ITS INTRODUCTION INTO ENGLAND. 19 



arms and thighs, on the sides of the face, the labia of the 

 female and the prffiputium of the male, parts which are 

 either nude or covered only with hair ; but, on sepa- 

 rating the wool, the whole of the skin was seen to be 

 similarly affected, although less intensely. 



In the second stage greater debility and emaciation 

 existed : the discharge from the Schnciderian mem- 

 brane was increased, viscid, and adherent to the alae of 

 the nostrils, im])eding the respiration ; the capillanes 

 of the eyelids were in a highly congested state ; the 

 pulse was indistinct even at the heart; the ears and 

 feet were cold ; and the wool came off easily, shewing 

 the skin underneath it inflamed, the redness existing 

 principally between the elevations, although no distinct 

 areola was present. The summits of the nodules were 

 blanched, arising from effusion of a very small quantiiij 

 of serous fluid beneath the cuticle, which scarcely gave 

 to it the character of a true vesicle. All the papulae, 

 however, had not taken on this change. 



In the third stage the vital powers were prostrate ; 

 the fever had become of a typhoid character, the dis- 

 charge fi-om the nostrils fetid, and the other general 

 symptoms much aggi'avated. The cuticle covering the 

 majority of the nodules had assumed a brown colour, 

 and pus here and there was formed on the margins of 

 some of them, shewing the ulcerative state to have com- 

 menced : in others, simple desquamation of the cuticle 

 had begun to take place. 



In some extreme cases the ulceration had extended 

 to the subcutaneous structure, and large unhealthy 

 sores existed on the sides of the face, the inferior parts 

 of the abdomen, the prepuce, and the inside of the 

 thighs. I was at once struck with the resemblance of 



