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feeds upon these exposed surfaces in contradistinction to such elusive 
insects as body lice, fleas, and bed bugs which generally suck their 
blood under the protection of clothing. In this connection however 
one must not forget the recent experiments of Basile on the flea trans¬ 
mission of canine leishmaniosis. 
Number of sores on each individual. It is probably safe to say 
that the single sore is most commonly encountered, and this one may 
be on the cheek, lip, nose, eyelid, foi’ehead, arm, hand, leg or foot. 
Two, three, and even four sores are by no means uncommon, but cases 
with larger numbers are certainly rare. It often happens that during 
the growth of a single sore secondary sores will develop on some exposed 
surface, either near the primary one, or further away. Such secondary 
sores are most likely subinoculations from the first. A child with a 
sore on its face will almost certainly inoculate any wound it may have 
upon its hand, and airy slight abrasion of skin upon the face will be 
infected by the swarms of flies that are constantly walking across the 
sore. Some of these secondary sores may however be the result of 
a normal infection. I have seen the case of a child about 12-18 months 
old, where there were eighteen sores upon the face, one on each of the 
limbs except the left arm which had two, making a total of twenty- 
three sores. I have heard of cases where the numbers have been even 
greater, but the character of the sores in these cases had not been 
established by microscopical examination. In the case of this child 
with twenty-three sores, it is interesting to note that they were all 
limited to the exposed surfaces of the body. If the disease is the local 
manifestation of a general infection, it is difficult to explain how the 
sores limit themselves to the exposed surfaces only in these cases of 
multiple infections. One would expect that at least some would appear 
upon the body. On the other hand, it is not quite clear that each sore 
can be a separate inoculation by some fly, though in my opinion this is 
the more probable explanation. 
Incubation period. On the subject of the incubation period it is 
difficult to obtain precise information from the observation of natural 
infections. The youngest child I have seen with a sore was seven 
months old. Cases of Europeans becoming infected wdthin two months 
after reaching Bagdad, are not uncommon, and I have a reliable history 
of a case in which two red spots appeared upon the feet a fortnight after 
arrival. The subject of these sores was badly bitten upon the feet 
while sleeping on the roof without a mosquito net. All the marks 
produced by the bites disappeared except the two red spots mentioned. 
