from above downwards, situated centrally, as seen in the illustration, with a patent and pointed opening in the centre, through which urine passes freely. The ulcer is rough, indurated, covered with angry

looking granulations, bleeding profusely on manipulation. The margins of the ulcer are indurated, thickened and everted. The whole ulcer is raised above the skin level, but fixed and adherent to the subjacent tissues. The femoral and inguinal glands are enlarged. Wassermann reaction?Positive.

Urine?Specific gravity





Slightiy acid,




was put on liquor hydrarg. 45, and mist. pot. iodidi. 3 oz. (1 oz. t.d.s.). Locally antiseptic dressings soaked in tartar emetic solution per cent.). He had nine intravenous injections of tartar emetic



A CASE OF GRANULOMA INGUINALE. By M. G. RAMACHANDRA RAO, m.b.&c.m., Medical and Sanitary Officer, Maharaja's





Previous history.?The patient, a male Hindu, aged 35 years, gives a history of venereal ulcers on his penis with subsequent secondary symptoms, which subsided after taking some native


History of present illness.?About 2i years ago the patient noticed an ulcer on the lateral aspect of his penis. He applied some paste given by a barber surgeon,

but the ulcer extended on all sides in a circular way round the penis. Within six months the ulcer "had spread, involving the root of the penis and giving rise to much irritation and pain. The penis at this stage was amputated by a barber surgeon at the level of the ulcer. The ulcer did not heal, but spread upwards involving the stump of the penis left by the barber and extending towards both the groins from over the pubic

region. Examination.?The penis

was absent and in its place there was a reddish ulcer covered with granulation tissue and with a sanious and foul-smelling discharge. It is about three inches from side to side and two inches

cent, solution (fresh) every 5th day, with \ c.c. and increasing by i c.c. till 2 c.c. and then \ c.c. to the end. The patient in all received 18 c.c. of the 1 per cent, solution. The ulcer rapidly healed and on 22nd March, 1930, the patient absconded. 1



A Case of Granuloma Inguinale.

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