OBSERVATIONS ON KALA-AZAB IN KASSALA I’EOVINCE 
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Liver and spleen were considerably enlarged, the conjunctivae were yellow, and the 
urine contained bile and a trace of albumen. 
The spleen decreased in size under quinine injections, but this drug had no effect on 
his temperature. 
On February 1th, 1908, a spleen puncture was performed, but no parasites found. 
On February 19th, 1908, a second splenic puncture was positive, typical “bodies” 
were found, but in very small numbers. 
On February 22nd, 1908, he was started on the atoxyl-fuchsin-sublimate treatment, 
but though no untoward symptoms appeared, yet there was no improvement. Weakness 
and emaciation steadily increased, cedema of legs appeared on March 14th, 1908, trouble¬ 
some and persistent epistaxis on March 22nd, 1908, and he died on March 26th, 1908. 
An autopsy was not performed owing to the strong objections of his relations, so it was 
not possible to prove if the parasites had disappeared from sjileen and liver. 
It is greatly to be regretted tiiat more autopsies were not performed, but the feeling 
is so strong against this procedure that it was considered unwise to insist, for undoubtedly 
by doing so very great harm would have been done to the civil work. 
