NEUROSYPHILIS HYPOGLOSSAL PARALYSIS FACIAL PALSY PARALYSIS OF PALATE (POST-DIPTHERITIC) BULBAR PALSY PSEUDOBULBAR PALSY MYOPATHY—FACIO-SCAPULO-HUMERAL TYPE OF LANDOUZY AND DEJERINE MYASTHENIA GRAVIS FRIEDREICH’S ATAXIA LARYNGEAL TABES ALCOHOLIC INTOXICATION POST HEMIPLEGIC LENTICULAR DISEASE BILATERAL ATHETOSIS MULTIPLE SCLEROSIS DEAF MUTISM PARALYSIS AGITANS CHOREA STAMMERING TICS HYSTERICAL APHONIA CHART 17 The ready suspicion was that the case was one of apoplexy of slight degree with post-apoplectic phenomena. Upon investigation, this suspicion was confirmed since it appeared that Mrs. B. had been apparently quite well until about six months before admission, when without particular warning she began to act strangely and promptly fell into a series of convulsions. These convulsions would begin with twitchings of the face, and then spread throughout the body. There would be a period of unconsciousness for two or three hours. It is not certain how many of these convulsive seizures the patient had. At all events she is reported to have recovered therefrom completely, remaining well for three months; whereupon, suddenly, while visiting a friend, she suffered a paralysis of the left side of the body. She remained dazed and had hospital treatment for about a week. Ever since this left-sided paralysis, the aphasic condition above described has persisted. Such a phenomenon has often been dismissed in the past as due to an early arteriosclerosis, but most neurologists and internists of today would look beyond the diagnosis of mere arteriosclerosis and consider syphilis. The only suggestive feature in the case, aside from the post-apoplectic reflex disorder and spastic phenomena, is the irregularity and diminished light reaction of the pupils. Our suspicions were confirmed by the positive serum W. R. The W. R. of the spinal fluid proved, however, to be negative. There was a moderately strong gold sol reaction of the syphilitic type. There was a slight excess of albumin, and there was an exceedingly slight amount of globulin. There was but one cell per cmm. On the whole, it would seem best to consider the case of Mrs. Bartlett to be one of CEREBRAL ARTERIOSCLEROSIS OF SYPHILITIC ORIGIN, and a case in which there is no evidence of meningitis or meningoencephalitis.