cess, and suppuration transforms the ringworm into an ulcer
covered by a dirty-brown rind and disagreeably colored serum.

The ulcers of lupus are of various, generally irregular shape, the rims
not hard, the ground flat and covered with purulent matter and decayed
tissue; they are commonly surrounded by a faint reddish areola. These
ulcers gradually become epulotic and form irregular, generally slightly
protruding white scars in which new tubercles may appear.

Lupus appears most frequently in the face and especially frequent on the
nose. Sometimes its appearance is indicated only by an inflammation and
swelling of the mucous membranes of the nose and at the same time a
reddening of the epidermis. The nostrils are stopped up by a thin rind
which, if torn off, is replaced by a thicker one below which an ulcer is
formed that spreads with greater rapidity on the mucous membranes of the
nose than on the external epidermis of the same.

Sometimes the whole process on the nose is so rapid, that very often the
physician is not called to the patient, before a large part of the wing
of the nose or of the nasal epidermis is destroyed and deep ulcers have
developed under the rind. New tubercles of lupus are commonly noticed to
spring up on the margins of these ulcers; the cartilage as a rule
resists the progress of the disease for a longer period and may be
unhurt, while the skin on the wing of the nose may be completely
destroyed.

Frequently the process is extended to the mucous lining of the hard
palate and to the gums. Lupus generally appears on the lips in the same
manner as in the nose. The upper lip especially appears very much
swollen and covered with ulcers after a prolonged existence of the
affection. Sometimes even the aperture of the mouth itself is reduced in
size by the development of ulcers and scars on the surrounding parts.

If the process extends to the lower eyelid, the connective tissue as a
rule becomes much swollen and reddened. The malady especially attacks
the inner angle of the eye, destroys the entrance of the lachrymal duct,
and from there the lupous tubercles appear on the connective tissue.
Gradually tubercular formations develop on the cornea and sight becomes
impaired.

On other parts of the face lupus generally appears in the form of small
knots, about the size of millet seeds, which remain for a time then
multiply and spread. The epidermis swells between these knots and
irregular ulcers deve