In women, unusual symptoms at menstrual periods; age at menopause, nervous symptoms accompanying climacterium?
4. Diseases and Injuries:
Any previous nervous affection or symptoms, such as headaches, nervous prostration, chorea, epilepsy, hysterical attacks, etc.?
Mention severe infections diseases and sequella, if any. Inquire concerning tuberculosis, rheumatism, heart disease, nephritis, etc.
Venereal disease, syphilis and gonorrhea, full account, if possible, of how acquired, age, treatment and after affects.
Severe injuries, particularly head traumata, should be described as regards their immediate and subsequent effects.
5. Occupation:
Kinds of work undertaken, ambition, efficiency, wages, etc. Length of time in different positions, reasons for change, etc.
6. Alcoholism and Other Toxic Influences:
Intemperate, moderate or total abstainer? If intemperate, age at which drinking began, apparent cause of same, kind of beverage consumed and approximate amounts. Periodic or steady drinker? Usual reaction to alcohol?