_The longer the disease lasts the more does the neuritis predominate_; the ulnar and peroneal trunks may be felt to be thickened, they are sensitive to pressure, and, if carefully felt for, the peripheral finer branches may be felt as delicate thickened cords. In one case we were able to feel the cutaneous nerve branches in a patch, growing daily more and more thickened, in contrast to the large not especially affected nerve trunk. The large palpable nerve trunks are not equally thickened in their whole length, but the thickening appears about the joints where the nerves run across bone. The symptoms of this neuritis are various; at first neuralgia, and later, widespread anæsthesia, with trophic disturbances, such as the formation of pemphigoid bullæ; we have often seen hydrarthrus and pains in the joints. Motor pareses and paralyses are never absent, but they are not, as Neisser argues, due to a leprous affection of the muscles, but are a secondary neuritic symptom, as we have discovered from anatomical examination of the muscles. As the neuritis especially affects the peripheral nerve trunks, we find the secondary symptoms in the peripheral regions, usually only in the extremities and on the face. We will now more closely consider the various nervous symptoms. Neuralgia is usually present in the extremities, in the ulnar and peroneal regions. The anæsthesia relates to the different qualities of sensation, and is not only present in the patches, but progresses gradually from the periphery toward the centre, so that at last the whole extremity, and often also parts of the trunk, become anæsthetic; the face is always more or less anæsthetic. We have often found thermal anæsthesia present alone, or accompanied by anæsthesia or analgesia. The anæsthesia may become more and more extensive, or it may very gradually disappear, indicating that the neuritis of the affected nerve has disappeared. Trophic and vaso-motor disturbances are never absent if the neuritis is pronounced and lasts for any time; the skin may become œdematous, or it becomes thin, shiny, and slightly scaly (glossy skin). We have often seen, especially if the neuritis has lasted long, and the later symptoms such as mutilation have commenced, dark-coloured hyperkeratoses, usually symmetrical on the front of the leg, or on the dorsal surface of the hands. In one patient we observed on the toes horny, thick (1.5 cm.) symmetrically placed formations, which when thrown off left a new-formed rosy-red skin, with intact sensibility; the patient had on the front of the leg the appearances of ichthyosis. The changes in the nails are a part of the trophic disturbance; they become thickened, brittle and cleft, and sometimes thin and diminished in size, as one finds them, as we shall see later, in the terminal stages. The secretion of sweat is affected, being diminished over the anæsthetic areas, and the hairs there are altered and fall out.