72 SPIROCHiETES 



Tropical Ulcer. — Still another human disease that has been 

 attributed to spirochaetes is tropical ulcer, also known by the 

 more impressive name, " tropical sloughing phagedaena." This 

 is a type of sore on the skin, most commonly of the leg, which 

 originates either in some slight abrasion of 

 the skin or in some preexisting wound or 

 sore, especially in persons debilitated by 

 some other disease or by alcohol. It begins 

 in a tiny blister which soon bursts, and the 

 sore thus exposed spreads very rapidly, con- 

 stantly sloughing a yellowish, moist and 

 exceedinglj'- fetid matter. After a few days, 

 (Drrwn"from°';hoto"by while the sore is Still Spreading, the center 

 Halberstadter in KoUe of the slough begins to Uquefy and is grad- 

 and wassermann.) ^^jj^ gloughed off and heals. Usually the 



ulceration confines itself to the skin but sometimes it goes deep 

 into the muscles, nerves and bloodvessels, even injuring the 

 bones and joints. Sometimes permanent deformity or even 

 death results from these extensive excavations, death resulting 

 especially from the opening of some large bloodvessel. 



Tropical ulcer occurs in nearly all hot damp tropical countries. 

 Although not definitely proved, it is usually accepted that the 

 spirochaetes, Spirochoeta schaudinni, which can almost always be 

 found in the ulcers, together with cigar-shaped bacteria found in 

 association with them, are the ringleaders in producing it. The 

 treatment usually recommended is a thorough cauterization of 

 the sore, followed by antiseptic washes and applications. Sal- 

 varsan and other arsenic compounds haVe been found beneficial 

 in many cases. Finocchiaro and Migliano in Brazil claim to 

 have found a specific cure for this loathsome disease in an appli- 

 cation of powdered permanganate of potash or in a compress of a 

 one to ten solution of this substance. They achieved a complete 

 cure in from ten to thirty days in every one of seven cases. 



Ulcerating Granuloma. — Of a somewhat similar nature to 

 tropical ulcer, and of wide distribution in the tropics, is " ulcerating 

 granuloma of the pudenda," a sore which spreads, very slowly 

 however, over the external genitals and along the moist folds 

 of skin in neighboring regions. Both spirochaetes and bacteria 

 have been found deeply situated in the tissues at the bases of 

 these sores, but to what extent either or both are responsible for 



