As to other drugs, experience has not given me much confidence 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 one month, and again in six months, “No improvement in the pains, but I walk well and briskly, can jump on a moving street-car, and have ridden a horse twenty miles in a day without fatigue.”

This case was in one way favorable for treatment:  the patient, an educated and intelligent man, helped in every way, carrying out minutely all orders, and had the good sense to begin treatment early.  But the acuteness and rapidity of onset of the tabetic symptoms were so great that in a little more than two years they had reached a condition which most cases only attain in from five to ten years, and this makes the prognosis somewhat less favorable.