=General Paralysis of the Insane, Paralytic Dementia.=--This is a most interesting form of dementia. It is closely allied to, if not identical with, locomotor ataxy. Its most prominent and characteristic symptom consists in delusions of great power, exalted position, and unlimited wealth--megalomania. The exaltation is universal, and the patient may maintain at one and the same time that he is running a theatrical company, that he is the Prince of Wales, and that he is the Almighty. Moral perversion is a common symptom, and the patient is often guilty of criminal assaults, indecent exposures, bigamous marriages, and the like. It is accompanied with progressive bodily and mental decay. Women are comparatively rarely affected by it, and it generally commences in men about middle age, and its duration is from a few months to three years. It is commonly parasyphilitic in origin. Paralytic symptoms first appear in the tongue, lips, and face; the speech becomes thick and hesitating. The paralytic symptoms gradually go on increasing, the sphincters refuse to act, and death may occur from suffocation and choking. Sometimes, during the earlier stages especially, there may be maniacal paroxysms or epileptic fits. The delusions remain the same throughout, the patient always expresses himself as being happy, and his last words will probably have reference to money and other absurd delusions. When a person of hitherto blameless life is charged with an act of indecency, he should be examined for G.P.I. The condition of his prostate should also be investigated. He may be suffering from either mental or physical disease, or both (see p. 59). XLIII.--MANIA Under the term 'mania' are included all those forms of mental unsoundness in which there is undue excitement. It is divided into general, intellectual, and moral, and each of the two latter classes again into general and partial. =General Mania= affects the intellect as well as the passions and emotions. Mania is usually preceded by an incubative period in which the patient's general health is affected. The duration of this period may vary from a few days to fifteen or twenty years. When the disease is established, the patient has paroxysms of violence directed against himself as well as others. He tears his clothes to pieces, either abstains from food and drink or eats voraciously, and sustains immense muscular exertion without apparent fatigue. The face becomes flushed, the eye wild and sparkling; there is pain, weight, and giddiness in the head, with restlessness. =General Intellectual Mania=, attacking the intellect alone, is rare; but some one emotion or passion, as pride, vanity, or love of gain, may obtain ascendancy, and fill the mind with intellectual delusions.