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Chapter XXX 



THE LEISHMAN-DONOVAN BODIES 



Leishmania donovani 



1. The parasites known by this name were 

 discovered in the spleen in the disease so common 

 in India, known as chronic ' malarial ' cachexia, Dam- 

 dam fever, Kala-azar, tropical spleno-megaly, etc. 

 They have since been found by splenic puncture in 

 a few cases of chronic fever from Africa. 



2. The same (?) parasites also have been found in 

 the granulation tissue of Tropical ulcer, Delhi boil, 

 Aleppo button, Scinde sore, Oriental sore, etc. 



CLINICAL CHARACTERS OF THE FEVER 



1. Great enlargement of the spleen, which fre- 

 quently reaches the umbilicus and even the pubis. 

 This is the most distinctive character of the disease. 



2. Emaciation. Usually present in advanced 

 cases, and in fatal cases it is extreme. 



3. Irregular pyrexia. Uninfluenced by quinine, 

 the accompanying chart indicates its character in a 

 well-marked case. 



4. Abdominal symptoms. Dysenteric ulceration 

 with blood and mucus in the stools in advanced cases. 

 Death from peritonitis following perforation is not 

 uncommon. 



5. Ulcerations. Cancrum oris, Noma vulvae, 

 or other phagedaenic processes are common. Small 



