back, and elsewhere; all or any of these for months may herald the explosion of unequivocal leprosy.
Another curious feature in early leprosy, also noted by Leloir, is the liability in many instances to excessive sweating, which comes on without apparent or on very slight provocation. I had once under observation an Englishman who subsequently developed leprosy, in whom this prodromal symptom was particularly pronounced, so pronounced that he had remarked it himself. This gentleman for many years kept a diary in which, among other things, he recorded very carefully matters relating to his health; so that it was easy to trace from this diary the gradual evolution of his leprosy. The first unequivocal manifestation of the disease, an extensive erythematous patch on the ulnar side of the left arm and hand, which afterwards became anæsthetic, and two or three pigmented spots on the cheek, back, and leg, was noted on March 3rd, 1894. Five years before this there is an entry in his diary, under date June 4th, 1889, of the first of a long series of severe headaches, transient febrile attacks, and progressive deterioration of health and vigour. Under date of June 9th, 1892, is the first mention of the profuse perspiration which, occurring without obvious cause, continued to be a prominent feature until several months after the appearance of the skin lesions referred to. In the diary such entries as the following frequently occur : " Nov. 20th, 1892. Feel poorly and sweating inordinately; wondering what is coming over me. I am very ill." " Dec. 5th to 19th, 1892.— 111 in bed. 1 had furious sweats during this time, and had dreadful pains in the back, the lower part." And again: "Dec. 21st, 22nd. Feeling very ill; awful sweats; weak; done up." As pointed out by Leloir, this hyperidrosis may be general or it may be confined to particular parts, generally the trunk, the limbs being unaffected or even being the subject of anidrosis. A still more limited anidrosis is sometimes noted; it usually happens that these non-sweating Spots become anæsthetic at a later period of the disease.
