CASE HISTORIES 43 



first heterosexual intercourse, and stopped after four or five ex- 

 periences. He was much afraid of venereal disease. 



Fantasies: On his admission he said he dreamed of being 

 home in Poland and of working in the factory. Now he was 

 absolutely inaccessible, spending all his time in his own thoughts. 

 They must have been pleasant for he disliked any interruption 

 and gave no signs of conflict or distress. 



General observations: He was absolutely indifferent to the 

 external world. When standing, his arms were thrust down 

 inside his trousers though not touching his genitals, and he 

 walked with eyes downcast or stood staring by a window. In 

 cold weather he huddled over a radiator, hands clasped over the 

 nape of his neck. For hours he crouched in a heap in a corner, 

 eyes shut and fingers stuck into his ears. He seemed to want to 

 turn in on himself physically as well as mentally. But when the 

 pantry door opened at meal time he was usually the first to reach 

 it in spite of his apparent isolation. As he carried his tray to 

 a table his grin of satisfaction was almost animal-like. 



When one forced oneself on his attention he sometimes struck 

 out in annoyance, and then mumbled an unintelligible mixture of 

 Polish, German and English punctuated with guffaws of laughter. 

 I once distinguished the German vulgar term for feces and the 

 ever-present son-of-a-bitch preceded by profanity. He repeated 

 this phrase several times with delighted laughter and then pointed 

 to his teeth. He pressed his lips tight together and pouted them 

 forward and back a great deal. A Polish-born nurse spoke to 

 him in his own tongue, but he rebuffed her like the rest. 



Occupational therapy: He remained entirely inaccessible. 



Physical examination: Medium type of skeleton. Skin pale. 

 Entire chest and abdomen covered with long, thick hair. Gen- 

 italia normal. Abdomen protuberant. Heart weak and irregular. 

 Pupils pinpoint. Reflexes sluggish. 



Endocrine diagnosis: Submyxedema. 



Glandular therapy: Thyroid was given. The stimulation 

 seemed to force him to extrovert in spite of himself. He dropped 

 his hands from his ears from time to time and looked about him 

 in half surprise as if wondering where he was. He paced rest- 



