434 The " Oriental Sore " as observed in India. [part ii. 



owing to the lack of analyses of assured accuracy, yet appears highly 

 probable, judging from the geographical position of the stations and from 

 the statements of residents of several of them, that the well waters manifest 

 properties similar to those which they possess in Delhi. The well waters in 

 many of the places where the sore prevails, in Egypt, Asia Minor, Syria 

 and other countries, are also notoriously more or less brackish : 



9. It seems, therefore, probable that although the salts, which cause the hardness 



of a water, may of themselves not be the actually deleterious ingredients, 

 nevertheless this quality may serve as an index of properties in it which 

 tend to favour the production of cutaneous disorders. Several salts exert 

 a peculiar action on the skin ; those of Iodine and Bromine, for example, 

 produce very characteristic eruptions : 



10. With regard to the special skin affection in question, we have no hesita- 



tion in suggesting that the disease, as commonly observed at Delhi, setting 

 aside all cases which are manifestly due to syphilis, scrofula and the like, 

 is in no way distinguishable from one or other of the various forms of 

 Lupus : its clinical history is similar, as is also its morbid anatomy ; and the 

 treatment which has proved the most satisfactory is that which is generally 

 recommended for Lupus : 



11. It is probable, however, that, owing to climatic and other influences it may be 



somewhat modified from its European prototype as suggested by the fact 

 of its prevalence being limited to particular districts — a feature which, so far 

 as we are aware, does not characterise it in Europe in any special manner ; 

 and 



12. Finally, we have suggested that the tendency which this form manifests to 



become endemic may be taken advantage of for purposes of nomenclature, and 

 have therefore proposed that this form of Oriental sore should receive the 

 designation Lwpus endemnicus. 



Calcutta, 

 November 1876. 



