Of the facial muscles the orbicularis palpebrarum is most apt to show paralysis. The eyes are affected much less frequently in nerve leprosy than nodular, 45% as against 85% for nodular leprosy. The most common changes in nerve leprosy are ectropion of the lower lid and subsequent corneal ulceration. =Mixed Leprosy.=—In mixed leprosy we simply have a combination of the manifestations of the two main types and as a matter of fact the majority of cases tend eventually to assume a mixed type. SYMPTOMS IN DETAIL _Temperature Course._—On the whole leprosy runs an afebrile course except for the accessions of irregular fever at the time of the appearance of the successive crops of spots. This leprotic fever lasts for a few days or a week or so and then the course becomes afebrile. At such times sweating may be present and suggest malaria. In the final stages of leprosy the patient may run a high fever for long periods, associated with profuse sweating and loss of weight. _Skin._—The raised spots of nodular leprosy tend to come out in numbers on lobes of ears, over eyebrows and on cheeks, as well as backs of hands and forearms and on buttocks and feet. Soles of feet and palms of hands almost never show spots. In nerve leprosy the spots are often single and flat and often appear on parts of body covered by the clothing, as trunk, thighs or arms. The spots of leprosy are anaesthetic, often showing dissociation of sensation. The indurated spots of nodular leprosy are succeeded by tubercle-like growths. The hair falls out of the areas occupied by the spots. _Mucous Membranes._—The nasal mucosa is in particular studded with nodules which later undergo ulceration. An ulcer of the septum is often the first place from which leprosy bacilli may be obtained. The pharynx and larynx are also involved early. _Nervous System._—Besides the characteristic anaesthesia we have various manifestations of neuritis, especially involving the ulnar, facial and peroneal nerves. The affected nerves show a fusiform enlargement and are tender. Later we have trophic changes in skin, bone and nails of the fingers and toes. Absorption of bones and perforating ulcers are common. Muscle palsies and atrophies, especially the main-en-griffe, are common. The orbicularis palpebrarum is not infrequently paralyzed. The olfactory, optic and auditory nerves are rarely if ever involved. The reflexes are slightly exaggerated. Patients often complain of a sensation of cold. Some authorities have called attention to the frequency of a mental and moral apathy in lepers. _The Circulatory System._—Honeij considers a high pulse rate, especially in the morning, as characteristic of progressive stages of leprosy.