LftlSHMANlA DONOVANl 669 



service at Dum-Dum, an unhealthy cantonment near Calcutta, 

 he suspected he had to deal with an undescribed disease. In 

 1900 he noticed in the spleen of such a case peculiar bodies 

 which, from comparison with certain appearances found in 

 degenerating forms of Tr. brucei, he suggested might be 

 trypanosomes, and on publishing his observations in 1903 he 

 put forward the view that trypanosomiasis might prevail in 

 India and account for the aberrant cases of cachexial fever met 

 with there. Soon after Leishman's paper appeared, his observa- 

 tions were confirmed in India by Donovan, and the bodies 

 associated with the disease are usually called the " Leishman " or 

 the " Leishman-Donovan " bodies. They were found by Bentley, 

 and later by Kogers, in the disease known in Assam as kala-'azar, 

 the pathology of which had long puzzled those who had worked 

 at it, from the fact that, while it resembled malaria in many 

 ways, no parasite could be demonstrated to occur in those 

 suffering from it. This disease has gone under various synonyms, 

 e.g., cachetic fever, Dum-Dum fever, non-malarial remittent 

 fever, but is now recognised as a single specific entity. 



Kala-azar (or "black disease," — so called from the hue 

 assumed by chocolate-coloured patients suffering from it) has 

 been known since 1869 as a serious epidemic disease in Assam, 

 where it has spread from village to village up the Brahmaputra 

 valley. The disease is now known to occur in various sub- 

 tropical centres — cases where the Leishman bodies have been 

 found having been met with in many parts' of India, China, 

 Turkestan, the Malay Archipelago, North Africa, the Soudan, 

 Syria, and Arabia. The disease is characterised by fever of a 

 very irregular type, by progressive cachexia, and by anasmia 

 associated with enlargement of the spleen and liver, and often 

 with ulcers of the skin and with transitory dropsical swellings. 

 Rogers has pointed out that there occurs a leucopenia which 

 differs from that of malaria in that it is almost always more 

 marked, — the leucocytes usually numbering less than 2000, — 

 and further, in that the white cells are always reduced in greater 

 ratio than the red corpuscles, which condition, again, does not 

 occur in malaria. The disease is chronic, often going on for 

 several years, and in, at any rate, 80 per cent, of the cases has a 

 fatal issue. Post mortem, there is little to note beyond the 

 enlargement of the liver and spleen, but in the intestine, especially 

 in the colon, there are often large or small ulcers, and there is 

 evidence of proliferation in the bone marrow, the red marrow 

 encroaching on the yellow. 



In a film made from the spleen and stained by Leishman's 



