LEISHMANIASIS— DIFFERENTIATION 67 



Fevers typical of the disease, 



K. A. Double remittent type of fever in certain cases. Double 

 continued type. Low continued type. Frequency of 

 different types of fever in various stages of the disease. 

 O. S. No fevers. 



Recovery after septic complication. 



K. A. Such as cancrum oris. 



O. S. Septic complications no effect, as the parasite thrives best 

 in cultures with masses of cocci and bacteria. 

 Effect of quinine. 



K. A. Large doses in early cases have cured. 

 O. S. No result. 



General symptoms in — ■ 

 K. A. Early cases give history of rigors daily, headache, sick- 

 ness, ^s per cent, of cases in hospital show diarrhoea, 

 and 7 per cent, dysentery. 

 O. S. None of these symptoms present. 

 Spleen and Liver. 



K. A. Enormous enlargement of both viscera. 

 Coagulability of blood decreased. 



O. S. No enlargement of viscera, and coagulability increased. 

 Distribution of parasite. 



K. A. Polynuclear leucocytes infected. Spleen, liver, bone 

 marrow heavily infected. Intestinal ulcers and 

 cutaneous ulcers contain the parasite. 



O. S. Superficial polynuclears rarely, if ever, contain the 

 parasites, whereas they swarm in the large mono- 

 nuclear cells seen in a smear. 



Cultivation and development. 



K. A. At 27° C, in blood containing 10 per cent, citrate, 

 parasites live for several days and multiply, but there 

 is no material alteration in their form, and no increase 

 in size. 



At 22° C, and not above 2^° C, flagellated forms 

 appear. 



Exposure to a temperature of about 25° C. causes 

 rapid death and degeneration of the developing forms. 



Sterility of the culture tubes is of crucial importance. 



Contamination with micrococci and bacteria causes 

 rapid death and degeneration of the parasites; staphy- 

 lococci the most deadly contamination for the parasite. 



