The cases are very frequent in which the patients have for several years only scattered nodules, and then suddenly a fresh outbreak of numerous nodules. The disease always advances by outbreaks of eruptions which repeat themselves at longer or shorter intervals. It is very often the case that the older nodules soften during a fresh outbreak, and completely or partly disappear; and these outbreaks are always accompanied by fever, the temperature rising to 39° or 40° Cent. Now we know that the nodules, if the patient is affected by another febrile disease, may disappear. It is, therefore, difficult to decide whether the disappearance of the nodules is the cause or the result of the eruptive fever. But we possess certain observations in which the disappearance of the nodules has begun before the onset of the fever, and in which, therefore, the fever and the later eruption appear to be caused by the softening of the nodules. Supported by these observations we regard the eruptions as auto-infections, in which bacilli (or poison) from the older lepromata pass into the blood, and thus new areas of the skin or other organs are affected. We have often observed that an irido-cyclitis, or an affection of the throat, arises during an eruption, and also that the nerves beneath the nodules become swollen and painful, and once we have seen the testicle become swollen and painful during an eruption. As to the affections of the liver and spleen we have no clinical observations; they appear to cause no clinical symptoms, or at all events, such indefinite ones that, although our attention has been directed to them, they have escaped observation. _The eruptions are of the most varied duration._ Some last only a few days and cause so little fever that the patients experience no particular disturbance to health; they only know that a few new nodules appear, or that they are sore about the throat. Others last for weeks, indeed, months, with remittent fever, the temperature rising to 40°. Quinine has no effect. During such eruptions the strength of the patients is of course distinctly diminished, but when the eruption is over they recover rapidly and feel themselves all right again; only they are more leprous than before, or at least have more leprous manifestations. The number of eruptions varies greatly in different cases. Sometimes the patient has, for several years, several eruptions every year; in other cases the eruptions appear only very rarely--one or two in the whole course of the disease, and they may be very slight. It appears as if the bacilli in different cases were of varying virulence, or possibly the structural conditions are different in different individuals, so that in some the bacilli (or the poison) reach the blood more easily than in others.