=PARETIC NEUROSYPHILIS (GENERAL PARESIS)= =PHYSICAL SYMPTOMS= EARLY HEADACHE VISUAL DISORDER HYPALGESIA ADIADOCHOKINESIS ATAXIA NASOLABIAL FLATTENING VOCAL CHANGE SPEECH DISORDER WRITING DISORDER LOSS OF MANUAL DEXTERITY PUPILLARY CHANGES REFLEX CHANGES SEIZURES LATE: PARALYSIS, CONTRACTURE CHART 9 =PARETIC NEUROSYPHILIS (GENERAL PARESIS)= =MENTAL SYMPTOMS= INTAKE IMPAIRED CONSCIOUSNESS CLOUDED FATIGUABILITY INCREASED HALLUCINOSIS RARE AMNESIA—RECENT! CHRONOLOGY AND STORAGE IMPAIRED. FABULATION OVER-SUGGESTIBILITY JUDGMENT IMPAIRED FANTASTIC DELUSIONS INSIGHT INTO ILLNESS NIL EARLY IRRITABILITY OR HEBETUDE QUICK SHIFTING EMOTION CHARACTER CHANGE CONDUCT SLUMP CHART 10 1. What is the duration of paretic neurosyphilis (“general paresis”)? If we omit the doubtful, early, and prodromal stages and count the beginning of the disease with the occurrence of definite symptoms, we find (Kraepelin) that almost half the patients with pronounced paretic signs die within the first two years of their disease. Kraepelin’s observations upon 244 cases are as follows: Year: 1 2 3 4 5 6 7 8 9 10 14 Cases: 51 63 52 41 22 4 5 2 2 1 1 The average duration of the disease in months has been calculated as varying from 24 to 32 months. Juvenile paresis runs a slower and more insidious course. The duration of paresis, according to many observers, diminishes with the increasing age of the patient. It is now held that a combination of tabes with paresis does not prolong the duration of the paresis. As noted above in the discussion of Case Harrison (9), our conceptions of the characteristic duration of paretic neurosyphilis must alter with the increase of our knowledge due to the early application of laboratory tests.