The diagnostics and treatment of tropical diseasesStitt, E. R. (Edward Rhodes)
Science
The diagnostics and treatment of tropical diseases
Stitt, E. R. (Edward Rhodes)
Tropical medicine
There has been a great deal written about the origin of the disease
in drinking water, various inorganic constituents having been
incriminated as factors. In certain places, as Delhi, oriental sore
has decreased among the British troops with the discontinuance of
the use of water from certain city wells. We know that oriental
sore is rather easily inoculable, it having been stated that
certain people of Bagdad inoculated their children in order to
insure against the possible appearance of the sore on the face with
the resulting scar disfiguration. Wenyon found that the virus would
not pass through the unabraded skin.
The disease is most prevalent about the end of summer and in the
autumn. It is a disease of towns. Some have thought that it might
be transmitted through the medium of the laundry. Not only can man
be infected by inoculation but this is also possible with monkeys
and dogs when a scarified area about nose or over eyebrows is
inoculated with virus from a sore.
The lesions are similar to those in man but last a shorter time.
It has been suggested that the dog may be the reservoir of this
virus as well as for that of infantile kala-azar. There is some
experimental evidence to show that an animal which has recovered
from a visceral leishmaniasis is immune to a cutaneous one.
There has been an idea that lizards or snakes might serve as
the reservoir of virus for oriental sore and that species of
_Phlebotomus_ feeding on these reptiles might take in the
flagellates and subsequently transmit them to man. Laveran,
however, has been unable to infect lizards with _L. tropica_.
Patton’s observations point to infection from the crushing of
infected sandflies when biting the exposed surfaces of the skin.
The natural infection of man with oriental sore produces a rather
lasting immunity.
As regards the American sores there is a great deal of difference
of statement as to the probable transmitting agent. These sores
seem to occur in forest regions where clearing of the trees is
going on. Infections occur in late summer or autumn. Marshy
districts appear to favour infection. Brumpt thinks the fact that
dogs, which are susceptible as well as monkeys to inoculation with
the American leishmaniasis, are often bitten by ticks without
the production of the sore, is against the view that ticks act as
transmitting agents. He rather favors a tabanid fly and in a case
reported by Darling the patient incriminated a tabanid fly.
Five cases are reported by Cerqueira as following the bite of
_Phlebotomus lutzi_.
The disease seems to occur naturally in the dog in the infected
regions.
=Pathology.=—In oriental sore there is an infiltration of the corium
and its papillae with plasma and lymphoid cells as well as with large
phagocytic cells packed with leishman bodies which cells Wright
regards as endothelial cells. There is atrophy of the epidermis.
Public-domain text, read in full here on John Shaqi.
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