Dr. Raecke has made an elaborate study of 136 patients suffering from general paralysis. Of these, twenty-nine men and three women were followed to the end, the others being transferred to various asylums. His inquiries confirm the results of previous observers. The evidence of the great part played by syphilis in the causation of the malady is powerful. The previous existence of lues was found to be certain in 57 per cent., of the cases, to be probable in 20.9 per cent., unknown in 10 per cent., and denied in 11.8 per cent. Only fifteen of the sixty-three had been under medical care for venereal disease prior to the onset of nervous disease. Antispecific treatment was practised on twenty-eight patients with little success. Immobility of the pupil to light in both eyes was found in fifty-four patients, and on one side only in ten; slow reaction of the pupil in thirty-eight, prompt in eight, i. e. the reaction was impaired in 92 per cent. In only one case was there a return of pupil activity. In above half the cases the patellar reflex was increased. Dr. Raecke found that the paralysis of the pupil and exaggerated patellar reflex frequently go together, though he does not consider that impairment of the pupillary reaction indicates affection of the posterior column of the spinal cord, as Gaupp has maintained. Tremor of the tongue appears to be about the most constant symptom. It was present in ninety-five cases; deviation of the tongue to one side in twenty-four. He found the duration of general paralysis to be two years and three months. Sprengeler, from an observation of 337 cases in Gottingen, found the mean duration to be two years and six months for men, and three years five months and a half for women.
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