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The article discusses the treatment of and attitude towards dementia paralytica by Dutch psychiatry from 1870 to 1920 in reference to varying interpretations of the disorder depending on the social and institutional context of where patients were examined. The author argues that diagnoses and interpretations of the disorders were based in part on a social-cultural basis. Other topics discussed include the diagnosis, care, and treatment of patients in asylums, the pathological-anatomical research of the physical causes of the disease, and the public debate on the frequency and causes.