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The patient, an unmarried woman of thirty-three, became ill following the death of her father, which occurred three years before her treatment began. She had helped manage her father's business, and on his death, with the help of her stepmother, she took over the trusteeship of the estate. This proved a heavy task, and the patient suggested that one of her father's friends, a bank treasurer, also be made a trustee. The choice proved unwise, for, some time after this, the man absconded with money belonging to the estate. This worried the patient, who felt guilty, as she considered that she was to blame for his appointment. It was during this period that she became seclusive and complained of being tired and languid. Her stepmother noticed that the patient's attitude towards her too had changed; the patient was no longer as cordial and friendly as she had been hitherto. Suspecting that something was wrong, the stepmother advised her to consult a physician.
When the physician examined her, misinterpreting something he asked her about her menses, the patient thought he was implying that she was pregnant. She thought that this pregnancy was the result of masturbation. She then spent some months in a sanitarium, where she expressed suspicions concerning different persons. She felt that she had committed a great wrong, that she was being hypnotized, and that her food was "doped." On one occasion, during a menstrual period, she accidentally touched a man's hand and immediately felt as if a penis was in her vagina. However, she improved sufficiently to warrant her leaving the hospital.
Some months later, before her admission to McLean Hospital,