With few exceptions, all patients committed as insane from 40 counties in southwestern and central Minnesota are admitted to the St. Peter State Hospital. The population of this area is i ,oI8,66o.* St. Paul, with 271,606 inhabitants, is the only city in the territory with a population over 15,000. During the four years from January I, 1928, to December 31, 1931, inclusive, there were 2317 admissions to the hospital. 57 of these were transfers from other state hospitals and 70 were duplications due to readmissions within this period. 2190 patients were received directly. The spinal fluid of 2088, or 95.3 per cent of the latter, was examined and evidence of paresis was found in 179, or 8.2 per cent. Usually serological examination of the blood as well as of the spinal fluid was made both in the hospital laboratory and in the laboratories of the Minnesota State Board of Health. If the reports were doubtful or those from the two laboratories differed, repeated examinations were made. A diagnosis of paresis was not made unless it was substantiated by definite spinal fluid findings. The youngest patient in the paretic group was a female 22 years of age, and the oldest a male aged 77. Paresis was found more frequently among the male than among the female patients, except in the third decade when the ratio was almost reversed. The incidence curve of the male is sharper than that of the female and reaches its peak a decade later. Paresis of the aged, presumed by authors of most text books to be rare, was not infrequent in this series. The Wassermann reaction of the blood was negative in 18.5 per cent of the paretic group as a whole, and in 30 per cent of those 65 years of age and over. This undoubtedly explains why paresis of the aged often is diagnosed arteriosclerotic or senile psychosis.
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