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XI] exhaustion. The lymphatic glands are often involved, but the abdominal and thoracic organs are spared.

Leishman bodies are to be found, though not in great profusion, in scrapings and sections of the fungating ulcers; giant cells also occur. Dermal ulcers of oriental-

Fig. 60.—Ulceration of nares and lips in leishmaniasis Americana. (After Splendore.)

sore type may concur with the buccal and nasal lesions. It is believed that the original sore in this grave form of leishmaniasis develops at the site of the bite of a jungle insect of unknown species. Treatment is the same as for oriental sore (p. 225).

—The student is referred to Laveran's recently published work, "Leishmanioses" (Masson et Cie.), for a full and accurate discussion of this important subject.