The nerve deafness of late congenital syphilis is usually an isolated neurological finding without concomitant evidence of neurosyphilis and without abnormalities in the cerebrospinal fluid. Keidel and Kemp1found 22 such cases among 230 patients with congenital syphilis. In contrast to most of the manifestations of syphilis, which respond to treponemicidal therapy and which can be attributed to the direct destructive effects of Treponema pallidum, the nerve deafness of late congenital syphilis does not respond to such therapy.2The scantiness of the postmortem material available permits no certain conclusions about the pathology or even the anatomic site of the lesion. Interstitial keratitis and Clutton's joints (intermittent hydrarthrosis of the knees), both manifestations of late congenital syphilis, behave like hypersensitivity phenomena in that they are resistant to therapy with penicillin but responsive to that with corticosteroids. In speculating about the nature of late isolated nerve deafness in congenital syphilis,