Remote Antecedents. (Notes furnished by the mother.)—Father: 35 years old, tailor's cutter, large, strong, of calm temperament, a smoker; numerous excesses of alcoholic beverages, especially absinthe—as many as eleven a day; venereal excesses; came home intoxicated almost every day; never had convulsions in infancy, nor any nervous shock; suffered only from eczema. No syphilis.—Father's Family: Paternal grandfather a mason, sober, died of heart disease. Paternal grandmother, of calm temperament, enjoyed good health. No other information regarding paternal ancestry.—Mother: 33 years old, seamstress, good health, regular features; no convulsions in infancy. Menstruated at age of 13 years, married at 20. Suffered from migraine since she was nine years old. These headaches lasted three days and occurred at the menstrual periods, ceasing throughout pregnancy and lactation. The symptoms were: headache, buzzing in the ears, to the point of deafness, and vision of sparks before the eyes. The attacks terminated with vomiting. Mother's Family: Father sober and in good health; mother died of influenza. No information regarding either the ascendant or collateral branches; but there seem to have been no other cases of nervous disease in the family. No consanguinity, no disparity in ages. Brothers and Sisters of the Patient: The mother of D—— had five children; the first, a boy ten years and a half old, intelligent, no convulsions; the second, a girl, died at fourteen months, after having convulsions that continued for eight days; the third, a girl, seven years old, intelligent, no convulsions; the fourth, the patient in question; the fifth, a girl, born after D——'s admission to the asylum; she is intelligent and healthy, no convulsions.
Near Antecedents. The child's mother is convinced that the conception took place during alcoholic intoxication. Pregnancy was accompanied by generalised œdema from the fifth month onward, due to albuminuria. No eclampsia. No fainting fits, etc. Delivery timely, difficult, but accomplished naturally. The child at birth was strong and not asphyxiated. Was nursed by the mother for the first two months, after which he depended upon hired nurses and artificial feeding (was sent to the country where he was fed chiefly from the bottle). Was returned to the mother at the age of eleven months; could not walk; would eat anything within reach of his hands, coal, excrements. Cried continually, day and night, to the great disturbance of the neighbours. Cut his first tooth at five months; and at the age of three years the first dentition was not yet completed. Has a habit of swaying his body forward and backward; beats his head against the wall, the chairs, etc., and strikes his forehead with his clenched fist. Has habitual constipation. Is extremely affectionate, loves to be caressed. Yet he will bite anyone who approaches him, including his brothers and sisters. It cannot be learned whether when he was staying with the wet-nurse he ever had convulsions. It is certain that he had none after his return to the family. The habit of onanism dates from the time of his return from the nurse. Vaccinated at 13 months, slight attack of varioloid at the age of two years; no other infectious diseases. No manifestation of scrofula; no traumatism.
Objective Examination of the Patient (omitted).—The history is accompanied by eight photographs of the boy, taken respectively at the ages of 3, 4, 6, 8, 11, 15, and 16 years, three of which, namely, those taken at the ages of 6, 11 and 16, are reproduced on page ([278]).
Diaries
July 2.—He is uncleanly (emissions of fæces and urine). Does not know how to behave at table; when he eats he spills his food over his clothing. Is gluttonous but not voracious; he does not steal the food of his companions, but he protests when he sees food given to others and not to him. Is mistrustful, hides his bread for fear that it will be taken from him; and if any one takes notice of this, he utters a cry of rage. He is affectionate, very timid, jealous, obstinate, grumbling, somewhat sullen, seldom laughs. Although weak, he fights his companions and frequently falls into fits of anger; then he flings himself on the floor and beats his head against the furniture. He sways his body forward and backward. His power of speech is limited to three words: papa, mamma, and no. He is able to make himself understood when he wants anything.
August-September.—Two slight attacks of ophthalmia. The child has now learned to walk.
January-March, 1885.—Otitis (Inflammation of the ear).
August.—The ability to speak is developing progressively. He has begun to give notice of his natural necessities; is seldom uncleanly, so that it is now possible to let him wear trousers. The habit of balancing his body back and forth is tending to disappear. The accesses of anger have become rarer. He is less jealous and plays indiscriminately with his companions.
January, 1886.—The improvement continues. D—— is now very attentive in school. When out walking he takes an interest in the things he sees and asks for explanations. Is doing well in the first gymnastic exercises. Makes a good appearance.