An expectant treatment is usually resorted to, the crusts being softened and removed with antiseptic fomentations with subsequent disinfection of the ulcer with bichloride or potassium permanganate solution and the application of some antiseptic ointment or powder. Thorough cauterization with pure carbolic acid followed by rapid neutralization with alcohol can be tried. The injection of killed cultures of _Leishmania_ does not seem to have been effective. Wenyon has had good results from an ointment of equal parts of methylene blue, lanoline and vaseline in an American sore. Carbon dioxide snow has been shown by Mitchell to be an efficient local application for oriental sore. The remarkable effect of antimony on the parasites of leishmaniasis was first noted in the treatment of the cutaneous types. The treatment is similar to that described under kala-azar. The effect of the drug is less pronounced on the lesions of the mucous membranes. CHAPTER IX DYSENTERY DEFINITION AND SYNONYMS =Definition.=—The designation dysentery refers to a symptom-complex of (1) small, frequently passed mucous or muco-sanguinolent stools and (2) pains connected with spasm of the sphincter ani (tenesmus) or intestinal gripings (tormina). The condition may be set up by numerous causes but of these two so outweigh the others that it is usual to have in mind either bacillary or amoebic dysentery when the term is employed. =Synonyms.=—The Bloody Flux. French: Dysenterie. German: Ruhr. GENERAL CONSIDERATIONS As will be noted in the sections dealing with amoebic and bacillary dysentery our present knowledge of these conditions is of recent date. There was so much that was etiologically, epidemiologically and clinically contradictory that the subject was impossible of elucidation until the existence of a group of dysentery bacilli was generally accepted, following the reporting, in 1898, by Shiga, of his bacillus of dysentery. Although Hippocrates was the first accurately to describe the disease we now know as dysentery yet there is good ground for believing that the disease existed in Egypt and India for centuries before Christ. Many of the older writers failed to differentiate conditions which showed admixtures of mucus and blood in the stools from those with blood alone. Commencing with the last century, authorities have considered the association of mucus with the blood as essential in clinical diagnosis. It is interesting that with a better knowledge of etiology we are now recognizing as of dysenteric nature diarrhoeal conditions in which there is an absence of the typical stool of dysentery.