General paresis / by Emil Kraepeli ; authorized English translation by J.W. Moore.

  • Kraepelin, Emil, 1856-1926.
Date:
1913
Catalogue details

Licence: Public Domain Mark

Credit: General paresis / by Emil Kraepeli ; authorized English translation by J.W. Moore. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    heeds advice, makes remarkably little struggle against his disease in comparison with his emphatic complaints, does not follow the physician's instructions, does not keep up treatment and is often not at all improved by simple rest. The paretic depression may show a great similarity to circular depressed states. In favor of paresis are the occurrence for the first time in middle life, the marked weakness of judgment, the mood, the behavior, and especially the memory, impaired orienta- tion for time, loss of grasp of the surroundings, the ease with which he is influenced and to a certain extent also the senseless- ness and irrelevance of the delusion formation in spite of perfect mental clearness. It remains to be said that absurd time dis- crepancies, great defects in knowledge, inability to calculate and extreme disturbance of volition may be simple circular retarda- tion symptoms which perhaps have disappeared on the next examination. The diagnosis from stuporous states depends on the fact that circular insanity, on the one hand, shows somewhat better comprehension and, on the other, is associated with more definite motor symptoms. The patients follow the happenings in their neighborhood with great keenness, become easily anxious if one threatens them with a pin; the inner excitement sometimes shows itself in their whispering to themselves. Stuporous paretics, on the contrary, concern themselves little with the outer world, hardly notice approaching dangers, are more free in their movements, either restless, anxious or dull and unapproachable. It is, however, naturally impossible in some cases to acquire suffi- cient clearness regarding the patient's mentality to differentiate quickly and satisfactorily without reference to the physical symptoms. The expansive excitement of paresis may be confused with manic states. Aside from the physical symptoms, the inability to receive new impressions, uncertainty in recollection of dates and school knowledge (calculation), fantastic and inconsistent delu- sions, very striking exhibitions of emotion when talking, great