Case VIII should be excluded as probably not delusional.
Case X might perhaps be transferred with propriety to the unpleasant-delusion group.
Certain cases of felt passivity under divine influence separate themselves out from the group; indeed VI and IX probably belong in the unpleasant-delusion group (see below).
These subtractions leave seven cases to deal with. Three of these seven, viz. I, II and III, are apparently best regarded as examples of frontal lobe atrophy, and their grandiosity may resemble that of certain cases of general paresis.
Of the remaining four, two, Cases IV and VII, are phthisical; one, Case VI, showed an episodic identification with God (incident in fatal septicemia), and one, Case XI, uttered manic-depressive exalted statements about wealth and poetical power.
I turn to a consideration of the unpleasant-delusion group, which as first constituted was to contain eleven cases (XII-XXII) but to which must be added three more (VI, IX, X).
Case XII should be at once excluded from present consideration on account of its microscopy.
CASE 12. (D. S. H. 12282, Path. 942) died in a second attack of depression (manic-depressive insanity?). Catholic, always of a quiet and reserved disposition, happy in married life. Delusional attitude concerning an abortion which she said she had induced. "Soul lost," "I'll see hell."
Autopsy: Death from gangrene of lung and acute fibrinous pericarditis. Erosion of cervix uteri. The edema of the brain, irregular pink mottlings of white substance, and an exudative lesion of one focus in the pia mater of the right side suggested an encephalitis more marked on the right side. Microscopically a few small vessels showed plugs of polynuclear leucocytes. The nerve cells were affected by various acute changes. The visuo-psychic portion of an occipital section (right) showed suprastellate cell-losses of a somewhat focal character
Of the remaining ten (XIII-XXII), one, Case XIII is another of mixed emotions ("am Eve and have to suffer;" "in Purgatory;" etc) of a religious type. It is the only case in the unpleasant group with phthisis pulmonalis, (combined, however, with abdominal tuberculosis and nephritis).