n which the whole affair was
fully described. He read the account through, but without exhibiting
the slightest emotion, and said, "Isn't that awful, doctor?"

"How do you feel about this affair of your babe being dead?" "I don't
know anything about it."

"How much is 2 times 3?" After considerable delay and in an absorbed
mood he said, "70."

"How much is 6 times 7?" After a long pause he said, "Don't know."

"Which is the largest newspaper in Washington?" "Don't know." (Patient
was on the staff of a local newspaper.)

When we remember that only several hours before this the patient gave a
coherent account of his past life and showed nothing grossly psychotic,
the foregoing symptoms, such as the lack of knowledge of his wife's or
babe's name, inability to solve problems such as 2 times 3, the fainting
spell, etc., must be looked upon as unquestionably malingered. When
examined the following day he showed still further signs of malingering,
the detailed account of which must, however, be omitted on account of
lack of space, and yet this man was unquestionably insane; the act
itself (the infanticide) was unquestionably an insane act, as will be
shown later. We have mentioned the fact of his neurasthenic symptoms and
how as a result of these he lost his position. The physical examination
of the patient revealed certain neurological signs, such as
exaggeration of the patellar reflexes, lateral nystagmus of both eyes,
which determined us to look further into the question of his physical
state, especially in view of a history of luetic infection five years
before. A spinal puncture was accordingly performed, and the spinal
fluid findings were as follows: Fluid clear, pressure moderately
increased, Noguchi butyric acid reaction positive, a rather uncommonly
heavy granular type of precipitate, cells per cubic millimeter 129.
Differential cell count: Lymphocytes, 94 per cent; phagocytes
2.2 per cent; plasma cells, 0.25 per cent; unclassified cells,
2.25 per cent. Wassermann reaction with spinal fluid negative, both
active and inactivated. Wassermann reaction with the blood-serum
negative. This, however, became positive later on in the disease. The
above findings indicate unquestionably that he was suffering from
cerebral syphilis.

It is not necessary to enter into further detail concerning the progress
of this case. Suffice it to say that with proper treatment he entirely
recovered and was so discharge