Dick (1947) described the structure and arrangement of elastic tissue in normal and in oedematous skin. In this paper the resistance of the skin to stretching is investigated and the part played by elastic tissue in the tension of the skin is discussed. Hass (1939) reviewed the properties ofelastic tissue in general and emphasized, as had the German school at an earlier date (Sternberg, 1925), that changes in staining properties of elastic fibres did not necessarily signify changes in function or structure of the fibres. In later studies on the aorta, Hass (1942, 1943) freed the elastic fibres by a severe chemical process and tested their extensibility, retractility and maximum tensile strength. Krafka (1937Krafka ( , 1939Krafka ( , 1942) also studied elastic tissue, muscle and collagen fibres in the aorta, and concluded that collagen fibres act as a check against over-distension of the elastic and muscle fibres at high pressures. He thought that there was no change in the elasticity of elastic tissue with advancing agebut he was using results from ligamenta nuchae of oxen. Saxton (1942) showed that in some animals, e.g. the rabbit, vascular changes are not found in advancing age as in man.The limitations to the precise study of the elasticity of the skin and of the fluid content of the subcutaneous tissues were recognized by Crosti (1933) when he reviewed the information given by the 'elastometer'. This instrument, introduced by Schade (1912) and elaborated by Schwartz (1916), by Kunde (1926) and others, records the effect of removing a weight which has been pressing on the skin for a stated period.Sodeman & Burch (1938) measured with a calibrated spring caliper the extent of stretch of skin in different areas of the body, but they could not calculate the stretch per unit area or the resistance of the skin to stretching.

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Visitors to the hospitals of Papua New Guinea are often surprised by the many beds occupied by young men with an asymmetrical arthritis, predominantly affecting the legs. Scrutiny of their notes often elicits the enigmatic term "tropical arthritis." Such patients have been the subject of several studies. Maddocks came down firmly in favour of Reiter's disease as the diagnosis in most of these cases.' A later study from Goroka Base Hospital founTd no extra-articular manifestations of Reiter's disease and concluded that the disease was a distinctive type of arthritis of unknown aetiology.2 Subsequently Brewerton et al described a close link between HLA-B27 and Reiter's disease.3 HLA studies in patients with arthritis in Papua New Guinea have not previously been published. Patients, methods, and results We studied 64 patients with arthritis, who presented to the physician (JER) at Goroka Base Hospital between October 1984 and March 1985. During this period only four other patients with arthritis were seen (two with gout, one with osteoarthritis, and one with rheumatic fever). All patients were examined by JER. Sixty two were of highland origin and two were from the coast. Histocompatibility testing was done by the procedure outlined by Bhatia et al.4 The frequency of HLA antigens in the patients was compared with that in 128 Papua New Guinean blood donors matched for age, sex, and province of origin (two controls per patient). HLA-B27 was found in 45 (70%) of the 64 patients and in 16 (13%) of the 128 controls. It was present in all 10 patients with the classic triad of symptoms of Reiter's disease and in 13 (87%) of the 15 patients with less complete forms of Reiter's disease (table). Information about sexual exposure before arthritis was not readily obtained. Shigella flexneri serotype I had been isolated from one patient during an earlier admission for dysentery. Keratoderma blennorrhagicum and other mucocutaneous lesions (except balanitis) were not seen. HLA-B27 was noted in 22 (56%) of the 39 patients with symptoms confined to joints.

1. The laboratory findings in a series of 215 cases of enteric fever are described and discussed, with special reference to early diagnosis.2. In the majority of the cases reviewed, the leucocyte count was about the lower level of normal limits, though considerable variation both upwards and downwards occurred.3. Blood culture was a very satisfactory and early method of diagnosis; the method used is described fully.4. Certain variations from normal in the behaviour of the organisms were encountered and are described.5. Bact. faecalis alkaligenes was isolated from blood culture in five cases in which enteric group organisms were also isolated from blood, faeces or urine and in three which were clinically enteric fever. The relation of these observations to the possibility of primary Bact. faecalis alkaligenes septicaemia is noted.6. Seventeen cases were fatal. The causes of death are described.

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