38 — more common on women than men and involve chiefly the prepatellar region of the knee. Other common sites are over the lateral malleolus, great trochanter, and olecranon. I have practically never found them on situations not exposed to hard rubbing or pressure on the ground. I have never, however, found a case with them on the gluteal region.

Ulcers. Sixty eight cases of ulceration were treated. These are included here, as about 75 per cent, appeared to owe their origin to syphilis or yaws. The remainder chiefly confined to the lower leg appeared to originate in the implanta¬ tion of a mixed infection on a preceding abrasion or other injury. The specific ulcers occurred chiefly on the neck, axilla, and groin and in many cases were multiple. No Leishman-Donovan bodies have so far been found in ulcers, but further investigations are being carried out.

General bone pains. If this condition is a tertiary yaw or syphilitic manifes¬ tation, its incidence appears to me to be out of proportion to the number of primary and secondary lesions encountered. The impossibility of clinically verifying the symptoms may encourage imposition to a certain extent, but the fact that most cases are prepared to go to any inconvenience to receive treatment shows that the condition really widely exists. This is the chief type of case which I think might originate from antecedent malaria, deposition of pigment in the tissues and bone capillaries leading to deficient nutrition and consequent pain. The improvement acknowledged after treatment with Novarsenobillon might be attributable to the general tonic action of the drug commonly observed in chronic malaria. On the other hand it is difficult to explain on this hypothesis why at least 75 per cent, of cases occur in adults.

Many of these cases if encountered in England would be diagnosed “ chronic rheumatism ” but if the “ micrococcus rheumaticus” exists it is remarkable that no case of acute rheumatism has been found.

Eye. Trachoma. Several hundred of children were examined, but no cases of trachoma wTere found.

Other eye diseases include : — Conjunctivitis Corneal opacities Cataract Trichiasis 1253 25 36 115 Total 1429 Children were the greatest sufferers especially from conjunctivitis and trichiasis.

The large numbers of cases of conjunctivitis appear to be due to dust and smoke as most of a child’s early life is spent grovelling in the former and in an atmosphere of the latter. Smear preparations of discharges will be made during the continuation of the trek to try and identify the affecting organism. Trichi¬ asis would appear to originate from those cases of severe conjunctivitis in which the chief lesions are on the palpebral conjunctiva. Healing wdiether spontaneous or otherwise results in cicatrical contraction which presumably induces the deformity.

Corneal opacity also seems in many cases to originate from antecedent conjunctivitis.

Cataracts occurred mostly in the aged. Unfortunately the majority of these owing to hypermaturity and deliquescence are unlikely to give successful results on operation.