- ô 36 - 
are sometimes dilated. Here and there the inner root sheath and to a 
great extent the outer root sheaths, are also transformed into a shiny mass, 
probably cornified. In the connective tissue around the hair follicles cavities 
are found filled with shiny flaky masses which, according to the wav they 
are eut on section, appear of a round or oval form. In conséquence of the 
cornification of the root sheaths no new growth of hair is possible. The blood 
vessels exhibit endothélial prolifération which mav le ad to their entire 
oblitération. » 
Firth 12 in Allbutt's (( System of Medicine » has quite a lengthy des¬ 
cription as follows : 
« The histology of these sores has been thoroughly worked out ; and, 
if sections be made of the initial papule before ulcération, no difficultv is 
experienced in demonstrating that the whole thickness of the skin and sub- 
jacent tissue is infiltrated with lymphoid and epithelioid (mesoblastic) cells, 
accompanied by more or less complété disintegration of the normal tissue- 
elements thereby. In the centre of the papule the infiltration by young round 
cells is so complété that little can be see of the sweat-glands. Towards the 
edges of the diseased area the new cells occur in isolated clusters or groups, 
ebiefly round blood-vessels or lymphatics. The infiltration does not seem prï- 
marily to involve either the hair-follicles or the sebaceous glands. The indi- 
vidual cells of this infiltration vary from 7 to 9 p ; their nucléus from 5 to 
6 ix ; the nuclei are large, generally single, but in parts multiple. The anato- 
mical structure of the papule and surrounding skin indicates that oriental 
sore is of the type of a granuloma ; in fact, the most elementary microsco- 
pical examination of the lésions shews that it is a reaction of the skin 
against some virus of low virulence, which has produced granulomatous 
changes in the corium beneath and round the ulcer. So chronic are the chan¬ 
ges which are sometimes not with that a close resemblance to tubereuîo- 
sis may be occasioned. It is important to bear his in mind because it has 
several tiines been suggested that certain of those lésions are tuberculous. 
Doubtless, svphilitic and tuberculous ulcers hâve from time to time been 
placed in this group, but that there is an entitv to which the term oriental 
sore is applicable, which is due to some virus different from syphilis and 
independent of tubercle bacilli, seems certain. » 
Jackson 13 on the other hand States that the pathological anatomy of tro¬ 
pical ulcer needs to be cleared up bv further study. None of these accounts, 
it will be seem, mention the presence of cell nests or even the increase in the 
rete Malpighi which was so marked a feature in the sections of the smalî 
growth first studied. We were inclined to ask if this tumour was taking on 
malignant features, if it was a true oriental sore in the papular stage or if 
these descriptions referred only to the ulcerative stage of the lésion. Manson's 
brief statement, however, distinctlv mentions section of the papule. 
Another and larger growth of four months duration, that on 
the outer surface of the left forearm, was excised and examined. 
After excision blood was taken from the out surface but no pa¬ 
rasites were found in it nor were they présent in blood stained 
sérum obtained by thrusting a capillary pipette though this sur¬ 
face an some distance into the tumour mass. This is a point of 
some interest. 
This sections were made of the growth and stained bv Leish- 
