According to Cushing, growths in the brain may give rise to no disturbance whatever, show well defined focal signs, occasion only general manifestations, or have both general and focal symptoms, depending on the location of the neoplasm. General symptoms may be briefly summarized as follows:—headache, vomiting, choked disc, vertigo, drowsiness, convulsions, disturbances of the pulse rate, respiration and temperature, as well as mental disorders. The focal signs depend wholly on the site of the growth. Cushing mentions the following symptom complex as resulting from lesions of the frontal lobes:—"Indifference, unpunctuality, mental enfeeblement, loss of memory and power of attention, change in disposition with more or less marked irritability or taciturnity or obstinacy or jocularity, etc., often a rambling speech, lack of realization of the illness, and change in the general conduct of life with habits of untidiness. These, in greater or less degree, characterize most of the cases, although it is often astonishing to find how inconspicuous the symptoms may be with a very extensive growth. They may often be of rather abrupt onset and not until the situation of the lesion is definitely disclosed and careful interrogation made into the patient's previous mental state is it possible to learn that in all probability some mental alteration has been of long standing." Bruns did not find psychoses associated very often with frontal lesions. Jacobi, however, in reviewing the literature of growths in that region, found mental symptoms in forty-nine per cent. Schuster observed them in from fifty to sixty per cent of all brain tumors. Redlich[194] described mental conditions as being either incidental and not related to the growth, or definitely caused by it, and was even of the opinion that the neoplasm could in some instances be the result of a psychosis. Two of Redlich's patients, moderately alcoholic, showed a typical Korsakow syndrome. He refers to the fact that in cases reported by Oppenheim, Friedrich and Fürstner, "Witzelsucht," or the tendency to joke, disappeared after growths were removed from the frontal region. A patient of Begerthal, who had hallucinations, delusions and somatic symptoms, recovered after a tubercle was excised from the paracentral lobule. A case of Friedrich's which showed an alteration of the personality, erotic symptoms, sudden explosive laughter, poor memory, etc., recovered after a sarcoma was removed from the right frontal lobe. A patient of Thoma's after three attacks of mental depression showed a gliosarcoma in the occipital lobe at autopsy. Schuster, Bruns and Schönthal have reported cases of brain tumor with hysterical manifestations.