A Child Analysis

When first seen Alan was nine years and three months old and presented the following picture: a large, fat, slow moving child, with white face, tragic staring eyes, heavy scowl, clenched jaw, his whole body rigid and with the abdomen protruding strikingly. He sidled into the room hugging the walls taking first a step forward and then one backward, watching me warily. He sat stiffly on the edge of a chair, his right hand tightly clenched in his pocket and with the left arm he made rhythmical pushing away movements. He never once removed his terrified eyes from my face.

The history was obtained from parents and the family physician. Alan was a healthy, happy baby. He was breast fed ten months and presented no problems until when he was eighteen months old the maternal grandmother came to live with the family until her death six months later. She was an invalid requiring much care. The family being in very limited circumstances the mother carried the entire household duties unaided. Alan promptly showed his disapproval of the consequent neglect by making many demands which his mother had no time to meet and he soon changed from a happy child easily cared for to a restless, unhappy one.

At the age of two years, shortly after his grandmother's death, he fell and cut his forehead. It bled profusely and in alarm his mother picked him up and rushed him to a doctor. There he was held by his mother and the doctor's wife kicking and screaming on a table while several stitches were put in. A few days later he began blinking, scratching his face, twitching and shrugging. In the hope of relieving these symptoms a tonsillectomy was performed two months later, but this made him worse. For several months sun lamp treatment, outdoor activity, changes in diet and other measures were tried but the condition grew worse and his sleep became greatly disturbed. He was in a constant state of excitement and motor activity.