LEISHMANIA INFANTUM G3. r > 



tropical regions. All attempts to include it among the malarial 

 cachexias, which clinically it so much resembles, have failed. 

 In this atypical cachexial fever there is always present a parasite 

 of very special characters belonging or closely allied to a group 

 which contains many varieties capable of giving rise to similar 

 diseases. Beyond this we cannot go, but at present we must 

 admit that there is strong presumptive evidence of the parasite 

 described being the cause of the disease. 



Methods of Examination. The Leishmania douovani can be 

 readily seen in films or sections of the organs in which we have 

 mentioned its occurrence. These should be stained by the 

 liomanowsky stains. Fluid taken from the enlarged spleen with 

 a perfectly dry needle during life may be examined, but it is 

 probable that in this disease puncture of the spleen may not be 

 a very safe operation, as death from haemorrhage from this 

 organ is a not uncommon natural terminal event. During life . 

 the main points on which a pathological diagnosis may be based 

 a iv the demonstration of the parasite in the circulating blood 

 which should always be attempted, the absence of the malarial 

 parasites from the blood, and the features of the leucopenia 

 which have been alluded to. 



Leishmania Infantum. Nicolle, working in Tunis, observed 

 a disease clinically identical with kala-azar, but presenting the 

 peculiarity of only affecting children of about two years of age. 

 Mr found in the spleen in such cases an organism, microscopically 

 indistinguishable from the Leishmania donovani. It was 

 cultivated on a modified Novy and MacNeal's medium, the 

 cultures presenting characters similar to those observed by 

 Rogers and by Leishman in the other Leishmania. It was 

 found that dogs could be infected with the parasite, and, taking 

 into account the fact that this animal is not susceptible to infec- 

 tion with the Leishmania donovani, and the further fact that the 

 disease is apparently confined to infants, Nicolle considered the 

 organism to be a separate species and gave it the name, 

 Leishmania infantum. In his view, the infection of the dog 

 possesses a further significance in that this animal may be the 

 reservoir from which, by means at present unknown, children 

 become infected. In support of this, he observed the fact that 

 a certain proportion of dogs destroyed in Tunis contained the 

 parasite in the spleen. This disease occurs in other parts of the 

 Mediterranean littoral; in 1905 Pianese described it in children 

 in Italy, and the parasites have been found in cases in that 

 country and also in Sicily and Malta. 



Leishmania Tropica. In various tropical and sub-tropical 



