222 REPORTS FROM THE SECTIONS. 
disease being therefore accountable for nearly + of the total death- 
rate among the male, and about +}; of the deaths among the 
female patients. 
T am unable to point to a single instance of recovery, though in 
not a few instances there has been for a time such an arrest in the 
progress of the disease under treatment as to ‘call forth strong hopes 
of a better result. In three or four instances the arrest and “indeed 
the improvement was so marked that, viet to the entreaties of 
friends whose unpractised eyes failed to see that the had 
not disappeared, I discharged the patients to their care, with a result 
which I anticipated, —their return in a longer or shorter period to 
hospixal. In one case I was hopeful that recovery had really taken 
place, but the hope was not ee 
On searching the records of Psychological Medicine and compar- 
ing notes with other workers in the same field, I am unable to dis- 
cover that anyone has been really more successful than m, self. Tam 
unaware of an instance of recovery in a well marked case of this pecu- 
liar affection. I am, however, be from believing that the disease isin 
its early stages completely and thor oughly intractable and incurable. 
The improvement which I aly noticed i in well marked cases under 
treatment renders it tom s begin 
ning isamenable to medical treatment, anditis with this feeling that I 
am particularly commending it to your attention. Tt is in in privat 
practice and not in special institutions that its beginnings a 
seen. epralissce — the march of the disease is so te SOE there 
is such a stran ixture of ange with mental aberration, some 
into a Court of Justice, I saw a poor fellow standing in the dock m 
whom I recognized almost at a glance the well-marked symptoms 
of general paralysis. He had stolen some article in the full belief 
of seine jena not long since a man was sent to my care after 
apd Wiis, tally ioe. Both these cases had been 
medical observation without any recognition of the disease in its 
early stages. I may here remark that general paralysi is appear esd 
a a Tule to attack persons between their 30th and 45th y rea and that 
cases occurring before or after these times are few. smog 
cases at Gladesville, the youngest was 26, and the oldest 52, 
