SENILE INSANITY arises in suspicions and a generally deluded state of mind regarding those persons whom there is every reason to trust—namely, relations and near friends—and as extraordinary credulousness of designing persons whose interest and character would naturally suggest being on the guard against them. There is impaired judgment, as shown by the mismanagement of property and diminished capacity for business, usually some perversion of the sexual instinct. The suspicions and credulousness in time amount to insane delusions, and if life lasts the end is in marked dementia. But there may be no mental impairment evident to casual observers or to ordinary acquaintances for many years. The improper relations assumed with the opposite sex, the neglect or abuse of those nearest by ties of blood, the squandering of property on strangers, and the omission to provide properly for the members of the family, are wrongly attributed to a character become bad rather than to destructive brain disease, where they belong. Not seldom senile insanity is a moral insanity, and shows itself by an entire change of character not explainable by other circumstances than disease, and is then marked by {174} indecent exposures, loss of the fine sense of the decencies and proprieties of life, destruction of the discriminating power between right and wrong acts. The course of senile insanity is slow, unless there be also some fatal disease with it, and evident mental impairment may be so late that the disease may be overlooked for years. The TREATMENT is abundant nutrition, including wine, removal from irritating conditions of life, protection of the individual against himself, and guarding the community against harm or indecencies. Small doses of morphia daily are often of great benefit, and there is no real danger of acquiring the opium habit if reasonable discretion is exercised in its use. SENILE DEMENTIA is simply an excess of the natural mental weakness of old age out of proportion to the bodily state, an exaggerated childishness of senility to the extent of producing irresponsibility. It is in reality a subacute primary dementia modified by the peculiarities of old age. Memory fails first, and a condition of general weakness of mind follows rapidly afterward. Secretiveness, suspicions, delusions, and hallucinations of the special senses are almost always present. It is not uncommon for the early symptoms to consist in an inhibition of the higher faculties of the mind, so that the lower impulses become prominent. The sense of right and wrong and the moral perceptions may become entirely weakened. Acts of indecency, dishonesty, injustice, depravity may follow impaired judgment, and yet so far precede strikingly perverted memory and general intelligence as to make the insanity, which is obvious to an experienced observer, entirely fail to impress itself upon the minds of the community.