CHAPTER XXI. 



KALA-AZAR (BLACK FEVER). 



LEISHMANIA DONOVANI (LAVERAN AND MESNIL). 



" KALA-AZAR," " Dumdum fever," "Febrile tropical spleno- 

 megaly," " Non-malarial remittent fever," is a peculiar, fatal, 

 infectious disease of India, Assam, certain parts of China, the 

 Malay Archipelago, North Africa, the Soudan, and Arabia, 

 caused by a protozoan micro-organism known as Leishmania 

 donovani, and characterized by irregular fever, great enlarge- 

 ment of the spleen, anemia, emaciation, prostration, not in- 

 frequent dysentery, occasional ulcerations of the skin and 

 mucous membranes, and sometimes cancrum oris. 



Because of its protean manifestations the disease has been 

 given many names, and has been confused with the various 

 diseases which its symptoms may resemble. It was not 

 until 1900 that it was finally differentiated from malarial 

 fever and came to be regarded as a distinct entity. 



In 1900 Leishman* noticed in the spleen of a soldier re- 

 turned from India and suffering from " dumdum fever " 

 a fever acquired at Dumdum, an unhealthy military can- 

 tonment not far from Calcutta certain peculiar bodies. He 

 reserved publishing the observation until 1903, so that it 

 appeared almost simultaneously with a paper upon the same 

 subject by Donovan, f As the publications came from men 

 in different parts of the world, appeared so nearly at the* same 

 time, and showed that they had independently arrived at the 

 same discovery, the parasite they described became known 

 as the Leishman- Donovan body. For a long time its nature 

 was not known and its proper classification impossible, but 

 after it had been carefully studied by Rogers J Ross, and 



*"Brit. Med. Jour.," 1903, i, 1252. 



t Ibid., 1903, n, 79. 



J "Quarterly Jour. Microscopical Society," XLVIII, 367; "Brit. Med. 

 Jour.," 1904, i, 1249; n, 645; "Proceedings of the Royal Society," LXXVII, 

 284. 



"Brit. Med. Jour.," 1903, n, 1401, 



566 



