The following case, studied in Dr. T. H. Weisenburg's wards of the Philadelphia General Hospital, is of considerable interest for several reasons. Although cerebral syphilis frequently causes symptoms of brain tumor, it generally does so by the formation of gummata in relation with the meninges or vessels, and not, as in this case, by occlusion of the foramen of Magendie and resulting chronic internal hydrocephalus. The comparatively frequent occurrence of congenital internal hydrocephalus in association with congenital syphilis has often been noted. The pathology of congenital hydrocephalus is not well established, but occlusion of the foramina of communication between the ventricular system and the subdural space of the brain has been found postmortem by various observers, and appears to be the cause of the condition in at least some of the cases.
Acquired, or secondary, hydrocephalus has been found in numerous cases to be due to mechanical obstruction of the foramen of