188 PROCEEDINGS OF THE SECTIONS. 
elements in the cortical layers of the cerebral hemispheres, and 
that as nutrition and health were re-established the memory 
return The whole history of the cases puts any question of 
coarse pathological changes out of consideration 
In ast case there was no return of function 
bcsaut a certain point, and in this there were the complications 
of syphilis and alcoholic excess. It isto the latter that I attribute 
the failure, as amnesia is one of the most frequent and marked 
symptoms of cerebral Senile, due to chronic alcoholic poison- 
ing. The mental exaltation, accompanied by delusions of grandeur, 
which was distinctly present in the 5th case, was extremely 
marked in the 3rd and 4th cases, and it is somewhat curious that 
I have not been able to find recorded any cases of brain affection 
due to injury in which similar symptoms have been observed, but 
they have been noticed in some cases of acute mania and of 
multiple schlerosis, and in rare cases of chronic cerebral softening 
or multiple thrombosis such as those recorded by Dr. Gasquet in the 
Journal of Mental Science for April, 1884. The existence 
that the original injury or disease involved the highest sepsis. 
plexuses of the cerebral corvex, and that with the temporary 
abolition of functions of these neues the lower centres, no longer 
controlled, were thrown or sprang into activity. he patients 
of grandeur and extravagance, and whether this was due to 
rm amgan or physical changes, or was due to temperament, I 
can offer no explanation, though I would point out that in all 
these cases ideo was a stage of irritation or inflammation with 
increased blood supply, involving an augmentation of functional 
activity. These delusions undoubtedly possess a diagnostic import- 
ary 
t times inclu 
In che: cases above mentioned there were no delusions as to 
Pp n 
these cases under your notice because they appear ne 
interesting by reason of the cnthelbgioal re agar in 
m, and as showing, as far as two of them are concerned, how 
completly abr memory may be re-established, even after long 
oss has been due to uncomplicated injury to ; 3 
