In the instance to be next related there was also antecedent syphilis, and the patient had already been heavily dosed with iodides and repeatedly salivated with mercury.  His recovery was and has remained remarkably complete.

H.B., travelling salesman, from New York, aet. forty, single, a large, strongly-made man, a hard worker, given to excesses in sexual indulgence and alcohol for years.  Syphilis was contracted fifteen years before the first traceable symptoms of ataxia, which had shown themselves after an attack of grippe, in 1890, in sudden remittent paralysis of the external muscles of the right eye, followed within a few months by gastric crises, general lightning pains appearing a few months later.  During the two years succeeding he was drenched with drugs and grew steadily worse.  When admitted to the hospital in 1892 he was very ataxic in the legs, suffered greatly from gastric and other pains, difficulties with bladder and rectum, loss of sexual power, various anaesthetic areas, could not stand with eyes open unless he had help, total loss of knee-jerk, paralysis of right rectus, indigestion from the irritation of the stomach from medicines as well as from the disease, and, though muscular and over-fat, was flabby and pallid.  He had no ataxia or loss of sensibility in the upper half of the body.  He was in bed for two weeks, on milk diet, with warm baths and massage.  Systematic movements were begun and massage continued.  After the stomach improved he grew better with unusual rapidity.  He is now able to work hard again, travels extensively, can walk strongly, but wisely takes his exercise more in the form of massage and systematic gymnastics.  He appears to report himself once or twice a year.  There has been a partial return of sexual ability.

The next case has points of interest in the later history, but the first examinations and early treatment may be passed over briefly.  X.Y., aet. forty-two, a steady, sober merchant, closely confined by his business, always of excellent habits, with no possible suspicion of syphilis, was seen first in 1894 in a somewhat advanced stage of tabes, but with no optic or gastric disturbances.  His station was very bad, but when once erect and started he could walk without a stick.  Girdle-pains very marked; bowels very constipated; some trouble in emptying bladder; several points of fixed sharp pain; lightning pain occasional and severe, but not frequent.  He was ordered to bed for six weeks.  Galvanism, alternate hot- and cold-water applications to the tender spots, careful massage, and a two-months’ course of Brown-Sequard fluid after getting up made a new man of him.  Massage and systematic exercise were kept up together for six months.  The massage was stopped and the exercises continued, and improvement went on steadily, though the fixed pains kept up in only slightly less severity.