50 PROCEEDINGS OF THE CANADIAN INSTITUTE. 



and judgment ; in other words, dementia. Second, variable mental state ; 

 which may be hypochondriacal, or melancholic, or maniacal. Usually, the 

 patient is active and exacted ; entertains delusions of great strength, of vast 

 wealth. He has extravagant plans and boasts. These exalted notions are 

 very numerous, and constantly changing in a given case. They are not 

 fixed ideas. 



Q. What is the chance of recovery in the case of a person afflicted with 

 Dementia Paralytica ?— A. There is no chance of recovery. 



Q. To which of the two classes of symptoms, physical or psychical, do you 

 attach the most importance in Paresis ? — A. The physical symptons are more 

 constant, and appear earlier, in my opinion. In some cases of Dementia Para- 

 lytica, the physical symptoms, together with failure of memory, are the only 

 symptoms to the end of life. 



Q. What is the mode of attack in Dementia Paralytica ? — A. Usually by 

 the gradual development of the physical symptoms I have named and diminu- 

 tion of memory, and by faults in judgment. 



Q. In your experience, have you known a case of sudden attack in Demeu- 

 Paralytica ? — A. I have not. 



Q. Are the exalted notions to which you have referred confined to Dementia 

 Paralytica, or are they found in other forms of insanity ? — A. When varied 

 and numerous, exalted delusions are highly characteristic of Dementia Para- 

 lytica, but not pathognomonic. When the exalted notions are few and fixed, 

 they are indications of a condition of mania subacute or chronic. 



Q. Can there be said to be anything hereditary in the disease, Dementia 

 Paralytica ? — A. The hereditary tendency in this disease is not strong, and is 

 usually indirect. 



Q. Generally speaking, have persons afflicted with Dementia Paralytica 

 testamentary capacity ; and, if so, what ? — A. In some cases with uninter- 

 rupted progressive development of the disease, there is usually no such capa- 

 citj' ; in other cases characterized by alternations of excitement or mania and 

 remarkable remissions, the patient may, in my opinion, be capable during such 

 remissions of correctly expressing his testamentary wishes. 



Q. Generally speaking, is testamentary capacity affected in Locomotor 

 Ataxia ? — A. Not at all, in my opinion. 



Q. Is there any defined limit to the advancement of the disease. Locomotor 

 Ataxia ? — A. There is none. It may terminate fatally in a few months, or 

 there may be no advance in the symptoms for many years. 



Q. Is there any defined limit to General Paresis of the insane ? — A. There 

 is no defined limit, but I have stated it as my opinion that no case has 

 extended over six years which has not terminated by death. I have known" 

 no case which has recovered, and it is my opinion that it is always fatal. 



On tliis point also I had the opportunity of examining Di". Wni, 

 A. Hammond, one of the best known scientific experts in America, 

 or perhaps now living. In this examination, of course, I pursued 

 only the facts of the particular case. T incline to the view (though 



