Among the symptoms of apoplexy, says one of the most distinguished of our recent writers on medicine, that are more especially of evil omen, are those which can be traced to the involvement of the automatic functions of the cerebro-spinal axis; nineteen out of twenty patients will die, in whom the phenomena appear which indicate derangement of this portion of the nervous system. I fear that in cases of the special disease we are now considering, the loss of power over the “sphincters” is almost of equally fatal import, but still it very naturally differs from the same symptom in ordinary apoplexy, inasmuch, as it may exist for many months, before the fatal issue of the complaint. Apparent want of power over the sphincters may arise in general paralysis from various other causes besides absolute lesion of the cerebro-spinal axis, such as the presence of delusions, or the supervention of sudden spasm in the patient, and still more frequently from a want of attention on the part of the attendants, and these last are of course essentially distinct in their nature, and require a special treatment; but even in cases in which the loss of power has been sudden, even those in which paraplegia has appeared, and the patient, comatose and insensible, seems on the point of death, if they have before been suffering from general paralysis, they may, and often do rally; in fact, the prognosis is less gloomy when there has been long-continued disease of the brain of this kind, than in patients in whom the symptoms have supervened upon perfect health.