TWO CASES OF NON-ULCEKATING 



' ORIENTAL SOKE 



195 



The blood was taken bj- means of a fine capillary pipette thrust through a small needle 

 puncture into the depth of the growth. This slight operation was not unattended with 

 pain, the patient wincing and complaining. 



Before going further, it is interesting to compare these results with those obtained 

 by Cardamatis' in several cases of oriental sore in Greece. In three cases he took 

 blood from the linger and from the congestive zone at the periphery of the lesions. His 

 counts are not at all unlike those recorded on page 194, and he found in the blood from the 

 congestive zone the same marked increase of large mononuclear elements as we record 

 in the case under discussion. Indeed, as regards this third case, the counts are almost 

 identical. .\s mentioned, Ijlood taken from the growths by puncture and made into films 

 in the usual way, when fixed and stained by the Leishman method, showed parasites Presence of 

 belonging to the genus Leishmtuiid. It was thought advisable to examine the contents Leishmnnui 



^ '^ n o . . in the sjrowths 



of nearly every one of the growths. It will be best to consider these briefly in detail. 

 1. Face growth. — Parasites numerous, both free and in the mononuclears. None seen 

 in the polymorphs. Many of the mononuclears are crowded with them, thirty being no 

 uncommon number in one cell (Fig. 42). Some of these mononuclear cells are very large with 

 nuich extra-nuclear protoplasm, and are evidently the large endothelial cells commonly 

 found infected in cases of kala-azar and oriental sore. The free parasites occur singly, 

 in pairs and in the larger groups which have been so often described by various observers. 



As many as 12 lying in close apposi- 

 . "z '"''li'iii,^ tion were counted in one clump. The 



blepharoplasts are both rod-shaped 

 and spherical. Single, somewhat large 

 forms with curved blepharoplasts 

 noted. In addition, there are small 

 coccoid bodies which may be free 

 nuclei or special parasitic forms, and 

 there are also somewhat pear-shaped 

 or wedge-shaped cells staining a light 

 rose-pink, and exhibiting each a small 

 spherical nucleus, but no blepharoplast. 

 2. Neck (jrowth. — The parasites 

 are not so numerous as in 1. They 

 show vacuoles better, and occur l)oth 

 free and in the mononuclears. Curved 

 blepharoplasts were again noted 

 in some of them. Blood and white 

 cheesy matter, mixed, were also 

 obtained from this growth, kept in a 

 sealed, sterile capillary tube lor six hours at room temperature (about 35" C), and then coccoid bodies 

 smeared and stained. Parasites were found free and in mononuclears, and groups of 

 what seemed to be large cocci were observed, as was a number of pale blue homogeneous 

 structureless masses with regular outlines, probably formed from the matrix of ruptured 

 host cells. 



3. Left upper arm grutrth. — Parasites fairly numerous. Coccoid bodies and pink 

 pyriform and wedge-shaped cells present. Small clumps comparatively common. A large 





Pig. 42. — ^Parasites free and 



mononucleated cell. 



uped tn^ether lu the cytoplasin oi a k-ii'ie 



^ Cardamatis, J. P. (May 12, 1909), '* Leishmaniosis en Gr^ce (Bouton d'Orient)." 

 E.ruf. Paris. 



Bull. Soc. Path. 



