IfiO 



K.\r,A-AZ.\n COMMISSION 



so far sliown no parasites in tin.: spleen or peripheral blood and is still under observation 

 in Sin)^a Hospital. Ei^lit more Abyssinians lived with the above and all were examined. 

 One had an enormous spleen but tiie othei's appeared liealth) . Tlic peripheral blood 

 was examined in all eases with the following results: — 



No. 1 

 o 



„ 3 



„ 4 



„ 5 ... 



,, fi 



„ 7 ... 



Urine and F^^.ces in Kala-azak 



Flagollatod 

 bodies in f^ces 



Somewhat 

 similar hcxlirs 

 found in 

 heahhy 

 controls 



Examination of these was carried out in order to determine, if possible, if the kala-azar 

 parasite leaves the body with tlie excreta. In the urine, albumin was twice present, but 

 microscopical examination failed to reveal anything abnormal. In the fasces no kala-azar 

 parasites were found. In 4 of the 8 cases examined, however, flagellated bodies were 

 present in the feeces, in 3 of them in enormous numbers. In hanging-drop preparations 

 these are seen as actively motile bodies darting backwards and forwards across tiie field. 

 .\s tiiey gradually lose their motility they become actively amoEboid and throw out long 

 narrow pseudopodia. In specimens stained by Leishman's method they appear as oval 

 l)odies varying greatly in size but averaging about 13/i by ll/i. They appear to have 

 4 flagella (sometimes only 3 can be seen) coming off near the nucleus, and one flagellum 

 is longer than the others (Plate X., figs. 1-4). In one of the small forms, measuring 59/1 

 by 10-2/1, the longest flagellum measured LSfi/i in length, and in another similar parasite 

 tlie flagellum measured 20 fi in length. The protoplasm is vacuolated and there appear to 

 be bacteria, etc., in tlie interior of the parasite. They remain alive and actively motile 

 at 22' C. for at least G days. They were best found in the fluid portion of the stool 

 after an aperient had been administered. If not originally present, cultivation at 22" C. 

 did not show any parasites. 



In Case 3, the ova of T.vnin nana were constantly present in the stools and tiie ova 

 of Tieiiia sfiUnm were also found on two different occasions. Actively motile spirocha>tes 

 were also frequently found. 



In order to determine if these flagellated bodies are common in the alimentary canal of 

 tiie inhabitants, numerous controls, numbering 35, were examined. Twenty of these were 

 school-boys attending school, 3 w^ere apparently healthy young children, and the remainder 

 were patients sick with fever and other illnesses. Flagellated bodies resembling the above 

 were found in 5 cases but always in small numbers. They appeared similar to the above 

 but they were present in such small numbers that microscopical examination of stained 

 specimens was impossible. Three of the positive cases were school-boys; No. I, Spleen 

 normal, no fever, quartan malaria and eosinophilia in his blood ; No. 2, Spleen normal, 

 no parasites in peripheral blood ; No. 3, Spleen enlarged, no fever, quartan malaiia 

 and e()siMO])iiilia in the peripheral l)lood. Of the other two, one was a woman admitted 



