15 ^ 
liver lobules, was so characteristic that it could not possibly be over¬ 
looked. j\Iy impression, therefore, is that a true malaria] cinhusis 
of the liver does occur, but that it is certainly decidedly rare e\en 
in highly malarious Lower Bengal, for a large proportion of our cases 
come from tiie iinliealtliy districts surrounding Calcutta. 
I may also mention that typical atrophic cirrhosis is extremely 
common in Bengal, more so even tiian in Lurr)pe, although it is 
certainly not as a rule due to alcohol. Major O. W. Sutherland has 
also recorded a similar experience in tiie Punjab. Thus in five per 
cent, of over 4,000 post mortems in Calcutta cirrhosis of the liver was 
found, although 40 per cent, of the deaths were from typically tropical 
diseases, such as cholera. &c. If these are excluded the percentage 
rises to between 8 and 9 per cent, of the deaths. On tlie other hand, 
in Berlin Forster found cirrhosis of tlie liver in but i per cent, of 
3,300 post mortems. This very important subject, however, is 
beyond the scope of the present paper. 
SUMMARY 
tbp‘ most chronic cases of kala-azar not infrequently terminate 
their course with ascites due to cirrhosis of the liver. 
distn'biii-' ^ peculiar intralobular type of uniform 
distribution and with a smooth surface to the organ 
found in the T parasite of kala-a.nr, which may be 
found m the hver and other organs after death. 
Bental Zf commoner in Lower 
atrophic cirrhosis due ,o unknown ersir 
