ers of
sensibility. Later results, are a nasal catarrh, atrophy of the sexual
organs in both sexes, with impairment or loss of procreative power,
hopeless blindness. However the course of the disease is very slow, and
years may elapse before these several changes are accomplished. Often the
disease appears quiescent for months at a time, after which fever occurs
and with it acute or sub-acute manifestations appear, including gland
disease, orchitis, ulcerative processes, slow or rapid, followed by
gangrene and a relatively rapid progress is made toward a fatal
conclusion.

Toward the last the mutilations effected by the disease may result. Parts
of the fingers or toes, whole fingers or toes, and entire hand or foot may
become wholly or partially detached by the ulcerative and other
degenerations. This stage of this type of the disease may extend through
ten or more years. After it has fully developed the dejected countenance
of the leper, with his leonine expression and general appearance is highly
characteristic.

[240 MOTHERS' REMEDIES]

LEPRA MACULOSA.--This form is more common in tropical countries and is
distinguished chiefly by its macular (spotty) lesions. In size they vary
from a small coin to areas as large as a platter. They are diffused or
circumscribed, roundish or shaped irregularly, yellowish, brownish or
bronzed in color, often shiny or glazed. They may be infiltrated and may
be elevated, or on a level with the adjacent tissues. The patches are
usually at first very sensitive, but they finally become insensitive, so
that a knife can be thrust deeply into them without being felt. The
regions chiefly affected by this type are the back, exposed parts, the
backs of the hands and wrists, the forehead, the cheeks, ears, back of the
feet, and ankles. The eruptions may be scanty or general; conspicuous or
insignificant. The eruptive symptoms are associated commonly, early or
late, with the serious phenomena described below.

LEPRA ANAESTHETICA. (Nerve Leprosy. Atrophic Leprosy. Lepra
Trophoneurotica).--Before the development of this form of leprosy there
may be one or two years of ill-health. Usually the skin at this time
becomes in localized patches over-sensitive, sometimes there is
over-sensitiveness and special nerves, because of their enlargement,
become accessible to the touch. Those named later become tender, and the
seat of lancinating or shooting pains. This clinical variety may be
commingled in