In the diagnosis of this case, we must probably separate the convulsive phase from the remainder of the phenomena. The conduct disturbance, emotional outbreaks, and suicidal attempts date from early youth, and no doubt the diagnosis defective delinquent would fit Vivian from the beginning. The hereditary taint is characteristic enough. The sundry phenomena in the insane hospital, and particularly the hallucinations, lead one to wonder whether Vivian is not possibly even suffering from dementia praecox. As to the convulsions, it would hardly appear that they are typically epileptic, although certainly epileptoid. Their onset at 22 is somewhat unusual. Several features of the seizures together with the opisthotonos and the previous history of hysteria, lead one to think of making the diagnosis hysteria. 1. Can cerebrospinal syphilis cause the symptoms? We found the serum W. R. to be positive though Vivian denied syphilitic infection. (She also denied gonorrhœal infection despite the clinical and laboratory findings.) We found that the spinal fluid yielded a gold reaction of a typical syphilitic nature, showed an excess of albumin, a slight amount of globulin, and 130 cells per cmm. Even these findings, however, would perhaps not justify stating that the convulsive seizures are of syphilitic nature. The seizures disappeared under the administration of antisyphilitic remedies. It would seem, therefore, that the seizures should be regarded as of syphilitic nature. In any event, the diagnosis of cerebrospinal syphilis is justifiable. This syphilis, however, is of an active nature and probably of recent production. We should be at a loss to explain the earlier mental features in Vivian as syphilitic and are therefore fain to associate the two psychoses, PSYCHOPATHIC PERSONALITY and DIFFUSE CEREBROSPINAL SYPHILIS. =NEUROSYPHILIS (“paresis sine paresi”) in an habitual criminal, a forger.= =Case 88.=[17] —— was brought to the hospital by the police. He was charged with having forged a check, and on account of the crudeness of the work his mental condition was suspected. =Family History.= The paternal grandfather was considered fast, drank a great deal and was said to be a thief. The father is said to have been forced to leave the State when a young man in order to avoid the reformatory. Paternal cousin murdered a man; the sisters of this cousin said to have been wild and one brother married a prostitute. Nothing known of maternal relatives.