The distribution among the classes of people is illustrated in Table 5. Farmers were less affected than people, who spent most of their time in closed rooms. A great percentage of our patients were students, but very few soldiers who on the other hand represent our richest clinical material in neurosyphilis.

The clinical picture of encephalitis epidemica does not differ essentially from what we see in western countries. Also in China the Parkinsonian type (35% of all forms) represents the largest group. It is strikingly interesting how closely members of the white and yellow races come to resemble each other, how the racial differences disappear in the mask-like face with lacking mimic expressions and when movements and gestures are restricted to a stiff doll-like appearance.

Parkinsonian Types.

Among the Parkinsonian types (Figure 1) were the cases of longest duration, the 5 cases with onset in 1919 belong to this group. The interval between the onset of the disease and the first manifestation of symptoms of disturbance in movements (bradykinesia) varied a good deal. The earliest date at which I found Parkinsonian signs fully developed was 3 months after an acute onset with fever, oculomotor symptoms and lethargy. Other patients and also their relatives affirm that 2 and even more years had elapsed between the initial symptoms and the appearance of the first kinetic disturbances.

A striking feature in the history of this group of patients is the pronounced sleepiness, which usually greatly impresses the patient as well as his family, so that this symptom is rarely forgotten by the patient, when relating the history. The patients fall asleep while standing and talking to someone, at their meals, in the bath tub or at other such like occasions. In the other forms of encephalitis the lethargy does not play this important role in the history as in the Parkinsonian type. In a few cases a trauma was considered the provoking agent of the

Encephalitis Epidemica. Parkinsonian type. Mask-like face, rigidity of arms, increased salivation, (middle), staring eyes (right).