CASE HISTORIES 55 



Physical examination: Skeleton slender. Dome-shaped pal- 

 ate. Perspires easily. Radial arteriosclerotic pulse under tension 

 and rapid. Hair, normal male distribution. Genitalia normal. 

 Thyroid gland, both lobes enlarged about one third and isthmus 

 is hypertrophied. A noticeable exophthalmos with eye globes 

 under tension. Fine toxic tremor of fingers. All reflexes ex- 

 tremely exaggerated. 



Endocrine diagnosis: Hyperthyroidism. 



Glandular therapy: None. Even the thyroid tolerance test 

 had to be stopped on the second day because of his excessive 

 reaction to it. 



Four months later: He still had parole and his behavior was 

 exemplary. The hallucinations and delusions persisted, but were 

 not yet well systematized again. He said there were men and 

 women inside him, and they put things in and took things out 

 of his body, particularly his eyeballs. The symbolism was as 

 rich as ever with Scottish rites, Satan and the rest. 



Mental diagnosis: Schizophrenia with projection. His own 

 explanation of his psychosis at the time of the infection was very 

 accurate except he would not admit that the " force " came from 

 within rather than from without himself. The coincidence of the 

 disappearance of the perverse cravings with the height of the 

 infection makes one presume a connection between the two 

 phenomena, particularly since there are records of many similar 

 cases in which severe infections apparently cured psychoses. 



During the dominance of the perverse tendencies his sexual 

 power was lost, probably a suppressive act of self-defense. I 

 have found this phenomenon in many similar cases. When the 

 improper impulses are again well repressed, potency returns 

 as it did with this patient. It will be recalled that he stated some- 

 thing had been taken away from him, that his testes and eyes had 

 been removed (since some eyes and testes were there, he had to 

 invent the theory of substitution), and that voices told him he 

 would never have children. His delayed sexual development 

 was shown by his timidity with girls, his fear of fighting 

 another male for the girl he might want, and his lack of satis- 

 faction in coitus. 



