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This excellent monograph is based on a study of forty-three cases of juvenile paresis personally observed by the author, and of six hundred and ten cases recorded in the literature. In addition, there is appended an extensive bibliography of five hundred and thirty articles or monographs.
The study is complete, covering all aspects of the disease. Each chapter concludes with a helpful summary.
Dr. Menninger's study shows that forty percent. of four hundred and twenty-six cases of juvenile paresis reviewed, were mentally retarded before any other signs or symptoms developed to establish the diagnosis. Sixty percent. developed normally mentally until the onset of the disease.
Hypophrenia in individuals developing juvenile paresis is in no way different from other forms of mental deficiency. He finds that normal physical development occurred in forty-nine and seven tenths percent. of cases. Thirty-five percent., however, showed physical underdevelopment, manifested in most cases by stunting and genital hypoplasia.
Convulsions were recorded in seventeen percent. of the entire series of six hundred and fifty-three cases.
The neurologic syndromes encountered in juvenile paretic neurosyphilis are in general more frequent, more diverse and more advanced than those in adult paresis. They represent combinations of focal brain syphilis, meningovascular syphilis and involvement of the spinal cord, as well as diffuse syphilitic encephalitis. Congenital syphilitic stigmata are present in about seventy-five percent. of cases. Defective development of the teeth, including the Hutchinson type is the most frequently occurring stigma, present in about forty percent.
The endocrine disorders associated with juvenile paretic neurosyphilis are frequent and variable, and no one type is characteristic.
The commonest mental picture observed in juvenile paresis is characterized by confusion, mental regression to simple dementia, inadequate emotional response, and restless purposeless be