KALA-AZAR 173 



The marked improvement in the condition of kala-azar 

 patients who have recovered from an intercurrent attack 

 of some inflammatory affection suggests the trial of 

 measures for inducing leucocytosis. 



The diet should be liberal, but it is important to avoid 

 overfeeding and foods difficult of digestion, for, as has 

 been seen, the voracious appetite of kala-azar patients, if 

 unchecked, frequently results in digestive troubles. 



Prevention. In view of the part played in all prob- 

 ability by the Eastern bed-bug, Cimcx rotundatus, in 

 the transmission of kala-azar, cleanliness, domestic and 

 personal, is the best safeguard against the disease. In 

 countries where the disease prevails, every- effort should 

 be made to rid houses of these parasites. Old bug- 

 infested houses should be abandoned and burnt, as it is 

 very difficult, if not impossible, to free such houses from 

 bugs by milder measures. In other circumstances, should 

 the disease appear, the patients should be isolated, the 

 infected houses thoroughly fumigated with sulphur or 

 pyrethrum, all beds and furniture likely to harbour bugs 

 soaked in boiling carbolic solution or similar disinfectant, 

 and all clothes and bedding similarly disinfected. 

 Segregation of patients and the burning of infected huts 

 have proved successful in dealing with outbreaks of kala- 

 azar in Assam. 



Varieties. The specimens of the parasites obtained by 

 Darling in Panama present certain differences, in that the 

 parasites are larger and the ectoplasm more definite and 

 thicker. In this form the lungs are more frequently 

 attacked. It may be a different species. 



INFANTILE KALA-AZAR, LEISHMANIA ANEMIA. Spleno- 

 megaly, ponos, is a disease which occurs on the Medi- 

 terranean shores and in many of the islands, such as 

 Malta, Cyprus, &c. 



It is mainly a disease of early life, but each year more 

 records of cases in adult life are reported. The main 

 symptoms are irregular fever, splenic enlargement, and 

 steady emaciation. 



