Oriental sore.

  • Fox, Howard, 1873-1947.
Date:
[1912]
Catalogue details

Licence: In copyright

Credit: Oriental sore. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Reprinted from “The J D/^ptses, Including Syphilis,” !u- CORRESPONDENCE Oriental Sore. To the Editor:— Shortly before the publication in The Journal of Dr. Darling’s interesting paper on “Oriental Sore,” I received a letter upon the same subject from Dr. Walter B. Adams, Professor of Dermatology in the Syrian Protestant College at Beirut. In addition to his personal observations. Dr. Adams has also kindly sent me some photographs of the disease which will perhaps be of interest to the readers of The Journal, as the subject is one with which few in this country- have had any experience. In his letter from Beirut, dated November 10, 1911, Dr. Adams writes as follows: “Aleppo is the great ‘button factory’ in this part of the world, though in Baghdad, the cases are more numerous and severe than in Aleppo. A few weeks ago I had the pleasure of a long visit with Dr. Wenyon of the London School of Tropical Medicine, on the completion of his investigations of the ‘button’ in Baghdad and Aleppo. lie called on me here in Beirut. While the Leishman- Donovan bodies are now quite established as the cause of the disease, it is by no means certain what carries the parasite. I believe, and so does Dr. Altunian of Aleppo, that the mosquito is responsible. Dr. Wenyon seems rather inclined to the sand fly, but I do not think he is on the right track in this regard. “We have the disease occasionally here in Beirut. I have seen cases in people who have never in their lives been out of this city. It is very common in some of the suburbs of Beirut, Shweifat, Hadeth and Juny and in some of the villages of the Lebanon range, particularly in those which have many springs and an abundant water supply. “The scattered or multiple type of the disease is called by the people the ‘male’ variety, while large, long standing, severe lesions, generally single, are called the ‘female’ variety. I do not know why. It is all one and the same- button.’ I beg of you not to call it a boil. There is no central core, there is no pain, two of the essential qualities of the boils that once afflicted me. The term ‘button’ is admirable and distinguishes it from other diseases, unless we accept the ‘mean man’s wart’ that he had on the back of his neck and which, he used for a collar button. “The enclosed photographs were taken in Aleppo and are really very typical and are good specimens of the disease. All are boys. I suppose it is hard to induce girls to pose for their pictures. It is quite as common in the female as in the male sex, and you can understand how disfiguring it is. It is so common that it is as little thought of in Aleppo as a vaccination mark on a boy’s arm at a swimming pool. It is no bar to marriage there, being regarded as a- necessary evil.” In commenting upon the illustrations, Dr. Adams remarks that one of the patients (Case 1) is “well buttoned up despite the charm of the beads and the beshliks” that it is wearing. He adds that the beshlik is a Turkish coin, a little more than an inch and a half in diameter and worth about eleven cents. Im Case 2, “the lesion is beginning to crust, mixed infection is taking place.” Case- 3 shows small lesions upon the hand and larger ones upon the nose which is “by no means an uncommon site of the disease.” Case 4 presents lesions upon the cheek, forehead and ear, “which are all healing and quite typical of the ‘but- ton’ as it is nearing its end.” Howard Fox,