Disorders Of Memory

Many patients suffering from various nervous symptoms insist that they

are losing their memory or that it is becoming notably deficient in

some ways. If they are a little on in years they are sure that their

memory is not as good as it used to be and that they now forget many

things that were formerly remembered without difficulty. Especially

are they likely to assert that the names of people and certain words

will not come to them when they want them, that they often have to

seek for facts and dates that should be quite familiar, that they fail

to remember acquaintances and the like. These symptoms of which they

complain are often sources of considerable worry and serve to

emphasize in them the idea that there is something serious the matter

with their general health, or some pathological condition developing

in their brain. They have heard much of loss of memory as a sign of

degenerative nervous diseases and they are prone to think that their

own special loss of memory, be it real or imaginary, must be a

forerunner, or perhaps even an early symptom, of some important

organic lesion.



This idea of progressive memory disturbance as a preliminary of

nervous breakdown often becomes so firmly fixed as to be of itself a

profound source of anxiety to patients, and an almost unspeakable

dread. So it is important to make them understand what the real nature

of their condition is and what their loss of memory, supposed or real,

is due to. As a matter of fact, what many of these patients need is

not treatment for a diseased memory, but reassurance from what we know

about the psychology of memory, that their troubles are only quite

natural incidents in the life history of their particular memory

faculty. Many a man who is worrying about his supposed loss of memory

or, at least, impairment of it in some way, is not suffering from a

true pathological condition, but is usually the victim only of some

functional disturbance of the nervous system with the neurotic anxiety

and heightened introspection that accompanies such a condition.





Reasons for Memory Difficulties.--Nervous patients particularly

complain that they do not remember what they wish to as easily as they

used to a few years before. They say that it is much more difficult

for them to impress things upon their memories and, in addition, that

it is much easier for them to forget. There are three quite natural

reasons for these phenomena as far as they actually exist, which

should be pointed out to these patients. The first and most important

is that they are incapable of that concentration of mind which they

had in earlier years and which enabled them to give themselves up so

completely to the consideration of a particular subject that it could

not help but be impressed on their minds. They are now so much

occupied with many other things, and, above all, most of these

patients are so preoccupied with themselves that they cannot hope to

have the concentration of mind that was comparatively easy when they

were younger and is now impaired, but which is so necessary for the

enduring remembrance of things. Secondly, their over-anxiety to

remember things sometimes acts as an inhibitory motive in securing

that deep, impression that will enable them to remember details very

well. Thirdly, their supposed impairment of memory is due to a false

judgment with regard to themselves. They are not comparing their power

of memory now with what they used to have, but owing to anxiety about

themselves they have taken to comparing themselves with others and,

after all, the faculty of memory acts very differently for different

people and it is well known that what one man remembers with ease

another recalls with difficulty, or only because of special attention.





Attention and Memory.--The first of these causes for supposed

impairment deserves to be discussed further. It is often said that as

we grow older our memory is not so retentive as it used to be, and

that while we remember the events of boyhood and the things we learned

in the early years of school life, our recollection of recent events

and things learned in later years is much less vivid. This is all very

true, but the reason usually given, that in the meantime our memories

have failed in power is inconclusive. What we learned in early

childhood came to us with the surprise of novelty and for this reason

we paid close attention, it was new and impressed us with its

importance, it was dwelt upon for long periods and often, because

there was little else to think about, has been frequently recalled

since and, of course, is indelibly impressed upon our memories. The

same thing is true with regard to early acquaintances. We got to know

them so well that, of course, we cannot forget them. What we have

learned in later life, however, has come in the midst of many other

things, has not been dwelt on very long, has not been often recalled

and, of course, occupies much less place in the memory than the things

of earlier life. That is not, however, because of any defect in

memory, but because of lack of attention and repetition that means so

much for memory.





Age and Memory.--It is often said that people do not learn so

readily when they get older. This is, of course, a truth of common

experience, but it is not because of dullness of the faculty of

memory, but failure to concentrate the attention sufficiently for

memorizing. I have known old men who could learn things just as well

as any young man and indeed better than most of them. They were men

who had been accustomed all their lives to concentrate attention on

the subject they had in hand and who did not allow the cares and

worries of life to intrude on their studies. Cato learning Greek at

eighty is often quoted as an exceptional example, but I have had some

dear old friends who could learn things quite as readily as younger

men and whose minds were just as bright and clear. Whenever they

devoted as much attention to anything that they wanted to remember as

they did when they were younger men, I am sure that they remembered

quite as well. It is a question of attention and not of any loss of

faculty that makes the difference between the memory of the young and

the old until, of course, senile impairment actually comes.





Solicitude and Memory.--Everyone who has had to depend much on his

memory knows that over-anxiety with regard to the recollection of

anything may seriously inhibit the power to recall it. Public speakers

know that to hesitate is to be lost. If they want a particular name or

word which they know often escapes them, they must with confidence

begin the sentence in which it is to occur, though perhaps wondering

all the time whether the word will be on hand or not for them to use

it. Occasionally it will not come, but as a rule it turns up just in

time. If they allow themselves to be disturbed by the thought that the

word or expression may not come, then they know the hopeless vacant

blank that stares them in the face when they want it. They have to

make a circumlocution in the hope that it may turn up. Some let it go

at that, but many start another sentence in the hope to tempt it to

come and often it will eventually come, but sometimes it persistently

refuses to come. That is not a loss of memory but a failure of neuron

connections. There are some of us who know that certain words will

always do that with us. Archimedes has bothered me for years and his

name will often not come when I want it. Then there are certain words

with regard to which transposition is likely to take place. We

involuntarily and unconsciously substitute one word for another. We

call one man by another's name. We have done it before and we know

that we are likely to do it again. Somehow the connections in memory

exist along these wrong lines and are constantly mismade. The name of

something a man has written comes up instead of his name. This

heterophemia is often noted in men of excellent memory.





Peculiarities of Memory.--Memory is an illusive and elusive function

at best. All of us have had the sensation of having a word, and

particularly a name, on the tip of our tongues. We often know the

first letter and sometimes the first syllable of it. What memory

brings to us, however, may not always be the first syllable of a word

or name, though we are prone to think it must be, and we may go

looking for it in the dictionary of names only to discover after a

time that we are many letters away from its beginning. Very often we

have to give up seeking in sheer inability to get a hint of it and

then of itself it will come a little later. Sometimes it will come

when we no longer want it. As a rule, words that have escaped us once

in this way are prone to do so again. Over and over again the

experience will be that a particular word or group of words

escapes our memory, or at least fails to be at our command, as most

other things are. Those of us who are not much given to introspection

take no notice of these difficulties which are common-place

experiences enough, but the man or the woman who is looking for

symptoms, who is prone to believe for some reason or other that his or

her memory is failing, will take these hints of the more or less

natural fallacy of memory as confirmations, strong as direct proof of

the fact that memory is seriously deteriorating.



Such pauses and lapses of memory are much more likely to occur if we

are nervous and over-anxious about possible loss of memory. I was once

asked to attend for a few hours before the time fixed for his oration

one of the greatest orators of this country, who was about to talk at

a university commencement. What surprised me was that this practiced

speaker, who had often appeared before very large audiences, took a

very light meal in considerable trepidation, immediately after asked

to have certain books brought to him and certain facts looked up for

him, took notes in a hurried, feverish way and generally displayed all

the over-excitement of the schoolboy about to make his first oration.

He was a magnificent occasional speaker, often called upon, yet he

assured me that it was always thus with him and that the reason for it

was that in spite of previous preparation--and the finish of his

orations made it clear that he had devoted much thought to them

beforehand--certain of his facts and names and dates had the habit of

slipping from him in the midst of the development of his theme, unless

he had refreshed his memory with regard to them immediately before,

and that he feared that sometime he would find himself in the midst of

an address with an absolute blank before him and that he would be

compelled to sit down in disgrace. He had never done so and never did

in the many years that he, lived afterwards, though always with this

dread, never trusting his memory as most people do.





Name Memory.--There are certain circumstances in which memory may

fail and yet no significance of a pathological nature can be

attributed to the fact. All of us probably have had the disturbing

experience of undertaking to introduce two friends whom we had known

for many years and yet having to ask at least one of them for his name

before we could make the introduction. It is not that we did not know

the name, but at the moment we were utterly unable to recall it. After

this has happened once or twice it is prone to happen again, because

when we set about introducing people the thought of the previous

unfortunate occurrences of this kind comes to our mind and acts as an

inhibition of memory, making it impossible for us to recall names. Not

infrequently if we are brought to the pass of having to ask one of the

parties for his name we have to ask the other, though it was on the

tip of our tongue a moment before, because in the meantime the

disturbance of mind incident to having to ask has interfered with the

train of recollection. Men have been known to forget their own names

under circumstances of great excitement and such a forgetting is not

pathological, but only a physiological disturbance of function because

of secondary trains of association set to work in the brain which

disturb ordinary recollection. Of course, some people have an

excellent memory for names and never have such experiences, but they

are very rare, though practice in recalling names does much to keep

people from such embarrassing situations. On the other hand,

there are some people especially gifted with name memories. Napoleon

could recall all his soldiers' names.





Fatigue and Memory.--Occasionally it happens quite normally that when

we are very tired certain portions of our memory at least become vague

and indefinite and may even fail to respond to any excitation on our

part. Under these circumstances we seem to be able only with

considerable effort to exert the effort necessary to bring about such

connections of brain cells as will facilitate recollection and

reproduction and we may fail entirely. In a foreign country it is, as

a rule, much more easy to talk the language in the morning when we are

fresh than in the evening when we are tired. Especially is this true

if we are asked to pass from one foreign language to another, which

always requires a special effort. Everyone who has traveled must have

had the experience that on crossing the frontier suddenly to be

addressed in German after he has been talking French for weeks, may

quite nonplus the traveler, even though he knows German as well or

even better than French. This is especially true if much depends on

the answers, if he has been addressed by a railway official or customs

inspector. Apparently there must be a momentary wait until some

shifting operation takes place in the brain before the German memory

can get to work to establish the connections necessary to enable him

to talk German. After a man has been talking to a number of people in

one foreign tongue he is likely to be quite lost for words for a

moment if he has to use another. The effects of fatigue and excitement

and unusualness upon memory then must be remembered in order to be

able to reassure patients who pervert the significance of the

phenomena.



Ribot gives an excellent personal illustration of this peculiarity of

memory in his "Diseases of Memory," which is worth recalling here. He

says:



I descended on the same day two very deep mines In the Hartz

Mountains, remaining some hours underground in each. While in the

second mine, and exhausted both from fatigue and inanition, I felt

the utter impossibility of talking longer with the German inspector

who accompanied me. Every German word and phrase deserted my

recollection; and it was not until I had taken food and wine, and

been some time at rest, that I regained them again.





Sensations and Memory.--Just as soon as people compare their memories

with others, as they do when they worry and begin to grow

introspectively self-conscious, they find noteworthy differences and

because of differences they will be prone to think that their memory

is pathologically defective when it is only different, or, still more,

that because they are not able to remember some things, as others do,

their memory must be failing. It is well known that some people have a

good memory for things seen, others for things heard, and still others

only for things in which they have taken actual part. These are spoken

of as visual, auditory and action memories. Memories for things seen

are divided into special classes. Some people remember forms very

well, while others remember colors. It is evident that our memories

are somehow dependent on the special mode in which sensation affects

us and that our acutest sensations are the sources of our longest and

best memories. Color vision defectives are not affected much by colors

and easily forget them. The tone-deaf have no memory for tunes. Every

sense defect affects the memory. Sense defects are often unconscious.

Their effect on memory may only be noted when introspection

begins to bring out the special sensation and memory qualities of the

individual. Nature, not disease, may be the basis of some memory

troubles thus brought to recognition. All these curious phenomena with

regard to memory need to be recalled whenever there is question of a

supposed deterioration of it, for it is not easy to decide such a

question.





Limits of Normal Forgetfulness.--Curious instances of forgetfulness

may occur in the experience of men with excellent memories, which,

when they happen to persons morbidly inclined to test their every act,

are interpreted to signify something much more serious than they

really mean. Nearly everyone has had more than once the experience of

telling a story to a particular group of people and then forgetting

all about having told it and coming back a few days later to tell it

over again. Occasionally a teacher hears the same lesson a week apart

and yet does not remember that he went over it before, though the

class is almost sure to do so. A man may repeat a lecture that he has

given before to the same audience without realizing it. The story has

been told more than once of a clergyman delivering the same sermon on

two Sundays in succession and, though such lapses are very rare, they

do not necessarily indicate a failing memory, but may only mean a lack

of concentration of attention on the part of the human mind. Prof.

Ribot in his "Diseases of Memory" tells the story of one such case in

which the subject was quite alarmed lest it should indicate that he

was beginning to suffer from some serious memory disturbance due to

brain disease, though there was no ground for his fears:



A dissenting minister, apparently in good health, went through the

entire pulpit service one Sunday morning with perfect

consistency--his choice of hymns and lessons and extempore prayer

being all related to the subject of the sermon. On the Sunday

following he went through the service in precisely the same manner,

selecting the same hymns and lessons, offering the same prayer,

giving out the same text, and preaching the same sermon. On

descending from the pulpit he had not the slightest remembrance of

having gone through precisely the same service on the preceding

Sunday. He was much alarmed and feared an attack of brain disease,

but nothing of the kind supervened.





Attention not Memory.--When patients come with complaints of the loss

of memory, the most important thing is to analyze their symptoms

carefully. This will usually enable us to give patients ample

reassurance. I have known men who were convinced that they were losing

their memories because of their failure to recall important details in

their business affairs in the midst of much hurry and bustle in the

winter time, find that when they were living a simpler life in the

course of travel or life in the country during the summer time under

conditions different from the ordinary, their memory could be

absolutely depended on for trains and travel details and all important

matters to which they were now devoting attention.





Cultivating Looseness of Memory.--Many people complain of loss of

memory in the sense that they do not now remember when things took

place as well as they used to. For instance, I have had men of fifty

tell me that they were sure that their memories were growing weaker

than they used to be because a number of times within a year they had

found that events which they thought had taken place only a year or

two ago really dated four or five or even more years in the

past. Some are considerably disturbed by this. As a matter of fact it

is only another instance of lack of attention. Most of what we read in

newspapers attracts so little of our serious attention that it is no

wonder that we do not recall with exactness when events took place.

Events crowd each other out of memory. Newspaper reading is, indeed,

the best possible cultivation of looseness of memory that we could

have. We do not expect to remember what we read. We would probably

grow distracted if we did. At the end of the day if you ask a man what

he read in the morning paper he will have no idea at all, unless

something especially startling or particularly interesting to him has

turned up. After a week we could no more separate Monday's from

Tuesday's news of the week before than we could recall a random list

of events, having heard it but once. We cultivate looseness of memory

with great assiduity. Let us not be surprised if, to some extent, we

succeed.





Memories Individual.--People are often much worried over children's

memories and may communicate this worry and anxiety to the children

themselves, making them solicitous. It is probable that our memories

are like our stature. They are what they are. By thinking we cannot

add a cubit to the one nor facility to the other. The training of the

memory is a very small element compared to the natural faculty. It

must not be forgotten, however, that many distinguished men have been

noted for rather bad memories when they were young and yet these

faculties have developed quite enough to enable them to accomplish

good work afterwards. The memory is, after all, a comparatively

unimportant faculty in itself and other intellectual faculties surpass

it in significance. It is the faculty that first develops, however,

and so a child is often thought to be intellectually slow when it has

not so bright a memory as its companions, though a little later its

other faculties may develop so as to put it on a plane above its

fellows. Memories, too, are very individual and may not retain any of

the ordinary subjects, while they may be very attentive for certain

special lines of thought. This form of the faculty is better, for the

encyclopedic memory is usually of little use and, except in high

degrees, encourages superficiality rather than real knowledge.



As a matter of fact, few of our greatest thinkers have had what would

be called brilliant memories and it would almost seem as though the

diversion of mental energy to this faculty rather disturbed the

development of the others. Many a distinguished man has been rather

notorious as a child for bad memory, so that in the early days when

memory was the only faculty called upon at school he was set down as a

dunce. Perhaps the most striking example of this was Sir Isaac Newton,

who was actually called a dunce, and yet the world would welcome a few

other such dunces. Thomas of Aquin, the great medieval writer on

philosophy and theology, who still influences philosophy so much, was

so slow as a young man that he was called by his fellow pupils "the

dumb ox." His great teacher, Albertus Magnus, recognized the depth of

mind that his fellow students could not see and declared that the

bellowings of that "ox" would be heard throughout the world. Sir

Walter Scott was spoken of as a very backward child. This is all the

more surprising to those who know and appreciate the wealth of

information that he put into his Waverley Novels. Goldsmith, than whom

we have no more brilliant writer in English, seemed not only a dunce

as a child, but all his life, so far as outward appearance went,

was a numbsknll. This was due to a lack of readiness rather than any

lack of wit.





Tricks of Memory.--Some tricks of memory may be very disturbing to

those who are over-occupied with themselves and with the possibility

of losing their memory. For their consolation it is well for the

physician who hears their complaints to have at hand some stories that

illustrate certain of these curious tricks of memory. I had been

trying to persuade a literary woman for some time that it was not her

memory that was playing her false, but merely her habit of attention

and lack of concentration of mind on things because she is occupied

with a great many interests, when one day she came to me with what she

thought was absolutely convincing proof that her memory was going. She

had read a passage in a newspaper the day before which she liked very

much, but after reflection it sounded strangely like some of the

things that she had thought along these lines herself. It was a

quotation, but there was no indication to tell whence it came. A

little inquiry, however, showed that the quotation was from an article

of her own written only two years before. Here was definite proof of a

failure of memory. Strange as it may seem, however, this experience is

quite common. I feel sure that there is not a single writer for

periodical literature who has not had similar experiences. Anyone who

writes much editorially, where the articles are unsigned, finds it

rather difficult two or three years later, as a rule, to be absolutely

sure which editorials are his. Occasionally it happens that even by

the time the proof comes back for monthly periodicals, say six weeks

or two months, some at least of what was written may seem quite

unfamiliar. This will be particularly true if phases of the same

subjects have been treated in successive articles and thus repetitions

are caused.



There is plenty of good warrant for such occurrences in the lives of

distinguished writers. Scott once heard a song in a drawing-room that

he did not care for very much and he said rather contemptuously, "Oh!

that's some of Byron's stuff." His attention was called to the fact

that he was the author of the stuff himself. Carlyle confessed to

Froude when Froude went over some of the passages of Carlyle's own

autobiography with him, that he had quite forgotten some of the things

written down there. Manzoni, the distinguished Italian writer, whose

"I Promessi Sposi" has probably been more read throughout Europe than

any novel written during the nineteenth century, except possibly some

of Scott's, tells some stories of his own lapses of memory and, above

all, of having once quoted a sentence of his own to confirm something

that he was saying, though he confessed that he did not know by whom

the quotation had been written.





Memory and Low Grade Intelligence.--There are many people who complain

of their memory and of their inability to recall many things which

others recall without difficulty. They are prone to think that this is

some defect in them and not infrequently, as a consequence of

comparisons, they persuade themselves that their memory was better and

that it has lost some of its qualities. Until they became familiar

with some of the feats of memory possible of performance by others,

they were quite satisfied, but now they find in every instance of

forgetting a new symptom of an increasingly deficient memory. I have

found in these cases, that setting before such people some of the

curiosities of memory, and especially the fact that memory is by no

means necessarily connected with profound intelligence, so that,

indeed, its presence is quite compatible with a low grade of

intelligence or even with what is practically idiocy, will do much to

rob these gloomy forebodings of their terrors with regard to their own

supposed deterioration of intellect. Ribot, in his "Diseases of

Memory" [Footnote 52] has an excellent passage in which he sums up a

number of these peculiarities of memory that are likely to be

especially consolatory to people of ordinary memory who are worrying

about themselves.



[Footnote 52: International Scientific Series,

D. Appleton & Co., New York.]



It has long been observed that in many idiots and imbeciles the

senses are very unequally developed; thus, the hearing may be of

extreme delicacy and precision, while the other senses are blunted.

The arrest of development is not uniform in all respects. It is not

surprising, then, that general weakness of memory should co-exist in

the same subject with evolution and even hypertrophy of a particular

memory. Thus certain idiots, insensible to all other impressions,

have an extraordinary taste for music, and are able to retain an air

which they have once heard. In rare instances there is a memory for

forms and colors, and an aptitude for drawing. Cases of memory of

figures, dates, proper names, and words in general, are more common.

An idiot "could remember the day when every person in the parish had

been buried for thirty-five years, and could repeat with unvarying

accuracy the name and age of the deceased, and the mourners at the

funeral. Out of the line of burials he had not one idea, could not

give an intelligible reply to a single question, nor be trusted even

to feed himself." Certain idiots, unable to make the most elementary

arithmetical calculations, repeat the whole of the multiplication

table without an error. Others recite, word for word, passages that

have been read to them, and cannot learn the letters of the

alphabet. Drobisch reports the following case of which he was an

observer: A boy of fourteen, almost an idiot, experienced great

trouble in learning to read. He had, nevertheless, a marvelous

facility for remembering the order in which words and letters

succeeded one another. When allowed two or three minutes in which to

glance over the page of a book printed in a language which he did

not know, or treating of subjects of which he was ignorant, he

could, in the brief time mentioned, repeat every word from memory

exactly as if the book remained open before him. The existence of

this partial memory is so common that it has been utilized in the

education of idiots and imbeciles. It is worth noting that idiots

attacked by mania or some other acute disease frequently display a

temporary memory. Thus, an idiot in a fit of anger told of a

complicated incident of which he had been a witness long before, and

which at the time seemed to have made no impression upon him.





Training Memory.--In recent years in many departments of therapeutics

training has been found to be of value. This is especially true with

regard to nervous defects. Probably one of the greatest surprises that

nervous specialists have had in the last twenty-five years in the

domain of therapeutics came from the introduction of Frenkel's methods

of retraining the muscles in locomotor ataxia. This idea of retraining

has been found useful in such distinct departments as the use of the

eye muscles, the co-ordination of the muscles of speech, so as to get

rid of stuttering and stammering, and the muscles of the hand for

writing. We are only just beginning to realize that retraining can be

of great value in psychic affections also. Patients may be disciplined

against their dreads and tremulousness due to over-apprehension and

against even certain defective uses of their intellect. Urbantschitsch

of Vienna showed that by training defective hearing it might in many

cases be very much improved. What he accomplished, however, was not

any better use of the external auditory apparatus, but a more

intense attention of mind which enabled the patient to catch and

understand sounds which had hitherto been so vague that their

significance was lost.



In a number of cases of complaint of loss of memory I have

deliberately set patients to retrain their memories and have at least

relieved their apprehensions if I have not always succeeded in

increasing their actual memory power. It has even seemed, however,

that in old people some actual improvement of the memory faculties was

thus brought about. Under the head of Occupation of Mind I have

referred to the exercise of memory in younger people as representing

an excellent form of mental diversion. When the idea first suggested

itself it seemed as though patients would not take to it at all, and

yet I have found that with a little persuasion they become much

interested and find a great deal of pleasure in their gradually

increasing power to recall the great thoughts of great authors in the

literal original words. A reference to that chapter will tell more of

my experience. This made me more confident of the possibilities there

were of making people understand that if they were losing their

memories they could bring them back by proper exercise. In this way

many of the modern evils of lack of attention and of failure of

concentration of mind can be corrected.



My rule now is to tell patients who come complaining of loss of memory

that if there is any real loss of memory it is due to their improper

use of the faculty, or perhaps to their failure to exercise it

sufficiently, for the proper performance of function depends on

adequate exercise. They are then instructed to take certain simple

classical bits of literature and commit them to memory. At the

beginning such short poems with frequently repeated rhymes of the

modern poets as are comparatively easy to learn are set as memory

exercises. Later Goldsmith's "Traveler" and "Deserted Village" are

suggested. Then passages from Shakeaspeare are given. Just as soon as

the patient finds that he can commit to memory as he used to, if he

only gives himself to the task, a change comes over his ideas with

regard to the loss of memory. For many of these people the occupation

of mind is an excellent therapeutic measure. Besides selections can be

made in such a way as to keep before their minds the thoughts they

most need in the shape of memory lessons. It is a discipline of memory

that revives it and also a constant exercise in favorable suggestion.



Gregor in the Monattschrift fuer Psychiatrie und Neurologie, Band

XXI, has detailed some of his experiences with the retraining of the

memory of patients suffering from Korsakoff's Psychosis--alcoholic

neuritis with psychic disturbances, especially of memory. The patient

was required to learn words and then after a certain length of time

was tested to see if he could learn a similar series with fewer

repetitions than at first. The memory increased in capacity with the

exercises and there was evidently a definite gain in the faculty. In

this disease patients have also lost the power to some degree at least

of recognizing objects. After exercises in recognition they are much

more capable in this matter, however, and it is evident that in every

way the memory can be improved. This experience, with a serious form

of disease that gravely impairs the memory, shows how much can be

accomplished in circumstances far more unfavorable than are those

which usually bring patients to the physician complaining of

deficiencies of memory.