PROGNOSIS AND TREATMENT

OF 60 cases of juvenile general paralysis 38 were treated with malaria or tryparsamide or both, 20 with common arsenicals and bismuth or mercury, and two with radiothermy and diathermy respectively. Of the 20 treated with common arsenicals, 17 continued to undergo a mental and physical deterioration and several of these died. In 27 of the 38 cases treated with malaria or tryparsamide the treatment was effective in so far as it prevented further deterioration; five of these gained a complete remission and nine a partial remission. In the great majority of instances a period of from two to five years had elapsed after the beginning of the treatment. In studying the factors that affect the prognosis in the 38 cases treated with malaria or tryparsamide the prognosis was found to be better in (a) patients who prior to the onset of the paresis were of normal mental level; (b) patients who were in or past adolescence when the symptoms developed; (c) those showing the expansive and confused reaction types; (d) those in whom the elapsed time between the onset of the disease and the treatment did not exceed two years. Sex, character of the onset and antiluetic treatment prior to onset did not appear to affect the prognosis favourably or unfavourably.