The diagnostics and treatment of tropical diseasesStitt, E. R. (Edward Rhodes)
Science
The diagnostics and treatment of tropical diseases
Stitt, E. R. (Edward Rhodes)
Tropical medicine
As regards separating oriental sore from the visceral leishmaniases
Gonder has shown that white mice may be infected with both
kala-azar and oriental sore, there being produced in each case a
general infection with the presence of parasites in spleen and
liver. A point of difference, however, is that the oriental-sore
mice develop lesions on feet, tail and head which was not observed
with the kala-azar mice. There are some reasons for thinking that
in human cutaneous leishmaniasis a generalized infection may
precede the local manifestations.
Dogs and monkeys can be infected with _L. tropica_ as well as mice,
but in them we have only cutaneous lesions produced. Inoculation
should be made intraperitoneally.
A very interesting point is that the dogs in India never show a
natural infection with _L. donovani_, while in the regions where _L.
infantum_ is responsible for human infections the natural infection
of dogs is not uncommon, indeed many think the dog the reservoir of
virus for both _L. infantum_ and _L. tropica_. It has been suggested
that the dogs of India, where kala-azar prevails, may be immune.
_Morphology._—As regards morphology it is usually stated that the
parasites of the three species of _Leishmania_ are practically
identical. In cultures it has been noted that the flagella of _L.
tropica_ are longer and more twisted than those of _L. infantum_.
Again it has been observed that the parasites of the Oriental
and South American skin lesions may at times show a flattened or
band-like trophonucleus instead of the constant round or oval one
of the visceral leishmaniases.
Escomel has reported the finding of flagellated _Leishmania_ in the
South American sores.
_Relationship._—Within the past year the view has been generally
accepted that Indian kala-azar and infantile kala-azar are one and
the same disease, the points of difference between _L. donovani_
and _L. infantum_ which had been advanced from cultural and animal
inoculation standpoints having been disproved.
It has been suggested that the Mediterranean basin may have been
the original focus of visceral kala-azar and that it spread thence
to India by way of Greece and the Russian Caucasus, cases having
been reported from districts which would join the two foci.
Just as children bear the brunt of malaria in old malarious
districts and adults suffer in places in which the disease has been
more recently imported, so by analogy we may consider the disease
as of more recent introduction in India. We now know that visceral
leishmaniasis is widely distributed in China, north of Yangtse, as
well as in the Sudan, and quite recently a case of kala-azar has
been reported from South America, in an Italian, who had lived in
Brazil from 1897 to 1910.
Public-domain text, read in full here on John Shaqi.
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