280 
Oriental Sore 
inoculation always produces only a single sore, and that at the site of 
the inoculation. It then may he accepted that the incubation period 
is approximately two months. 
Character and development of the Bagdad sore. It is generally 
believed by the natives of Bagdad that there e.xist two kinds of sore 
which are designated male and female. Clinically this is true, for as 
the types of two extremes there exist the ulcerating and the non¬ 
ulcerating sore. The ulcerating as well as the non-ulcerating form of 
the disease commences as a minute red papule. This has a characteristic 
dusky red colour, which takes on a slightly brownish red tint, as it 
increases in size. It is only slightly raised at this stage, and does not 
produce any surrounding inflammation of the skin as does the common 
acne spot. In accordance with its chronic nature, it produces little or 
no irritation. It is not tender to the touch and would probably escape 
observation if it did not appear on a visible surface of the body. The 
original papule increases slowly in size and may finally follow one of 
two courses, which results in it being either a male or female sore. In 
the female sore the central portion breaks dowm leaving a shallow, 
indolent ulcer, from which exudes a yellow fluid in which are to be 
found the sore parasites and the numerous bacteria wdth which these 
ulcers become secondarily infected. This ulcer gradually extends till 
in severe cases a large area of skin may be involved. In one such case 
encountered the ulcer occupied the whole of one cheek, had destroyed 
the lower eyelid of this side, and extended across the bridge of the nose 
to the other cheek. Such extensive ulceration is however uncommon, 
the ulcers, as a rule, not exceeding the area of a five shilling piece. 
When small these ulcers frequently scab over with the dried up exudation. 
The scab is easily removed, and if allowed to remain, only serves to 
retain pus and make the ulcer painful by producing a surrounding 
inflammation. While extending in one direction the ulcers may heal at 
another part, producing a condition resembling that of a lupus. The 
surface of the ulcer is covered with granulations varying in colour 
according to the extent and nature of the secondary bacterial infection. 
The granulations readily bleed, and a scraping from the surface reveals 
a mixed infection of the typical parasite, bacteria and yeasts. One 
never obtains the specific parasite in such great numbers in these mixed 
infectious. I have encountered no case of spirochaete infection in these 
ulcerating sores. 
The second type of sore known as the male sore commences in the 
same manner as the female sore. The papule however increases in 
