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82 THE INDIAN MEDICAL GAZETTE.

[Mar. 1904. Recently an intelligent native, who left his village in Mangaldai after losing many relations from kalaazar, assured me that cattle disease broke out at the same time as the epidemic attacked his village, and that he and many others had lost relations and cattle, year after year, until the survivors feared to remain in that part of the country.

When questioned as to the symptoms of the cattle disease, he volunteered the statement that bloody urine was passed by a number of the affected animals.

A new coolie from Midnapur district, who came from his country suffering from an enor- mously enlarged spleen, gave, when questioned, a similar story.

He stated that many people in his village were now suffering from spleen and fever, and that he had lost two brothers from this cause only last year. Cattle disease had broken out, sume two or three years before, at the same time as the outbreak of “spleen fever” among the people.

When questioned as to the symptoms shown by the affected cattle, he at once referred to bloody urine as being of frequent occurrence. He said this without being asked leading questions, using the word for blood, and not merely stating that the urine was red.

These statements are of interest when taken in connection with the article on “ Red Water in Cattle” by Stewart Stockman, Esq. c.v.D. (I. M. G., Aug. 1903), and Laveran’s pronounce- ment regarding the nature of the parasite found in cases of “spleen fever” by Major Donovan.

Should Laveran’s theory prove correct, the spread of kala-azar and kindred diseases will probably be found to be due to the bite of some blood-sucking insect, such as a species of tick, or perhaps lice, fleas, or bugs.

There is also the possibility of the disease having been originally conveyed from cattle to man through the instrumentality of cattle ticks, for it is well-known that in many parts of India the people are accustomed to stable their cattle beneath the same roof or adjacent to their own houses, and enquiry will often elicitate the state- ment that people who live thus in close proxi- mity to their domestic animals are frequently attacked by the ticks which fall from these beasts.

It will be seen at once that the discovery re- corded in this article disposes once and for all of the Malta fever theory of the causation of kala- azar, although of course it does not necessarily negative the occurrence of this former disease in Assam.

It is hardly necessary to refer to the malarial theory of the etiology of kala-azar, because this has been abandoned as no longer tenable by all competent authorities.

I may, however, record the fact that the exami- nation of considerably over twelve hundred blood films from cases of this disease has resulted in the finding of malarial parasites in less than fifty.

Among those showing malarial parasites, Quartan, Benign Tertian and Malignant Tertian in single and mixed infeetions, have been re- corded in about equal proportions.

In spleen smears no malarial parasites have been seen, but old malarial pigment occurred in about half the specimens examined.

In regard to the suggestion that was thrown out at the last British Medical Association Annual Meeting, hinting at a species of trypano- some as the cause of kala-azar, I may state that little direct evidence can be brought forward in support of this idea. So far, although I have examined four or five thousand blood tilms from all kinds of fever cases during the past five years, I have never found any trace of a try pano- some in human blood, neither have I been able to discover trypanosomes in the blood of any species of mammal in this part of India. I have, however, frequently found trypanosomes present in the blood of two species of mud-fish, which live in the bheels of this part of Assam.

The examination of several hundred of these fish brought to light a strange fact, which has a special interest after the suggestion which has been made as to the possibility of kula-azar being trypanosomiasis.

It appears that mud-fish taken from marshy places adjacent to coolie lines in a great number of cases harbour trypanosomes. ‘The fish taken from bheels adjacent to a large set of lines in which kala-azar had broken out, in nearly every instance were the hosts of this parasite.

Thirty odd fish of this particular species, taken from a bheel adjoining a village which had been attacked by kala-azar, showed 100 per cent with trypanosomes. Fish of this kind from other parts of the district, or from other parts of Assam (Gauhati), were entirely free from this parasitic invasion.

What the explanation of this fact may be I cannot suggest, but the existence of diseased fish apparently only in water subject to feecal conta- mination, and the occurrence of this disease specially among fish in bheels adjacent to kala- azar-infected villages and lines, is a fact which appears to merit further investigation.

With special reference to the disease in Indian subjects and the question of choice of operation, With report of six complete Suprapubic Prostatectomies.

Case No. IT—-Waman Rangnath, aged 55, Brahmin, residence Fulthan, 75 miles from Miraj, admitted 15th July 1902.

History and description.—Patient enjoys fair general health, is slightly anzemic, fairly well nourished, heart and lungs normal.

Present trouble began a year, prior, to admis- sion with burning and frequent micturition;