INFANTILE KALA-AZAR 199 



it is possible that it has been imported from the Bfcst. 

 Both commerce and emigration are affected adversely 

 by the occurrence of this fatal disease in Southern 

 India. 



Recently much attention has been given to a 

 malady more especially prevalent among children 

 occurring on the Mediterranean littoral, both African 

 and European. It is often called Infantile Kala- 

 azar, as it resembles Kala-azar and is chiefly preva- 

 lent among children. A complaint known as 

 infantile splenic anaemia has long been recognized 

 in Italy, and is the same as Infantile Kala-azar. On 

 the European side, Crete, Greece, Turkey, Italy, 

 Malta, Sicily, and Portugal, all have the disease, 

 while it has been reported from Algeria, Tunis, and 

 Tripoli, on the African coast. Sicily and Calabria 

 are very heavily infected. 



The symptoms of infantile Kala-azar resemble 

 those of the Indian form, and the parasites (often 

 called Leishmania infantum) collect largely in the 

 spleen, which becomes much enlarged, and in the 

 lymphatics, liver, lungs, and pancreas. There is 

 much anaemia and weakness prior to death. In one 

 case Dr. Critien found the parasites in the stools of 

 a three-years-old Maltese child, but this is the only 

 case wherein it has been reported. 



L. infantum strongly resembles the Indian Kala- 

 azar parasite in appearance. While it is most deadly 

 to the young, some cases are known when heavily- 

 infected children have recovered suddenly and with- 

 out treatment. Such cases of spontaneous recovery 

 are of great importance, for it will probably be by 



