— 63 4 — 
into the uncier lying tissue, but there is no actual inva¬ 
sive process and there are no isolated masses of prickle cells. 
In these respects the condition resembled a papilloma. It is wor- 
thy of note that Bitter and Ferguson in Egypt hâve recently 
discovered a species of Leishmania in ulcerated papillomatous 
lésions on the limbs of Egyptian fellaheen (See paper bv Day-Fer- 
guson, in Arm. of trop. Med . a. Paras , vol. III, n° 3, nov. istoç). 
The cell nests, however, are most typical. At the centre of 
one of the nests, there is a clear glistening oval body about 
28 u x 18 y containirig numerous grains of what is undoutedly 
pigment. It is évident that there has been a hyper-chondrifrac- 
tion of the stratum corneum, as the body stains in the same way 
as the horny laver, giving rise to this curious appearance, an 
appearance not unlike a large molfuscum body but clearer, more 
glistening and as mentioned, studded throughout with pigment. 
It is known that in the negro’s skin pigment granules may be 
traced from the stratum granulosum to the outermost layers of 
the stratum corneum. The same is no doubt true though to a 
less extent, of the Egyptian. The cells of the rete shoAV marked 
perinuclear vacuolation while the papillary layer of the skin is 
hypertrophied or at least appear to be so, invading and even 
cutting off and disintegrating portions of the rete while itself 
invaded by infiltrating cells. There are islands of cellular 
tissue studded about in the mass of the princkle cells (fig. 5). 
In these earlier sections the sub-epidermic tissue présents the 
appearance of a cellular connective tissue undergoing inflamma¬ 
tion and some prolifération and does not apparently conform to 
the descriptions in English text books and papers of subepide- 
mic tissue in oriental sore, albeit examination with high powers 
of the microscope showed that the cytoplasm of numerous large 
cells with vesicular nuclei was full of Leishman bodies. These 
showed up best in sections stained by Van Gieson’s method or 
by haematin. Free parasites were also visible in the dilated ca- 
pillaries, in mononuclear leucocytes lying amongst the cells, no 
doubt as a resuit of diapedesis and between the cells themsel- 
ves presumably in the sero-fibrinous effusion. Some of the smal- 
ler vessels in this tissue showed distinct endarteritis. 
At this stage one may quote the description given by Fordyce 4 of the 
histo-pathology of multiple benign cystic epithelioma. He savs that under 
the microscope the tumours are seen to be a made up of irregularly rounded, 
oval and elongated masses and tracts of épithélial cells corresponding to 
