CASE HISTORIES 49 



himself did things though always criticized and never appreciated. 

 Once in a while he scolded about his food. These tirades oc- 

 curred during the night as well as the day, and in them he 

 articulated with difficulty, making extreme grimaces in which he 

 drew his mouth way over to the left. 



Occupational therapy: He was very resistive to the instruc- 

 tor's efforts to interest him but finally consented to try basket 

 weaving and managed to complete two pieces. Every morning 

 he had to be taught all over again as if he had never seen a 

 basket before. Some days he angrily refused to work telling the 

 instructor to do it herself. At any time he was liable to stop 

 work and go into one of his tirades. 



Physical examination: Slender type of skeleton. Skin pre- 

 sents a few brown pigmentations, particularly over shoulders. 

 Considerable hair over upper chest and about neck. Genital hair 

 and genitalia normal. Face asymmetrical, elongated on right 

 side. He has generalized arteriosclerosis and there is an occa- 

 sional stereotyped choreiform movement of the left side of the 

 face. Considerable photophobia. Reflexes hyperactive. 



Endocrine diagnosis: Submyxedema. 



Glandular therapy: The three day test of tolerance for des- 

 iccated thyroid gland had a bad effect on him. His pulse became 

 very irregular and rapid and he showed other signs of intolerance. 

 He grew much noisier. Afterwards he became quiet and somno- 

 lent again but seemed to have a little more initiative. For 

 instance, he soaped and scrubbed himself in the bath which 

 previously the attendant had been obliged to do. Because of his 

 advanced chronic heart disease no glandular treatment could be 

 given. 



Four months later: His condition was unchanged. 



Mental diagnosis: Schizophrenia with projection. His con- 

 tinual scoldings disclosed an inferior, inefficient man magnifying 

 his own abilities and accomplishments and decrying other men 

 who imagined themselves superior to him and failed to appreciate 

 his true worth. If he had a sexual conflict too, it was now 

 buried out of the sight of the onlooker, but his history gave 

 hints that the usual erotic difficulties had once been present. 



