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Indeed, no dozen cases would show all the symptoms and peculiarities of the irritable hypokinetic group. One must take care not to mistake the irritability which is the characteristic of all living tissue for the irritability here considered. E. is a man at present thirty years of age.
The generally excitable, overemotional type. This type is more common in the Latin, Hebrew and Celtic races. In some respects it corresponds to the hypokinetic irritable, but it is not necessarily hypokinetic. The artistic type of person, so called, is of this group, but is, of course, talented as well.
It may be only a temporary phase of their lives, but while it lasts it is very troublesome. In E.'s case the overexcitable hypokinetic stage lasted until about the ninth year, and then there was a great improvement, though he still was of the same general type.
The problem, therefore, in each case is to find the latent ability and interest and to regard no case as really hopeless. I say this despite the fact that I believe some cases are hopeless. The pessimistic attitude on the part of parent or teacher kills effort; the optimistic attitude fosters energetic effort. The irritable hypokinetic.
A philosophy of life which will help to control his irritability is necessary, and the intelligent of the hypokinetic irritable acquire the habits and the philosophy necessary for their welfare.
Though I have described E. as belonging to the slender type of person, it is necessary to say that stout, rugged-looking people are often irritable and hypokinetic. As a child E. "never could stand excitement or strain," as his mother says. What is meant is this: that he became overexcited under almost any circumstances and became profoundly fatigued afterwards.
Were it not for a small income he would have starved. After a few years he become very fat and gross looking, and then came a kindly pneumonia which carried him off. We must not mistake the stolid for the hypokinetic. There was a classmate of mine in the medical school, a large, quiet fellow, D. M., who got by everything, as the boys said, by the skin of his teeth.
This unfortunate discharges energy at a low rate is slow in action and often intermittent as well as hypokinetic. The loafer and the tramp are of this type. Around the water front of the seaports one can find the finest specimens who do odd jobs for as much as will pay for lodging and food and drink. Perhaps the order of the desired rewards should be reversed.
A more interesting type is T. He may be called the intelligent hypokinetic, the high-grade failure. As a baby he learned to walk late, though he talked early and well. He played in a leisurely sort of way, running only when he had to and content as a rule to be in the house. He was not seclusive, seeming to enjoy the company of other children, but rarely made any efforts to seek them out.
There are people of low energy discharge, and these it seems to me are of two main kinds, the one where nothing seems to arouse or create powerful motives and purposes, and the other in whom the main defect is a rapidly arising exhaustion. The first I call the simple hypokinetic group and the other the irritable hypokinetic group.
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