native children; European adults are by no means exempt, but the native adult is rarely affected.
Symptoms.— Pemphigus contagiosus closely resembles certain forms of the impetigo contagiosa of temperate countries, and is doubtless a variety of this class of skin disease. The individual lesions, as can readily be ascertained by inoculation experiments, begin as minute erythematous specks, which rapidly proceed to the formation of vesicles, bullæ, or even large pemphigus-like blebs. The little blister springs abruptly from sound skin; there is no, or very little, areola of congestion. For a short time the hemispherical bleb is beautifully pellucid, tense, and shining. Presently the serous contents become some-what turbid, and the blister gets flaccid and dull. At this stage, from scratching or from pressure, the blister is generally ruptured. The morbid process does not at once come to an end, but proceeds as an advancing, eccentrically spreading exfoliation of the epidermis; an exfoliation which may not cease to advance until an area an inch or more in diameter is denuded of epithelium. Then, in that particular spot, the disease stops, a pinkish, slightly glazed-looking patch, rarely covered with a tissue-paper-like scale, remaining for some time. Occasionally, after the rupture of the primary bleb, vesication may continue in the peripheral portion of its remains. Only one or two blebs may be visible on the entire surface of the body; generally there are many, the disease being spread by the fingers in scratching or rubbing.
Pemphigus contagiosus may occur in almost any part of the body. In young children it is usually diffuse; in adults it is mostly confined to the axillæ and crutch. In these situations it gives rise to much irritation and discomfort, owing to the successive crops of bullse running into each other and rendering the parts raw and tender, and predisposed to boils or some form of eczematous intertrigo. During warm, moist weather it nray be kept up indefinitely by auto-inoculation.
Assistant- Surgeon Soorjee Narain Singh describes a series of cases of a form of contagious pemphigus
