Distribution of Tropical Diseases in Africa. 475 
once supposed that tying the femoral artery would cure the 
growth in the leg, but that treatment is unsatisfactory. Per- 
sistent strapping from the foot upwards has also been recom- 
mended, but it likewise does little good. The scrotum may 
be removed, and even enormous tumours weighing 40 to 60 
Ibs. are often successfully treated in this manner. In 
a case I treated lately, in which the disease was limited to 
the body and the thighs as far as the knees, I obtained a 
cure, by enjoining absolute rest, giving the patient a hot 
bath every day, a moderate amount of food, chiefly milk, 
having the patient regularly massaged, and by applying the 
constant current for twenty minutes each day. A mixture 
was prescribed containing quinine, arsenic, iron, and 
strychnine, and the bowels were regulated by the frequent 
administration of aperients. 
Leprosy. 
This is a disease caused by a bacillus which is chiefly found 
in the exudation cells, but also in the diseased connective 
tissue, more rarely in the blood-vessels. There are three 
varieties—tuberculated, non-tuberculated, and anesthetic. 
The recent Commission which has been held on the subject 
does not believe that the disease is either contagious or 
hereditary. It is practically incurable, but benefit may be 
obtained by the internal and external administration of 
chaulmoogra oil, and quite recently extract of the thyroid 
eland has been given with marked success. It has been 
stated that the production of leprosy is due to extremes, 
frequent and rapid transitions of temperature, but it is not 
so. Various articles of diet have been blamed for its cause 
—fish diet, salt or rotten fish, immoderate use of pork, and 
the use of decomposing rice or maize, but none of these 
articles of diet can be its exciting cause. 
In Central Africa the natives certainly believe that the 
disease is contagious, and they also believe that sleeping in 
a hut which has been inhabited by a leprous patient is 
dangerous. It is, indeed, necessary to avoid contact with 
lepers as much as possible. White men in Africa rarely, if 
ever, suffer from this disease. 
