Genitourinary crisis is one of the symptoms of spinal syphilis, and visceral crisis includes genitourinary crisis. Spinal syphilis is an important type of central nervous syphilis and includes spinal consumption, spinal membranous vascular syphilis, and syphilitic myelitis. Syphilitic myelitis is also called syphilitic spinal myelitis because the lesions often involve the spinal membrane. The main symptoms are lightning-like pain, sensory ataxia and urinary incontinence. The main signs are loss of knee and ankle reflexes, impaired vibration and position perception of the lower extremities, and positive closed-eye difficulty sign. (1) Ocular manifestations: More than 90% of patients have pupillary abnormalities, usually manifested as a-lo pupils, i.e., bilateral pupils are unequal in size, narrow and irregular, and the light reflex disappears, but the adjustment reflex exists. Most patients have drooping lids and varying degrees of ocular muscle paralysis, and optic nerve atrophy is also common. (2) Sensory disorders: More than 90% of patients have lightning-like pain, mostly in the lower extremities, but also from the face to the lower extremities, the pain is sharp and brief, lightning-like, knife-like, tearing-like, burning-like, etc., and may occasionally persist in a certain place. Ataxia is caused solely by deep sensory impairment, and the gait is wobbly when walking, with a cross-threshold gait (the lower limbs are excessively elevated when walking, stepping harder, and the size of each stride varies), and it is difficult to walk in advanced stages even if the muscle strength is intact. (3) Sphincter dysfunction: Due to posterior root lesion of lumbar segment 2 to 4, bladder sensation is affected, and the bladder is full without the intention to urinate, resulting in urinary retention and filling incontinence. (4) Visceral crisis: Gastric crisis is the most common, manifested as sudden onset of epigastric pain, which may extend to the chest, with contraction in the chest, and may be accompanied by nausea and vomiting, vomiting is often repeated until vomiting bile, after the attack, the patient is often exhausted and feels soreness of the skin of the epigastrium. In small bowel crisis, colic and diarrhea are present; in pharyngeal and laryngeal crisis, swallowing movements and dyspnea attacks are present; in rectal crisis, urgency is present; in genitourinary crisis, pain and difficulty in urination are present. All crises are rare except for gastric crisis. (5) Spinal consumption arthropathy (Charcot arthritis): Charcot arthritis occurs in about 1/10 patients with spinal consumption, mainly involving the hip, knee and ankle joints, but also affecting the lumbar spine and upper extremities, initially as osteoarthritis, and later with continuous damage to the joints, destruction of the joint surfaces, loss of bone structural integrity, and fractures and dislocations. The activity of Charcot arthritis is not parallel to that of central syphilis. (6) Most patients maintain intact muscle strength: 2. Syphilitic spinal myelitis and spinal membranous vascular syphilis often develop 3 to 5 years after syphilis infection. Syphilitic spinal myelitis is also known as Erb’s spastic paraplegia because its clinical manifestations are dominated by bilateral corticospinal tract damage; some of them mainly involve the spinal membranes, often due to thickening of the spinal membranes, adhesions, compression of the nerve roots and spinal cord and manifest as radicular pain in the neck, shoulders, upper limbs In some cases, the spinal cord is predominantly involved, and the syphilitic amyotrophy with spastic-ataxic paraparesis of the lower extremities is often caused by thickening of the spinal cord, adhesions, compression of nerve roots and spinal cord. Meningeal vascular syphilis of the spinal cord is dominated by vascular involvement, often due to endarteritis and spinal vascular thrombosis, with rapid onset and symptoms depending on the extent of innervation, and occasionally anterior spinal artery syndrome caused by anterior spinal artery thrombosis, with deep sensation remaining intact. The diagnosis is not difficult based on the history of smut, syphilis infection, manifestations of spinal cord damage, typical a-lo pupils, and positive VDRL and FTA-ABS in serum and cerebrospinal fluid.