Whilst studying the pathological changes met with among those dying insane, I was much struck by the large number of cases in which chronic renal disease of a more or less advanced state was present. This led me to work out, from the post-mortem records of the Somerset and Bath Asylum, the percentage of chronic renal disease noted in such cases. But whilst engaged in these inquiries my attention was especially called to the number of general paralytics presenting this condition, and I proceeded, therefore, to collect all the cases of general paralysis of which the records were sufficiently trustworthy. In this way I collected 75 cases, and of these only nine were free, or apparently free, from renal disease. Of the 66 cases remaining 51 had what must be considered well-marked granular kidneys, and the other 15 had diseased kidneys which were most probably granular, though in a less advanced degree. One of these latter cases had renal calculus. In other words, only in 12 per cent. of the cases were the kidneys apparently healthy, and we may, I think, take it that almost all the remainder (88 per cent.) had granular disease of the kidney. I do not suggest that this is the usual percentage, but among the cases of one asylum it is sufficiently remarkable.
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