This paper records a case in which the diagnosis lay between dementia præcox with paraplegia and general paralysis. The patient was a youth, æt. 19, whose development up to the age of fourteen had been normal; there were no stigmata of degeneracy and no insane heredity. His education was fair, his health good, and his intelligence average. At fourteen years of age he began to deteriorate mentally, speech became hesitant, and his gait was affected. When brought to the asylum a year ago his articulation was impaired, his pupils unequal, knee-jerks increased, and gait uncertain. His mental state was one of general feebleness with some exaltation. There was no lymphocytosis in the cerebro-spinal fluid. The author had seen a similar case some years ago, which at post-mortem showed the lesions characteristic of dementia præcox and not of general paralysis. In this present case, however, the retention of a certain degree of psychic activity, the presence of emotional reaction and the affections, and the absence of the impulsiveness so usual in dementia præcox, confirm the diagnosis of general paralysis.
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