442 STRONG. 



small scab at the bend of the left elbow anteriorly and another posteriori}', and 

 a scab over the right popliteal space. The skin since has become entirely clean 

 and the patient has remained well. The lesions in this case were of a most 

 severe character. 



Case V. — Apolonia; female, age 9 years; mother also infected (see Case IX) ; 

 duration of the disease 4 years. The lesions consist of an ulcerated granuloma 

 over the left ankle, apparently a tertiary lesion. Over the right internal mal- 

 leolus there is a large f ungating mass with much scar tissue about it; there 

 are also granulomata about the toes and many scars and pigmented patches on 

 the right leg. Above the knee on the left thigh there is a large scar measuring 

 about 10 centimeters in diameter. There is also a large scar on the outside of 

 the knee of the right leg. Over the chest, abdomen, and back there are numerous 

 scars and patches of pigmented skin where previous lesions have apparently 

 existed. Spirochetal were present in a smear from one of the lesions. The 

 patient was given 0.3 gram of dioxy-diamido-arsenobenzol, injected as usual into 

 the buttocks. She could not be found nine days later, but was seen twenty days 

 after the injection, when the granulomatous lesions had entirely healed, and she 

 since has remained well. 



Case VI. — Teodoriea; female, age 6 years; duration of the disease 3 years. 

 The lesions consist of an ulcerating granuloma on the left heel ; pigmented patches 

 over the buttocks, posterior surface of the left leg, and the abdomen. Over the 

 sternum there is a scar measuring about 4 centimeters in diameter. There are 

 also large scars over the right side of the neck, which are reddened and have 

 evidently recently healed. There are two granulomata measuring about 3 and 4 

 centimeters in diameter on the right side of the neck and one of the left forearm 

 measuring about 3 centimeters. A smear from one of these shows spirochete. 

 The patient was given 0.28 gram of dioxy-diamido-arsenobenzol in the usual 

 manner. Fifteen days later the granulomatous lesions had entirely disappeared. 

 On the heel was a small clean scab. When seen one week later the heel also was 

 perfectly clean. There has been no return of the eruption. 



Case VII. — Ciriaco; male; age 16 years; duration of disease ten months. The 

 lesions consist of an ulcerating granuloma situated above the right ankle, and 

 measuring about 6 centimeters in diameter. Over the left external malleolus 

 there is a small ulcerating patch measuring about 3 centimeters in diameter. 

 There is also a small ulcerating granuloma over the left great toe. A smear from 

 this shows spirochetal and a few bacteria. There are pigmented patches scat- 

 tered over the skin of the whole left leg and over the thigh. These patches are 

 evidently the results of healed lesions. The chest and back are clear. The 

 patient was given 0.3 gram of dioxy-diamido-arsenobenzol in the usual manner. 

 He was seen nine days later, when the lesions had almost disappeared. Twenty 

 days later they had entirely healed. He has since remained well. 



Case VIII. — Buenaventura; age 10 years; duration of disease stated to be 

 eight months. The lesions consist of a granulomatous ulcer situated above the 

 left ankle, measuring about 5 centimeters in diameter. There are smaller ulcer- 

 ated granulomata over the right ankle. There are pigmented patches over the 

 knees and over the back of the thighs and legs. On the neck there are four 

 papular tumors measuring about 1 centimeter in diameter. A smear from one 

 of these shows spirochete. The patient was given 0.3 gram of the preparation 

 in the usual manner, and when seen twenty days later the skin was smooth and 

 the' active lesions were entirely healed; there has been no return of them. 



Case IX. — Maria; age 25 years; the mother of Case V; duration of disease 

 (?). The lesions consist of four granulomata ranging from 2 to 4 centimeters 

 in diameter, and situated on the buttocks and one within the gluteal fold. A 



