Identifier: medicaldiagnosi00gree (find matches)
Title: Medical diagnosis for the student and practitioner
Year: 1922 (1920s)
Authors: Greene, Charles Lyman, 1862-
Subjects: Diagnosis
Publisher: Philadelphia, Blakiston
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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ion lasting for fiveyears and the natives believe that one year is required to render safe anyhouse in which it has appeared. It spares no age and neither sex, and,what is more peculiar, attacks the acclimated quite as readily and violentlyas the stranger. Its mortality is frightful, being put at 90 per cent, byManson, and its victims may linger on for a year or more. It seldomattacks Europeans. * The first case reported is said by V. Schilling to have occurred at Dum-dum nearCalcutta. In 1869 British administrative officers in Assam had to deal with a severeepidemic in the Garo Hills. It was for many years regarded as a peculiarly severe andobscure form of malarial fever. io6o MEDICAL DIAGNOSIS Etiology.—Peculiar oat-shaped, circular or oval protozoan bodies (theLeishman-Donovan bodies1) 2 to 4^ in size, and first discovered by Irish-man and Donovan in 1903, are found in most cases if the spleen or liver bepunctured, or they may appear in the leucocytes of circulating blood, or, as
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Fig. Fig. 512. Fig. 513. Figs. 511, 512, 513.—Liver and spleen in child suffering from leishmaniasis. (After Nicolle.) apparently free bodies, if the leucocyte host be damaged in making the smearpreparation. On appropriate culture media they develop flagellar. In the blood they are most frequently carried by the large mononuclearleucocytes. They are abundant in the spleen, liver and bone marrow. The readiest and most certain method of recovering the specific organism is by smears of spleen juice obtained by the somewhat hazardous splenic-puncture. The mode of conveyance of Kala azar is not yet established but it is1 probable that in India bedbugs are the carriers and that along the Mediter-ranean, fleas may transmit the disease. Symptoms.—The high fever, often preceded by vomiting or chill, mayassume either a remittent or intermittent type, lasting one, two, four, or sixweeks; then follows an apyrexial period, then an exacerbation, and so on formonths, when the fever becomes persi

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