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Chapter XXVIII 



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 clironic ' malarial ' cachexia, 

 Dam-damfever, 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 P'ever 



1. Great enlargement of the spleen, which 

 frequently 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 ulcera- 

 tion with blood and mucus in the stools in advanced 

 cases. Death from peritonitis following perfora- 

 tion is not uncommon. 



5. Ulcerations. — Cancrum oris, noma vulvae, 

 or other phagedaenic processes are common. 

 Small ulcers occur about the knees and elbows, or 

 z 



