Now, since on the one hand every _cunnilingue_ is not attacked by _mentagra_, while on the other sometimes ulcers of the inner portion of the mouth, sometimes _mentagra_, and the latter sometimes local, sometimes of wide extent, are noted, the following question calls for an answer. What circumstances conditioned these phænomena and, generally, the special frequency of _mentagra_ in Italy? Leaving out of account a variety of other considerations, we are bound in this place to call in along with other factors of our explanation some special and particular influence of the _Genius epidemicus_ (the aggregate of epidemical conditions at large), which just at that time favoured the rise of skin complaints. However slight the material Antiquity affords us on this point, and especially so far as concerns the time a little before and after Our Lord’s birth, still we _do_ find a datum for Italy at any rate which we certainly ought not to leave unutilized. This is the statement of _Pliny_ (ch. 5. and Bk. XX. ch. 52.) to the effect that it was in the time of Pompey the Great, or according to _Plutarch_ (loco citato) in that of Asclepiades, that _elephantiasis_ first showed itself in Italy. It follows that at that period favourable external circumstances also were in existence in connection with the conditions of disease at large,—as indeed the ready extension of _mentagra_ from the chin onwards to the rest of the body proves even more clearly. But it must not for a moment be supposed that therefore _mentagra_ was of _epidemic origin_. Without at all wishing to embark on the consideration of the ætiological factors of _elephantiasis_, we may just mention the fact that according to Pliny’s account this disease too, equally with _mentagra_, would seem to have always begun with the _face_[117]. The conjecture is all but unavoidable, that very possibly in either case it was the practices of the _cunnilingue_ that supplied the exciting cause for the misfortune; and this would also probably explain how it was _elephantiasis_ came to be connected in men’s minds with the _Morbus phoeniceus_ (Phoenician disease). Still, as already explained, this would only be equivalent to making it responsible in _individual_ cases,—cases that tend inevitably to render the proper understanding of the action of _elephantiasis_, as well as of its history, considerably more difficult. May it not also be to some extent the case that under the general name of _elephantiasis_ forms of disease of very different sorts have been confounded? The views held by the Ancients on this and on the other skin diseases still remain in too much obscurity for anyone to be able to give a decisive judgement on the point. For the rest most probably the _atra lues_ and _scelerata lues_ (black contagion, abominable contagion), spoken of above, likewise come under the category of _mentagra_. This we have felt ourselves constrained to ascribe not solely to the practise of the vice