1908 Journal of the American Medical Association  
in this neglected condition. He believes that in many of these cases that have resisted all medical treatment previously, and in which there is the Slightest evidence of any vegetations on casual examination, those little creases and sulci and pharyngeal recesses that are so prevalent in all of these adults can be found in the vault. This little remaining fibrous condition is of the greatest importance in the relief of all conditions in the middle ear, chronic eatarrhal conditions, and the many
more » ... tions, and the many infectious diseases found in the nasopharynx. The crises, as suggested by Dr. Mayer, are likely to recur, and this tissue is a ground for the culture of all infectious material. Dr. Logan has been able to make numerous investigations along the line of the vault of the pharynx in these apparently indifferent cases of all classes of bactériologie and pathologic manifestations, and has found the Klebs-Loeffler bacillus, streptococci and staphylococci. Unfortunately I was prevented from attending that meeting, but the investigations were not abandoned; on the contrary, they were repeated. Afterward, all the cases of multiple sclerosis were also examined, with the view of clearing up some pending questions, especially in regard to paralysis of the abductors, the modifications of the voice, the ataxic movements of the cords, etc. Finally, a visit was made to the City Hospital on Blackwell's Island, and fourteen cases of tabes were examined. But I do not consider these last findings of absolute statistical or scientific value, for the reason that the patients were examined only once, which can not be considered a sufficient basis on which to pass final judgment in locomotor ataxia. The statements of Dr. Harland that "the larynx is very seldom seriously affected in locomotor ataxia," and that he was unable to find a tabetic case with laryngeal crises, were so much at variance with my own experience and all that I had read on the subject, that I naturally devoted especial attention to these points. In order to make it easier to understand these cases, their histories should have been given in full, but they had to be abridged or this paper would have been too lengthy. The histories of the cases examined only once at the City Hospital were purposely omitted. The same has been done, to a large extent, with the cases of multiple sclerosis, as in this connection they are of secondary importance, although highly interesting in themselves. Case 1.-History.-Samuel W., aged 50. admitted June 6, 1907. Chancre at age of 20; used tobacco in excess. Present illness began twenty-five years ago, with shooting pains in both legs. One year later right arm suddenly became paral-
doi:10.1001/jama.1908.25310500014002a fatcat:ibthmdaib5eulnnl53wdhggezy