CASE HISTORIES IO7 



months. I said I was tired of waiting and fell in a fit. I was 

 seven or eight years old then." The father had been absent 

 a long time and the boy had meanwhile been the center of his 

 mother's life. She had been awaiting the father's return with 

 joyous anticipation. I asked the patient if he thought jealousy 

 had played any part in the spell, and he broke into sudden loud 

 laughter. " I wouldn't be a bit surprised if that was the founda- 

 tion of the whole thing, of my having these spells. Mother 

 would hold me down during them so I wouldn't move around 

 much. I'd be weak after them and she'd pay a good deal of 

 attention to me. I think pressure on the brain and jealousy may 

 have caused these spells." It will be recalled that the severe 

 seizure which ushered in his psychosis came at a time when he 

 had worried over his father's danger in France and had had 

 visions of his corpse in a coffin. His spells in the hospital no one 

 was able to connect with any particular emotion or incident. 



Occupational therapy: He had parole and didn't work in the 

 ward but liked to visit the occupational carpenter shop occasion- 

 ally where, on account of his poor eyesight and incoordinate 

 movements, he did very poor jig sawing and broke many saws, 

 but enjoyed it immensely. 



Physical examination: Slender type of skeleton. Oxycepha- 

 lic skull. Arrest of development of lower jaw. Teeth irregular 

 and notched. Hair distribution normal. Genitalia normal. Ab- 

 domen protuberant. Heart irregular and rapid. Bilateral in- 

 ternal strabismus. Chronic middle ear disease. Athetoid facial 

 expressions. General incoordinations. Numerous tics and 

 slightly hyperactive deep reflexes. Slurring speech defect which 

 patient attributes to previous tongue adhesions. 



Endocrine diagnosis: Dyspituitarism. 



Glandular therapy: He was given desiccated pituitary 

 (whole gland). Some observers thought his epileptic seizures 

 occurred less often, but this was difficult to decide, for they had 

 always been irregular. 



Four months later: He seemed a bit duller. 



Mental diagnosis: He was a defective and epileptic, who had 

 recovered from a psychosis with schizophrenic features in which 



