the alkalinity of thk blood sekum ix kala-azak 177 



Conclusions 



It is evident that the alkalinity of the blood iu these four eases of undoubted kala-azar 

 was diminished, and it is worth remembering that Eogers, Leishman, Statham, and other 

 observers found that the ideal culture medium for successful cultivation of the Leishman 

 body is an acid one. 



If, then, the alkalinity of the blood serum iu cases of kala-azar be diminished, it is 

 conceivable that the blood and tissues present a more favourable medium for the Leishman 

 parasite than is usually the case ; and, in order to obviate this, it would not seem 

 unreasonable, whatever specific line of treatment be adopted, that dj-ugs should be 

 administered which tend to increase the alkalinity of the blood. 



Of the above eases, only one was subjected to an alkaline treatment by calcium 

 lactate, and unfortunately the disease was so far advanced in this instance that the drug 

 had scarcely a fair trial. 



A specific drug for the successful treatment of Leishmaniosis has not yet been found. 

 Quinine and various arsenical preparations have not given satisfactory results up to the 

 present, 1 and hence the record of these four cases points to the advisability of employing 

 such remedies as would increase the alkalinity of the blood. 



Further, the alkaline reaction obtained in testing the serum of kala-azar cases may 

 be of service in assisting the diagnosis in early cases where splenic enlargement is 

 not marked. 



I am indebted to Colonel Mathias, D.S.O., Principal Medical Officer, Egyptian Army, 

 for his kind permission to publish these results, and to the officers of his staff at the 

 Khartoum Military Hospital, for their assistance. 



' Miiir has recently reported favourably on the use of quinine by hypodermic injection, especially in 

 early cases. — Indian Medical Gazette, February, 1911. — A.B. 



