The course of the disease is characterized by great restlessness often with a tendency to talkativeness. There is, however, no flight of ideas or rhyming. Delusions of persecution occur in some cases. Anesthesias, hyperesthesias, paresthesias, hypalgesias and sensitiveness of nerves and muscles are noted. Romberg's sign is present in some instances. Speech is often ataxic and paraphasic, and in advanced eases entirely meaningless. Tremors of the tongue and fingers are very characteristic. Writing is very much affected as a result. Epileptiform convulsions sometimes occur. Rarely focal symptoms, facial paralysis and hemiplegia appear for a short time. Reflexes are increased and ankle clonus occasionally appears. Defective papillary reaction and unequal pupils may be found, with diplopia and muscular weakness. Sleep is seriously interfered with. Bodily weight is reduced and blood pressure lowered. The temperature is usually elevated and the pulse accelerated. Albumen and sometimes sugar is present in the urine. The delirium often stops as suddenly as it begins, terminating in sleep, the patient being clear when he wakes. The memory of events is not well retained on recovery. The delirium may, however, become chronic and last for months. Some cases terminate in a hallucinatory feeblemindedness. This is likely to occur in psychopathic individuals. Hallucinations of hearing are more common in such conditions. People read their thoughts and influence their minds. They are subjected to hypnotism and electricity. The delusional ideas may be of a sexual nature or grandiose in character. The mood may be anxious or irritable. Suicidal tendencies sometimes appear. Later a humorous trend is often noted. Tremors and other neurological symptoms sometimes occur. Bonhöffer found at autopsy a considerable fibre loss in the central convolutions, the cerebellum and the column of Goll. In the large pyramidal and motor cells of the anterior central convolution the processes were deeply stained. Some nuclear changes were noted and occasional cells destroyed. Nissl described a granular degeneration of the neurones with a prominence of the "unstainable" substance, together with a swelling and crumbling of the cell bodies. Alzheimer often found free nuclei near the apical processes. In the glia cells and vessel walls granular detritus was observed. Acute and chronic cell alterations are more common in old alcoholics. Pachymeningitis hemorrhagica is sometimes found. Kraepelin considers it very doubtful whether wine or beer drinking ever causes delirium tremens, whisky and gin being the etiological factors as a general rule.