The opportunity was recently afforded me of studying a patient suffering from late syphilis, on whose elbows and knees were symmetrical, extremely hard, subcutaneous nodules, which had existed unchanged for two years. That the patient was syphilitic was evident from the Wassermann reaction (++++) and a characteristic group of nodules arranged in a circinate manner upon one arm. The appearance of the hard, symmetrical, subcutaneous, nodular masses did not correspond, however, with any clinical manifestation of syphilis with which I was familiar. The usual conception of a nodular syphilid, I considered, was that of firm (but not extremely hard) nodules, asymmetrically placed, with a tendency to change in size and configuration and to ulcerate. The history of the case which forms the basis of this communication is as follows:
REPORT OF CASE
History.—
A. P., a negress (of about three-fourths pure blood), aged 45, born in the United States, and who