The patient may have delusion of persecution, that people are watching him, talking about him, trying to harm him. He may have ideas of references or that people are trying to influence him and compel him to do things. These fixed ideas or erroneous beliefs are not only impervious to reason, but are apt to be contested. The patient may be suffering from delusion or infidelity (especially as projection mechanism in the elderly and impotent): delusion that his food is being poisoned or other attempts made on his life: and in defense or retaliation may have ideas of murder. All these delusion may be vague or systematized, primary in paranoid trends or secondary in Read the rest of this entry

The spontaneous production or stream of mental activity and responses to questions should be carefully noted. Repetition by the patient of words or phrases spoken to him and repetition of nonsense word (verbigeration) or stereotype repetition of movement (echopraxia) are also to be recorded. A patient may show catatonic attitude or hold an arm indefinitely in an awkward position placed by the examiner (catalepsy).

Does the patient express any fears, anxieties, or phobias? Very often he will complain of a great many signs or symptom when in reality he is anxious about dying, is afraid something vague will happen, dreads insanity, heart Read the rest of this entry

Full term or premature birth, normal or instrumental delivery, asphyxia at birth (blue baby), general health (snuffles and rashes), age at teething, walking, talking and closure of fontanels, convulsions in infancy or childhood, early diseases, early development, progress at school, behavior at home –all this are questions which may have possible bearing on diseases of the nervous system. Do another brothers and sisters suffer from the same illness (familial), or the parents and collaterals (hereditary) and is the affection due to prenatal influences (congenital)? Are the parents related (consanguinity)? Among previous illness (aside form any condition with Read the rest of this entry

Inquiry into the sexual life of the patient requires knowledge, skill and tact. Boys and men should be asked directly whether they masturbate (or a simpler expression used if they do not understand) and promptly assured that it is not an awful thing in order to forestall a possible denial. (Self gratification is infinitely more descriptive and less odious then self abuse). With girls and women the same question can be put more tactfully but ultimately no less directly, again assuring them that it is neither sinful or harmful in order to prevent anxiety. The question of potency and libido both desire and gratification should be put to men and women, though somewhat differently to each, the question coitus interrupts should be Read the rest of this entry