Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 1.djvu/165

 sum up, he thought it should be laid down as a principle that kala-azar was due to invasion by Leishman parasites, but that other diseases, not only in the Tropics but at home, had very similar symptoms, and that a diagnosis could only be made by finding the parasite.

Dr. Harford remarked that he had taken peculiar interest in the case the President had brought forward, as the patient had been under his own care, he being responsible for him as one of the missionaries of the Church Missionary Society. The points of interest were that this began as a case of fever, about which there seemed nothing unusual, that it was met with in this country, that there was an indefinite history, and that the patient did not at first show any symptoms of severe illness. He had suffered from an attack of what was supposed to be enteric fever in the year 1890, and from that time there were evidences of nervous trouble, which had affected him ever since. He desired to ask the President to give his opinion as to what was the actual nature of the original fever the patient was suffering from when he came home in 1904. A little later in 1904, when treated with quinine by Dr. Tirard, it seemed to have a very definite effect, for the temperature became normal, and it was not until 1906 that serious symptoms showed themselves. Was this fever the real starting point of kala-azar, and were they to regard the disease as going back to 1904, and even earlier, in spite of the fact that serious symptoms only began in 1906 ?

Dr. Sambon said he could say little on the clinical side of the question, but he desired to refer in a few words to the remarks of Major Leishman as to the unequal division of the bodies. He had no experience of cultures of the kala-azar parasite, but in trypanosome cultures an exactly similar and unequal fission was witnessed, and he was therefore quite in agreement with what Major Leishman