17

remembered seeing the small red puncture next morning, but soon forgot all
about it. Three months later a small pimple was noticed on the same spot
which gradually developed into a typical Oriental Sore, which the people in
whose house she had slept on the night of the fire, had no hesitation in calling
a " Cambay boil." The sore lasted many months resulting in a typical scar,
which was recently excised in England on account of the disfigurement. I
have elsewhere drawn attention to a case recorded by Schneider in a European
lady who lived for some time at Zerguendeh, a village close to Teheran, who on
waking one night with the sensation of something biting her on the cheek, put
up her hand and caught a bug. Schneider adds that in the same house there
were four children who had had the sore the preceding year, and that the house
was infested with bugs. The lady subsequently developed a large sore on the
spot were the bug had bitten her.

    Lieutenant-Colonel Ashton Street, I.M.S., in the discussion on Dr. Row's
recent paper, relates the case of a military officer who developed several Oriental
Sores in Karachi a few days after being pestered by bugs in the hotel in which
he was staying. Dr. Row, in reply, takes exception to the short incubation
period, and states that it is always of about two months' duration in the monkey.
Here again my studies of the disease in monkeys Macacus sinicus are at
variance with those of Dr. Row, I have reproduced, by subcutaneous inocula-
tion, a typical lesion in a monkey after eighteen days' incubation, and my own
sore developed on the sixteenth day; in both cases the parasites were recovered
on these days. It will be seen then that my observations correspond exactly
with those of Nicolle in Tunis. The reason why Dr. Row finds that the incu-
bation period in his monkeys is nearly always two months, is very simply
explained. I had the opportunity, when he visited Madras, of seeing the
technique he employed. He first scarified the sore with a knife, then pipetted
the fluid up into a capillary tube and deposited it on similar scarifications and
rubbed it in; the operation lasting about ten minutes. On the contrary I
puncture the sore with a fine capillary pipette and draw up the infected
material, and immediately with the same pipette, puncture the skin of the
monkey and blow the fluid in. This operation lasts a few seconds. In this
way I have found that, by inoculating a monkey with a very few parasites, the
incubation period is about two months, whereas if richly infected material is
used, containing many thousands of parasites, the early nodule may be detected
on the fourteenth day. On puncturing such a nodule, the parasites will be
found in the macrophages, and cannot therefore represent those which were
originally inoculated into the skin, for in the interval nothing can be felt.
This method of reproducing the disease is exactly comparable to the way in