CEREBRAL SYPHILIS MVP CEREBROSPINAL SYPHILIS MVP PARETIC NEUROSYPHILIS MVP TABOPARESIS MVP =DOUBTFUL (TOXIC?, IRRITATIVE?) NEUROSYPHILIS (?)= “PARESIS SINE PARESI” SYPHILITIC NEURASTHENIA TABETIC PSYCHOSIS SYPHILITIC PARANOIA SYPHILITIC POLYURIA, POLYDIPSIA SYPHILITIC NEURALGIA CHART 4B =Summary:= We have here dealt at length with a long-standing DIFFUSE NEUROSYPHILIS affecting to some extent the entire =meninges= and producing a destruction of posterior column fibres and numerous other fibres of the spinal cord (=tabetiform= portion of the neurosyphilis =picture=). We have also found central lesions of the corpora striata affecting the destruction of both pyramidal tracts (=paraplegic= portion of the neurosyphilis =picture=). We have found evidences of acute inflammation (=lymphocytosis=) in the cervical region of the spinal cord and in the left eighth nerve (=progressive inflammatory= neurosyphilis =picture=). In short, we have presented a case of =diffuse= (meningovasculoparenchymatous) =neurosyphilis= characterized by an ascending character in a course of at least 16 years; we have indicated a number of possible clinical correlations, not only with the major portion of the clinical course (symptoms of myelitis and pyramidal tract destruction), but we have also mentioned, merely for their suggestive value, a number of finer correlations between histological findings and certain clinical features (notably transient losses of vision and hearing, and a partial return of the lost knee-jerks). Bearing in mind the clinical and anatomical findings of this case, we shall be able to discuss the cases that follow in a briefer and more condensed fashion. =TABETIC NEUROSYPHILIS (“tabes dorsalis,” “locomotor ataxia”) complicated by vascular neurosyphilis (hemiplegia). Autopsy.= =Case 2.= Francis Garfield had been a successful lumberman and had enjoyed good health until his forty-fifth year. Suddenly one day, while walking on the street, Garfield lost the use of his legs and for a time was quite unable to walk. However, he recovered locomotion and after a time there was nothing wrong with his leg movements except a slight ataxia. At the age of 52 Garfield had to give up work. It appears that he had been becoming cranky, sometimes, for example, shouting, whistling and slamming doors, apparently to annoy the family. His intellectual capacity seemed to be maintained, although his memory was slightly impaired. At 67 years there was an ill-defined seizure, followed a few days later by another seizure with aphasia (wrong words used and lack of understanding of things said).