On Creeping Disease

the itebiug i^art iu preference to the extremity and cut it together with the small nodule in a wedge-like numner.Fortunately he was right in his judgment and could demonstrate a larva wrapped np in chitin as iu a sack in the coriiim.After the treatment the itching entirely stopped, and the line disappeared, gi'adnally with no sign of reajijpearance.As to the line, it began on the right buttock and extended obli(|uely above the waist.It changed its direction about eight times almost at right angles to each former course, with little curves and crooks here and there.From this point it proceeded serpiginously to the middle of the back and then went up obliquely towanls tbe left shoulder.The line looked like tangled thread on the shoulder and tbe back.Tlie exact length conld not be ascei-taiued, but as it traversed an adult's back from the right l.iuttock to the left shoulder it was cei'tainly very long.It took about fifteen days to form the wl)ole line.It WMS red brown in colour and from 1 to 2 mm. in breadth.The line was interrnpted here and there, forming dott^?d lines.Where its direction was changed, especially at right angles, it formed round papules as large as hemp-seeds and was raised very markedly above tlie skin level, but all the rest of the line was not raised.This case belongs to the erythemato-papular form.(2) Dr.Sakai'scase'*'': A man, aged32yenrs.He came to his hospital on Noveml'f^r 1st.1908, with the diagnosis of parasitic-like inflammation, and left it in tlnve weeks completely cured.On the fifth day after he came Dr. Sakiii happent'tl to find a dark-red linear, slightly cun'"ed.irregular raised lesion ou tbe right side of the navel.In four days the irregular line became marked iu form and was perceived creeping in a defijaite direction.On the seveuth dny it abruptly struck otf outwards almost at right angles and advanced 3i cm. in a day.For three days following no marked extension was perceived, but on the twelfth he saw a circular diffused erythema as large as a finger-end at the extending end of the line.The erythema was most vivi<l in the centre, and the boundary between the erythema and the healthy skin was not clear.It disappeared altogether in two days and another iiTegular creeping line like the first appeared instead.On the sixt^Hnth it extended straight ujijward and inward, and again at its extremity another distinct erythema appeared.Here he excised a piece of skin I'* cm.wide and 'S cm.long at the ^progressing end.Tbe appearance of the dark-red creeping line dated from only a few days after the disease began The rate of its progression was not regular.It was looping and curving.The elevation and size of tbe line was generally uniform.But here and there were somewhat thick, knotty spots.The colour and elevation were most marked iu the extending end of the line but faded as it neared the beginning.The most remarkable feature was that now and then the extremity of tlie progressing part showed a pervading erythema, and that when it ceased brouglit a curving line in its place.Surveying the whole lesion one noticed that the Hne was not exactly continuous, but gave an appearance of interruptions.The whole length of the line was 5.j cm.As a subjective symptom the patient felt pr in the progressing part.No parasite was found, nor was any histological investigation made.This case belongs to the erythemato-papular form.