148 
CHRONIC SPORADIC KALA-AZAR TERMINATING WITH 
CIRRHOSIS OF THE LIVER 
The patient was a Hindu male, ajjed about 30. He had suffered 
from enlarged spleen with frequent attacks of fever on and off f« 
five or SIX years. During the last six months he had taken connti}- 
liquor, but not in excess. He was in hospitrd for 35 days beforehis 
death, during whicli time he sufTered from ascites with cnlargeoienl 
of the hver and spleen, and [KTsistent diarrhoea, and was greatly 
emaciated and anaemic, and had a troublesome cough. No malarial 
parasites could be found in his blood, and he only occasionally had 
a slight rise of tenijjcrature, flic disease was diagnosed as 
kala-azar. 
post mortem was performed and the following conditions notec 
ody was extremely emaciated, and the subcutaneous fat wa 
very scanty. The peritoneal cavity contained 30 02s. of clear fiuic 
oedema of the legs, the dropsy having decrease 
t e diarrhoea w'hile in hospital. Tlie pleural cavities showe 
some fibrous adhesions, but the lungs were crejntant throughoul 
although slightly congested at the bases. Both tiie parietal am 
pericaidium showed extensive haemorrhages (these beinj 
various positions). The heart muscle wa 
rhaerj^'^ stomach showed petechial haemor 
foSs nfV The small intestines showed a fev 
tomatT r of a small number of anchylos 
showed som “■ ulceration. The large intestim 
W part of * 
Solfth b J The liver weighec 
smooth, and of I gJ^fnLrbrown 
substance could not be brol-en d “T ' 
The gall bladder was healtH ^The'' 'T '''™‘ a’ '’r"' 
having become much diminished in ? 
brownish-red colour and very T'" " ’ 
The kidneys were healths ! 
difficulty, but left a smooth s.Xe Th 
surface. The brain was healthy. 
