86 LEISHMAN BODIES AND LEISHMANIASIS 



the parasites being transmitted by some biting insect which 

 appears during this season. There can be no doubt that the 

 myriads of flies which collect on the sores must mechanically 

 carry the parasites in many cases from infected individuals and 

 deposit them on wounds or cuts of others where they gain access 

 to the body. It may be that one or more kinds of insects act as 

 intermediate hosts; in fact, it has been claimed that in India the 

 bedbug is an intermediate host for this as well as for the kala-azar 

 parasite. In Teheran, where a large proportion of the dogs (in 

 one case 15 out of 21 street dogs) show Leishmanian sores, the 

 parasites have been found in the gut of a fly, Hippobosca canina, 

 common on the dogs. Camels and horses are also subject to 

 infection in some places. A number of French workers in North 

 Africa have suggested that the sandfly, Phlebotomus minutus, 

 which is very abundant there, is the transmitter of the disease 

 and that the common Algerian gecko, Tarentola mauritanica, 

 may play the role of a reservoir for the disease. The sandflies 

 swarm about the lizards in large numbers, and also bite man 

 readily. Leishman bodies have been found in the blood of a 

 number of geckos near Tunis. On the western face of the Andes 

 in Peru there occurs a similar disease known as uta, which has been 

 shown by Townsend, of the U. S. Bureau of Entomology, to 

 develop in the intestine of two little gnats, Forcipomyia utce and 

 Fordpomyia townsendi, very closely allied to the American 

 " punkies." Inoculation of the gut contents of these insects into 

 guinea-pigs produces sores believed to be identical with uta, and 

 Townsend believes the insects transmit the disease in nature by 

 voiding the Leishman bodies from the anus while sucking blood, 

 the puncture being contaminated in this way. Whether this dis- 

 ease is a very mild form of espundia, described below, or is more 

 closely allied to true oriental sore, is difficult to say. According 

 to the description given by Dr. Strong and his colleagues of the 

 Harvard expedition to Peru, uta is not so mild, and may attack 

 the mucous membranes as does espundia. Possibly both diseases 

 occur there. Dr. Strong has pointed out that the flagellated 

 stage of the uta parasite differs from that of other Leishmania 

 in possessing a basal granule in addition to the nucleus and para- 

 basal body. 



The Disease. Although oriental sore often has a long incu- 

 bation period, and produces such profound constitutional changes 



