CASE HISTORIES 47 



material. His general mental condition seemed to improve also. 



Physical examination: Heavy type of skeleton with general- 

 ized adiposity, which is exaggerated on shoulders and abdomen. 

 Weighs 248. Skin smooth and almost hairless, though there is 

 a slight beard and some scanty hair about the mammary glands 

 which are enlarged, being filled up with adipose tissue. Fingers 

 are short, stubby and without tremors. Breathing is shallow 

 and emphysematous in character. Penis very small, genital hair 

 normal. Heart rapid. Reflexes normal. 



Endocrine diagnosis: Submyxedema. 



Glandular therapy: He had been steadily improving for a 

 long time before taking desiccated thyroid gland. But with the 

 first large doses he grew more active, talkative, industrious and 

 complaining, and talked about getting out of the hospital in a 

 few months. 



Four months later: After occupational therapy had been 

 discontinued in the ward he began working in the pantry and kept 

 it up industriously. Perhaps the opportunity to get extra help- 

 ings of food had something to do with his willingness to wash 

 dishes. The attendants said he had no sleepy spells and was 

 fairly energetic. His mental condition showed no particular 

 change. 



Mental diagnosis: Schizophrenia with projection. His diffi- 

 culties tallied with those of the majority, that is, he had little 

 interest in women and he was struggling against homosexual 

 cravings. His description of the wicked brain trying to control 

 him but losing the fight was an admirable one. He really had 

 gotten sufficient control of his unpermissible cravings to make a 

 happy adjustment to institution life. 



KIMMEL 



History: He was a deteriorated patient forty-eight years old 

 who had been in the institution nine years. He had a wife and 

 five children. His mother's father had died of senile dementia 

 and her sister was insane. One of his own sisters had suffered 

 from a nervous affection since she was eight years of age. The 

 others were healthy. 



