We are here, however, not considering the origin and relations of pure word-deafness but present the case as one of =tabes dorsalis= of 20 years standing, terminated by two characteristic syphilitic complications, first, an extensive destruction of brain tissue through =cerebral thrombosis= and secondly, =fatal aortic aneurysm=. =Summary=: We have here dealt briefly with a long-standing case of NEUROSYPHILIS of the TABETIC type: A characteristic but not necessary complication of the case is the LATE CEREBRAL VASCULAR INVOLVEMENT. The =posterior column sclerosis= is virtually the only spinal change. Spinal meningeal changes are absent (although it is to be assumed that chronic inflammatory changes in the posterior roots were at one time present in some quantity and although the spinal fluid characteristically shows lymphocytosis in tabetic neurosyphilis). Whether the spirochetes produce special toxic components able to cause tabes or whether special kinds of spirochete are the tabes-making kinds is hard to say. Special qualities of individual tissue may be involved. The =cerebral lesions= of a =cystic= nature are of vascular origin, like the differently localized encephalic lesions of Case 1 (Alice Morton). Vascular syphilis is not a special property of the vessels of the nervous system. In fact this very case died of =aortic aneurysm=. =PARETIC NEUROSYPHILIS (“general paresis,” “dementia paralytica,” “softening of the brain”). Autopsy.= =Case 3.= James Dixon, 44, was first seen at the Danvers Hospital, reciting verses in a dramatic and noisy way. He remained good-natured and jolly; nor was there any change in his euphoria until he had become physically weaker and more generally demented. In fact, Dixon appeared to become more and more expansive as he became physically weaker. He was in the habit of describing himself as “O. K., No. 1, Superfine.” =Physically= the patient was gray and bald on vertex, had a dusky complexion, was very thin (6 ft. in height, weight 155 lbs.); the mucous membranes were pallid; the teeth rather poorly preserved; the heart was somewhat enlarged; the pulse irregular in rhythm, of poor volume and tension. =Neurologically=, the patient showed a characteristic Romberg sign and ataxia in walking a straight line. The tremulous tongue was protruded to the left, and there was a coarse tremor of the extended fingers. The knee-jerks were absent, and the Achilles jerks could not be obtained; the plantar reactions were slight; the arm reflexes were present. The pupils were stiff to light. There was a marked vocal tremor. The sensations could not be tested on account of the patient’s mental state. It appears that Dixon had left school at about 16, at about 22 had gone into the provision business, and later had become a hotel clerk. He had married at 28; there had been two miscarriages, at three months and six weeks respectively; one child was stillborn; four children were living.