l68 TROPICAL MEDICINE AND HYGIENE 



proved that it was possible to trace every step in the 

 degenerative changes which had led to the formation 

 of the small rounded bodies, the two chromatin masses, 

 one of which represented without doubt the macro- the 

 other the micro-nucleus of the trypanosomes from which 

 they had been formed (fig. 49). This second observation 

 gave a clue to the explanation of the first, and Leishman 

 felt himself justified in suggesting not only that the soldier 

 had suffered from trypanosomiasis, but that "some of 

 these severe tropical cachexias, such as Dum-dum fever, 

 as well as kala-azar and sleeping sickness, might be due 

 to trypanosomiasis. These suggestions have been justi- 

 fied to the extent that the parasites have been proved to 

 develop flagella, and therefore belong to the flagellates. 



In July, 1903, Donovan announced that some months 

 previously he had seen the bodies described by Leishman 

 in the spleens of several patients, who had died at Madras 

 of what was considered to be chronic malaria, but he was 

 not aware of their nature until he had seen Leishman's 

 paper, and that he had since found identical bodies in 

 the blood, obtained by puncture, of the spleen during 

 the life of a patient suffering from irregular pyrexia, 

 and in whose blood no malarial parasites could be found. 

 In the following January, Bentley discovered similar 

 bodies in spleen smears from living patients suffering 

 from kala-azar in Assam, and since then numerous 

 similar observations have been made as regards cases 

 presenting similar symptoms, where the disease was con- 

 tracted in or near Calcutta, and in certain other places 

 in India and elsewhere. It may, however, be noted here 

 that the parasite has not been discovered in patients 

 suffering from " malarial cachexia and enlarged spleen " 

 in the Punjab where organisms morphologically similar 

 have been shown to occur in Delhi boils. 



A further stage in the etiology of the disease was 

 reached in November, 1904, when Rogers announced 

 that he had observed the development from the parasite 

 of flagella, leaving, as he said, " but little room for doubt 



