ABSTRACT
The paediatrician saw Leon when he was seven-and-a-half years old. For the previous year, Leon had been messing himself, though he had been in full control of his sphincters before that. The consultant was told that Leon was able to defecate in the toilet once or twice per week, after which his soiling improved for a few days. When the consultant paediatrician saw Leon one month later, he was told that there had been no change in the situation. Leon’s soiling had started about eighteen to twenty-four months earlier; the parents were unable to agree on a precise timing. When Leon began to soil himself, Mr L had reacted quite angrily to his messing. Leon smiled, with a faint touch of recognition of something familiar. The parents were to make a chart and Leon would get two points for each day in which he defecated normally, without messing himself.
