Machado and Vianna in Brazil for dermal leishmaniasis, and subsequently applied to kala-azar by Castellani, Rogers, and others with remarkable success. If instituted before the case has become hopeless it seldom fails to ensure recovery. The drug may be given as in trypanosomiasis (see p. 180). The expulsion of intestinal parasites, change to a healthy climate, good food, warmth, rest, physical comfort, and good hygienic conditions are indicated.
Prophylaxis.—— Having regard to the character of the disease, in the endemic districts the cases should be dealt with as infectious; they should be isolated, and their houses and fomites should be disinfected or burnt. Domestic and personal cleanliness is of great importance. Infected dogs and cats should be destroyed ; and as far as possible, in the endemic districts, dogs should be kept free from fleas and not in too close association with man. By segregation of the sick, burning of houses, clothing, and furniture, etc., and provision of new huts, Price, Rogers, and Young have succeeded in exterminating the disease in infected coolie lines.
Oriental sore and kala-azar.—— If the parasite of oriental sore be specifically identical with that of kala-azar, it must somehow have been deprived of its virulence; for, although kala-azar is a fatal disease, oriental sore is eminently benign. It is known that one attack of oriental sore confers immunity against further attacks of the same disease. It affects dogs and other animals. May it not be that the virulence of the Leishman body is removed by passage through some animal other than man; or, possibly, by being transmitted by some intermediary other than that which transmits the virulent kala-azar? If this be so, we have at hand a vaccine against kala-azar. The idea is worth testing: " Are those who have had oriental sore immune as regards kala-azar, and vice versa?" *[1] In support of this suggestion it has long
- ↑ * Nicolle has succeeded in producing a certain amount of immunity in dogs and monkeys to oriental sore and to kala-azar by injecting them intraperitoneally with cultures and infected material containing the leishmania of the local and of the general disease.
