Of the inflammatory conditions of the meninges Kraepelin[201] makes special reference to mental disturbances associated with tuberculosis. The patient is depressed, anxious, irritable and apathetic, often with the first appearance of the disease. Dulness and memory disturbances become more and more apparent. The patient soon becomes clouded and disoriented, confused and delirious. Occasionally hallucinations appear. The disturbance of consciousness becomes more and more marked. The patient becomes incoherent, restless, noisy and often violent. The excitement may reach the stage of an actual mania with delirious confusion. Sometimes the symptoms are strongly suggestive of katatonia. In alcoholics a condition very similar to delirium tremens develops, terminating as a rule in stupor and coma. Speech disturbance, aphasia, convulsions, hyperesthesia or muscular weakness may be observed in such cases. Other forms of meningitis are quite similar but more rapid in development and of shorter duration. In some instances, as after epidemic cerebrospinal meningitis, states of mental enfeeblement may follow the disease. It must be admitted that our information on the subject of multiple sclerosis is far from being complete. In a discussion of the mental symptoms accompanying this condition, Henderson[202] expressed the following views:—"Cases of disseminated sclerosis which present definite, well marked psychoses are extremely rare. When mental symptoms do occur, they usually come on when the condition is well advanced, the most common symptoms are mild euphoria, labile mood, apathy and dullness, and a slightly defective memory. In some cases, however, depression has been described as the outstanding feature, while hallucinations of sight and hearing are not uncommon accompaniments. In certain cases the mental symptoms may come on early, and these are usually of excessive severity and are rapidly followed by complete dementia." Dunlap has described cases associated with general paresis and showing the characteristic lesions of both diseases at autopsy. According to Kraepelin[203] mental disturbances sometimes appear before physical symptoms are observed. These take the form of depression, anxiety, fear, with occasional deliria, hysterical manifestations, emotional dulness, variable moods and a marked irritability. Later in the disease more marked euphoric or depressive tendencies appear, with excitements and confusional states. Delusions of a persecutory nature, or ideas of grandeur may be observed. Hallucinations are infrequent. According to Kraepelin, from ten to thirty per cent of the cases terminate in a general mental enfeeblement which is not usually of an advanced degree. He also describes a lobar cortical sclerosis with much more marked mental disturbances suggesting dementia praecox.