March.—D—— has now become altogether cleanly. Furthermore, he knows how to wash, dress and undress himself alone. At table, can handle his spoon and fork quite properly, but cannot yet manage his knife. Is less gluttonous; his speech is fully developed. Although he cannot keep still in school and constantly changes his position, he has succeeded in learning to know his letters, the different colours, etc., can count up to 50, and can name the greater part of the objects contained in the boxes used for object lessons. The balancing of the body has completely disappeared. D—— has a tendency toward onanism. Accesses of anger an still noted, during which he is very vulgar.
December.—Condition stationary. Misconduct in class, frequent fits of anger, during which he abuses everyone and strikes his smaller comrades.
March, 1887.—D—— is calmer and does better work. Can count up to sixty. His general knowledge has increased. Can tell his age, his name, the name of his parents, what their employment is, where they live, etc.
April, 1888.—The improvement continues. His behavior is better. Has learned the names of materials, of plane surfaces, of solids; can distinguish vowels from consonants. It has been impossible to induce him to trace simple strokes even upon the blackboard.
December.—Is more diligent and has taken a fancy to writing.
January-June, 1889.—Is in the infirmary on account of anal ulcers.
December.—Notable improvement in general knowledge. Has begun to write certain letters in his copybook.
December, 1890.—D——'s conduct is good. He is no longer disorderly; and if at times it is necessary to reprove him, he recognises his fault, cries, and promises to do better. He fears above all that his misconduct will be reported to his mother. Has a fairly accurate notion of right and wrong, is no longer so extremely jealous and shows affection for his comrades. Has learned to write syllables well; is able to copy short paragraphs; can do simple sums in addition; gives clear answers to questions. Walking, running, jumping, going up and down stairs have become easy for him. The child uses his fork and knife at table; chews his food well, does not suffer from any digestive disturbance. Is orderly, and attends to himself in all details of his toilet.
April 21, 1891: Objective Examination.—The child's face has a uniformly ruddy complexion; lips full-blooded; skin smooth, without scars or eruptions, excepting a slight scaliness due to eczema. Two small ganglia in the left submaxillary region, but no others in any other locality. Cranium symmetrical; volume and form normal. Frontal and parietal nodules slightly prominent; occipital nodule quite prominent (pentagonoid cranium). Hair light blonde, abundant, fine, growing low upon the forehead. Posterior vortex normal, forehead wide, but not high. Visage oval; with a slight depression of the nostril and corner of the mouth on the right side; has on the whole an intelligent expression; it is mobile and reflects the moods and feelings natural to boyhood. The superciliary arches are only slightly arched. The eyebrows are chestnut in colour and scanty; the lashes are abundant and long. Iris dark blue; pupils equal in size and react under the influence of light. No functional disturbance, and no lesion in regard to the eyes. Field of vision normal. D—— recognises all the colours. Nose small, and straight, with a pronounced aperture of the nostrils. Zygomata regular, without exaggerated prominences; naso-labial furrows barely indicated. Aperture of mouth very wide and habitually half open. Lips thick and slightly drooping. Tongue normal. Palatine vault distinctly ogival. Tonsils enlarged; the boy is subject to tonsillitis. All these parts show quite a blunted sensibility, which permits of an examination of the pharynx, without causing nausea. Chin rounded, without indentation. Ears long and thick, the outer edge is normal, including the fold of the helix; the ears protrude conspicuously from the cranium and are very peculiar in shape; namely, the upper two-thirds of the external ear form with the lower one-third an obtuse angle of such nature that the concha or shell really represents the outline of a very deep and almost hemispherical sea-shell. The lobule is thick, regular, and notably detached. The ear is the seat of frequent attacks of erythema, complicated by swelling. Neck rather short and quite stout; circumference 26 centimetres. The lobes of the thyroid glands are plainly palpable to the touch.
Thorax and Abdomen.—No notable peculiarities. Auscultation and percussion show that the internal organs are normal. Body is hairless. Genital organs are normal. The upper and lower limbs are normal in all their segments.