FEEJEE GROUP. 397 
peculiar to this group of islands, is what the natives call the “ dthoke.” 
It somewhat resembles the “ yaws” of the West Indies, so common 
among the negroes. In adults who are afflicted with it, it assumes 
the’ form of secondary syphilis, and those unacquainted with the 
history of the disease, would unhesitatingly pronounce it a syphilitic 
taint. It usually attacks children from two to nine years of age, 
and, according to the natives’ and white men’s experience, none 
escape. Dr. Fox is of the same opinion; every child of ten years of 
age that fell under his observation, had had this disease, and in many 
cases, still had it. ) 
Its first symptoms are fretfulness and inactivity on the part of 
the child; a swelling of the fingers and pains in the bones follow ; 
these pains, which are rheumatic in character, continue at intervals 
throughout the disease, and are followed by small red spots in dif- 
ferent parts of the body. These become round pustules, varying in 
size, and result in ulcers. After the eruption has appeared, the pains 
about the bones cease to be so general. Sometimes they disappear in 
fine weather, but return when it is damp and wet. In other cases 
they lose the fugitive character, but have a constant fixed pain over 
some bone, which is not relieved until the integuments inflame and 
carious bones find exit. 
In the first attack there is much irritation, particularly at night, 
and more or less fever. This also disappears in most cases as soon as 
the eruption is out. The mouth, arms, and umbilicus, ulcerate around 
the whole circumference. The extent of the disease about these 
parts, Dr. Fox thinks is owing to the constant scratching of the 
child. Very large and extensive ulcers, at the same time, exist in 
various parts of the body, some having the appearance of a fungous 
mass. In adults the pericranium is oftener affected than in children, 
the bone is denuded, and frequently pieces of the table of the skull 
come away. In some cases the eruption does not appear, or after 
appearing immediately dries up. ‘These cases are said to prove inva- 
riably fatal. Cases are by no means rare of the loss of the bones of the 
palate and nose. In several instances we observed the upper lip en- 
tirely gone, and the teeth and gums denuded. The females, in particu- 
lar, are very often seen with deep cicatrices about the lips, so much so 
that in making inquiries relative to their customs, I was induced to ask 
Whippy, if making cicatrices in their lips was one of them. Dr. Fox 
imputes it to the dthoke, though Whippy refers it to tattooing: I am 
inclined to believe the former is the true cause. This disease varies in 
duration, from nine months to three years. The ulcerations continue 
longest on those parts of the body that are easily reached by the 
