84 LEISHMAN BODIES AND LEISHMANIASIS 



The Disease. The disease is much like true kala-azar in 

 most of its clinical manifestations, though differing in details. 

 It is characterized by fever, aches and anemia, and by excessive 

 enlargement of the spleen, the liver also enlarging somewhat. 

 Though in some places comparatively mild, in others it is ex- 

 tremely fatal. Recovery is rarer the younger the patient; in 130 

 cases reported from Palermo and Naples, 93 per cent of the chil- 

 dren under two years old succumbed to it, while 87 per cent of 

 the older children died. Similar high mortality has been re- 

 ported in other parts of Italy. 



Usually after recovery from a single attack immunity is given, 

 almost always lasting until the susceptible age is passed. 



Treatment and Prevention. Wonderfully successful results 

 have been obtained in the treatment of infantile kala-azar with 

 tartar emetic as described on page 81. Of eight children treated 

 with tartar emetic in Italy, all of whom were between five and 

 27 months old, except one boy of six years, seven recovered com- 

 pletely. In the last stages of the disease the vitality is so weak- 

 ened that recovery is impossible even with the destruction of all 

 the parasites. 



Prevention obviously lies in keeping infected dogs away from 

 children. In endemic regions dogs should be kept scrupulously 

 free from fleas, and all dogs showing the slightest symptoms of 

 feverishness, enlarged spleen or emaciation should be killed, and 

 their bodies burned to destroy fleas. Even if this were done it 

 would not be sufficient to stamp out the disease completely, since 

 so many dogs carry the infection in latent condition, serving as 

 a reservoir for it without showing any appreciable symptoms. 

 Basile showed the value of attacking the disease in dogs by de- 

 stroying all obviously infected dogs in a certain township in 

 Italy. In the year the dogs were destroyed there were seven 

 new cases of the disease in children in a population of 2000, but 

 in the following year not a single new case appeared, and in the 

 year after only one. 



Oriental Sore 



One of the commonest sights in many tropical cities, particu- 

 larly in the cities of the eastern Mediterranean region and south- 

 western Asia, is the great number of children, usually under three 

 years of age, who have on the exposed parts of their bodies un- 



