ORIENTAL SORE l8l 



liable to attack. Where less common, persons between 

 15 and 30 are most affected. Otherwise, age, sex and 

 race appear to be without influence. The seasonal preva- 

 lence varies in different places, but the attacks appear to 

 be most common at the beginning and end of the hot 

 weather. 



Diagnosis. The description given above should be a 

 sufficient guide to the nature of the affection, and the 

 diagnosis can be established by the discovery of the 

 specific parasite. Syphilis is the disease for which Oriental 

 sore is most likely to be mistaken. The absence of the 

 other symptoms of syphilis and the failure of anti- 

 syphilitic treatment should enable a correct- diagnosis to 

 be made. 



Treatment. The treatment of Oriental sore, unless 

 thoroughly carried out, is very unsatisfactory. Medication 

 by the mouth has no effect, but Nicolle and Mauceaux 

 had excellent results from salvarsan, a simple 0*6 gr. 

 dose being followed by the healing of the ulcers in three 

 weeks. If protected from irritation the sores heal very 

 slowly, but with slight scarring. Of local applications, 

 copper sulphate solution, i to 4 per cent., sometimes gives 

 good results. Cardamatis' ointment, composed of methy- 

 lene blue and lanolin, has been used with apparent 

 benefit in some cases, whilst Row has recorded cases of 

 cure from inoculation with killed cultures of the organ- 

 isms. If the diseased tissues are completely destroyed 

 healing is more rapid but the scar may be greater. In 

 the early stage complete excision may be possible, but 

 failing this, the surface and edges of the ulcer should be 

 thoroughly scraped and ordinary antiseptic dressings 

 applied. Should scraping be considered inadvisable some 

 caustic application, preferably strong carbolic acid, may 

 be applied. Others use caustic alkalies, such as potassa 

 fusa. Change of air is often of great benefit in obstinate 

 cases. 



Prevention. In the present state of knowledge concern- 

 ing the manner in which Oriental sore is contracted it is 



