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An examination of the reports of our insane asylums will show the large proportion of cases of general paralysis of the insane among the inmates of these institutions, and treatment has rarely resulted in recovery. Sometimes, as is familiar to the medical officers of asylums, there will be a marked improvement in the mental condition of patients of this class, and the hope is entertained that recovery will follow; but this improvement is usually temporary, and the relapse is a condition worse than before.
A short time ago Dr. T. Claye Shaw reported in a conservative manner a case of general paralysis with bulbar symptoms, that was seen also by Dr. Ferrier, who agreed that the case was fast becoming one of dementia, and that trephining alone afforded hope of relief. Dr. Shaw based his conclusions of the promise of relief afforded by the operation on the fact that pathological
THE SURGICAL TREATMENT OF GENERAL PARALYSIS OF THE INSANE.. JAMA. 1890;XIV(6):203–204. doi:10.1001/jama.1890.02410060023004