Book II ELEPHANTIASIS 163

turn various colors with varying degrees of hardness, rough—
ness and attenuation. In one place it turns livid, in another
white, in another dark red; some parts of the skin become hard,
others softer, or again, rough and scaly, or thickened like leather
that has been hardened by fire. At the same time hard and
for the most part purplish pustules appear over the whole body;
these in the course of time become ulcerated and discharge
pus,55 though not much, and drier than it is in syphilis. The
adjacent members swell, and some are contracted, others length—
ened. Hence, in many cases, the nose becomes hollow, the
mouth on both sides is stretched towards the ears, the eyes as—
sume a rounded form and become like those of satyrs in paint—
ings. Hence this disease has often been called 'satyriasis?
also; though some think that it is called satyriasis because of
the abnormal sexual excitement that accompanies it.**  Then
the toes and fingers begin to swell, and the feet come to
resemble those of an elephant. Some authorities claim that
this is the reason why it is called elephantiasis.  Archigenes,**
however, says that it is so called because of the magnitude of
the disease. Moreover the small blood—vessels under the tongue
become like varicose veins, the patient feels itching, and with
it violent sexual excitement. Presently the patients smell
badly and so become unendurable, and in many cases the skin
of the whole body turns white, a condition which is held to be
incurable.

"TThis disease is contagious, not only by contaect but also by
fomes, and even from the patient's breath, though it is slow to
insinuate and propagate itself. It attacks men more than wo—
men, and very few eunuchs have been observed to contraet
this malady, hence we read that some persons have castrated
themselves in order to avoid being attacked by it. In some
countries, for instance Egypt and Judaea, it is domesticated,
while other countries are hardly acquainted with it.  Generally
speaking, those parts of the world which have the extremes of
heat and cold suffer more from this malady than countries with
a temperate climate. So Aetius states, on the authority of
Archigenes. Hence the Germans, Scythians and Arabs are
especially liable to it. Galen, however, seems to contradiect
Archigenes, for he says that the Germans and Scythians are
free from this disease.*5  The Italians and Greeks are less liable
to it. It certainly has appeared rarely in Italy at all times,