Amongst the early symptoms of general paralysis are mentioned disorders of digestion, wandering neuralgic pains, a diminution in mental activity, a feeling of tightness or beating within the orbits, flashes before the eye, sounds in the ear, with pulsation in the arteries of the neck and temples. The reproduction of ideas becomes sluggish. He cannot hit upon the right word, and has to use less appropriate expressions. His memory begins to fail him. Sometimes, on the other hand, the intensity of intellectual power seems increased, even while the patient is suffering from the troubles of digestion, loss of flesh, sleeplessness, inequality of the pupils, and heightened patellar reflex, and he is able to work as well or even better than usual. At an early date the patient becomes more emotional, and shows a sentimental distress at anything pathetic or unpleasant. He has paleness of the face and a blue ring around the eyes. There is often a rise of temperature during the night and an increased secretion of saliva.
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