TWO CASES OF NON-ULCEEATINC; " OKIENTAL SOKE " 205 



Having seen Nicolle's paper, I then tried his special agar. At that time, not having 

 invented the apparatus described on paijes 107-108, I found it very difficult to prevent 

 contamination by air organisms. The result was that though I obtained a partial 

 development I was never able to secure flagellated forms. It occurred to me that, from 

 the nature of the lesions, the parasites might be either obligatory or facultative anaerobes, 

 so I endeavoured to cultivate them under anaerobic conditions, without any better result. 

 Finally, as stated, the sores healed up and I was unable, owing to the disappearance of 

 the parasites, to carry out any further work in this direction. 



From a more detailed study of the morphology of the parasite I must confess that Possibility of 

 I am unable in any way to differentiate it from [j. tropica, hence any special description is species of skin 

 luinecessary. This agrees with the findings of Ferguson and Eichards, but I do not think Leishmania 

 the question of species can be settled without knowledge of the cultural forms, the effects 

 of inoculation and the carrier, the matter being on the same footing as animal trypano- 

 somiasis. I note that Castellani and Chalmers' think it very probable that there are 

 different species of skin Leishmania. 



During the whole course of these cases the parasites found were characteristic save on 

 one occasion, namely on January 2, 1910, when the contents of the right shoulder growth 

 of Case I were examined. Films made from the face nodules and from a small accessory 

 growth on this date were negative as regards the presence of parasites, but in the shoulder 

 growth films, curious cockle-shaped bodies were found along with the spherical homogeneous 

 blue bodies which are so characteristic of LvisIi.iiLania infections and which may or may not 

 be portions of the cytoplasm of fragmented hosl-cells (macrophages). It is difficult 

 to say what these cockle-shaped bodies are. Do they represent a preflagellate stage of 

 development or are they degeneration forms in a healing nodule ? Again, may they 

 not represent an accidental contamination Vjy some form of yeast cell, considering that the 

 shoulder growth had been frequently punctured ? It is possible they are a form of 

 Leishmania, and are evidence that the parasites in these nodules are a distinct species, 

 but I am not inclined to subscribe to this hypothesis. Amongst them there were some 



W^ 



i 



■.\ 



--■'-'- X 1000 </iam 



h'iiiH 47 and i^ — Cai-ious *eWP«e"Sftwpi!* tr.d;.^s 



bodies resemVjling the vermicules of haemogregarines but nuich more minute. They vary " Cnckit- 

 in shape and size, some being cockle-like, others elongated. Their nuclei, or what may bodies 



' Castellani, A., and Chalmers, A. J. (1910), Manual of Tropical Medicine. Loudon. 



