Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 2 (3).djvu/38

 "JEDDA ULCER" AND THE NON-IDENTITY OF NILE BOILS WITH ORIENTAL SORE.

By p. M. SANDWITH, M.D., F.R.C.P.

This specimen from the skin of an adult Arab of Jedda was kindly sent to me by Dr. J. E. Creswell, of Suez, labelled "Jedda Ulcer," and I do not know that I am justified in rechristening it, though I should be unwilling to add to the long list of names by which the disease is already known. Its official name is "Oriental Sore," but I am interested to see that the latest French author of a tropical book has called it Leishmaniose cutanee (Neveu-Lemaire, 1908).

The etiology of Oriental sore is still obscure, though most writers incline to the belief that the parasite is probably inoculated by means of a biting insect.

Our earliest accounts date from Aleppo in the middle of the eighteenth century. Volney says that the inhabitants of Aleppo were mostly disfigured by scars on the face, and he accepts the native belief that the malady was due to bad drinking water. This supposed cause was repeated by various writers for more than 100 years, and is still believed in by many Orientals. It is also stated that in India and elsewhere the disease has become less prevalent since the improvement of the water supply. As the disease is confined to tropical and sub-tropical climates, is observed more frequently in towns than in country districts, is usually present on uncovered parts of the body, and can be communicated by inoculation