papulo-pustular skin affection which is common in certain parts of tropical Africa, and is often the cause of much suffering to the traveller. It, or a similar disease, is by no means confined to Africa, for I have seen it in patients from India, and was at one time very familiar with it in South China. At the earliest stage the disease begins as an itching papule, very possibly at the seat of a mosquito bite. The itching provokes scratching, whereby some form of pyogenic micro-organism is inoculated. Pustulation follows, and is spread over feet and legs by soiled shoes and stockings and auto-inoculation. In this way an ulcerating, pustulating dermatitis is kept up. Cantlie's "foot tetter" is of this nature. The veld sore of South Africa and the "Barcoo rot" of Australia, if not the same, are similar diseases.
Treatment.—Emily describes a very efficient treatment. Pustules are opened, crusts removed, and ulcers scraped. Boric-acid powder is then dusted freely on the parts after a thorough scrubbing with sublimate lotion (1-1,000), boricated vaseline applied on lint, and over all absorbent cotton and a bandage. The dressings are not disturbed for a week, when the parts will be found soundly healed. Such and similar auto-infective diseases of the hands and feet, so common in the tropics, I used to treat with a foot-bath of warm carbolic-acid lotion (1-20), followed by dry dressing with abundance of boric-acid powder, at the same time insisting on destruction of infected slippers, shoes, and stockings.
CHAPPA
Under the name "chappa" Read describes a disease which he has met with in the western district of the colony of Lagos. During two and a half years he has seen six examples, two in males, four in females. He thus describes it:—
"The patients all give the same history. The disease commences with severe pains in the limbs, muscles, and joints. After a few months the pain decreases, and some joints begin to swell and convey the sense of fluctuation. About the same time nodules develop in different parts of the body. These nodules are in the subcutaneous tissue, and are about
