63 



A similar phenomenon is also noticed with Babesia higeminum after 

 death. In a case of East Coast fever, as already stated, parasites make 

 their appearance a few days after a rise of temperature is recorded. At 

 the beginning of the disease, no corpuscles are found to be affected. As 

 the disease progresses an invasion of the corpuscles takes place. The 

 mcrease may be slow and never reaches a high percentage ; it may be 

 continuous and reach a high percentage, or it may be almost sudden, 

 invading all the corpuscles. 



In the initial or middle stages when the percentage of cells affected 

 in a blood smear is yet small, it resembles that of a smear from B. mutans 

 infection. It is here that a definite diagnosis becomes embarrassing. In 

 such a case the only course would be to continue daily the microscopic 

 examinations when an increase of parasites usually takes place. In a 

 case of Babesia mutans no notable increase, or only a slow one, is observed. 

 Blood changes, viz., lesions of anaemia will, however, in most cases 

 be recognised with the appearance of this piroplasm. These take the 

 form of anisocytosis, poikilocytosis, basophile, and polychromatic cells 

 (nucleated red cells being rarely found). This is specific for mutans and 

 not for parvum infection. In those cases of East Coast fever in which 

 lesions of anaemia are noted, it is due to the comphcation with Babesia 

 bigeminum, ordinary redwater (Texas fever), and other blood infection. 



Other elements found in smears from spleen, kidneys, lymphatic 

 glands, and in rare cases in blood smears of cattle affected with East 

 Coast fever are the so-called Koch's granule. They were first described 

 by Professor Koch. They are contained within a cell-shaped body and 

 vary in size, shape, and numbers in the same smear ; two varieties may 

 be distinguished, viz. : — 1st. Those in which the cell-shaped body stains 

 a deep blue tint and with granules varying in size ; the cell-shaped body 

 varies in size from l-5-9;« in diameter. 2nd. Here the granules vary in 

 size from 0*5-0 '75^, and the granular matter does not appear as compact 

 as in the former variety. 



It will be interesting to review here the result of investigations of 

 Martin Mayer,* Assistant in the Institute iol Tropical Diseases, Hamburg, 

 in connection with the study of spirochaeta Duttoni. In an end note 

 he points out that he found bodies containing granules corresponding to 

 Koch's granules in various numbers in the endotheliurn of normal kidneys 

 of cattle, mice, and guinea pigs, and of different other animals which had 

 passed through a certain infection or intoxication. 



He also points out that these globules are produced by contraction 

 of a part of the plasma of the cells, and that phagocytes transport these 

 to other cells, and that it seems a new proof that the endothelial cells 

 of the kidneys have a very great importance for destroying parasites and 



' Ai-chiv far SohifE und Tropen Hygiene, Bd. XII, No. 22, 1908. 



