Everywhere they touched he was acclaimed with honor, and it was one triumphal ovation after another for him in city after city until they finally doubled back through the Middle East and reached Cairo, where Milo cornered the market on cotton that no one else in the world wanted and brought himself promptly to the brink of ruin.
There are no more uses of "Middle East" in the book.
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It is as likely as fair weather in southern California and unrest in the Middle East.
Basically any area between the two Tropics—Cancer and Capricorn—is a complete wasteland now Central and South Americas, most of Africa, the Middle East and southern Asia.