LEISH MANIA DONOVANI IN PERIPHERAL BLOOD 221 



azar. Thirty-one of the specimens showed flagellates (91 per 

 cent.), 82/115 culture tubes being positive. 134 cultures were 

 also made from forty specimens of blood from kala-azar patients 

 treated with several forms of antimony. When these were ar- 

 ranged in ascending order of doses of milligrams of antimony 

 per kilogram weight of patient it was found that up to a total 

 dosage of 12 mg. (0.162 to 11.96 mg.) positive cultures were 

 obtained in 60 per cent, of the fifteen cases and in 22/59 of the 

 culture tubes. Beyond that point, i. e., doses of 20.66 to 77.64 

 mg., seventy-five cultures from twenty-five specimens were uni- 

 formly negative. Three similar series were made from spleen 

 juice. The first showed twenty out of twenty-two (91 per cent.) 

 specimens positive (68/108 tubes) in untreated cases. The nine 

 specimens from patients treated up to 12 mg. (0.05 to 10.2 mg.) 

 per kilogram of their weights had seven positive (77 per cent.) 

 with 30/56 of the tubes showing growth. Only three spleen cul- 

 tures were made from patients who had received more than 12 

 mg. (12.9, 30.7 and 95.87 mg.) All were negative. Compari- 

 son was made betwen the results obtained by the author's tech- 

 nique (Series A) and that of Row 16 (Series B). A third series 

 (Series C) was made from the cloudy fluid above Row's sedi- 

 ment after centrifugation. Series A showed 30/69 (43.5 per 

 cent.) tubes positive; Series B, 16/46 (34.8 per cent.) and Series 

 C 10/43 (23.3 per cent.) The only obvious difference between 

 Series A and C was that in the latter, the material had stood in 

 contact with the diluted human serum for from 15 to 20 hours. 

 The greater number of positive cultures in Series B than in 

 Series C suggested a search of the layers of the red cell sedi- 

 ment obtained after slow centrifuging of the diluted blood 

 specimen. 



In the bottommost part of this sediment both mononuclear and 

 polymorphonuclear leucocytes were found and in a few of them, 

 Leishman-Donovan bodies. Of twenty-seven smears made from 

 nine blood specimens from five untreated kala-azar patients 

 twenty-one showed intracellular parasites. Of twenty-six slides 

 from seven specimens from four cases treated with 0.49 to 5.13 

 mg. of antimony per kilogram of patient's weight fifteen gave 



16 Row diluted %-2 c.c. of blood in 20 c.c. of citrated saline and after 

 sedimentation over night, planted the sediment in N.N.N, tubes. 



