From a 16th century monastery to a 21st century orthopaedic hospital.

bmj.com). The demon for boils and skin diseases has skin lesions that look like carbuncles on the face (fig 2, left). It is not surprising that the masks for malaria and high fevers (fig E on bmj.com) and for cholera and chills (fig 2, middle) are similar and have fiery red complexions. The mask for high fevers can usually be distinguished by flames across the forehead, which may be reminiscent of the temperature chart from a febrile patient. The mask for lameness and paralysis always has a unilateral facial deformity that could represent a neurological lesion such as stroke (fig 2, right). The mask for bilious diseases usually has a yellow or orange complexion suggestive of jaundice. Hence the sanni demons do seem to represent disease syndromes, and their masks show clinical features that are familiar to clinicians today. This classification of disease has considerable merit, especially considering its origin among non-medical practitioners many centuries ago. Sri Lanka has an ancient history of medical achievements, including the first recorded hospitals and a system of Ayurvedic medicine that dates from the 4th century bc. Our observations should further enhance this reputation. In an era of “faceless” diseases, clinicians may wish to “know their enemy” by being aware of masks relevant to their own specialty.We hope this will lead to cultural enrichment and give the sanni demons the recognition they deserve.