Kala-azak tn the Anglo - Ehyt'tian Ruoan 
Historical 
First case of 
present series 
Mafaza an 
apparent 
centre of 
disease 
BY 
S. Lyle Cummins, M.B, B.Cil, B.A.O., R.TM., E.A.M.C. 
Kala-azar has been known to exist in Nortli Africa since Laveran described a case from 
Tunis’ in 1904. In the same year Dr. Sheffield NeaYe- proved its existence in the Anglo- 
Egyptian Sudan, reporting the discovery of the Leishman-Donovan liody in the spleen of a 
Sudanese boy, under treatment in Omdurman Hospital. 
In August, 1904, Dr. L. Phillips’’ called attention to certain cases observed in 
Kasr-el-.Ainey Hospital, which he considered to be kala-azar. Two of them had contracted 
their illness in .\rabia, while two would appear to have acquired it in Egypt. 
In 1906, Captain E. B. Black reported a case of splenomegaly with continued fever, 
from a village near the River Dinder; stating that it seemed to him to resemble kala-azar. 
Being ■without microscopic appliances of any kind, he was unable to settle the diagnosis. 
This case gains importance owing to the subsequent discovery of the disease in this 
neighbourhood. 
The series of cases which are dealt with in the present article began with the post 
mortem discovery of the Leishman-Donovan body in the spleen of an Egyptian soldier, 
dying of a disease, diagnosed “ malaria,” in Abbassieh Hospital. Colonel Leishman, to 
whom I submitted my specimens, to put the matter bej'ond doubt, very kindly examined 
them and confirmed my observation. A short note on this case and certain othei's appeared 
in the Journal of the Eai/al Army Medical Corp.A of February 1st, 1908. Details of the eases 
mentioned therein form part of this article, but I venture to recaj)itulate the main facts. 
The illness was proved to have commenced at Senga, on the Blue Nile. Enquiries were 
instituted as to the presence or absence of cases resembling kala-azar in the man’s own 
Egyptian village; a medical officer of the Sanitary Department being sent for this purpose 
through the kindness of Sir Horace Pinching, K.C.M.G., at that time Director-General of 
the Egyptian Sanitary Department. No such cases were found, and it was concluded that 
the disease must have been contracted where it commenced, at Singa. 
All Egyptian soldiers who had lived in the barracks with the man, while at Senga, were 
now examined. They were found to be in good health, with one exception. This case was 
under treatment for “malaria” in Khartoum Hospital. Captain F. F. Carroll at once 
carried out splenic puncture, and proved the case to be one of kala-azar. Within a short 
time another Egyptian soldier arrived from Ivassala, and was found to be suffering from the 
same disease. His illness was traced to Mafaza, on the Eahad, a tributary of the Blue Nile. 
Enquiries were at once instituted, through the authorities of the Kassala and Blue Nile 
districts, with the following results : — Captain R. B. Black reported two suspicious cases in 
Arab policemen on the Blue Nile. Specimens were sent for examination to the Gordon 
College, and Dr. Andrew Balfour confirmed the diagnosis in both cases. 
Both, these men were found tn have contracted the disease during a visit to Mafaza. 
A third Arab policeman died in the Southern Sennar district; the description of his 
illness, as given by the medical officer who attended him, making it almost certain that he 
too died of kala-azar. lie had come from Senga, and reported sick shortly after reaching 
’ Laveran, A. /iullrfh/ (fr VAvwHmie de MidacUic., March 23rd, 1904. 
- Neave, Sheffield. Bidtish Medictd Jounml^ May 28th, 1908. 
^ Phillips, Llewellyn. .Tonrunl of Tropical Medicine^ August 1st, 1904. 
^ Cummins. S. L. Jonrnnl of the. Uoijal Army Mrdicnl February, 1908. 
