Out of a total of 3916 cases of insanity (2493 male and 1423 female) observed at the Moscow Clinique for Mental Diseases between November, 1887, and January, 1901, there were 682 of general paralysis —590 men and 92 women; so that nearly 25 per cent, of the male and 6.57 per cent, of the female cases were general paralytics. The proportion is larger in recent years than in the earlier years of the foundation of the clinique. The greater number of cases in men were between thirty-six and forty years of age; in the case of women the commonest age is thirty-one to thirty-five years. The authors give notes of three cases of juvenile general paralysis. Various tables of classification dealing with occupation, nervous heredity, alcoholic inheritance, presence of syphilis, etc., are given, and the following are some of the authors' general conclusions:—General paralysis is uncommon or even rare in the case of farm labourers. The importance of heredity is great in the case of general paralysis, as in other psychoses or mental diseases. Syphilis was present in more than 75 per cent, of the cases, and in 90 per cent, of these there was an interval of from six to twenty years between the date of infection and the appearance of morbid symptoms. Alcoholism is of importance in the ætiology of general paralysis in men; in over 60 per cent, there is a marked history of abuse. The demented form of general paralysis was observed in half the male cases, the maniacal form being next in frequency. In women two thirds of the cases were of the demented type, and a quarter of the maniacal. The demented type was decidedly commoner in recent years. Concerning certain symptoms especially noted in general paralysis, the authors found that among men exaggeration of the knee-jerks was present in about half the cases, absence in one fifth; among women exaggeration was found in about 60 per cent., and absence in 15 per cent.
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