Diagnosis. F. H. Psychosis. Mental. Physical. Social. Recreational. GENERAL PARALYSIS CASE 19 General paralysis. Male; age 42; born in Russia; U. S. 15 years; watchmaker; married; wife and four children. Patient admitted a specific, infection at age of 18 years; three years later complained of lightening pains in legs and body. At age of 41 years remained out of work for several months due to numerous somatic complaints. For a year had been more nervous and irritable than formerly, and had failed physically; complained of pains in region of heart and of general weariness; had no ambition to work and was depressed because hands were so tremulous that he could not hold a position. Taken to psychopathic ward and committed to a state hospital; there two months and paroled. Method Referred to clinic after discharge from state hospital, examined and advised regarding further treatment. Came to clinic thereafter at irregular intervals, coming particularly when he did not feel quite well. Arranged for necessary treatment of patient at a general hospital. Wasserman tests taken of other members of family and found to be negative. Aided family with living expenses when necessary. Advanced sum of money to patient with which to buy a quantity of barber supplies; peddled same and for a period of five years has managed to earn enough to help family become totally self-supporting. Younger children sent to summer camp. Advised at clinic, though patient felt he needed but little since he was out in the open most of the day. Result Patient has not returned to a state hospital and has not deteriorated mentally, though he has shown but little improvement with advancing years. Diagnosis. F. H. P. H. Psychosis. Mental. Physical. Recreational. ARTERIOSCLEROSIS CASE 20 Arteriosclerosis; organic nervous disease. Male; age 63; born in Russia; U. S. 40 years; no occupation; widower. For several years patient disoriented; unable to give age to examining physician; nor date and place of birth; failed to recognize his children; at times very confused; became excited; wandered about; threatened to harm grandchildren. Method Patient brought to clinic by children for examination and advice as to what should be done, as they could not care for him because of his mental condition. Advised to commit patient to a state hospital as the only solution under the circumstances. No need. Diagnosis. P. H. Psychosis. Result Patient committed to a state hospital as was advised. MENTAL DEFICIENCY CASE 21 Mentally inferior with hypomanic traits. Father queer, deserted family number of years ago; mother paralyzed in lower limbs for about 15 years. Male; age 15; born in U. S.; attended public school. in ungraded classes. Patient was a pupil in a truant school, and was sent to Children's Court by principal because of strange behavior; got into many fights with other pupils; would bring knives and slugs to school and cause much trouble. From court sent to psychopathic ward for observation where diagnosis was made. Returned to school with a reprimand from judge. Method Mental. Physical. Social, Recreational. Diagnosis. P. H. Psychosis. After discharge from hospital followed-up and induced to come to clinic. Stated that at times he heard voices, became dizzy, was weak and frequently fell. No history of epilepsy could be discovered; patient was examined regularly at clinic and advised. Condition good; well-developed for his years; no serious ailment found. Mother and ailing sister advised. Patient could not get along well with the principal and teachers in the school which he attended last. Obtained transfer to another truant school and did very well there during the few months he had to attend till his sixteenth birthday. Worker conferred with principals of both schools. Patient accounted for his bad behavior by stating his mother was very ill and poor and he wanted to go to work to help support her and a sick sister; thought by misbehaving would be given working papers and discharged from school. Advised and helped patient obtain proper employment; arranged for admission to a trade school. Helped patient plan his evening and spare-time activities; joined athletic group in public school center. Result At end of two years, working regularly as helper, salary $20.00 per week, all of which he gives to his mother. No longer complains of hearing voices; no dizzy spells. Hypomanic condition cleared up, though he is still mentally inferior. Female; age 33; born in Russia; U. S. 16 years; housework and embroiderer; deserted by husband; one child. After a great deal of trouble with her husband he deserted her; shortly thereafter she suffered a physical Mental. Physical. Social, Recreational. breakdown. At that time, i. e., three years before being referred to mental hygiene agency, doctors told her she had heart trouble and advised her not to exert herself unduly. Went to bed and did not rise for three years, fearing she would die if she exerted herself. Taken to a general hospital, remained there five weeks, transferred to psychopathic ward, and taken home next day by relatives. Method After discharge from psychopathic ward, patient visited by mental hygiene worker. Since patient could not leave the house, psychiatrist visited her at home. Worker visited patient almost daily for several months; through much coaxing and persuasion, patient was induced to do things she had formerly feared because of her supposed heart condition; gotten out of bed and made to sit in a chair; later walked a few steps; gradually began to dress and care for self; taken down to street and for automobile rides until she finally gained sufficient confidence in herself to walk home from where she had been left, several blocks from her home. Physician brought to patient for physical examinations; taken to hospital for X-ray of lungs, which were found to be negative for tuberculosis, of which there had been a suspicion; treated for her minor cardiac condition, both at home and in hospital. Confidence restored in learning that there was nothing seriously the matter with her. Family aided financially so that patient might be sent to seashore for bathing and convalescence. Family educated in proper care of patient. Walks with worker; automobile rides; ocean bathing. Result After being under care for one year, patient entirely recovered mentally and much improved physically. Members of family and neighbors think a miracle was achieved. Diagnosis. F. H. Psychosis. Mental. Physical. CONSTITUTIONAL PSYCHOPATHIC INFERIORITY CASE 23 Constitutional psychopathic inferiority with depressed episodes. Negative; father many years older than mother. Female; age 19; born in Russia; U. S. 3 years; factory worker; single; three adult brothers in city. Patient became depressed because of loss of position and attempted suicide by drinking carbolic acid; taken to psychopathic ward; remained there a few days and was discharged. Within a week again attempted suicide by drinking iodine; returned to psychopathic ward and committed to a state hospital, where she was detained two months. Shortly after discharge, threatened on several occasions to commit suicide and to kill several persons known to her. Often became drunk. Attempts to have her committed again unsuccessful, as brothers refused to sign commitment papers and physicians on psychopathic ward refused to admit her unless papers were first signed. Method Following discharge from state hospital patient came to clinic at irregular intervals for about four years. Advised by physician about her depressions, etc. Social worker spent much time with patient, helping her over her periods of depression and trying to give her a new outlook on life. During examination at clinic stated, "I heard voices when I was in the convalescent home because it was very quiet there. I was afraid to sleep-I imagined I saw things and heard voices in my head. Sometimes I heard someone walking-I was afraid to be there I was nervous.” Patient taken to physicians and hospitals for examination and treatment of various ailments complained of by her. For a long time insisted she had some gynecological difficulty; examinations by women physicians failed to discover anything. Sent to convalescent home when rundown physically. |