537 
in the water of condensation. One cubic centimeter of blood from this 
monkey was inoculated into another one (Chart No. 3), and 1 cubic 
centimeter of an extract of spleen pulp into a third (Chart No. 4). 
In monkey No. 1 the liver was much congested and there was a marked 
congestion at the site of inoculation. One cubic centimeter of a pure 
blood serum culture seventy-two hours old was also inoculated into a 
rabbit. No effect was produced and the animal is still alive and active. 
As the charts will show, monkey No. 4 died a month after inoculation, 
during which time it has had a very irregular temperature. Unfor- 
tunately, death occurred late in the afternoon and the animal was badly 
infected (post-mortem) when it was examined. The organisms with 
which it had been infected could not be isolated. The spleen was not 
especially enlarged. The other monkeys (Nos. 2 and 3) are still alive 
and will be closely watched. 
Pieces of the tissues obtained at autopsy from the original case and fixed in 
Zenker’s solution were imbedded in paraffin and sectioned. Sections were stained 
with carbol-fuchsin-gram-picro-indigo-carmin, methylene blue and eosin, hematoxy- 
lin and eosin, resorein-fuchsin, Mallory’s reticulum stain, and by Gram’s method. 
The liver showed the usual picture of a well-marked mono- and multi-lobular 
cirrhosis with a slight degree of central cirrhosis. No bacteria could be demon- 
strated. The spleen section showed a marked congestion and a moderate degree 
of fibrosis which was especially noticeable in the immediate vicinity of the blood 
vessels. Atrophy of the malpighian bodies was also present. Sections stained 
by Gram’s method showed clumps of small, polar-staining rods, scattered irregu- 
larly in the organ but chiefly noticeable in the more congested parts. None of 
these organisms were demonstrated either in the follicles or in the lymph glands. 
If we compare these cases with those reported as kala-azar we see that, 
aside from the one point of absence of the Leishman bodies, a close 
analogy exists between them. Diarrhea is a common feature in all 
of them. While, perhaps, amoebe do not play a part in the causation 
of this symptom, yet, in the Tropics, other intestinal parasites are so 
frequent that we rarely encounter a native’s stool free from one variety 
or another and frequently several may be met with simultaneously. In 
addition to the diarrhoea, the symptoms common to all of our cases were 
splenic enlargement, irregular temperature, transient cedemas, rheumatic 
pains, loss of weight and strength, and probably anemia. Together 
with these, the liver may be enlarged or atrophic and there may be 
ascites. Of all of these symptoms the most important is splenomegaly. 
What is its cause ? 
In the Philippine Islands and elsewhere in the Tropics, malaria is 
an extremely common affection and its occurrence might explain the 
increase in the size of the spleen. However, in sections we do not find 
the evidence we should expect, for we encounter neither pigment nor 
parasites. Then, too, the irregular temperature in splenomegaly is not 
satisfactorily explained on these grounds, for quinine does not affect it. 
Another disease which we are beginning to consider a much more common 
