CASE HISTORIES 79 



He slipped away from the guards in a theater and escaped. 

 Months later a brother wrote to the hospital that the patient was 

 getting along all right in freedom and requested that his name 

 be stricken from the roll. 



Occupational therapy: He consented at once to try bead 

 work, but though interested was rather careless. He seemed to 

 be more interested in having the instructor sit by him than in 

 the work itself. He got more indifferent and as soon as parole of 

 the grounds was granted him, stopped work altogether. 



Physical examination: Medium type of skeleton with well 

 developed muscles. Skin well nourished, perspires easily. 

 Brown pigmentation on back. Hair of head gray and scanty. 

 Body hair scanty. Genital hair normal in amount but submas- 

 culine in type. Genitalia normal. Heart regular but rapid. Ex- 

 tremities cold and slightly blue. Eyes protrude. Reflexes nor- 

 mal. Thyroid gland slightly palpable. 



Endocrine diagnosis: Hyperthyroidism. 



Glandular therapy: He went through the tests which es- 

 tablished the endocrine diagnosis, but escaped before any real 

 glandular therapy was begun. 



Mental diagnosis: Schizophrenia paranoid. Not only were 

 his improper sexual impulses projected onto other people but, as 

 the years went on, he built up a somewhat systematized structure 

 of persecution in other matters besides sexual. The delusions 

 themselves did not change so much as did his belief in their 

 reality. At times he had considerable insight as shown by such 

 a remark as, " I realize I was nutty, and I may be yet at periods." 



It is easy to trace the effect that his mother incest impulse had 

 on his life. His father's brutal punishments and his mother's 

 attempt to shield him probably helped to fix his libido on her in 

 the first place. He felt resistance toward taking his father's 

 place in the family after the latter's death, and had a revulsion 

 of feeling toward her, seeming to prefer the father image. His 

 suffering when during her raving spells he had to hold her on the 

 floor was perhaps not entirely due to her unlovely condition. He 

 was quite ready to suspect her of illicit relations with the priest. 

 His fear of infecting her with gonorrhea was hardly justified. 

 His incest fears drove him to abandon her even though he knew 



