40 



was discharging a thick, yellow pus ; the small ulcers 

 on the edge of both nostrils were increasing in size. 



On the sixty-ninth day a corded lymphatic had 

 now developed on the near side of the neck, running 

 downwards from the pustule. 



On the seventy-fourth day several corded lymphatics 

 were radiating from the sore which had now formed on 

 the neck, and several other pustules were rapidly develop- 

 ing along their course. There was also a good deal of 

 discharge from the wound ; and the ulcerating sores on 

 the edges of both nostrils were increasing in size and 

 beginning to coalesce. The case having first been tested 

 with mallein, and, giving no reaction, was now destroyed. 

 The post-mortem examination revealed that the internal 

 organs were healthy, and no further lesions of the 

 disease other than those already described were present. 



It occasionally happens that attempts to reproduce 

 the disease are only followed by one or more subcutaneous 

 indolent nodules, which after fluctuating up and down 

 for some weeks or months, finally disappear, leaving 

 no sign of the disease. These conditions are no doubt 

 brought about by the active resistance of the tissues, 

 and the effect of phagocytes. Nocard and Leclainche 

 state that considerable resistance is made by the tissues, 

 and that phagocytosis is very active — that the 

 cryptococci which penetrate beyond the lymph glands 

 are attacked and nearly all destroyed by the leucocyctes, 

 but that occasionally the organisms get into the circu- 

 lation and set up specific lesions in the lungs. 



A man is reported to have inoculated himself with 

 the disease (in the arm) during the early part of an 

 outbreak which occurred in Bangalore, India, in 1899. 

 I regret that I am not in possession of the facts of this 

 case, but I understand that all the symptoms became 

 well developed, numerous bubos formed along the 



