560 THE POPULAR SCIENCE MONTHLY 



There is, however, one mental disease depending upon a preceding in- 

 fectious disease which overshadows all others in importance. This is 

 general paralysis or " general paresis/' " paresis " or " paralytic de- 

 mentia " as it is variously known. Almost invariably fatal within a 

 few years after its onset, often a danger to the reputation or to the 

 happiness of whole families in its earlier stages and distressing in its 

 final phases, this disease occupies a place of its own in the interest of 

 physicians and of others who chance to become familiar with it. Six 

 hundred and sixty-four patients, or 12 per cent, of all the 5,301 new 

 cases admitted to the New York state hospitals last year, had general 

 paralysis. Some comparisons with the prevalence of other more fa- 

 miliar diseases may make the significance of this number clearer. 

 Last year there were 1,368 deaths from typhoid fever in New York. 

 Half as many persons died of general paralysis. Cancer of the breast 

 is a relatively common and a much-dreaded disease, yet there were more 

 deaths from general paralysis than from cancer of the breast. Angina 

 pectoris is another frequent cause of death, but more people die of gen- 

 eral paralysis. More people died in 1908 in New York from general 

 paralysis than died from smallpox in the whole registration area of 

 the United States in that year and the three preceding it. 



The fact about general paralysis which is of the greatest importance 

 is that it depends upon previous infection with syphilis. To just what 

 extent it is not possible to say, but, whatever other causes may combine 

 to produce general paralysis, testimony is increasing that syphilis is 

 essential. In other words, if these 664 men and women had not had 

 syphilis, very few of them would have had general paralysis. 



Whatever is to be accomplished in the prevention of disease by the 

 medical profession and an enlightened public will be brought about by 

 concerted action. "Without authoritative information and skilled lead- 

 ership, popular movements in this field will be unlikely to succeed and 

 may even result in harm, and, without popular support, the efforts of 

 doctors will end in academic discussion and in plans incapable of exe- 

 cution. In this alliance frankness is essential ; there must be no secrets 

 or half-hidden truths between allies in the battles which are to be 

 fought together for the public health. So the prevalent belief that 

 syphilis is a menace only in an underworld of criminals, prostitutes 

 and the utterly depraved must be abandoned, and the truth realized 

 that it is a peril from which no class of society is exempt and to which 

 the thoughtless, the innocent and the immoral are equally exposed. 

 Three fourths of the 664 cases of general paralysis were married and 

 69 per cent, of them were in comfortable or affluent circumstances. 

 The most unfortunate feature of general paralysis is that it occurs 

 most often in the third and fourth decades of life; frequently in those 

 who have long since abandoned the immoral or heedless mode of life 



