Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 1.djvu/162

 examined pus obtained in that way from a case at Millbank without success. But the suggestion was a good one, and worthy of being thoroughly tested. There was another point in regard to development on which possibly some one of those present might be able to give further infor- mation, namel}, the connection of the parasite as seen in disease with cultivation forms. The Society might remember that he had described the constant presence of some peculiar bodies, and that he traced their origin to irregular longitudinal fission which took place in- the cultures during the flagellate stage. He knew, however, that many competent observers considered them to be merely artifacts. That was not his own impression. He mentioned this because a short time ago, through the kindness of M. Nicolle, the head of the Pasteur Institute at Tunis, he had received specimens of successful cultures made there from the spleens of kala-azar cases in Tunis, and in those preparations, although the development had not gone so far as he (the speaker) had been able to trace it, there were identical fission forms, little segments which seemed to split off" one side of the flagellated parasites. He should be glad to have an opinion on that point, because his own impression that they were definitely connected with a stage of development was a very strong one.

Dr. Low said that he had listened with great interest to the descriptions of the cases, and he thought the only conclusion must be that, unless parasites were actually demonstrated by liver or spleen puncture, it could not be stated with certainty that any case was kala-azar. He had had opportunities during the past year of seeing many patients from the Tropics suffering from chronic enlargement of the spleen, often with enlargement of the liver — chronic cachectic cases — in which the Leishman-Donovan parasites had not been found. It was difficult to say what