CASE XXI.—E. S., aged forty-three. Diplopia from paralysis right external rectus, pupils small, each with Argyll-Robertson phenomenon; visual left acuity only 6/12, and small but distinct central scotoma, with some contraction of the peripheral field; knee-jerks distinct, and no ataxia or other evidence of spinal disease. Three early miscarriages, no full-time child. No change while under observation for nine months, but on two occasions severe attack of vomiting and abdominal pain, extending over several days and without recognized cause (? gastric crises). CASE XXII.—A. M., aged fifty-five. Left ptosis and paralysis of external ocular muscles supplied by third nerve in 1887, the pupils being normal, followed by incomplete recovery. In 1897 development of identical condition on the right side, and pupils found to be small and with Argyll-Robertson phenomenon; knee-jerks very slight and with great difficulty, but no other evidence of spinal disease. No history of syphilis. CASE XXIII.—H. F., aged thirty-seven. Right ptosis with diplopia (seven days) and defective inward excursion of right eyeball; pupils very small, not quite equal, and with Argyll-Robertson phenomenon; optic disks pale and marked contraction of visual fields, but normal central vision; knee-jerks scarcely to be obtained, but no other evidence of spinal disease. No history of syphilis. Father of four healthy children. Seen after a month’s interval, paralysis of all external right ocular muscles supplied by third nerve, and knee-jerks absent. (c) _Ocular Paralysis, with More or Less Evidence of Spinal Disease._ CASE XXIV.—G. S., aged forty-one. Ptosis and complete ophthalmoplegia externa on left side, with dilated and immobile pupils and some degree of right ptosis, these conditions or some of them having been present for five years. Knee-jerks distinct, and no ataxic phenomenon, but imperfect control over bladder, and failure of sexual power during last six months. No admitted syphilis. CASE XXV.—J. L., aged forty-two. Diplopia and drooping left upper eyelid for four years. Ptosis left side, and marked defect of ocular movements in each eye; left pupil dilated and immobile; right small, contracts during convergence, but no light response; no other ocular defect. Knee-jerk scarcely obtained on either side; no ataxia, but attacks of “twitching pains” in lower limbs, and for some time difficulty in starting the flow of urine. Venereal sore in 1882, and subsequent loss of hair, but no other secondary symptoms. Patient watched for twelve months without appreciable change.