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918 maxillary and nasal bones. For æsthetic reasons they were removed by the chisel, and were found to consist of compact bone with a cancellous core. Strachan states that he had seen two similar cases, and had often noted a "ridge" in this part of the face of West Indian negroes. He suggests that the condition may be an example of atavism, referable to some tribal peculiarity of the original West African stock.

Fig. 223.—Goundou in a West Indian child. (Dr. Henry Strachan.)

Chalmers has given an admirable and well-illustrated account of this affection as seen on the Gold Coast, where it is fairly common and is known as "henpurge." He confirms Strachan as to the anatomical characters of the swellings, which he regards as the result of an osteoplastic periostitis due to yaws. He affirms that the morbid process begins during, or soon after, an attack of yaws, and is correlated in some way to an anatomical arrangement of the blood-vessels of the parts, an arrangement which, he gives the reader to infer, is peculiar to the negro of this part of Africa.