152 
these cases to the present paper. Wc desire further to acknowledge 
our indebtedness to Professor Bitter for allowing us to reproduce 
his excellent micro-photographs of the parasites seen in PI. XIV, 
figs. II, 12, 13. 
1 here is no doubt that this condition was equally common in 
the past, and the diagnoses show that there was less difficulty in 
distinguishing it from other diseases than in finding a suitable 
name for it. Among the names previously employed by various 
English and Egyptian members of the staff, we find ‘ papilliferous 
degeneration of skin’; ‘chronic benign papilloma’; ‘pseudo¬ 
epithelioma’; ‘false elephantiasis’; ‘hypertrophic dermatitis'; 
‘lupus erythematosus exanthematosus’; ‘granuloma of foot’; 
‘partial ichthyosis’; ‘parasitic growth’; ‘fungous growth'; 
‘ fungating granuloma.’ 
Cases bearing these very varied titles seem, as far as we can 
gather from reports, and in some cases observation, to have 
belonged to the class described above. These names are interesting 
as showing the clinical features which struck a number of different 
observers in individual cases. 
Incidence. In the ten cases we have selected, the age of the 
patients varied from eighteen to sixty, with an average of thirty; 
they weie all males, and with the exception of two students, all 
fellaheen. Five of them were affected on the forearm or hand, 
four on the legs or feet, one on the face. Half of them had single 
lesions, half multiple. The duration of the disease varied fro 
six weeks to ten years; excluding the last figure they averaged s: 
months. 
Consequently, as far as we can conclude from so few cases, tl 
disease, as we meet with it, is one affecting male fellaheen at an 
time in their adult working life, it may be single or multiple, an 
it affects the arms and legs about equally: the patients usual! 
apply for relief about six months after the disease has begun. 
We have never obtained any history of similar cases in the san 
ylla^e from which infection might have been acquired. XV hci 
infection is multiple, the lesions are usually near one anothe 
his may be due to simultaneous infection,"but more probably 
especially where there is an interval of time between them, t 
auto-inoculation from scratching. 
k 
