Sign. No. of Per cases. cent. Alterations of light reflex 235 78 Inequality 205 68 Abolition of light reflex (bilateral or unilateral) 156 52 Abolition of light reflex (bilateral) 133 44 Irregularity of pupil 117 39 Irregularity of both pupils 109 36 Diminution of light reflex 108 36 ditto (bilateral) 79 26 Alteration in accommodation reflex 79 26 Diminution of accommodation reflex 52 17 Mydriasis 41 13 Myosis 40 13 Diminution of light reflex (unilateral) 35 11 Abolition of accommodation reflex 35 11 Diminution of accommodation reflex (bilateral) 29 9 Abolition of accommodation reflex (bilateral) 26 8 Diminution of accommodation reflex (unilateral) 23 7 Fundus changes 21 7 Vascular changes 16 5 Abolition of accommodation reflex (unilateral) 12 4 Paresis of the third nerves 10 3 Ptosis 9 3 Irregularity of one pupil 8 3 Nystagmus 7 2 Visual acuity lost 7 2 Atrophy of disc 6 2 Total blindness 5 2 Paralysis of the fourth nerves 1 1 =Can neurosyphilis exist in the absence of positive findings in the spinal fluid?= =Case 56.= There was no great difficulty in setting up a diagnosis of general paresis in the case of James Burns, a mechanic of 31 years of age, who came voluntarily to the Psychopathic Hospital for treatment. The point in Burns’ case was that the spinal fluid proved entirely negative in all respects despite the fact that the serum W. R. was positive, and despite the following facts of history and mental examination.