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political office awakens in his mind the belief that he has had, and still has, some of the highest which are within the power of his fellow-citizens to bestow. He at once becomes the Governor of the State, or the President of the United States, or an Ambassador to some foreign court, where he will be happy to present you to the Emperor or Queen.

At other times the bits of glass become diamonds, and his benevolence boundless. He intends to make the largest benefactions to all friends and relatives, erect hospitals for the sick, and libraries for the free use of everybody. There will no longer be need of suffering or ignorance, which will have an existence only in the memory of by-gone days. These pleasing delusions seem to be glorious realities, and are recounted again and again with a countenance beaming with self-satisfaction and joyousness, and yet with a stammering tongue and half-paralyzed lips, to any passer-by who will listen to the story. They will depend as to their material largely upon the antecedent experiences and education of the brain; those of the ignorant or uneducated person will cover a field which will be totally foreign to the disciplined mind of a professional man, but the essential character of expansiveness and largeness belongs alike to both.

A pleasing sensation becomes magnified a thousand fold. The patient is the happiest person in the world,- has never been in such perfect health; he weighs one thousand pounds; is eight feet in height; has walked one hundred miles with his attendant this very morning, and carried the world with case on his shoulders; and yet to-morrow may become emotional, irritable, fault-finding, and changeable. With tears and painful anxiety, he will tell you that his wife has left his home, and it is of the first importance

that he leave by the next train; or again, that his children are dead, his house burned to the ground, and his wife locked up in the State prison, or that she is a fugitive with some scoundrel who has seduced and inveigled her from her home. He is positive that this is all true, for he saw it with his own eyes last night. At the next visit you shall find the patient with some book or a newspaper in his unsteady hand which he has been fumbling over, but not reading. He greets you with an affectionate welcome; a pleasant look is on his countenance, and he makes no allusion to the strange story he told you in the morning. That sad vision seems utterly to have faded from the brain, and now he is serene and laughs at nothing, with a silly, imbecile laugh which causes the half-characterless face to become, if possible, more characterless still. All is now well with him again; he has not a care in the wide world, and you are his best friend.

On another occasion the patient will confidentially tell you that he has adopted a son and heir to his fortune, and leads you to a primary dement, who he declares is a very Apollo in beauty; he smooths his hair, brushes his coat, and assists in putting it on, and then goes with him for a walk on the lawn or to the chapel. He sits beside him and lists his drooping head and gazes upon his idiotic face with as much of rapture as he is capable of feeling. After the chapel exercise is over, he buttons his coat for him and leads him carefully back to the hall, and yet in a short time he has ceased to remember that he ever expressed the slightest interest in him.

In some cases the sensory system becomes largely affected, and the mind of the patient is absorbed by hallucinations of some of the special senses. He walks back



and forth in the hall with eyes intent upon an imaginary vision of some face or person, with whom he holds converse; again he rushes to the window and talks with some one outside; and at another time he holds long conversations with the clock on the mantel, whose ticking he believes to be the sound of a voice whose subject is concealed within it. He is delighted with the charming sounds which respond to him, and fully believes that all is a reality, and yet forgets it on the slightest intimation from an attendant that he is ready for a walk around the court or a ride to the city.

The character of hallucinations, like the other symptoms in the emotional general paretic, frequently changes. The patient who to-day has seen his wife and children, and carried forward a delightful conversation with them, may to-morrow tell you that he saw them scattered from their homes and among strangers. To-day he sees the bare walls of his room hung with priceless pictures from the studios of the greatest living artists, and to-morrow he will tell you that he sees nothing but horrible daubs on them. To-day he hears music which is being made for his special delectation in the next room, and to-morrow he will tell you that during the night he heard the sobs and groans of his poor children coming from the same room.

Hallucinations of sight and hearing, according to my experience, are the most frequent in the pronounced period of general paresis. Hallucinations of smell have been rare ; while those of general sensation have been confined almost exclusively to the later periods, except those relating to the sexual organs. In a report of the private asylum at Ober Darbling, Austria, mention is made of an investigation on the subject of hallucinations among general paretics, with the result that they were found in only

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twenty out of 194 cases.* This is a considerably lower percentage than I have found in cases at the Retreat.

And here it may be noted as characteristic of the emotional general paretic, that his conduct is at entire variance with the delusions which have occupied so large a place in his mental operations. All the grand offices he has occupied or is about to possess; the billions of golden sovereigns he has on his person; the lovely children he is the fortunate father of; the visions of charming faces with which he has held converse; the horrible scenes of his night-waking hours, in which he has seen his home burglarized, his wife taken away and ravished in his very presence, and his children orphaned or dead, -all these pleasing or horrible visions, with kaleidoscopic movement, vanish, and he will be as happy or miserable as if he had never experienced such delusions and seen such visions.

* Journal of Insanity, p. 392.


GENERAL PARESIS. (CONTINUED.) Depression-Much Less Common During the Pronounced Period than Exalta

tion and Elation-Melancholic Symptoms May be Present-Periods of Excitement-Illustration-In Some Cases Neither Excitement nor Depression Exist-States of Elation May become Changed by Suggestions--Extravagance of Delusions-Physical Symptoms of the Pronounced PeriodTongue-Lips-Muscles of the Face-Handwriting-Epileptiform Seizures—Corpulence-Gait- Eye Symptoms—Period of Boasting - Increase of Dementia- Paralysis-Sphincters—Convulsive Seizures—Bed-sores-Bone Fractures-Case.

Depression.-In my own experience the symptoins of depression and melancholia have been comparatively rare in the pronounced period of general paresis, and yet, at the time of this writing, there are two such cases in the Retreat. According to the statements of friends, one of them had never presented symptoms of excitement or exhilaration prior to his admission, and since then the mental state has been one of depression. The hallucinations and delusions partake of this character, and render him exceedingly suspicious. He says that he sees persons entering his room at night, sometimes by the windows, and at others by the doors, and he is confident that they are his enemies, that at times they take a camera into the room for the purpose of securing a photograph of him. At other times they pound his feet and legs until they become black and blue, and in evidence of this he begs you to examine them

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