i 7 6 



CHAPTER XII. 

 ORIENTAL SORE. 



ALEPPO EVIL, AURANGZEBE, BOUTON DE BAGHDAD, 

 CLOU DE BISKRA, DATE SORE, DELHI BOIL, 

 FRONTIER SORE, ORIENT BUELE, YEMEN ULCER. 



THE various names mentioned above, and many others, 

 are given to ulcers occurring in Algeria, Egypt, Asia 

 Minor, the Levant, Cyprus, Arabia, Persia, Northern 

 India, the Sudan, and South America and Panama, 

 and other subtropical countries. Possibly these are 

 different forms due to parasites which morphologically 

 are indistinguishable. These ulcers are characterized 

 by the thick crusts which form on their surface, and by 

 their great chronicity. There are several distinct types, 

 some scaly and not ulcerating. 



(1) A non-ulcerating form, the usual one in the Sudan, 

 but not rare in India. 



(2) Superficial flat ulcer, the usual form of frontier 

 sore. 



(3) Deep ulcer with overhanging raised edges, the 

 common form in Arabia, India, and South America. 



The affection begins as a small red, itching papule, 

 resembling the effect of a mosquito bite. This soon 

 increases in size, becomes shiny and transparent, and 

 surrounded by a red areola. In the non-ulcerating form 

 this simply gets larger, lasts for some months and slowly 

 subsides. Later in the ulcerating forms there is a serous 

 discharge which, together with desquamated epithelial 

 scales, form a crust which is often studded with small 

 yellow points. Underneath the crust ulceration takes 

 place, until the crust giving way, an indolent ulcer is 



