ositive involvement ot the central nervous
system has not been shown, but some of the nerve trunks are found to be
inflamed and swollen, with a tendency toward hardening.

#What several diseases are to be eliminated in the diagnosis of leprosy?#

Syphilis, morph[oe]a, vitiligo, lupus, and syringomyelia.

When well advanced, the aggregate symptoms of leprosy form a picture
which can scarcely be confused with that of any other disease. In
doubtful cases microscopical examinations of the involved tissues, for
the bacilli, should be made.

#State the prognosis of leprosy.#

Unfavorable; a fatal termination is the rule, but may not be reached for
a number of years. The tubercular form is the most grave, the mixed
variety next, and the anaesthetic the least. Patients are not
infrequently carried off by intercurrent disease. Proper management will
often delay the fatal ending, and exceptionally, in the anaesthetic
variety, stay the progress of the disease.

#What is the treatment of leprosy?#

Hygienic measures are important. Chaulmoogra oil and gurjun oil
internally and externally are in some instances of service. Strychnia
alone, or with either of these oils, is ofttimes beneficial. Ichthyol
internally, and external applications of the same drug, and of resorcin,
chrysarobin, and pyrogallic acid, have been extolled. Change of climate,
especially to a region where the disease does not prevail, is often of
great advantage.

#Pellagra.#
(_Synonym:_ Lombardian Leprosy.)

#Describe pellagra.#

Pellagra is a slow but usually progressive disease occurring chiefly in
Italy, due, it is thought, to the continued ingestion of decomposed or
fermented maize. It is characterized by cutaneous symptoms, at first
upon exposed parts, of an erythematous, desquamative, vesicular and
bullous character, and by general constitutional disturbance of a
markedly neurotic type. A fatal ending, if the disease is at all severe
or advanced, is to be expected.

Treatment is based upon general principles.

#Epithelioma.#
(_Synonyms:_ Skin Cancer; Epithelial Cancer; Carcinoma Epitheliale.)

#What several varieties of epithelioma are met with?#

Three--the superficial, the deep-seated, and the papillomatous.

#Describe the clinical appearances and course of the superficial variety
of epithelioma.#

The superficial, or flat variety (_r