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XLVI] however, by bandaging a swab smeared with discharge from a typical sore (discharge containing large numbers of his bacillus) on to the surface of an abrasion from which the scab had been removed, succeeded in producing a characteristic sore, in the discharge from which his bacillus was present in great profusion.

Etiology.—Doubtless depending on the proliferation in the affected tissues of some specific micro-organism, not yet satisfactorily separated, the germ of sloughing phagedæna attacks the healthy as well as the debilitated, young or old, male or female. It finds its special opportunity in the bodies of men who, from overwork, underfeeding, exposure, malaria, dysentery, scorbutus, and the like, are physically depressed. Thus it is apt to attack the half-starved, malaria-stricken pioneers in jungle lands, overdriven slave gangs, and soldiers campaigning in the tropics. In such circumstances a slight wound, an abrasion, even an insect bite, or an old chronic ulcer may serve as the starting-point for one of these terrible sores. Where yaws and sloughing phagedæna are co-endemic, the sores of the former may become infected with the virus of the latter, and serious sloughing and cicatricial contractions result. The feet and legs, being most exposed to injury, are the most frequent locations for this form of ulceration; but the arms or any other part of the body may also be attacked.

Symptoms.—If the disease occur in previously sound skin the first indication is the formation of a larger or smaller bleb with sero-sanguinolent contents. The formation of this may be attended with some pain and constitutional irritation. When, in the course of a few hours, the bulla ruptures, an ash-grey, moist slough is exposed. The sloughing process rapidly extends in all directions until the skin and subcutaneous fascia over an area of an inch to many inches in diameter are converted into a yellowish, moist, horribly stinking slough. After a few days the centre of the slough beings to liquefy, the sore still continuing to extend at the periphery. In the course of a week or longer the sloughing process may