The ordinary typical case of general paralysis is much as follows: An apparently perfectly sane and normal man suddenly goes out and orders a dozen motor-cars, or twenty-three cameras, or fifty arm-chairs, or a dozen sets of gymnastic apparatus or something equally silly; then he goes home to his wife very well pleased with himself and boasts how he has suddenly become the best cyclist in Europe or the most famous cricketer. No doubts for him, gladsome fellow! Probably he will also tell her that he is God. Or perhaps he will indecently assault some little girl before the very eye of some hitherto friendly policeman. Sometimes the disease will begin with purely neurasthenic and gloomy symptoms, so that even a clever doctor may be put off the scent for months or years. But when he is examined carefully it will generally be found that his hand is tremulous so that he cannot write intelligibly; his tongue trembles and perhaps wobbles in and out like a trombone; his speech is indistinct; the pupils of his eyes may be unequal or not circular. Later come the fits and increasing dementia that haunt him till his death. The fact that Nietzsche suffered from doubts about money and showed no sign of obscenity seems to point to a totally different form of insanity. Faithful to the principle that no doctor ought to offer a diagnosis without having seen the patient, I hesitate to say definitely what was the matter with Nietzsche, especially as Dr. Oscar Levy of Hamburg is still alive and knows the Nietzsche case intimately; but I should not wonder if the poor overwrought man was suddenly seized by something akin to melancholia,[23] that last infirmity of sensitive minds. As clods do not suffer from migraine they comparatively rarely attain to the heights—or depths—of melancholia. Under the influence of nursing, rest and protection from the attacks of the world, he partly recovered, but, as generally happens with melancholia in middle age, he seems to have become more emotional and partly demented before the chronic trouble that may have caused his headaches ultimately killed him. Throughout his insanity the difficulty in speaking pursued him. “I don’t speak prettily,” he would pathetically say; and after a tremor that may have been uræmic he passed away.