764 Diseases 0/ the Ge?iital Organs 



Dourine and genital horse pox may readily coexist, caus- 

 ing confusion in diagnosis. 



Some writers, in describing dourine, accept the presence 

 of the depigmented areas about the vulva and anus as con- 

 clusive evidence of precedent ulceration, but depigmenta- 

 tion of the skin does not necessarily follow vesicular or pust- 

 ular eruptions, nor does its presence indicate that eruptions 

 have occurred. I had excellent opportunity for observing, 

 day by day and week by week, the depigmentation of the 

 skin of the vulva and anus in dourine, and saw it begin and 

 gradually spread, without the presence of any visible vesi- 

 cles, papules or ulcers. It was a depigmentation without 

 ulceration. 



Numerous writers place emphasis upon the presence of 

 specific eruptions in dourine, but fail to describe their char- 

 acter, and do not intimate that they have personally ob- 

 served them. In the extensive Illinois outbreak, among 

 more than one hundred cases of the disease, no eruptions 

 were observed, nor could the most diligent inquiry among 

 owners reveal any history of such in any animal. Baldrey, 

 after an extensive experience with the malady in India, fails 

 to record the occurrence of vesicles and pustules. 



It seems to me that the apparent differences in observa- 

 tion and view in reference to vesicles, pustules and loss of 

 pigment in dourine is due to the constant confusion of the 

 two wholly distinct veneral diseases and to accepting the 

 erroneous conclusion that depigmentation indicates prior 

 pustular or vesicular eruption. 



In reference to the alleged occurrence of eruptions it 

 should be noted that the character of the micro-organism 

 which causes dourine is contradictory to the appearance of 

 such lesions. Trypanosoma, in general, have little or no 

 tendency to produce eruptions or suppuration, and it would 

 seem unique to expect that, in this one disease, alone, of the 

 great group, there should occur characteristic vesicles or 

 pustules. 



The elliptical swellings or plaques in the skin of the flanks, 

 hips and other parts of the body have long held a high place 

 in diagnostic value, but they do not always exist. 



