man’s method, with Heidenhain’s iron-haematoxylin, with hae- 
matin, Vax Gieson’s stain, eosin and methylene blue, haemato- 
xylin and thionin blue and, following Nattan-Larrier and Bus- 
sière 14 , with carbol-thionin. 
The appearances presented by these sections were much more 
like the description quoted. There was not nearly so great a 
prolifération of the rete Malpighi, though here also, in some 
parts, a tendency to downgrowth and to the formation of cell 
nests was noted. A study of the sections stained with eosin 
and methylene blue, however, showed that the cells pré¬ 
sent in the sub-epidermic laver, answered very closelv to those 
mentioned by Wright. Indeed ail the classical signs were to be 
observed and there could be little cloubt that the condition was 
identical with that found by manv observers. In these sections 
there were not as a whole nearly so manv parasites as in those 
of the small growth first examined and they seemed to be con- 
fined to the endothélial cells and the mononuclears. In certain 
areas, however, sections stained with carbol-thionin and care- 
fullv differentiated with spirit showed a heavv infection of the 
cells. 
At certain points, the infiltration of the epidermic layers by the 
round-celled growth was évident but at most points there still 
persisted a considérable layer of the rete. We could find no évi¬ 
dence of actual necrosis nor were giant cells visible. It was not 
until we consulted the recent French work on tropical medicine 
by Jeaxselme and Rist that we found a description of anything 
like the condition seen in the sections of the first small growth 
observed. There, however, we came across an excellent account 
of rhe histo-pathology of <( Bouton d’Orient ». These authors 
State that the dominant changes consist in a thickening of the 
rete Malpighi (hyperacanthosi and an incomplète keratinization 
of the corneal laver (parakeratose). The prickle cells are sepa- 
rated one from the other by an interstitial oedema and perinu- 
clear vacuolation occurs. They go on to describe the State of the 
sub-epidermic tissue in much the same way as, other writers but 
lay stress on the foci of necrosis and the presence of giant cells. 
Their diagrams, both of skin sections and of the peripherv and 
centre of a tvpical inflammatory nodule, are very instructive and 
save for the absence of cell nests and the presence of the giant 
cells might apply to oui* sections of the small growth first remo- 
ved and studîed. 
