=Physically,= the signs of a left hemiplegia were appropriate. Spasticity on the left side was found; there were Babinski, Gordon, Oppenheim reflexes and ankle clonus on the left side (all absent on the right). Speech defect was present. =Mentally,= aside from the delusions noted at the beginning of our analysis, a striking feature was the patient’s childishness. While reciting delusions, the patient was overactive and evinced a somewhat childish interest. Arithmetically, Jackson had preserved a fair ability but his apathy and lack of interest interfered with tests, and possibly also with the exercise of memory. As above noted, we were compelled to maintain the suspicion of syphilis throughout despite the attractive hypotheses of traumatic and post-decompressive effects and cerebral tuberculosis. A history of the acquisition of syphilis an unknown number of years before admission entered to strengthen the suspicion of the syphilitic nature of the mental symptoms. TYPICAL LABORATORY FINDINGS IN NEUROSYPHILIS (NONNE, 1915) ─────────────┬─────────┬─────────┬─────────┬───────────────┬─────────── DIAGNOSIS │ W. R., │ W. R. │ SPINAL │ PHASE I, │PLEOCYTOSIS │ BLOOD │0.22 CC. │ FLUID, │ GLOBULIN │ │ SERUM │ BLOOD │ 1.0 CC. │ │ │ │ SERUM │ │ │ ─────────────┼─────────┼─────────┼─────────┼───────────────┼─────────── PARESIS OR │POSITIVE │POSITIVE,│POSITIVE,│POSITIVE, │POSITIVE, TABOPARESIS│ IN │ 85–90% │ 100% │ 95–100% │ ABOUT 95% │ ALMOST │ │ │ │ │ 100% │ │ │ │ │ │ │ │ │ TABES (not │POSITIVE,│POSITIVE,│POSITIVE,│POSITIVE, │POSITIVE, combined │ 60–70% │ 20% │ 100% │ 90–95% │ 90% with │ │ │ │ │ paresis) │ │ │ │ │ │ │ │ │ │ CEREBROSPINAL│POSITIVE,│POSITIVE,│POSITIVE │POSITIVE almost│POSITIVE SYPHILIS │ 70–80% │ 20–30% │ ALMOST │ always; │ ALMOST │ │ │ ALWAYS │ NEGATIVE only│ ALWAYS │ │ │ │ EXCEPTIONALLY│ ─────────────┴─────────┴─────────┴─────────┴───────────────┴─────────── CHART 8 [Illustration: Syphilitic thrombosis. Contours of brain preserved. ] The W. R. proved positive in blood and spinal fluid. The gold sol reaction was of the syphilitic type; 37 cells were found per cmm.; there was a slight amount of globulin and a slight excess of albumin.