The massage was stopped and the exercises continued, and improvement went on steadily, though the fixed pains kept up in only slightly less severity.
In a year the patient was better in general health, looks, and spirits than he had been for many years before, and remained in good order, except for the daily recurrences of paroxysms of pain of varying but not unbearable severity for two years.

He then presumed for a month on his strength, and took much more exercise afoot than was wise, worked late at night over his books, had some additional nervous strain from business worries, and came to Dr.J.K.Mitchell in October, 1898, barely able to crawl with two canes, having lost weight, become sleepless, suffered great increase of pain, and grown so ataxic that he could scarcely walk.

This change had all occurred in three or four weeks.

He became steadily worse for two or three weeks till he could not stand or walk at all, had cystitis from retention, violent attacks of rectal tenesmus, stabbing pains in rectum, perineum, scrotum, and groins, with almost total anaesthesia of the sacral region, buttocks, scrotum, and perineum, inability to retain faeces, while passages from the bowels took place without his knowledge.

He found that an increase in the rectal and abdominal pain followed lying down.