THE PATHOGENIC PROTOZOA 287 



fever so prevalent in India might be a form of trypanosomiasis. 

 Later in the same year Donovan, working independently in India, 

 confirmed Leishman's findings, and the organisms became known 

 as the Leishman-Donovan bodies. The disease to which they 

 give rise has been called by a variety of names in different sections 

 of the tropics, e.g. dumdum fever, non-malarial cachexia, and 

 kala-azar. Recent investigators have reported cases in many 

 parts of India, China, Turkestan, Algiers, Egypt, Italy, and 

 Greece. 



Kala-azar is characterized by fever of an irregular type, a pecul- 

 iar dark earthy pallor of the skin, progressive anemia and emacia- 

 tion with enlargement of the spleen and liver, and frequently 

 edematous swellings and ulcers of the skin. The disease is chronic, 

 continuing for several years and having in about 80 per cent of 

 cases a fatal ending. 



In a film preparation made from the spleen the characteristic 

 bodies appear round or oval and usually 2.5 to 3.5 /* in diameter. 

 Within the protoplasm two intensely stained bodies can be dis- 

 tinguished : one, large, round or heart-shaped, situated near the 

 periphery ; the other, rod-shaped and generally distinct from the 

 larger body. The organisms may be seen free or packed within 

 phagocytic cells. 



In the body the parasite multiplies ordinarily by simple division. 

 Sometimes, however, multiplicative reproduction occurs, the 

 nucleus dividing several times within the cytoplasm and giving 

 rise to a corresponding number of new organisms. 



Cultivated outside of the body on Novy and MacNeal's medium 

 the organism develops into a flagellate form. The cell lengthens to 

 about 20 fji. The smaller nucleus moves near to one end and from 

 it arises a long, fine flagellum. The whole development occupies 

 about ninety-six hours. It was not until the organisms were culti- 

 vated on artificial medium that their relationship to the flagellates 

 was established. 



Nothing definite is known as to the manner in which the disease 

 is spread. Bedbugs fed on kala-azar patients have been found 

 to harbor flagellates, but since a variety of similar organisms 



