Henpuye starts in a native of West Africa during or soon after an attack of yaws in which there is a history of the nasal mucous membrane being attacked as a small bony swelling symmetrically placed on either side of the nose. This swelling, which is generally oval with the long axis directed downwards and outwards, is attached to the nasal bones, the nasal process of the superior maxilla, and also to the superior maxilla in the more advanced cases. It is produced by the deposition of new bone under the periosteum on the external aspect of these bones and grows slowly in all directions. It in no way affects the mouth or the orbital or nasal cavities in any case which I have seen, and the nasal ducts are quite unaffected. Rarely the growth is asymmetrical, being situated only on one side of the nose. Pain in the nose and the presence of a sore in that organ are the symptoms complained of at the commencement of the disease; later headache is sometimes felt, and pain in the swelling during wet weather. As the growth becomes larger it seriously interferes with the sight by growing up in front of the eyes and even hiding them, but I have never seen it cause destruction of the eyeball. In many cases the patient has to bend his head downwardsin order to be able to see over the tops of the swellings. The skin over the tumor is normal and is freely movable. The course of the disease is that the swellings may cease to grow at any period of their existence or may continue to grow for years—that is to say, they may remain quite small or may grow to be large lumps, in the latter case giving rise to the deformity and the interference with the sight, but I am unacquainted with any case in which they break down or ulcerate. Finally, the disease is much more common, in my experience, in men than in women.