88 LEISHMAN BODIES AND LEISHMANIASIS 



The sores usually last for a year, more or less, gradually healing 

 over, but leaving permanent scars. The uta sores of the Peru- 

 vian Andes, which have a much shorter incubation period, may 

 run their course and heal in much less time, according to Town- 

 send in as short a time as 15 days. Except in rare cases, after 

 an oriental sore has once run its course and healed a person is 

 permanently immune to any further attacks. 



Treatment and Prevention. — The use of tartar emetic as a 

 cure for oriental sores is as productive of good results as it is in 

 the case of other Leishmanian infections. With the usual one per 

 cent or two per cent solutions of this drug injected into the veins 

 the sores yield promptly and, if treated at an early stage, can be 

 prevented from leaving scars. 



In badly infected places there might be some advantage in 

 allowing the sore to run its course, inoculating it on an inexposed 

 part of the body where it could cause no visible disfigurement, 

 since in this way a permanent immunity to further infection 

 could ])e prevented. It is better to keep the sores open than to 

 allow a scab to form over them, since the scab shuts in the pus 

 and results in more extensive ulceration and inflammation. Ap- 

 plications of various kinds which will soothe the inflammation 

 and keep the sores as dry and clean as possible are beneficial. 

 The use of hypodermic injections of dead cultures of the parasite, 

 as in anti-typhoid vaccinations, has been found to hasten the 

 healing. The inoculation of the active disease germs on inex- 

 posed parts of the body, especially in young children in whom 

 the sores are never very extensive, is easily accomplished, and has 

 been practiced in Bagdad and other cities where the disease is so 

 prevalent as to make avoidance of it almost impossible. Such 

 a procedure tends to lessen the number of exposed sores, to 

 which flies or other insects might get access. Unless the disease 

 should be found to be transmitted by insects which suck the 

 parasites from the circulating ))lood, which seems very unlikely, 

 the protection of the sores will greatly reduce the prevalence of 

 this unpleasant feature of tropical cities. 



It is possible that an immunity may be established by the 

 inoculation of dead parasites as in the case of typhoid fever, but 

 this has not yet been demonstrated. 



