azar, I had the opportunity of examining blood abstracted from his spleen on two occasions, and found it swarming with the peculiar bodies already described by Leishman, Donovan, and Marchand. I was able to show that these bodies were not endocorpuscular parasites, as suggested by Laveran and Mesnil, who had expressed the opinion that they belong to the genus Babesia.
Then followed observations by a number of investigators, and we learnt that kala-azar was a widely distributed, though hitherto unrecognized, disease. It was found in various parts of the eastern side of India, in China, Arabia, the Soudan, Tunis, Sicily, Italy, Algeria, Crete, Spain, Portugal, Greece and the Grecian Archipelago,*[1] Malta, the Caucasus, Central and South America, and South Africa, etc. Besides those of Leishman and of Donovan, amongst the most important papers on the subject are those of Christophers, who showed that the parasite attacks the endothelial cells; of Leonard Rogers, who in cultivating the parasite obtained a characteristic flagellated form; of Dr. J. H. Wright, of Boston, U.S.A., who found parasites morphologically indistinguishable from those of kala-azar in the granulation cells of tropical sore; of James, who confirmed and extended Wright's observation; of Patton, who considers he has discovered the extracorporeal developmental forms of the parasite in a species of bed bug; of Nicolle and Comte on the occurrence of the same or a similar parasite in children and dogs in Tunis, and in kittens in Algiers; of Laveran on experimental Leishmania, and many others. †[2]
Epidemiology.—— Our knowledge of the epidemiology of kala-azar is gathered mainly from the Assam epidemic, which began about 1870, when the disease
- ↑ * In the Ionian Islands and Greece the disease known as " ponos" was found by Gabbi to be infantile kala-azar.
- ↑ † Nicolle gave the name Leishmania infantum to this variety of the parasite in order to call attention to the special liability of children to the infection in Mediterranean countries, and not because he considered it specifically distinct from the Indian form, which attacks adults and children indifferently.
