Symptoms.—The incubation period varies from a fortnight to a year. The sore may occur on any exposed part of the body, but is most common on the forearm, hands, and face. Multiple sores are frequent. The first sign is a small red, scaly papule, which increases in size and eventually breaks down, forming a painless ulcer, with a hard, dry edge. Non-ulcerating forms occur, but are not common. The condition is very chronic, but healing usually sets in after six to twelve months. When the ulcer heals a white or pink scar is left, which is disfiguring.
Prophylaxis.—Sleep under a sand-fly net, containing 22 holes to the linear inch. Warn against the danger of infection by personal contact and the risk of re-infecting oneself by scratching. It is advisable to paint the sites of all fly and insect bites with iodine as soon as possible.
Treatment.—The best treatment at present known is intravenous injection of tartar emetic. This, of course, can be carried out only by a medical man. Good results have, however, been obtained by applying a 2 per cent. ointment of tartarate of antimony, and this method can be carried out by the patient himself. Local injections of emetine have been recommended, and there are various other ways of treating Oriental sore, but they need not be here considered.
Tropical Ulcer.—This is a special and serious form of ulcer found in all parts of the world, and especially amongst East African natives. It is found chiefly in the lower third of the leg and in the region of the foot and ankle.
Cause.—This is somewhat obscure, but it is believed to be due to certain organisms possibly acting in association with one another.
Symptoms.—The condition starts as a small, tender, and often itchy papular bleb, surrounded by a dense inflammatory zone. An ulcer results, which is more or less painless, and one of the characteristics of which is the way it spreads and destroys all the tissues with which it comes in contact. It is often mistaken for a syphilitic ulcer, but it does not usually yield to anti-syphilitic remedies.
Treatment.—The best remedy would appear to be formalin, though the iodoform ointment mentioned under ulcers may aid the condition. It can be effectually treated only by a medical man.
Veldt Sore.—This condition, which is also known as Barcoo Rot, is frequently in evidence in countries with hot, dry climates, as, for example, Egypt, Palestine, South Africa, Mesopotamia, etc.
Cause.—It is due to certain bacteriological organisms, and is apt to occur in persons who are debilitated, who are not receiving proper food, or who are living under conditions where it is not easy to keep clean. Some think the sores are commonest in men who have to deal with horses.
Symptoms.—Veldt sores are most common on the hands and forearms. They begin as itchy papules, which become blebs, then pustules, and finally ulcers. They are usually multiple, and when they heal they leave areas of thin, glossy skin.