-5- 



Asia, the cutaneous disease was referred to as "Balkh Sore" (after a 

 town in north Afghanistan, near the Russian border), and by early 

 travelers as "Aleppo Boil" in Syria and "Baghdad Boil" in Iraq 

 (Lainson, 1982). In the Americas, Peruvian and Ecuadorean pottery 

 from the era 400 to 900 AD depicts human faces with mutilations very 

 similar to those caused by cutaneous and mucocutaneous leishmaniasis. 

 Spanish historians at the time of the conquest described severely 

 mutilating sores on the faces of Peruvian Indians (Lainson, 1982). 



Because the major signs and symptoms of visceral leishmaniasis 

 resemble those of several other tropical diseases, it is difficult to 

 trace clear-cut references to this disease in ancient writings in 

 either the Old or the New World. The disease first attracted public 

 attention in 1882 when Clark, of the Sanitary Commission of India, 

 gave an account of 100 cases of a severe form of malarial cachexia, 

 depopulating areas of the Garo Hills, Assam. Natives of the area 

 called the disease "kala-azar" (black fever) and it appears that it 

 was known to them as early as 1869 (Strong, 1945). Epidemics of what 

 must have been the same disease, under the name of "Burdwan fever," 

 occurred in lower Bengal from 1854 to 1875, causing a quarter of a 

 million deaths (Strong, 1945). During this same period in the 

 Mediterranean region it was referred to as "infectious splenic anemia" 

 or "infantile splenic anemia" (Lainson, 1982). 



Visceral leishmaniasis apparently was unrecognized as a distinct 

 disease in Latin America until the time of the first parasitological ly 

 proven case, in Paraguay in 1913 (Migone, 1913). This fact, coupled 

 with clinical, epidemiological, and biochemical similarities between 

 Mediterranean and American visceral leishmaniasis, suggests that it was 



