CASE HISTORIES 2 7 



ENGEL 



History: He was a man thirty-nine years old and mentally 

 deteriorated. It was difficult to get him to tell of his past life, 

 and the medical records were brief. His boyhood and youth were 

 spent in a great city, where he received a fair education. After 

 leaving school at fifteen he loafed at home for several years and 

 then worked in a tailor shop and a piano factory. At the age of 

 twenty-two he entered the army and was an officer in the Philip- 

 pine Guards when taken sick ten years later. He married at 

 twenty-nine but had no children. His father died of alcoholism 

 and his mother of tuberculosis. He himself never drank to 

 excess. 



His wife said he overworked in the Philippines and had a 

 breakdown lasting a month during which he had fearful dreams, 

 one being that he had killed her. Two years after this illness he 

 grew depressed and anxious and felt unworthy. One day at 

 table he rushed out of the dining room greatly excited, saying he 

 was choking and and his throat felt sticky. He was afraid she 

 had left him and married another man. Voices accused him of 

 disgracing himself and called him a thief and coward and other 

 bad names. He feared he might die or be killed, and made one 

 half-hearted attempt at suicide. 



After reaching St. Elizabeths he was suspicious and had un- 

 systematized delusions of persecution. A twitching tic of the 

 mouth was noticed, and sometimes he kept his tongue protruding. 

 He said he was bad and had wronged his wife, and the police 

 were after him. He stuffed his ears so as not to hear the per- 

 secuting voices, and complained of peculiar sensations in his head 

 and of frontal headaches after the sticky feeling in his throat 

 and the resultant choking. 



Sex life: In answer to my question what was his chief pleas- 

 ure as a boy he said, " Playing with myself, jerking off." He 

 added that when he was twelve or thirteen years old a servant girl 

 of thirty-five gave him all the coitus he wanted. After her he 

 had relations " with a lady, nice and clean." No further informa- 

 tion could be obtained. 



Fantasies: He had a great habit of scolding at nobody in 

 particular. During one of these tirades I asked what bothered 



