His fourth case was that of an artful, deceitful, arrogant, selfish boy, always clever in excuses, who had stolen from the age of twelve, often stolen things that he threw away. Though of Protestant family, he delighted to draw Catholic insignia and embroider religious characters. He finally entered the university, always lying and stealing. At the end of three months he was taken home in debt 2000 marks. He later became a Catholic. Outside of normal expense he had cost his father 28,000 marks. By the time he was studied he had already taken opium for four years, having started because of neuralgia. There had been a severe operation on account of some trouble with the teeth. It was discovered that there was contrary sexual feeling in this case also. The patient had a great inclination for doing woman's handwork. Delbruck again considered the early appearance of character anomalies and perverted sex feeling to prove a deep-seated abnormality of nervous constitution. He diagnosed it as a case of constitutional psychosis; the extent of the abnormalities showing the individual to be irresponsible. His last patient was an alcoholic adventurer, early life unknown, who had an idiotic sister. He had lived long in America and returned to Germany full of stories of his wonderful achievements over seas. This case does not concern us except to emphasize the influence of alcohol in the development of such cases. This outline is sufficient to show the justification of his conclusion, namely, that just as in healthy people a mixing of lies and mistakes may occur, so the same combination may reach a pathological height, and one can diagnose a mixture of lies with delusions or false memories. These studies focus our attention on the following points which are valuable to emphasize for the purpose of this monograph: the complexity of details to be examined in the life of any one patient in whose delinquencies pathological lying is a factor, the variety of cases in which this factor may occur, hence the difficulties in the way of determining the extent to which the patient is responsible for his deeds and whether he belongs in a reformatory or an insane hospital. From the standpoint of society Delbruck's work has great use, since it reveals so plainly the menace that these liars are to their families and to the community as a whole, their unscrupulousness in financial dealings, their tendencies to bring false accusations involving families and friends alike in useless expense and litigation. German studies on pseudologia phantastica since Delbruck's time have followed the line of amplification of his views and clarification of the subject by the addition of new types.