Cask of Kala-azar treated by " 606 " 



BY 



The Director 



AND 



Captain K. G. Archibald, M.B., R.A.M.C., attached E.A. 



Pathologist iiml Assistant Bacteriologist 



Wellcome Tropical Research Lahoratories, Khartoum 



As we were desirous of testing the new drug, dioxydiamidoarsenobeuzol, or " 606," 

 on protozoal infections in the Sudan, and more especially on cases of kala-azar and fowl 

 spirochaetosis, a request was sent to Professor Ehrlich asking him if he could kindly 

 spare a supply of his remarkable preparation. He most generously despatched a 

 considerable quantity of the drug and also favoured us with full instructions for its 

 administration, his views as to the type of cases in which it should not be employed, 

 and the precautions which he considered advisable in its use. Its action on fowl 

 spirochaetosis is discussed elsewhere (vide page 99), but Captain Byam, the S.M.O. of 

 Kassala, having been good enough to send a case of kala-azar, in a Sudanese boy, to 

 Khartoum, expressly for the purpose of treatment with the new preparation, we were 

 able, by the kind permission of Captain A. G. Cummins, E.A.M.C., who had charge of 

 the case in Khartoum, to observe the action of dioxydiamidoarsenobeuzol on a disease 

 caused by one of the most resistant of haematozoa, and on a fever which is one of the 

 most intractable in the Tropics. 



The following are Captain Byam's notes on the case up to the time the boy left .Summary 

 Kassala. They are accompanied by the temperature chart (Fig. 37) shown on page 188. °f*ecase 



Hassan Said. Age 10 years. 



September 6, 1910. Reported sick at Civil Hospital, Kassala, stating that he had been 

 ill with "fever" for the previous three months. Admitted to hospital. On examination, 

 general condition good and patient apparently in no pain. Spleen extended to one hand's 

 breadth below costal margin. 



September 13, 1910. Has suffered with daily remittent fever. Placed on quinine. 



September 21, 1910. Examination of peripheral blood having shown no malarial or 

 other parasites on several occasions, splenic punctures performed. Leishman-Donovan 

 bodies discovered in large numbers, mostly free. 



September 22, 1910. Isolated. Father, mother and two brothers examined and 

 found healthy. Has always lived in Kassala to the west of River Gash. 



Tukl and all personal belongings burnt. Treatment with senega (tincture) commenced. 

 Quinine by mouth and injection has had no effect on the fever, though the spleen varies, 

 almost daily, in size. No diarrhoea or profuse sweating. 



October 24, 1910. Has recently increased in weight. By sick convoy to Khartoum. 



On arrival in Khartoum the patient was admitted to the Khartoiim Military Hospital 

 on November 6, 1910. His general condition was fair. The most noticeable sign was a 

 very prominent abdomen, which was tight as a drum. The skin was somewhat dry 

 but showed no evidence of the presence of any petechial spots. The conjunctiva? were 



