1. What is the reason for the negative spinal fluid W. R.? The theory would be that the syphilitic lesion is localized in the vascular system and that the parenchyma is only secondarily, if at all, involved. The W. R. producing bodies are accordingly not found in the fluid. 2. How frequently are several of the spinal fluid tests negative, while others are positive? Whereas, clinically speaking, the five tests in the spinal fluid (W. R., globulin reaction, excess albumin, pleocytosis, and gold sol reaction) are each indicative of a pathological condition in the central nervous system, yet a specially intensive study of the distribution of these tests has shown that they are prone to occur independently. Consequently, we must concede that they do not all represent the same inflammatory products and chemical conditions. The W. R. producing bodies, the gold sol reaction producing bodies, as well as the globulins and albumins, have been proved to be separate. Special work has also shown that _these tests disappear under treatment at different rates_. There is, unfortunately, no doubt that the rate and intensity, presence or absence, and the order of disappearance of these tests in either treated or untreated cases, do not at all parallel the clinical conditions of the patients. 3. What is the prognosis in vascular neurosyphilis, such as in the case of Wescott? The prognosis is identical with that of cerebral arteriosclerosis in general, that is to say, bad, but with frequent periods of improvement. In the neurosyphilitic type of arterial disease thromboid formation is frequent. Where the lesion is chiefly perivascular infiltration, rather than disintegration of the vessel wall, improvement may very well occur as a result of treatment. Wescott showed slight improvement under treatment. He has already lived two years since his first convulsion, and three and a half years since the onset of symptoms. =DIFFUSE NEUROSYPHILIS (so-called “cerebrospinal syphilis”) is often marked by SEIZURES.= =Case 19.= Agnes O’Neil, an unmarried woman of 28 years, was first examined five weeks after the initial symptoms. It appears that she had had certain seizures, with unconsciousness and twitching of the limbs (otherwise not well described), followed by confusion of mind and sometimes by a weakness of the left side and a difficulty in speaking. Headache had been almost constant, as well as pains in the arms and legs. =Physically=, both in general and =neurologically=, there were no signs or symptoms; mentally, we could discover no symptoms. Syphilis was denied, although possible exposure to syphilis was admitted.