nfidence in any
of those usually recommended. Strychnia, belladonna, and those
antiseptic drugs which are eliminated chiefly by the kidneys are of use
when cystitis has to be treated and the bladder muscles urged to
activity. Arsenic, the chloride of gold and sodium, and chloride of
aluminium are suggested by various authorities, but they have not been
of any value in my hands. In hopeless cases, where all treatment fails,
as will sometimes happen, or in patients in whom the paralytic stage is
already far advanced, if other measures are unsuccessful, morphia is
left as a forlorn hope, which will at least relieve their pains.

An outline report of several cases of different types and degrees is
appended:

M.P. of North Carolina, aet. thirty-seven, general health excellent until
syphilis in 1894, was admitted to the Infirmary in 1898. He had had for
two years recurrent attacks of paralysis of the external rectus muscle
of the right eye, slight gastric crises, and stabbing pains in the legs;
station very poor, but strength unimpaired, and he was able to walk
after being a few minutes on his feet; when first rising he was very
unsteady. Knee-jerk lost, no reinforcement. No sexual power. Some
difficulty in emptying the bladder. Examination showed slight atrophy of
both optic nerves, Argyll-Robertson pupil, and myosis. He was ordered
two weeks' rest in bed, with massage, cool sponging daily, and
galvanization of the areas of neuralgia. After two weeks he was allowed
to get up gradually, to occupy himself as he pleased, but not to walk.
Lessons in balance and co-ordination were begun in the fourth week of
treatment, and supervised carefully for two weeks more. When his station
and gait were both improved, he was permitted to walk, always with care
not to fatigue himself. At this time, six weeks from commencement of
treatment, his eyes were glassed by Dr. de Schweinitz. He had gained
some pounds in weight, and walked on straight lines without noticeable
incooerdination, but in turning short or walking sharp curves he was
still unsteady. He found walking much easier than formerly and was less
easily tired. After nine weeks he could stand or walk, even backward,
with closed eyes. He was sent home for the summer, with directions to
continue his co-ordination movements, to walk very little, and take
such exercise as he needed on horseback, riding quietly. He had still
some stabbing pains two or three times daily.

He reported in