"This boy suffers from asthma; he has very bad tonsils, which ought to be removed but his grandmother won't permit it. He is getting duller - thought to be due to his tonsils. He has missed a lot of schooling with ill-health. Illegitimate. Not a nervous child. Has also discharing ears. Mother 30-40. Her mother would not let her marry [patient's] father. A bit soft. Laundry worker. Grandmother, a difficult old woman, up against authority - the school and the school doctors are always wrong. Also works in laundry. Home dirty but not overcrowded. Far too many cats. No P.A. Nurse confirms that this boy is a bit dull, but thinks he is improving. Dr. thinks this child's upbringing is at fault."