. Railway and other accidents with relation to injury and disease of the nervous system : a book for court use . toid explosion, which is so often apt to bethe case in the early stage of the disease. He may thussustain a head injury, which is ascribed as the causeof the subsequent accentuated disorder. I have noticedin the prodromal stage, when the patient is superficiallyemotional, he is likely to become pliable under the influ-ence of suggestion, and through the machinations of dis-honest plotters may misrepresent his real condition orelse allow others to do pretty much as they please. Acase
. Railway and other accidents with relation to injury and disease of the nervous system : a book for court use . toid explosion, which is so often apt to bethe case in the early stage of the disease. He may thussustain a head injury, which is ascribed as the causeof the subsequent accentuated disorder. I have noticedin the prodromal stage, when the patient is superficiallyemotional, he is likely to become pliable under the influ-ence of suggestion, and through the machinations of dis-honest plotters may misrepresent his real condition orelse allow others to do pretty much as they please. Acase of Le Grand du Saulle, previously reported by thewriter, is that of two brothers who consulted a Parisianpsychiatrist of note, who made a diagnosis in one ofparetic dementia. The other took the patient to an in-surance examiner, who promptly recommended a policy,apparently not noticing the existence of the the man died two years later, the money was paidwithout protest. It is quite probable in this case, as inmany others, that the paresis developed from a light i6o RAILWAY AXn OTHER form of syphilis, with sHght primary lesion, and that nostigmata were found. Paretic dementia, beginning with an initial stage ofdepression or exaltation, develops quite rapidly, althoughits course may extend over a number of years. The idea formerly entertained thatthe disease ends in eigh-teen months or two yearsseems to be erroneous,for subjects are found inevery asylum in whomit has lasted for ten orfifteen years. There ismuch uncertainty in itsdebut, the physical pre-ceding the mental symp-toms, or vice versa, butusually we find them coincident in the fully developeddisease. There are commonly a decided change in themorals of the patient, especially so far as sexual ex-cesses are concerned, and a great deal of optimism,which is succeeded by expansive and preposterous delu-sions of importance. In the beginning he may be prod-igal in his expenditure of money as the resul
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