572 Kala-Azar 



with the artificial cultures containing the flagellate forms of 

 the organism 



TROPICAL ULCER. 

 LEISHMANIA FURUNCULOSA (FIRTH). 



In India, northern Africa, southern Russia, parts of China, 

 the West Indies, South America, and, indeed, most tropical 

 countries, a peculiar intractable chronic ulceration is occa- 

 sionally observed, and is variously known as Tropical ulcer, 

 Oriental sore, Biscra boil, Biscra button, Aleppo boil, Delhi 



i 



Fig. 198. Helcosoma tropicum, from a case of tropical ulcer ("Delhi 

 sore") smear preparation from the lesion stained with Wright's Roman- 

 owsky blood-staining fluid. The ring-like bodies, with white central 

 portions and containing a larger and a smaller dark mass, are the micro- 

 organisms. The dark masses in the bodies are stained a lilac color, 

 while the peripheral portions of the bodies, in typical instances, are 

 stained a pale robin's egg blue. The very dark masses are nuclei of 

 cells of the lesion. X 1500 approx. (Wright). (From photograph by 

 Mr. L. S. Brown.) 



boil, Bagdad boil, and Buton d'Orient. It has long been 

 known as a specific ulcerating granuloma. The lesions, which 

 begin as red spots, develop into papules which become covered 

 with a scaly crust which separates, leaving an ulcer upon which 

 a new crust develops. The lesion spreads and is much larger 

 when the crust again separates. A purulent discharge is 

 given off in moderate quantities and the ulcer becomes deep 

 and perpendicularly excavated. It lasts for months some- 

 times a year or more and gradually cicatrizes, forming a con- 

 tracting scar that is quite disfiguring when upon the face. 



