l8o TROPICAL MEDICINE AND HYGIENE 



and are directly inoculated by accidental abrasions. It is 

 at least possible that infection may be carried directly 

 from an Oriental sore to simple ulcers or wounds by flies 

 so common in places where the disease is prevalent. 

 The circumstance that these sores are most common on 

 parts of the body not protected by clothes, and especially 

 on the face and neck which are not particularly liable to 

 abrasions, is in favour of the view that the parasite is 

 introduced by some biting insect, the nature of the 

 organism favouring this view. 



It has been suggested that true Oriental sore only 

 occurs in countries in which camels are in common use, 

 and that infection is in some way derived from camels. 

 The disease, however, is more prevalent among town- 

 dwellers than among those who have especially to do 

 with camels or who usually lead a nomadic life. 



It has been shown that Oriental sore can be directly 

 inoculated in man, and there is a strong popular belief 

 that recovery is followed by immunity, so much so that 

 in certain places it is the practice to inoculate children 

 on unexposed parts of their bodies with matter taken 

 from such sores, with the object of avoiding disfigure- 

 ment of the face. Attempts have been made to inoculate 

 dogs with pus from Oriental sore, with a certain amount 

 of success, but some monkeys are susceptible to inocula- 

 tions. Sores occurring in dogs at Delhi, and locally 

 believed to be of the same nature as Delhi boils in man, 

 were shown by James to contain numerous spirilla, but 

 no Leishman bodies. After inoculation with the parasites 

 dogs appear to be in good health and may not develop 

 sores, but the parasites may be found in large numbers in 

 their liver and spleen. Possibly dogs serve as the reser- 

 voir and man acquires his infection from them. No 

 general infection of dogs is found in places where 

 Leishmania tropica occurs as is found where infantile 

 Leishmania ancemia occurs. 



In places where Oriental sore is very prevalent children 

 are the principal sufferers, and newcomers are specially 



