Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 1.djvu/311

 the surrounding skin — and present a smooth tense surface ; they increase slowly in size and some of them coalesce. After a certain time the surface of the patches becomes somewhat wrinkled ; superficial cracks appear as white lines intersecting the brown surface of the patches ; later, they become deeper ; the epidermis splits, and flaky curled- up scales, whitish inside and dark on the outer surface, are often seen : these scales are removed by friction, when whitish round patches remain.

The eruption never develops in concentric rings like Tinea inihricata, the patches remaining isolated or fusing together to form irregular large areas. After a time, a few of them may disappear spontaneously. The general health of the patient does not seem to be aflfected. In some instances there is a slight degree of eosinophilia, which, however, may be due to intestinal worms.

Transmission of the Disease. — I caused one of the patients to scratch with his nails some of his patches and then to scratch a healthy Tamil coolie (who volunteered for the experiment) on the arms and upper part of the chest. On the arms nothing developed ; on the chest at the inoculated place there was — on the second or third day — much itch- ing ; and on the fourth day two tiny dark, very slightly elevated, roundish spots appeared. These enlarged slowly, and a few days later their surface showed several whitish cracks. Unfortunately, at this stage, the coolie, who com- plained of great itching, scrubbed himself thoroughly with sand soap, and the eruption disappeared.

The Fungus. — If a portion of one of the brown patches or a scale be removed and examined in Liq. potassae, the fungus is easily detected. It grows between the superficial and the deep strata of the epidermis, and is present on the inner surface, but not on the external aspect of the scales.

The organism presents the general characters of a trichophyton ; but what is very remarkable is the extreme