Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 2 (3).djvu/39

 to a healthy person, it is quite possible that the parasite is conveyed to man by some water-loving and town- dwelhng insect, living, for instance, in cisterns. The seasonal influence is also in favour of this theory, for the disease is most common in the autumn months, when gnats and other insects, which thrive in moderate heat, are most numerous in towns, and the season often corresponds with the date harvest, and has therefore been supposed to be connected with it (like dengue). In Tashkend the disease has been called for years the "fly bite." It would be interesting to know whether Oriental sore is ever met with in residents above the mosquito zone, say, 6,000 feet above sea-level. Another interesting point is the reported immunity of children during their first year of life, which, if true, must be difi&cult to explain by those who believe that the disease is con- tracted during the act of washing.

All books which refer to the geographical distribution of Oriental sore include Egypt as one of the countries in which it is endemic. Judging by the experience of the last twenty-five years, this is not strictly accurate, for all the Egyptian cases of which I know have been imported into Egypt from neighbouring countries. The evidence in favour of its having existed in Egypt in former days is mostly taken from Pruner's book, who, writing in 1846 from Cairo, says that he saw houton d'Alep there in men who had not been in Syria for forty years, and also that he saw it in Cairo in English officers from Sindh in India. He further states that in his twelve years' hospital experience in Egypt he often saw the "Yemen ulcer" cured in Cairo; this would probably be among Egyptian troops returning from the campaigns in Syria, but it might to-day be called tropical phagedaena.

It is quite true that the well-known Nile boil, some-