﻿NOTES ON CHRONIC ULCEUS. 



Table II. — Location and character of lesions in Manila cases. 

 [r.=right; l.=left] 



553 



No. 



Legs. 



Other places. 



Miscellaneous. 



»14319 

 >>2697 



»6536-3-P 

 '14612 

 » 14584 

 •'1495 

 '14125 

 " 11778 

 '14413 



'14518 

 "13842 



'12846 

 '14560 

 '13647 

 '14581 



Ulcer, ankle, r . 



Scars, r. and 1.; ulcer, 1. 



LTlcer, perineum, groin, 

 penis. 



Scars, r. and 1.; ulcer, r . 

 do 



Scars, r. and 1.; ulcer, 1 



Scars, r. and 1.; ulcers, r. 

 and 1. 



Ulcer, buttock, 1 



Inguinal glands 



Scars, vulva 



Scars, foot and arm, r . 

 Ulcer, palate 



General glandular en- 

 largement. 



Hypertrophic periostitis, 

 tibia, r. 



Scars and ulcer, foot, 1 . 



Scars, r. and 1.; ulcers, r. 

 and 1. 



Ulcer, sole of foot . 



Ulcer, ankle- 

 Ulcer, 1 



Scars and ulcers, foot, 1 



'St. Luke's Hospital number. b St. Paul's Hospital number. "Bilibid Hospital number. 



Strong (1) described three very different types of ulcer found in 

 Manila, exclusive of those due to tuberculosis, leprosy or syphilis. His 

 first two cases can best be discussed in relation to the first and second 

 cases described below. His third variety, observed in whites only, was 

 not found in this series. The report of cases follows. 



FIRST TYPE OF ULCERATION. 



Case I. — Native, 3 age 30, a laborer. Neither the patient nor his family have 

 previously had any similar disease. Patient stated that four years ago, without 

 assignable cause, a small boil appeared on his foot, that it burst spontaneously 

 and did not heal. When he began coming to the dispensary, a month before I 

 saw him, a diagnosis of phthisis was made. The patient denied that anything had 

 ever been done except to apply dressings but when Dr. Saleeby went on service 

 about that time he removed a stitch which was in the base of the ulcer. The 

 patient was fairly well nourished, had no scars suggesting syphilis, and only the 

 one external lesion. This was situated just below the external malleolus on the 

 right foot where there was an ovoid swelling 2.5 X 2.5 X 0.75 centimeters in size, 

 with a gash across it that went down nearly to the periosteum. The walls of the 

 gash were somewhat ragged and the lower side was undermined. A little, yellow- 

 ish slough was adherent to the base and sides. There was scarcely any discharge. 

 The superficial skin over the swelling was thick and rough. The subcutaneous 

 tissues were thickened. The swelling was firm. There was no tenderness, redness 

 nor pigmentation. The lesion was curetted and a small piece excised for examina- 

 tion. The wound healed rapidly under simple dressings. 



St. Luke's Dispensary, No. 14319. First seen March 30, 1907. 



