﻿NOTES ON CHRONIC ULCERS OCCURRING IN THE 

 PHILIPPINES. 



By George Cheyne Shattuck. 

 (From the Biological Laboratory, Bureau of Science, Manila, P. I.) 



On the occasion of a recent visit to Manila opportunity was afforded 

 me to work in the biological- laboratory of the Bnrean of Science and 

 I became interested in attempting to determine whether or not Oriental 

 sore occurs in Manila and in investigating the etiology of tropical 

 ulcerations in general, as the question of etiology at present is in a 

 state of much confusion. 



This paper, embodying the results of my investigations, is based on 

 clinical notes and microscopic findings in thirty-four cases of chronic 

 ulcerative processes. With the exception of one Chinaman, all the 

 patients were Filipinos. Fifteen of them lived in or near Manila, 1 

 and nineteen in the neighborhood of Catbalogan, on the Island of Samar. 

 The Catbalogan cases were found among a number of natives suspected 

 of leprosy who were being inspected by Dr. Heiser, Director of the 

 Bureau of Health. They were held under observation for one week, 

 and the ulcers examined repeatedly. Leprosy was not present in any 

 of the patients of this series. In the Manila cases, smears were taken 

 from the exudate on the surface of the ulcer and from the deeper 

 tissues exposed by the curette. A piece of tissue 2 was removed and 

 sectioned in four of these cases. In all the Catbalogan cases smears 

 were taken from the exudate on the ulcer and from blood or serum 

 expressed from a needle puncture close to the lesion. G-iemsa's(9) 

 new stain was used on the smears and a variety of stains were employed 

 for the sections. 



Table I. — Catbalogan cases. 

 [r.=right; l.=left.] 



No. 



Location of ulcers and scars. 



Other lesions. 



Legs. 



Feet. 



Arms. 



Hands and 

 shoulders. 



Other places. 



1 



Scar, r 



Scar, r .. 









Hj'pertrophic peri- 

 ostitis, tibia, ^con- 

 tracture of toes, r. 











1 Twelve cases are from Dr. Saleeby's clinic at St. Luke's Dispensary, two from 

 the service of Dr. Dudley at St. Paul's Hospital and one from that of Dr. Edwin 

 C. Shattuck at the hospital of Bilibid Prison. 



2 Tissue was first put in alcohol and subsequently treated with acetone and 

 embedded in paraffin. Thickness of sections 4 /j.. 



551 



