LEISHMANIA DONOVANI 105 



(1) Leishmania donovani, Laveran and Mesnil, 1903, the parasite 



of Indian kala-azar, a generalized systemic disease, usually 

 fatal, occurring in subjects of all ages. 



(2) Leishmania tropica, Wright, 1903, the parasite of Delhi boil, 



Oriental sore, Aleppo button a localized, cutaneous disease, 

 usually benign. 



(3) Leishmania infantum, Nicolle, 1908, the parasite of infantile 



kala-azar, occurring in children (and a few adults) around 

 the shores of the Mediterranean. The disease is perhaps a 

 form of Indian kala-azar, and the parasite is probably identical 

 with L. donovani. 



These diseases may be termed collectively leishmaniases. The 

 morphology of the various species is practically identical. 



Leishmania donovani, Laveran and Mesnil, 1903. 

 Syn. : Piroplasma donovani, Laveran and Mesnil. 



The parasite of Indian kala-azar was demonstrated in 1900 by 

 Leishman from a post-mortem examination of a case of " Dum-Dum 

 fever," but details were not published till May, 1903. In July, 1903, 

 Donovan found similar bodies from cases in Madras. Rogers 

 succeeded in cultivating the parasite in July, I9O4. 1 The original 

 centre of the disease was probably Assam ; it occurs also in Madras, 

 Ceylon, Burma, Indo-China, China and Syria. A variety of this leish- 

 maniasis is found in the Sudan. The patient becomes emaciated, 

 with a greatly enlarged spleen. There is anaemia and leucopenia. 



The parasite, commonly known as the Leishman-Donovan body v 

 is intracellular (fig. 50, 2, 3). It is found in the endothelial cells of the 

 capillaries of the liver, spleen, bone-marrow, lymphatic glands and 

 intestinal mucosa, and in the macrophages of the spleen and bone- 

 marrow. Some host cells may contain many parasites. It is rather 

 rare in the circulating blood, but may be found in the blood from 

 the femoral, portal and hepatic veins. It does not occur in the red 

 blood corpuscles as was formerly thought. The parasites liberated 

 from the endothelial cells are taken up by the mononuclear and 

 polymorphonuclear leucocytes. The Leishman-Donovan body is the 

 resting stage of a flagellate. As found in man it is a small, oval 

 organism, about 2*5 //, to 3-5 //, in length by 2 //, in breadth, and con- 

 taining two chromatinic bodies, corresponding to the nucleus and 

 kinetic nucleus (blepharoplast) of a flagellate. The latter element is 

 the smaller and more deeply staining, and is usually placed at the 

 periphery, transversely to the longer axis of the oval organism. 



1 The literature up to 1912, on kala-azar and other leishmaniases is reviewed in the 

 Kala-azar Bulletin. Afterwards in the Tropical Diseases Bulletin. 



