Henpuye starts in a native of West Africa during or soon after an attack of yaws in which there is a history of the nasal mucous membrane being attacked as a small bony swelling symmetrically placed on either side of the nose. This swelling, which is generally oval with the long axis directed downwards and outwards, is attached to the nasal bones, the nasal process of the superior maxilla, and also to the superior maxilla in the more advanced cases. It is produced by the deposition of new bone under the periosteum on the external aspect of these bones and grows slowly in all directions. It in no way affects the mouth or the orbital or nasal cavities in any case which I have seen, and the nasal ducts are quite unaffected. Rarely the growth is asymmetrical, being situated only on one side of the nose. Pain in the nose and the presence of a sore in that organ are the symptoms complained of at the commencement of the disease; later headache is sometimes felt, and pain in the swelling during wet weather. As the growth becomes larger it seriously interferes with the sight by growing up in front of the eyes and even hiding them, but I have never seen it cause destruction of the eyeball. In many cases the patient has to bend his head downwards in order to be able to see over the tops of the swellings. The skin over the tumor is normal and is freely movable. The course of the disease is that the swellings may cease to grow at any period of their existence or may continue to grow for years—that is to say, they may remain quite small or may grow to be large lumps, in the latter case giving rise to the deformity and the interference with the sight, but I am unacquainted with any case in which they break down or ulcerate. Finally, the disease is much more common, in my experience, in men than in women. DESCRIPTION OF CASES. The following cases will be described: (1) slightly developed cases; (2) moderately developed cases; (3) an advanced case; and (4) an asymmetrical case. _Slightly Developed Cases._—CASE I.—The patient, a boy of about seventeen years of age, said that about seven years ago he noticed two small lumps on the nose which began after yaws in which there was a sore in the nose. They increased slightly in size, but soon ceased to grow and have been in their present condition for some years. He never felt any discomfort or pain in them. The two lumps had their long axis directed downwards and outwards, the measurements being half an inch by a quarter of an inch. They were attached to the nasal bones just above the cartilages and the nasal process of the superior maxilla, and were firm, smooth, bony tumors. The skin over them was quite normal and they did not in any way project into the nasal cavity or affect the line of vision, being too small for the latter purpose. There was very little deformity and no treatment was necessary. In this case the lumps soon ceased to grow.