Frontier Sores

(1) An acute phagedenic ulcer, circular in outline with sharp punched out edges usually commencing on the site of some trivial abrasion not necessarily of recent origin. The rapid increase in area and depth of the ulcer was appalling. Within 24 or 48 hours a trivial abrasion might become an ulcer as big as a rupee and with deep fascia exposed in its base. Considerable swelling of surrounding tissues was present. (2) Sores were all situated on dorsum of foot or on lower third of leg. They might be single or multiple. (3) Intense pain was the rule. (4) The infective character of the sore was well shown in the case of a sepoy who was in hospital for a small healthy healing ulcer of the foot, the result of boot bite. The first cases of infective ulcer were admitted at this time, and this man's ulcer suddenly became acutely phagedenic. It transpired that the ward orderly had on the previous day dressed this case immediately after the infective cases, and had neglected to disinfect his hands or instruments between the cases.