Strategy: Medical and Asylum Records
By Dale E. Lee and AI
2026.07.29
Medical and Asylum Records
When trying to understand the human experience behind the names and dates, medical records and asylum files offer deeply personal insights. These underutilized sources can provide details about an ancestor’s health, family structure, social status, and even immigration history. If an ancestor was admitted to a hospital, poorhouse, asylum, or long-term care facility, the records generated during their stay can be revealing, particularly for those who vanished from other record types.
Why Medical and Asylum Records Matter
Medical and institutional files often contain:
- Full names and aliases
- Next of kin or emergency contacts
- Descriptions of ailments, treatments, and outcomes
- Mental health evaluations and physician notes
- Family histories of illness or trauma
- Photographs, physical descriptions, and clothing inventories
- Birthplaces, occupations, and immigration status
In some cases, these files also document causes of death, legal commitment processes, guardianship appointments, or letters from family members advocating for or against institutionalization.
For ancestors who suffered from chronic illness, disability, mental health issues, or poverty, these records may be the only surviving documentation of their lives during vulnerable periods.
Types of Institutions That Created These Records
1. Public Hospitals
Large city and county hospitals treated the poor, immigrants, and those with communicable diseases. Medical casebooks may include admission records, attending physicians, diagnosis notes, and family information.
2. State Mental Hospitals and Asylums
These housed individuals diagnosed with mental illness or cognitive disabilities. Files often contain detailed intake forms, affidavits from relatives, and lengthy evaluations.
3. Poorhouses and Almshouses
Facilities for the indigent and disabled often maintained registers listing residents, reasons for admission, and family connections.
4. Tuberculosis Sanatoria and Leprosy Colonies
Specialized institutions kept detailed medical histories and correspondence with family members. Sanatoria records frequently included long-term residents and migrants.
5. Veterans’ Hospitals and Soldiers’ Homes
Civil War and WWI veterans who entered care facilities often had extensive records, including pension applications, service details, and family contact info.
Where to Find Medical and Asylum Records
Accessing these records can be tricky due to privacy laws, but many have been transferred to archives and are open after a set number of years, typically 50–100 depending on the jurisdiction.
1. State Archives and Historical Societies
Many defunct or consolidated facilities turned their records over to state archives. State and county archives often hold historical records from public institutions like mental hospitals, almshouses, tuberculosis sanatoria, and county infirmaries.
Examples:
New York State Archives
- Willard Asylum for the Insane (1869–1995): Case files, patient photos, admission documents.
- Craig Colony for Epileptics, Hudson River State Hospital: Patient records often include biographical data, family contacts, and discharge information.
- https://www.archives.nysed.gov
Massachusetts State Archives
- Tewksbury Almshouse Intake Records: Include immigration status, family info, age, and birthplace.
- Danvers and Worcester State Hospitals: Institutional reports and patient casebooks.
- https://www.sec.state.ma.us/arc
California State Archives
- Records from Stockton State Hospital, Napa State Hospital, and others.
- May include admission books, case histories, and burial records.
- https://www.sos.ca.gov/archives
Illinois State Archives
- Almshouse registers and records from Jacksonville State Hospital, Elgin State Hospital.
- Often include patient age, residence, cause of commitment, and legal proceedings.
- https://ilsos.gov
2. County Archives
Some counties maintain records from local almshouses, county hospitals, and poor farms.
Contact county-level record offices for:
- Poorhouse admittance logs
- Coroner’s inquests referencing hospitalizations
- County infirmary census lists
- Probate records appointing guardians for mentally ill relatives
Example:
The Cook County, Illinois archives hold poorhouse records, death registers, and court records related to asylum commitments.
Tip: Check the local county historical society or genealogical society for microfilmed or transcribed records.
3. National Archives and Regional Branches (U.S.)
The National Archives (NARA) has extensive holdings on:
- Veterans’ hospitals and homes
- Military medical records
- Public Health Service hospitals
Search Record Groups (RG):
- RG 15: Veterans Administration Records (often includes medical and pension data)
- RG 418: National Institute of Mental Health
- RG 94: Records of the Adjutant General’s Office, including medical exams for Civil War soldiers
- RG 393: U.S. Army Continental Commands: Includes military hospital admissions.
Notable Records:
- Registers of Veterans at National Homes for Disabled Volunteer Soldiers, 1866–1938
- Contains personal details, service records, pension numbers, and next of kin.
- https://catalog.archives.gov
UK National Archives (Kew)
- Asylum admissions, Board of Control patient files, and Ministry of Health documents.
- Look for: MH 12, MH 94 (Lunacy Commission files), and HO 140 (criminal lunatics).
- https://discovery.nationalarchives.gov.uk
4. University Archives and Medical Schools
Some university hospitals and medical schools preserved patient casebooks and student records.
- Yale University – Medical Historical Library
- Early psychiatric evaluations, hospital casebooks, and student theses.
- University of Pennsylvania Archives
- Collections from affiliated hospitals, mental institutions, and clinics.
- Mayo Clinic Historical Unit
- Holds extensive hospital records from early 1900s forward (subject to privacy rules).
5. Online and Published Sources
FamilySearch.org
- Search for “Almshouse” or “Insane Hospital” under “Places” in the catalog.
- Many collections are image-only but browsable by county or institution.
- Use the Catalog feature to find:
- “Poorhouses”
- “Insane Asylums”
- “Hospitals”
- Examples
- “New York, Census of Inmates in Almshouses and Poorhouses, 1830–1920”
- “Massachusetts, Tewksbury Almshouse Intake Records, 1854–1884”
Ancestry.com
- “U.S. Federal Census – Non-Population Schedules” (1850–1880): Includes lists of institutional residents.
- “New York, Census of Inmates in Almshouses and Poorhouses, 1830–1920”
- England & Wales, Hospital Admissions and Discharges, 1840–1914
- U.S. National Homes for Disabled Volunteer Soldiers, 1866–1938
- New York, Insane Hospital Admissions, 1873–1910
- U.S., Veterans Administration Master Index, 1917–1940
Internet Archive, HathiTrust, and Google Books
- Digitized institutional reports, hospital histories, and medical society proceedings often include patient statistics or case studies.
Search for:
- “Annual Report of the [Hospital Name]”
- “Superintendent’s Report of the [State Hospital]”
- These often include statistics, anonymized case studies, and patient narratives.
6. Newspapers and Coroner’s Inquests
- Local papers sometimes printed commitment hearings, hospital admissions, or death notices from institutions.
- Newspapers.com, GenealogyBank, and Chronicling America often include:
- Commitment hearings
- Reports of suicide or institutional death
- Legal notices about guardianship of the mentally ill
- Coroner’s inquests (available at county archives) may reference hospitalizations or cause of death tied to long-term care.
- Cause of death tied to long-term illness
- Statements by family members and physicians
- Institutional or hospital involvement
7. Psychiatric and Mental Health Institutions
Museum of the Mind – Bethlem Hospital (UK):
- Archive for the Bethlem Royal Hospital, London’s historic psychiatric institution.
- Patient admission registers and case notes available (some as early as the 1600s).
- https://museumofthemind.org.uk
8. Specialized Institutions and Disease Hospitals
Leprosy Colonies
- Carville National Leprosarium (Louisiana): Now a museum and archive.
- Limited access to patient files (released after 75 years).
- Contact the National Hansen’s Disease Museum.
- https://www.hrsa.gov/hansens-disease
Tuberculosis Sanatoria
Many TB hospitals were operated at the county or state level and kept detailed records due to the long-term nature of care.
Example:
- State Sanatorium at Alto, Indiana: Admission registers available via Indiana State Archives.
Ethical and Legal Considerations
Access to medical records is restricted for records <50 years old (U.S.) under HIPAA and other privacy laws. However:
- Records over 50–100 years old are often available for research, especially if:
- The facility is closed.
- The patient is deceased and records are >75–100 years old.
- You’re a direct descendant requesting access.
- Next-of-kin may be granted access to closed records in some states.
- Redacted versions may be available through archives or Freedom of Information Act (FOIA) requests.
Tip: Always check if redacted or summarized versions are available through Freedom of Information Act (FOIA) requests or public archives.
Genealogy Applications
- A genealogist found a missing ancestor by identifying him as a patient in the Trans-Allegheny Lunatic Asylum, traced via census records and confirmed through state archives.
- Another discovered an ancestor’s cause of death was tuberculosis, with sanatorium admission records describing his family members and previous addresses; solving a mystery of a branch that “disappeared.”
Conclusion
While often overlooked, medical and asylum records offer a poignant, detailed window into your ancestors’ lives; especially when those lives were marked by hardship or hidden from public view. By tracing institutional admissions, you can uncover personal histories that go far beyond the census or birth certificate, revealing not just how your ancestor lived, but how they were cared for, remembered, and sometimes forgotten. This strategy requires patience and care; but the rewards can be both profound and deeply humanizing.
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