Large lymphocytes 
Small lymphocytes . 
Transitionals . . . 
Basophiles. 
There were many free nuclei of disintegrated mononuclears. Here then 
we find a marked increase of the larger mononuclear cells at the expense 
of the polymorphs. The blood was taken by means of a fine capillary pipette 
thrust through a small needle puncture into the depth of the growth. This 
slight operation was not unattended with pain, the patient wincing and 
complaining. 
Before going further it is interesting to compare these results 
with those obtained by Cardamatis 1 in several cases of oriental 
sore in Greece. In three cases he took blood from the finger and 
from the congestive zone at the periphery r of the lésions. His 
counts are not at ail unlike those recorded above and he found 
in the blood from the congestive zone the same m.arked increase 
of large mononuclear éléments, as we record in the case under 
discussion. Indeed as regards his third case the counts are almost 
identical. As mentioned, blood taken from the growths by punc¬ 
ture and made into films in the usual way, when fixed and stai- 
ned by the Leishman method, showed parasites belonging to 
the genus Leishmania. It was thought advisable to examine the 
contents of nearlv every one of the growths. It will be best to 
consider these briefly in detail. 
I. Face growth . — Parasites numerous, both free and in the 
mononuclears. None seen in the polymorphs. Many of the mono¬ 
nuclears are crowded with them, thirty being no uncommon num- 
ber in one cell. Some of those mononuclear cells are very large 
with much extra-nuclear protoplasm and are evidently the large en¬ 
dothélial cells eommonly found infected in cases of kala-azar and 
oriental sore. The free parasites occur singly r , in pairs and in the 
larger groups which hâve been so often described by various ob- 
servers. As many as 12 lying in close apposition counted in one 
clump. The blepharoplasts are both rod shaped and spherical. 
Single, somewhat large forms with curved blepharoplasts noted. 
In addition there are small coccoid bodies which may be free 
nuclei or spécial parasitic forms and there are also somewhat pear- 
shaped or wedge-shaped cells staining a light rose pink and 
exhibiting each a small spherical nucléus but no blepharoplast. 
II. Neck growth. — The parasites are not so numerous as in 1. 
They show vacuoles better and occur both free and in the mono- 
