REFERENCES 



1307 



History. — There is no literature on the subject as far as we know. 



Climatology. — We have observed it in tropical Africa, Ceylon, and India, 

 and probably it will be found in many other places. 



Symptomatology. — The disease begins insidiously in either children or 

 adults, but usually the case is not observed until either the anaemia becomes 

 well marked or the splenomegaly attracts attention. The symptoms are 

 more or less severe anaemia and a painless firm enlargement of the spleen, with- 

 out increase in size of the liver or other important signs. The blood shows the 

 ordinary signs of a severe anaemia, but no parasites can be observed. There 

 is no diarrhoea, and the mucosa of the mouth is not inflamed or ulcerated. 



Diagnosis. — The disease can be differentiated from malaria by the absence 

 of fever and of the absence of the parasites in the blood and spleen; from 

 kala-azar by the absence of the parasites in the spleen; from forms of febrile 

 splenomegaly by the absence of fever; from leucocythemia by the absence 

 of the great increase of the white blood cells. From other forms of splenic 

 anaemia it may be differentiated by the absence of any history or signs of 

 rickets, syphilis, etc. 



Prognosis. — Patients appear to live for years. 



Treatment. — This is purely symptomatic, but arsenic may be administered. 

 Leger*s Disease. 



Leger has recorded a case, from Guiana, of prolonged fever \m.t\i great 

 enlargement of the liver, in which he found organisms of two types. Some 

 were 3-5 fi, in length by i ^ in breadth, with a flagellum 3-5 fi long. Others 

 were of oval shape, without any flagellum. Leger considers his parasite to 

 differ from HcBmocystozoon brasiliense Franchini (p. i468),^as it never con- 

 tained any pigment, and encysted forms were absent. 



REFERENCES. 



The most complete and valuable references may be found in the Kala-Azar 

 Bulletin (1911-1912), which was published separately by the Bureau of Sleeping 

 Sickness, but is now merged in the Tropical Diseases Bulletin, in which many 

 references will be found. The most valuable single work is the excellent 

 monograph of Laveran (1917), 'Leishmaniases,' Paris. 



Indian Kala-Azar. 



Leishman (1906). Allbutt and Rolleston's System of Medicine, vol. ii., part ii. 

 Low (1919). Br. Med. Journ., June 7. 



Hanson (1908). Annals of Tropical Medicine and Parasitology, II., iii. 147. 

 Manson and Low (1909), British Medical Journal, i. 843. 

 Patton (1907). Nos. 27 and 31, Scientific Memoirs of India. 

 Rogers (1908). Fevers in the Tropics. 



Mediterranean Kala-Azar. 



Bandi (191 3). Journal of Tropical Medicine. 

 Gabbi (1908). Polichnico. 



Marcel, Targhetta and Ameuille (1918). Bull. Ac. de Med., April 25. 

 NicoLLE AND Cassuto (1907). Academic de Medecine. 

 PiANESE, G. (1905). Gazz. Internaz. Medicina. 

 ViSENTiNi (191 3). Quart. Journal Micro. Science. 



Pseudo-Kala-Azars. 



Castellani AND CHALMERS (1910-11). Ccylou Mcdical Reports, etc. 



Day AND Ferguson (1909). Annals of Tropical Medicine and Parasitology, 



iii. 3, 379. Liverpool. 

 Gabbi (1912). Malaria. Roma. 

 Leger (1919). Bull. Soc. Path. Ex., February. 

 Raubaud (1919). Bull. Soc. Path. Ex., February. 

 WooLLEY (1906). Philippine Journal of Science. Manila. 



Toxoplasmosis. 



Castellani (1913). Journal of Tropical Medicine, April 15. 



