474 LEFEBVRE. 



I sometimes met with the first species in leprous ulcers. I found it 

 also in. many eases of suppurative dermatitis following an infection of 

 the itch and- in the erosions caused by scratching. Some of the cases 

 were very severe, ,and one might even have thought the lesions to be 

 leprous manifestations; the feet and the lower part of the legs in par- 

 ticular were tumefied, very painful, the derma was exposed in many places 

 and yielded a continuous flow of seropurulent fluid. The fact that two 

 or three of these patients had leprous ulcers coexisting on the feet made it 

 all the easier to mistake this infection for an exacerbation of acute leprosy. 

 However, this disorder was due solely to the acarid of which I speak: in 

 fact, the bacteriologic examination of the pus, of the serum, or of the 

 scrapings of the diseased parts revealed no Hansen bacilli except at the 

 precise place of the preexisting leprous ulcers; the disease yielded in a 

 few days to the specific treatment for itch, and nothing was afterwards 

 seen on the skin except the well-defined leprous ulcers which were there 

 previously. 



This is not the first time that the presence of Tyrogiyphus or some 

 other saprophytic acarid has been remarked in ulcers, or in neglected 

 sores, as is evidenced by all doctors who have treated sores of long-stand- 

 ing, ulcers, cancers, etc., among the poor and persons not scrupulously 

 .clean. Leprologists themselves have often noticed it. I call attention to 

 it because of one point which touches on our subject; that is, that neither 

 in analyzing the pus nor in examining acarians themselves, was I able 

 .to discover the Hansen bacillus except at the exact place of preexisting 

 leprous ulcers, or in their immediate vicinity. This fact is all the more 

 significant because Tyroglyphi are very migratory acarians and even fairly 

 active ones, and also because the suppurative dermatitis is confluent with 

 leprous ulcers. 



From this statement it seems, that Tyroglyphi also should be eliminated 

 from the number of normal bearers of the contagion of leprosy. 



I wish merely to mention the other acarid of which I spoke and which 

 appears to be similar to the genus Tyrogiyphus. It presented an un- 

 expected characteristic, for I discovered it not in open ulcers but in the 

 serum from small, closed pblyctena?. I was unable, in any of my observa- 

 tions with the magnifying glass, to find the opening by which this parasite 

 made its way through the epidermis. As it was found on two patients 

 infected with the itch, and as these phlyctence were near the furrows of 

 the itch on one patient especially, it is a question whether there is any 

 connection between its work and that of the Sarcoptes or just what this 

 connection may be. Certainly there is no relationship, for these two 

 parasites differ as much from each other as does Sarcoptes of the itch 

 from Tyroglypmis. On the other hand, this new acarid, judging from 

 its habitat, is not a saprophyte, but a parasite. No acarian parasite 

 within the human skin is known at the present time except Sarcoptes of 

 the itch and Demodex. 



