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A mulatto woman, age thirty-eight, was first interviewed on the medical ward, to which she had been admitted for study, in December, 1932. The clinical clerk had filled eleven closely written pages with her medical history:
F.H. The father died of pneumonia at sixty-five. The mother is called rheumatic, with stomach trouble. Her apprehensions and sensations offered a paradigm for some but not all of our patient's difficulties. One younger brother is a chronic alcoholic, a graduate in law, never admitted to the bar. The three other siblings died in infancy of croup, meningitis and stomach trouble respectively.
P.H. Always delicate as a child the patient suffered from measles, chickenpox, and malaria from which she had but one relapse; sick headaches of childhood merged into menstrual headaches of adolescence. At eighteen, in 1913, she complained of fatigue, tremor, tachycardia and night sweats, lost weight and showed thyroid enlargement for which she has received various advice and treatment, and positive and negative diagnoses through exacerbations in 1914, 1919 and 1920. Intravenous iodine once gave her a severe reaction. Once she refused operation. Rest and diet with bromides, corpus luteum under advice and against advice, back rubbing by her mother with mentholatum, in Washington, Baltimore, Brooklyn and New York clinics as well as in her home in the south make up a history of nineteen years of fear of goiter, though we have no report of elevated basal metabolic readings.
She had taught one year after her graduation from Normal School at seventeen, then suffered her first “nervous breakdown,” stayed at home a year, then found she was much better away from home teaching, always worse when June brought home and hot weather. In 1918 her father died and the goiter was troublesome again but she