5/26/42 Medical Report:
STILL-HILDRETH OSTEOPATHIC SANATORIUM
MACON, MISSOURI
Name Miss [2721 Tentative diagnosis Schizophrenia
Address Rochester Minnesota Final diagnosis [blank]
PHYSICAL EXAMINATION
Age 18 Weight 115 1/4 Height 5' 3 1/2" General appearance
medium build
nourishment fair
Vascular
Blood pressure
Systolic 122
Diastolic 80 Skin and appendages clear
Pulse 80 skin
Pressure 42
Rate regular
Volume full Extremities
Arterial compressibility Upper negative
Heart Lower "
Size normal Lymphatics
Position " Cervical "
Sounds clear Axillary "
Thorax Inguinal negative
Contour normal Thyroid gland "
Lungs Body temperature 98.6
Resonance normal Spinal examination
Respiratory sounds clear Cervical
1-3
Abdomen Dorsal
2-8
Wall negative Lumbar
Viscera Pelvic
Stomach negative to palpation Coccyx
Liver " " "
Intestines " " "
Other organs " " "
Remarks
X-Ray report
NEUROLOGICAL EXAMINATION
Motor system Sensation
Tone normal Tactile perception subacute
Strength fair Pain " "
Motility unimpaired Thermal " "
Trophism average Muscle " "
Tremors none Stereognostic " "
Spasms none Organic disordered
Fibrillary twitching none Subjective unexperienced
Ocular movements normal Sleep quiet rest reported
Pupillary size moderately
dilated
Pupillary equality normal Reflex reactions
Speech indistinct Corneal active
Deglutition normal Pupillary "
Handwriting inattention Pharyngeal "
Index finger tests no
cooperation Tendon "
Gait steady Clonus none
Heel-toe test no evident
incoordination Babinski none
Romberg's sign " " " Abdominal
Cremasteric
Sphincter control at times
involuntary
Remarks
MENTAL EXAMINATION
General memory inaccessible Attention preoccupied
Orientation clouded Concentration not maintained
Insight inadequate Association phantasy content
Emotional status impoverished Judgment unreliable
Behavior deeply introspective Hallucinations probable
Sociability withdrawn Delusions vague
Remarks
The patient presents a morbid detachment and inaccessibility.
The attention is occupied with a practically impenetrable
reverie of random phantasy. No satisfactory discussion of
her experiences is obtainable and there is mainly absence of
response to questions. Alert and understanding cooperation
is lacking and the execution of simple requests often
ignored. There is mute indifference or an occasional mumbled
and indistinct remark which has no apparent connection with
immediate realities. The level of consciousness is
insufficient to maintain adequate awareness and all
sensibilities are in a measure clouded. Emotional reactions
are impoverished. Personal needs are neglected and soiling
of clothing at times occurs. There are dully confused
delusional interpretations. The problem represents a well
established dissociation of schizophrenic type.
SPECIAL EXAMINATIONS
Eye Conjective examination Ear Drumhead negative
Conjunctiva only External ear "
Iris Auditory canal left partly
occluded with
Lens Hearing (air conduction) cerums
Retina R
Optic disc L
Vessels Bone conduction (mastoid)
Astigmatism R
Vision with glasses L
R
L
Vision without glasses
R
L
Remarks
Teeth
3rd 2nd 1st 2nd 1st lateral median
molar molar molar bicuspid bicuspid canine incisor incisor
Rt. --- cavious ------ o.k. ---------------------------------
upper
Rt. ----- o.k. ----------------------------------------------
lower
median lateral 1st 2nd 1st 2nd 3rd
incisor incisor canine bicuspid bicuspid molar molar molar
Left o.k. --------------------------------------------------
upper
Left o.k. ------------------------------- cavious o.k. -----
lower
Palatine arch negative Nose and sinuses
Tongue " Nares negative
Tonsils " Septum "
Pharynx " Turbinates
Larynx not visualized R "
L "
Remarks Antrum
R "
L "
Frontal sinuses
R "
L "
Gynecological Genito-Urinary
External genitalia negative External genitalia
Vagina " Testes
Uterus " Prostate
Tubes and Ovaries " Rectum
Rectum "
Mammary glands "
Remarks
LABORATORY REPORTS
URINE EXAXINATION BLOOD EXAMINATIONS
Physical and Chemical Physical
Quantity day 150 c.c. Hemoglobin 90 (85-100%)
night 250 c.c. Erythrocytes 5,375,000 (4.5 to
Color straw (normal straw) 5.5 million)
N amber Color index .84 (1 or nearly 1)
Appearance cloudy (clear) Leukocytes 14,100 (7,000 to
N cloudy 10,000)
Sediment (little if any) 56% Neutrophiles 7896 (4,000 to
Reaction sl. alkalins (acid) 7,500)
N acid 26% Lymphocytes 3666 (1,500 to
Specific gravity day 1.021 3,000)
(1.012 to 1.025) night 1.036 4% Large mononuclears 564 (100
Albumin day neg mgm. to 1,000)
per 100 c.c. 14% Eosinophiles 1974 (50 to 400)
(none) night neg mgm. Basophiles (unimportant)
per 100 c.c. Abnormal cells
Sugar day neg % E B M J St Seg L M
(none) night " % 14 - - - - 55 26 4
Acetone (none) Sedimentation rate 1 hr. 7 mm
Indican " (none) Serological
Bile pigments " (none) N trace Kahn test negative
Phenolsulphonphthalein test Refractive index 1.9521
for kidney efficiency, Chemical
1st hr. %(40 to 55) Blood sugar 82 mg (80 to 120)
2nd hr. %(20 to 30) Urea nitrogen 16 mg (12 to 15)
*Non-protein nitrogen
Microscopic (25 to 30)
Red cells (none) *Uric acid (2 to 3)
Pus cells // (none) *Creatinine 1.6 mg (1 to 3)
Casts (none) *Hemoglobin
Epithelium cells (few if any) Sugar tolerancs test
Mucous threads (none) 1st hr. (150 to 160)
Cylindroids (none) 2nd hr. (100 to 120)
Amorph. urates (few if any) 3rd hr. (80 to 120)
Crystals calcium & oxa- (Figures above represent mgm.
(few is any) per 100 c.c.)
*Microscopic, stained late *Alkali reserve vol.% (55 to 65)
*GASTRIC ANALYSIS
*PROSTATIC SECRETION Free hydrochloric acid (25C to 50C)
EXAMINATION Combined hydrochloric acid
Gonococci (none) Total hydrochloric acid (40C to 65C)
Hydrochloric acid deficit (none)
Total acidity (50C to 75C)
*SPUTUM EXAXINATION Lactic acid (none)
Blood (none) Butyric acid (none)
Tubercle bacilli (none) Acetic acid (none)
Other bacteria Mucus (slight)
Curschmann's spirals (none) Blood (none)
Charcot-Leyden crystals (none) Boas - Oppler Bacilli (none)
*FECAL EXAMINATION
*BASAL METABOLISM TEST Color (light or brown)
B.M. Rate Mucus (little or none)
(normal +10 to -10) Parasites (none)
Blood (none)
Bile pigment (none)
Tubercle bacilli (none)
N.B. Tests marked with asterisk (*) are not routine but will
be made as indicated by patient's symptoms. We reserve the
right to change this classification if necessary.
5/26/42 F. M. Still's letter to EC:
Still-Hildreth Osteopathic Sanatorium
MACON, MISSOURI
Fred M. Still, D.O
Superintendent
Mr. Edgar Cayce
Virginia Beach
Virginia
Dear Mr. Cayce:
We are enclosing copy of our examinations of Miss [
2721]
whose mother Mrs. [...], ..., Oklahoma, you so kindly
referred to Macon.
Miss [
2721]'s condition seems to be a well established case
of dementia praecox, but because of her youth we are hopeful
much can be done for her.
During the past few months we have instituted the policy of
returning the examination fee to the referring doctor, and we
feel this should apply to you as well, we are enclosing our
check for $25.
Very truly yours
[signed] F. M. Still, D.O., Superintendent
fms;m enclosures -- 2
6/02/42 EC's letter to Dr. Fred M. Still: "Am in receipt of
yours of the 26th. Thank you very much for your letter and
for the report. I trust we may be favored with developments
in this case. I understand another is to be sent there very
soon, who now is in Boston or vicinity, but whose home is in
Fla., Mrs. [
2744].
"May I ask a favor, Doctor? We have several people in
Chicago who need the attention of a good osteopath. We
haven't a connection there that I am satisfied with; is there
some one there from the Kirksville School whom you would
recommend? Would appreciate it if you would give me the name
and address of such a one; we have them in many parts of the
country but not one in the Chicago area.
"Doctor, in the suggestions for Miss [
2721] there is an
appliance indicated that has been developed through the
information. This has been used in several mental cases
whom Dr. Frank Dobbins of N.Y. has treated with marvelous
results. Should you wish to try this there, will be glad
to have the young man [Marsden Godfrey] who makes these
appliances send you one to use in this case; while they are
home made, they have proven effective in every case they have
ever been suggested for, when followed. So you can let me
know about this.
"Again thanking you and believe me, yours sincerely..."
[See Dr. Still's reply under
2733-3 Reports.]
9/07/42 Mother's letter: "Last April you advised me, after
a Rdg., to take my daughter to Still-Hildreth Sanatorium
at Macon, Mo. At the time, I could not see how I was to do
this, for as you may recall, I am a Manila refugee and had no
work or any resources. Quite unexpectedly I got a good job
and she has been in the Sanatorium since May 3. I have not
been able to see her since May for I have worked 8 hrs. a
day, 6 days a wk. Letters from her doctor have given some
encouragement, though not a great deal. Now my work ends
September 15 and I am rather desperately hunting something
else to do. Unless I find it, I cannot meet the hospital
bills.
"You told me that you would find out through another Rdg.
about her progress. I am anxious to have that now, anxious
to know if we are on the right track. It means everything to
me."
9/23/42 See
2721-2.



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