We have been able to examine anatomically a few of the cases of articular affection referred to above, but we have not seen instances of the acute affections on the post mortem table. R. Thoma has described clinically and anatomically a case of _lepra tuberosa_ (_Virchow’s Archiv_, Bd. 57), in which first the elbow, and later the knee joint, was affected. Examination of the knee joint showed an inflammatory irritation of the nature of hæmorrhagic gonitis. Where we have noted joint affections in the maculo-anæsthetic form we have only noted a condition of hydrops. The chronic affections we may indicate as tubercular and tropho-anatomical. Tuberculosis attacks the joints of lepers by no means infrequently, as is easily explainable in the case of those already tubercular, by the frequent traumata to which the anæsthetic and paretic lepers are exposed. The carpal and tarsal joints are most frequently affected; but we have also seen the knee and elbow tubercular. The process is exactly the same, as in those who are not lepers. Chronic trophic joint affections are by no means so rare as was formerly believed. Prof. H. Heiberg has (_loc. cit._) drawn attention to this, and has described a foot which resembles that described by Charcot as _pied tabétique_. According to Heiberg a characteristic of these leprous tropho-neurotic joint affections is swelling and laxness of the capsule of the joint, a wearing away and atrophy of the ends of the bones, or _periostitis ossificans_, and hypertrophy of the ends of the bones, which is especially seen in the tarsal and metatarsal joints. We have been able to confirm these results of Heiberg’s, and have also seen in such an ankle, growth of the synovial membrane with villous projections; the capsule of the ankle joint was loose and lax, the talus smooth and oblique, the cartilage worn away; and marked outward subluxation of the foot was present. Other older spirit preparations showed changes in the joint capsule, which was flabby and loose or thickened, and further, slight irregular thickening of the synovial membrane, and thickening of the ends of the bones. We have also in some cases examined the tendon sheaths; but never, even when contraction had existed for a long time did we find any anatomical changes, which pointed to a tendo-vaginitis. Leloir and Wolff have noted this clinically, but we have been unable to confirm their observation. The pemphigoid bullæ we have repeatedly examined, and never found lepra bacilli in their contents; both microscopically and on culture we have found only pyogenic cocci, usually the staphylococcus aureus. Müller found (according to Neisser, _Virchow’s Archiv_, Bd. 103) lepra bacilli in the contents of a pemphigoid bulla. This was probably a mere accident. For other morbid changes found in maculo-anæsthetic leprosy the reader is referred to TABLE I, page 128.