LEISHMANIA DONOVANI 403 



appearance artificially produced in preparation. The organism may be 

 found in films of the peripheral blood, either in cells of the mononuclear 

 or polynuclear variety. 



The parasites, as already remarked, may occur in any tissue of the 

 body within the macrophages. They were demonstrated by Christophers 

 (1904) in intestinal ulcers, and in the papules which sometimes occur in 

 the skin of cases of kala azar. Bramachari (1922) has noted that cases 



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Fig. 187. — Section of Human Liver (x750): Leishmania donovani within 

 Macrophages and the Glandular Cells. (After Nattan-Larrier, 1913.) 



of the disease which have apparently recovered after antimony treatment 

 may develop nodules on the skin, which in one case were distributed over 

 the body, and resembled a form of nodular leprosy. Leishmania w^ere 

 present in all these lesions, though they had apparently disappeared from 

 the internal organs. Another similar case has been described by Shortt 

 and Bramachari (1925). Perry (1922) has found that in cases of kala azar 

 the subepithelial tissues of the wall of the intestine may be much swollen, 

 owing to the presence of enormous numbers of macrophages packed with 



