2iga 



ULCERATIONS 



Diagnosis —The ulcus infantum is differentiated from ulcus 

 tropicum by the less severe symptoms, by being almost always 

 multiple, by the smaller dimensions of the sore, by the absence of 

 spirochaetes, and by the absence of any tendency to phagedaena. 

 In contrast to veldt sore the ulcers are deep, and the crust very 

 thick. No streptococcus is found. 



Treatment. — Touch the ulcers with pure hydrogen peroxide once 

 every other day, and dress them with simple boric acid lotion 

 (2 per cent.). 



REMARKS ON ULCERS. 



Ulcerative conditions of the skin are extremely common in the 

 tropics. They may be classified as follows:— 



1. Cutaneous leishmaniasis. 



2. Ulcus tropicum. 



3. Ulcus infantum. 



4. Veldt sore. 



5. Ulcus inter digit ale. 



6. Gangosa ulcers. 



7. Leprotic ulcers. 



8. Ulcers of framboesial origin. 



9. Elephant oid ulcers. 



10. Blast omycetic, sporotrichitic, acladiotic, and, gener- 



ally, hyphomycetic ulcers. 



11. Cancerous and sarcomatous ulcers. 



12. Tubercular ulcers. 



13. Syphilitic ulcers. 



14. Glanders ulcerations. 



15. Ulcers of pyogenic origin (pyosis tropica). 



16. Ulcers due to varicose veins. 



17. Undetermined chronic or subchronic ulcerations. 



The ulcerative conditions which may be considered as strictly 

 tropical and well defined, such as Oriental sore, ulcus tropicum, etc., 

 have already been described. The cosmopolitan ulcerations, such 

 as the syphilitic ones and those due to varicose veins, show the same 

 characters in the tropics as in temperate zones, except that very 

 often, owing to their being neglected for a long time, they may 

 present enormous dimensions, and may show secondary infections 

 and become phagedaenic. Ulcers due to varicose veins are very 

 common among rickshaw coolies, who have to run and stand for 

 hours at a time. It is remarkable how quickly they heal in most 

 cases in these coolies, if the patient is kept at rest for some time ; 

 whereas in temperate zones the heahng of varicose veins ulcers is 

 of very long duration. 



