CASE HISTORIES 41 



nipples. Axillary hair very scanty. Genitalia normal. Ex- 

 tremities rather cold. Type of movement slow and deliberate. 

 Heart rate accelerated. Reflexes hyperactive. 



Endocrine diagnosis: Submyxedema. 



Glandular therapy: He was given thyroid. Treatment was 

 much interrupted by his frequent escapes. No change was seen. 



Four months later: During the summer he escaped again and 

 was allowed to stay home for a month until he attacked one of 

 his brothers for refusing to give him money. He had also bull- 

 dozed his mother when his father was at work. The attendants 

 reported he was masturbating frequently. No one had seen him 

 do this in the endocrine ward. He seemed worse ; more self-con- 

 tained, introverted, and on the defensive. 



Mental diagnosis: Schizophrenia with projection. He had 

 had considerable experience with insane hospitals and in his 

 partially recovered condition was smart enough to hide the symp- 

 toms he knew doctors were looking for. He claimed he was all 

 right and wanted to go home, so of course he wished to hide 

 any symptom that he had seen was considered bad. Thus, while 

 he resolutely denied hearing voices in the hospital, on one of his 

 escapes he told his cousin he was going to Union Station to find 

 out about the voices. A stereotyped hospital question is, " Do you 

 hear voices ? " As far as could be seen he had no delusions or 

 hallucinations except the vague fear that someone might hurt 

 him. He would rather sit or lie down than work. One never 

 saw him smile or give any indication of enjoying his thoughts 

 particularly. 



He had much autoeroticism. The staying in the bath showed 

 skin eroticism, and the association test disclosed oral eroticism 

 if not actual fellatio. It will be remembered that he sucked his 

 fingers for many years. 



Signs of his struggle against incestuous and homosexual 

 impulses were his resistance to his mother and brothers kissing 

 him and his alternating affection and aversion for his mother. 

 The flights from home were an attempt at emancipation from the 

 family, but he was not strong enough to stand alone and had 

 to return beaten. His childish relation to his mother and his shy- 



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