice / by E.G. Younger.

  • Younger, Edward George.
Date:
1914
Catalogue details

Licence: In copyright

Credit: Insanity in every-day practice / by E.G. Younger. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    3-, the undersigned {name of practitioner) 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 191... at (4) in the (5) of I personally examined the said {name of patient) and came to the conclusion that he is a lunatic, or 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, (6) viz. :— {,b) Facts communicated by others, viz. : (7) State the name in full of the person giving the information, with address and description (8) 3 certify that it is expedient for the welfare of the said {name of patient) [or for the public safety], that the said {name of patient) should be forthwith placed under care and treatment. My reasons for this conclusion are as follows : 4. —The said {name of patient) appeared to me to be {or not to be) in a fit condition of bodily health to be removed to 5. —I give this Certificate, having first read the Section of the Act of Parliament printed below. Bated 191... Signed Full postal address Extract from Section 311 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 misdemeanour.’ (4) Insert the place of ex- amination, giving the name of the street, with number or name of the house, or should there be no num- ber, the Christian and surname of the occupier. (5) County, city, or borough. (6) If the same or other facts were ob- served pre- vious to the time of ex- amination, the certifier is at liberty to subjoin them in a separate paragraph. (7) The names and Christian names (if known) of informants to be given, with their address and descriptions. (8) State- ment accom- panying Urgency Order. N.B.—By Section 28, '‘Every Medical Certificate made under and for the purposes of this Act shall be evidence of the facts therein appearing, and of the judgment therein stated to have been formed by the certifying medical practitioners on such facts, as if the matters therein appearing had been verified on oathl