Descriptions of epilepsy in the literature are based almost entirely on studies of institutional cases. Writers of textbooks and monographs naturally found epileptic patients in institutions most convenient for study. Here there are concentrated large numbers of persons with epilepsy; their observation is rendered comparatively easy because many patients and records are available at the same time and place, and owing to the conditions necessary on confinement the same patients are available for study over a long period of time. It must be remembered, however, that most persons with epilepsy are sent to institutions not merely because they are epileptic, but because they have developed mental disturbances that make incarceration imperative. Since writers on epilepsy studied the disease in patients accessible to them because of mental changes, it is easy to understand why they all considered mental deterioration so common and so integral a part of the disease. There are,