Page:Tropical Diseases.djvu/241

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XI]
HISTORY
205

cases of tropical splenomegaly I had studied in this country, the absence of tertian and quartan periodicity in the fever, and the uselessness of quinine in its treatment, I had come for some years to regard this disease as non-malarial and as one sui generis. In 1903, struck by certain features common to trypanosomiasis and kala-azar, I ventured to suggest in the third edition of this manual that the latter disease might be a trypanosoma disease.

A few months later, Leishman published a paper " On the Possibility of the Occurrence of Trypanosomiasis in India," wherein he stated that in 1900, at Netley Hospital, at the post-mortem of a soldier who had died of so-called dum-dum fever, he had discovered in smear preparations from the spleen-pulp a number of small round or oval bodies, two or three microns in diameter, which on being stained presented, besides the nucleus, a smaller rod-like chromatin mass, set perpendicularly or at a tangent to the circumference of the larger nuclear mass. At the time he was unable to explain the nature of these bodies; but in May, 1903, on coming across similar bodies in the blood of a rat which had died of nagana, and the blood of which during life contained numerous trypanosomes, he surmised that the bodies found in the soldier in 1900 represented degeneration forms of trypanosomes.

In July, 1903, Donovan stated that he had found similar bodies three months previously in smears of the spleen taken post-mortem from cases said to have died from chronic malaria. On June 17th he found identical bodies in splenic blood taken during life from a patient suffering from irregular fever and enlarged spleen, and whose peripheral blood showed no malaria parasites. Identical bodies had also been found by Marchand in January, 1903, in sections of the spleen, liver, and bone marrow from a patient who had taken part in the Pekin campaign and had suffered from a long-continued irregular fever, extreme enlargement of the spleen, and anæmia.

In December, 1903, having under treatment a patient from Darjeeling suffering from typical kala-