This contribution reports a study of chronic schizophrenics hospitalized in state hospitals who suffer from serious and life-threatening medical and surgical illnesses. Four primary findings are described and discussed: lack of verbalization of pain and discomfort; bodily self-mutilation; toleration and exhibition of loathsome lesions; and inability or unwillingness to tolerate medical care. Some examples of exceptions to these four findings are also presented. Possible explanations for the findings are discussed in terms of their biological, social, and psychological components, recognizing that no single factor can explain the findings in this complex and varied population. It is concluded that treatment staffs in the hospital or community must be alert to changes in patient state, must utilize compromise methods of care and must anticipate or deduce a patient's needs while the patient is physically ill.