Under this heading I propose to make a few inquiries relative to the principal forms under which this disease shows itself, and more especially into the likelihood that it is undergoing some modifications under various influences. This latter possibility has impressed me for some time, and, on addressing several specialists on the subject, I find that no few share the same opinion. So far as the question of modified type is concerned, the difficulty which presents itself at the outset is that it is uncertain whether the older writers recognized general paralysis under the Protean aspects now known to us—supposing them to have existed—and it may be an error to assume that its now varied forms are extensions of, or deviations from, a more concise and specialized group of symptoms. If, on the other hand, we can rely upon the observations of those who have spent a considerable number of years in lunacy practice, and can at the same time by statistics indicate that noteworthy differences are becoming apparent between recent and former cases of general paralysis, some basis for belief in a variation of type may be assumed.
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