As mentioned in the careful summary by Dr. Wilcox in this Journal, October, 1908, p. 761, Drs. Clarke and Atwood remark that “not a few English writers fail to diagnosticate general paralysis in the absence of euphoria during some stage of the disease, a view we believe to be largely due to Mickle's teaching two decades ago” (Journal of Mental and Nervous Diseases, September, 1907).