NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
M. S. Dept. Supplies.—Appendix VI.
24
Appendix VI.—contd.
Table IV.—Supplies by Medical Store Department—contd.
Item
No.
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
Articles.
C.—Medicines.
Acid urn aceticum
.
.
.
.
„
arseniosum . . .
„
boricum . . . .
„
carbolicum, B. P. . .
„
hydrochloricum . . .
„
nitricum . . . .
Aloe barbadensis . . . .
Ammonii carbonas .
.
.
.
Argenti nitras . . . .
Camphora . . . .
Cantharis pulv. . . . .
Catechu . . . . .
Cera flava . . . .
Chloral hydras
.
.
.
.
Chleroformum . . . .
Cocainœ
hydrochloridum
.
.
Creta præparata
.
.
.
.
Cupri sulplas
.
.
.
Extraetum belladonnæ . . .
„
cannabis
indieæ
.
.
Ferri sulphas
.
.
.
.
Gentianae radix pulv. . .
Glycerinum
.
.
.
.
Hydargyri iodidum
rubrum
.
.
„
perchloridum
(corrosive
sublimate).
„
subchloridum
(calomel) .
Iodoformum
.
.
.
.
.
Iodom
.
.
.
.
.
Liquor ammoniæ .
.
.
.
„
„
acetatis fortis .
„ avsenicalis
.
.
.
.
„ zinci chloridi . . .
Magnesii carbonas levis . . .
„
sulphas
.
.
.
.
Morphinae hydrochloridum . .
Nux vomica pulv.
.
.
.
.
Oil. cheer pine . . . .
Oleum ricini. .
.
.
.
„
sesami
.
.
.
.
„
terebinthinæ
Opii palvia
.
.
.
.
Phenyle
.
.
.
.
Pix burgundica
.
.
.
.
„ liquida (tar, Stockholm)
Piumbi acetas
.
.
.
.
Potassii chloras
.
.
.
.
„ iodidum . . .
„
nitras
.
.
.
.
„
permanganas . . .
Resina
.
.
.
.
.
.
Sapo mollis
.
.
.
.
.
.
Sodii bicarbonas
.
.
.
.
Solution antiseptic (a)
.
.
.
Spiritus ammoniæ aromaticus . .
Scale per 100 animals ;
Class I
hospital.
lbs.
1
0
0
2
0
0
2
2
0
1
0
0
0
0
0
0
1
0
0
0
2
1
2
0
0
0
0
0
1
1
1
0
1
10
0
0
4
2
1
4
0
2
1
4
0 0
0
2
0
1
6
2
0
1
oz.
0
1
8
0
0½
1
0
0
1
0
4
4
2
4
8
1
0
8
4
4
0
0
0
2
1
2
1
1
0
0
0
4
0
0 1
1
0
0
0
0
4
0
0
0
8
4
2
0
8
0
0
0
8
0
Class II
hospital.
lbs.
1
...
0
2
..
...
2
2
...
1
0
...
...
...
...
...
1
0
0
...
2
1
2
0
0
0
1
I
...
...
1
10
...
0
4
... 1
4
0
2
1
4
0
0
...
2
...
1
6
2
0
1
oz.
0
...
8
0
0
0
0
4
0
8
2
0
0
0
2
2
1
0
0
0
0
1
0
0
0
4
0
0
0
8
4
0
0
0
0
8
0
Remarks.
(a) Antiseptic solution is made of perchloride of mercury 240 grs., chloride of sodium 240 grs , glyeerine 6
fluid ounces, and rectified spirits 4 fluid ounces. One ounce dilated up to 5 pints with water makes a solution
equal to 1 in 2,000 parts.
25
Appendix VI.—M. S. Dept. supplies.
Appendix VI.—contd.
Table IV.—Supplies by Medical Store Department—concld.
Item
No.
121
122
123
124
125
126
127
128
129
130
131
132
133
134
Articles.
Spiritus ætheris .
.
.
.
„
„ nitrosi . . .
„
rectificatus .
.
.
.
Strychnina hydroclor
.
.
.
Sulphur sublimatum . . .
Tinctura aconiti
.
.
.
.
„
cardamomi composita .
„
iodi . . . . .
„
opii .
.
.
.
.
Unguentum acidi borici . . .
„ hydrargyri
. . .
Vaseline (paraffinum molle) . .
Zinci oxidum
.
.
.
.
„
sulphas
. . . .
Sale per 100 animals:
per annum.
Class I
hospital.
lbs.
1
2
1
0
2
0
2
0
2
0
0
1
0 2
oz.
0
0
0
.0¼
0
1
0
4
8
4
8
0
8
0
Class II
hospital.
lbs.
1
2
oz.
0
0
...
...
2
0
2
0
1
0
...
2
0
0
1
0
2
8
4
2
0
8
0
Remarks.
Item
No.
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
Articles.
D.—Necessaries (con-
sumable)
Corks, phials .
„
pints . .
„
quarts . .
Gallipots, country .
Gauze, antiseptic .
Ligature, flax . .
„ silk
.
Lint, boric . .
„
carbolized
Material staining and
mounting for micros-
cope in Class I. S. V.
H.'s and with the S. V.
O. of the Burma and
Quetta Divisions.
Phials, common, English,
narrow mouth.
„
wide
„ .
Pins, common, papers .
„
safety . .
Sponge . . .
Tape, broad, pieces .
„
for sutures, ¼-inch
Tow, carbolized . .
„
English . .
Twine, English, ball .
Wire for sutures .
Wool, absorbent . .
„
boric . .
E.—Disinfectants
for
Veterinary purposes.
Scale per
hospital
per annum.
12
per cent.
of
strength.
10 yds.
per
cent.
of strength.
½ oz. per cent. of
strength.
2 oz. per cent. of
strength.
8
ditto
(a)
3
per
cent.
of
strength.
1 per Batty, and 2 per
Regt.
6
per
cent.
of
strength.
6 oz. per cent. of
strength.
2 per Batty, and 4 per
Regt.
1 piece
1 lb.
8 lbs.
per cent. of
strength.
2 per Batty, and 4 per
Regt.
1 oz.
1 lb.
2 oz.
per cent of
strength.
See A. R. I., Vol V.,
App IV
Remarks.
(a) Staining and mounting materials for
microscope—
Consumable.
Bismarck brown, pure
. 1 tube
Fachsine, pure
. . 1 „
Gentian violet pure .
. 1 „
Hœmatoxylin (Delafield) .1 „
Methylene blue, pure . 1 „
Methyl violet, pure
. 1 „
Romanowsky stain (Leish-
man's powder)
.
. 1 „
Eosin, pure
.
.
. 1 „
Eosin, methylene blue (Louis
Jenner's stain)
.
. 1 „
Gram's iodine stain .
. 1 „
Slides Micro, ground glass
edges .
.
.
. 3 doz.
Cover glasses .
.
. ½ oz.
Filter paper, round .
.1 pkt.
Absolute alcohol
.
. 4 oz.
Methylic alcohol, pure . 4 „
Aniline oil
.
.
. 1 „
Liquor potass .
.
. 1 „
Balsam, Canada
.
. 2 „
Permanent.
Bottles, stoppered, glass,
4 oz.
.
.
. 6
Bottles, stoppered, glass,
½ oz . . . . .2
Bottles, drop, blue glass
1
oz.
.
.
.
.2
Pestle and mortar glass
3" wide
.
.
. 1
Measure glass, 50 c.c. . 1
Lamp, spirit, 4 oz. . .1
Funnel, enamelled, iron,
small, 4" . . . 1
Tubes, test .
.
. 6
Needles, microscopic
. 4
Brushes, camel hair
. 3
Burroughs and Well-
comes'
"soloid stains."
To be sup-
plied when
required.
Stationery and Supplies purchased locally—Appendix VI.
26
Appendix VI.—concld
Table V.—Supplies by Stationery Department. (a)
Item
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
Ar
ticles.
Permanent.
Desk knife . . . .
Glasses for inkstand . .
India-rubber . . . .
Needles
.
.
.
.
Paper-cutter . . .
Ruler
.
.
.
.
.
Wooden inkst and . . .
Annual supply.
Blotting paper . . .
Brown paper . . .
Draft paper, double foolscap . .
Envelopes, foolscap size . .
„
note
„ . .
Ink, black, powder . . .
„ red
„ . .
Pencil, lead .
.
.
.
Penholder
.
.
.
.
Sealing wax . . . .
Silk, thread
.
.
.
.
Steel pen, nibs . . .
Tape,
red
.
.
.
.
Writing paper
foolscap .
note . .
Scale per
hospital.
1
2
1
2
1
1
1
12 sheets.
2 quires.
3 quires.
250
200
4 bundles
1
„
4
1
1 stick.
1 skein.
24
1 bundle.
5 quires.
5 quires.
Remarks.
per officer or clerk.
per corps in veterinary charge.
(a) For submission of requisitions see I. A. F. Z2000.
Table VI.—Supplies purchased locally.
Item
No.
1
2
3
4
Articles.
Baskets
. . . . .
Brooms.
.
.
.
.
.
Beaters, bund, wood . . .
Rammers, earth, handled, wood .
Scale per
hospital.
5
5
2
1
Remarks.
per cent. of strength quarterly.
per cent. of strength permanently.
27
INDEX
Paras., etc.
A
Accounts of Poona school submitted
to Committee
.
.
.
.
Administrative veterinary offi-
cers. (See Officers.)
Allotment of officers, A. V. C. and
N. C. Os. (U. L.). . . .
Allowances—
charge of Poona School. . .
performance of civil duties .Appx.
Animals—
civil department, professional aid to
officers', except charters, not admit-
ted to hospitals . . .
of units admitted to hospitals .
Anthrax. diagnosis, of how confirmed
Appointments—
administrative, by whom sanctioned,
qualifications for, tenure of .
Army Veterinary Schools, (See
Schools.)
Arrival reports—
animals', to whom sent . . .
officers',
„ „ . . .
Articles, unserviceable, disposal of
Appx. VI (IV)
Attendance on chargers . .
B
Boards—
examination at veterinary schools .
survey of unserviceable articles
Appx. VI (IV)
Books—
supply of, to hospitals . . .
text, Punjab veterinary college
.
Boxes, Camp, Veterinary—
use on march
.
.
.
.
Buildings—
charge of . . . . .
C
Carcases, diseased animals, disposal of
Certificate-
transfer of stores, sent to S. V. O. .
veterinary, regarding chargers
58
1,2
56
V
14
50
30
39
5
13
20
3
50
66
3
76
75
48
32
38
22
51
Paras., etc.
Chargers—
admission to hospital . .
attendance on, by veterinary officers
examination by veterinary officers .
medicines supplied free to . .
Chests—
universal, kept complete . .
„
use of, at manœuvres
Classes, veterinary schools—
(See schools, Army Veteri-
nary.)
Classification —
diseases
.
.
.
Appx.
hospitals
.
.
.
.
.
College, Punjab veterinary. (See
Punjab veterinary college.)
Contagious disease. (See Disease.)
Correspondence—
D. G. A. V.
S.
.
.
.
P. V.
O.
.
.
.
.
S. V. O. with O. C. unit . .
transfer of stores.
.Appx. VI. (IV)
D
Departure reports—
animals', to whom sent .
.
.
officer's
„
„
. .
Destruction of animals—
cases of rinderpest and lymphangitis
to prevent spread of disease . .
Discharge of veterinary pupils . .
Discipline, veterinary classes . .
Director-General. A. V. S.—
correspondence with
.
.
.
receipts of medal, reported to . .
Disease, contagions—
detections of, by veterinary officers
duties of S. V. O. .
.
.
isolation and destruction of animals,
disposal of carcases, disinfection
reports by civil authorities of, out-
break .
.
.
.
Diseases, classification and nomencla-
ture .
.
.
.
.
Appx
Disinfection of stalls, gear, etc.
Disinfectants . . Appx. (IVE
Dressers, remount department-
admitted to Punjab veterinary
college
.
. . . .
recovery of value of text-books from
50
50
51
50
16
16
II
26
8
8
11
1
13
20
44
38
54
65
8
17
35
11,35
38
36
11
38
68
75
No. 31
(NEW SERIES.)
SCIENTIFIC MEMOIRS
BY
OFFICERS OF THE MEDICAL AND SANITARY DEPARTMENTS
OF THE
GOVERNMENT OF INDIA
THE DEVELOPMENT OF THE LEISHMAN-DONOVAN
PARASITE IN CIMEX ROTUNDATUS
SECOND REPORT
BY
CAPTAIN W. S. PATTON, M.B., I.M.S.
( On special duty. )
ISSUED UNDER THE AUTHORITY OF THE GOVERNMENT OF INDIA
BY THE SANITARY COMMISSIONER WITH THE GOVERNMENT
OF INDIA, SIMLA
CALCUTTA
SUPERINTENDENT OF GOVERNMENT PRINTING, INDIA
1907
Price Rupee 1 or 1s 6d.
No. 31.
(NEW SERIES. )
SCIENTIFIC MEMOIRS
BY
OFFICERS OF THE MEDICAL AND SANITARY DEPARTMENTS
OF THE
GOVERNMENT OF INDIA.
THE DEVELOPMENT OF THE LEISHMAN-DONOVAN
PARASITE IN CIMEX ROTUNDATUS
SECOND REPORT
BY
CAPTAIN W. S. PATTON, M.B., I.M.S.
( On special duty.)
ISSUED UNDER THE AUTHORITY OF THE GOVERNMENT OF INDIA
BY THE SANITARY COMMISSIONER WITH THE GOVERNMENT
OF INDIA, SIMLA.
CALCUTTA
SUPERINTENDENT OF GOVERNMENT PRINTING, INDIA
1908
Agents for the Sale of Books published by the Superintendent of Government
Printing, India, Calcutta.
IN ENGLAND.
IN INDIA.
HENRY S. KING & CO., 65, Cornhill, & 9, Pall Mall,
London.
THACKER, SPINK & CO., Calcutta and Simla.
NEWMAN & CO., Calcutta.
E. A. ARNOLD, 41 & 43, Maddox Street, Bond
Street, London, W.
S. K. LAHIRI & CO., Calcutta.
R. CAMBRAY & CO., Calcutta.
CONSTABLE & CO., 10, Orange Street, Leicester
Square, London, W.C.
HIGGINBOTHAM & CO., Madras.
P. S. KING & SON, 2 & 4, Great Smith Street,
Westminster, London, S.W.
V. KALYANARAMA IYER & CO., Madras.
G. A. NATESAN & CO., Madras.
KEGAN, PAUL, TRENCH, TRÜBNER & CO., 43, Gerrard
Street, Soho, London, W.
S. MURTHY & CO., Madras.
THOMPSON & CO., Madras.
GRINDLAY & CO., 54, Parliament Street, London,
S.W.
TEMPLE & CO., Madras.
COMBRIDGE & CO., Madras.
BERNARD QUARITCH, 11, Grafton Street, New Bond
Street, W.
P. R. EAMA IYER & CO., Madras.
B. H. BLACKWELL, 50 & 51, Broad Street, Oxford. A. R. PILLAI & CO., Trivandrum.
DEIGHTON, BELL & CO., Cambridge.
THACKER & CO., LD., Bombay.
T. FISHER UNWIN, 1, Adelphi Terrace, London, W.C. A. J. COMBRIDGE & CO., Bombay.
W. THACKER & CO., 2, Creed Lane, London, E.C. D. B. TARAPOREVALA, SONS & CO., Bombay.
SUNDER PANDURANG, Bombay.
RADHABAI ATMARAM SAGOON, Bombay.
ON THE CONTINENT.
GOPAL NARAYAN & CO., Bombay.
R. FRIEDLÄNDER & SOHN, 11, Carlstrasse, Berlin,
N.W.
N. B. MATHUR, Superintendent, Nazair Kanun
Hind Press, Allahabad.
RAI SAHIB M. GULAB SINGH & SONS, Mufid-i-Am
Press, Lahore.
OTTO HARRASSOWITZ, Leipzig.
KARL W. HIERSEMANN, Leipzig.
A. CHAND & CO., Lahore, Punjab.
ERNEST LEROUX, 28, Rue Bonaparte, Paris.
Superintendent, American Baptist Mission Press,
Rangoon.
MARTINUS NIJHOFF, The Hague, Holland.
RUDOLF HAUPT, Halle A. S., Germany.
A. M. & J. FERGUSON, Ceylon.
List of numbers of Scientific Memoirs by Officers of the Medical and Sanitary
Departments of the Government of India (New Series) published previous
to the present issue.
No. 1. Standardisation of Calmette's anti-venomous serum with pure cobra venom : the
deterioration of this serum through keeping in India, by Captain G. Lamb,
I.M.S., and Wm. Hanna, Esq., M.B. Price As. 3 or 4 d.
No. 2. Malaria in India, by Captain S. P. J ames, I.M.S. Price Re. 1-8 or 2 s. 3d.
No. 3. Some observations on the poison of Russell's Viper (Daboia Russellii), by Captain
G. Lamb, I.M.S., and Wm. Hanna, Esq., M.B. Price As. 5 or 6 d.
No. 4. On the action of the venoms of the Cobra and of the Daboia on the red blood
corpuscles and on the blood plasma, by Captain G. Lamb, I.M.S. Price
As. 8 or 9 d.
No. 5. Specificity of anti-venomous sera, by Captain G. Lamb, I.M.S. Price As. 3
or 4 d.
No. 6. First report on the anti-malarial operations in Mian Mir, 1901—03, by Captain
S. P. James, I.M.S. Price As. 12 or 1s. 2d.
No. 7. Some observations on the poison of the Banded Krait (Bungarus Fasciatus), by
Captain G. Lamb, I.M.S. Price As. 8 or 9 d.
No. 8. A preliminary report on a parasite found in patients suffering from enlargement
of the spleen in India, by Lieutenant S. R. Christophers, I.M.S. Price Re. 1-8
or 2s. 3 d.
No. 9. Second report of the anti-malarial operations at Miari Mir, 1901-03, by Lieu-
tenant S. R. Christophers, I.M.S. Price As. 10 or 1s.
No. 10. Specificity of anti-venomous sera (second communication), by Captain G. Lamb,
I.M.S. Price As. 8 or 9d.
No. 11. On a parasite found in persons suffering from enlargement of the spleen in
India—Second Report, by Lieutenant S. R. Christophers, I.M.S. Price
Rs. 2 or 3s.
No. 12. On the Morphology, Teratology, and Diclinism of the flowers of Cannabis, by
Major D. Prain, I.M.S. Price As. 14 or 1s. 4d.
No. 13. Oriental or Delhi Sore, by Captain S. P. J ames, I.M.S. Price As. 10 or 1s.
No. 14. On a parasite found in the white corpuscles of the blood of dogs, by Captain
S. P. James, I.M.S. Price As. 10 or 1s.
No. 15. On a parasite found in persons suffering from enlargement of the spleen in
India—Third Report, by Lieutenant S. R. Christophers, I.M.S. Price
As. 10 or 1s.
No. 16. The specificity of anti-venomous sera with special reference to a serum prepared
with the venom of the Daboia Russellii, by Captain G. Lamb, I.M.S. Price
As. 6 or 7d.
No. 17. Snake-venoms in relation to Hæmolysis, by Captain G. Lamb, I.M.S. Price As. 6
or 7d.
No. 18. Hæmogregarina Gerbilli, by Lieutenant S. R. Christophers, M.B., I.M.S. Price
As. 10 or 1s.
No. 19. On Kala Azar, Malaria and Malarial Cachexia, by Captain S. P. James, M.B.,
I.M.S. Price Re. 1-4 or 1s. 11d.
No. 20. Serum-Therapy of Plague in India ; reports by Mr. W. M. Haffkine, C.I.E., and
various officers of the Plague Research Laboratory, Bombay, by Lieutenant-
Colonel W. B. Bannerman, M.D., B.Sc., F.R.S.E., I.M.S. Price As. 14 or
1s. 4d.
2
No. 21. On the Standardisation of Anti-Typhoid Vaccine, by Captain George Lamb,.
M.D., I.M.S. (Director, Pasteur Institute of India ), and Captain W. B. C.
Forster, M.B., D.P.H., I.M.S. Price As. 6 or 7 d.
No. 22. Mediterranean Fever in India: Isolation of the Micrococcus Melitensis, by Captain.
George Lamb, M.D., I.M.S., and Assistant Surgeon M. Kesava Pai, M.B.,
C.M. (Madras). Price As. 10 or 1s.
No. 23. The Anatomy and Histology of Ticks, by Captain S. R. Christophers, M.B.,
I.M.S. Price Rs. 3 or 4s. 6d.
No. 24. On a parasite found in the white corpuscles of the blood of Palm Squirrels, by
Captain W. S. Patton, M.B., I.M.S. Price As. 12 or 1s. 2d.
No. 25. On the importance of Larval characters in the classification of mosquitoes, by
Captain S. R. Christophers, M.B., I.M.S. Price As. 8 or 9 d.
No. 26. Leucocytozoon Canis, by Captain S. R. Christophers, M.B., I.M.S. Price
As. 12 or 1s. 2 d.
No. 27. Preliminary Report on the Development of the Leishman-Donovan Body in the
Bed Bug, by Captain W. S. Patten, M.B., I.M.S. Price As. 8 or 9 d.
No. 28. The sexual cycle of Leucocytozoon Canis in the tick, by Captain S. R. Chris-
tophers, M.B., I.M.S., As. 12 or 1s. 2d.
No. 29. Piroplasma Canis and its cycle in the tick, by Captain S. R. Christophers, M.B.,
I.M.S., Price Rs. 2 or 3s.
No. 30. The development of the Leishman-Donovan parasite in cimex rotundatus—Second
Report, by Captain W. S. Patton, M.B., I.M.S., Price Rupee 1 or 1s. 6d.
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THE DEVELOPMENT OF THE LEISHMAN-DONOVAN
PARASITE IN CIMEX ROTUNDATUS.
SECOND REPORT.
IN my first report1 I gave a short account of the researches of different
investigators on the extracorporeal stage of the Leishman-Donovan body,
and examined the hypotheses advanced to explain the method of infection of the
human body by this parasite, pointing out that the disease is most probably
transmitted by the bite of some blood-sucking insect. In support of this hypo-
thesis it was shown that Kala Azar is usually contracted by people living in
close contact with others suffering from the disease; that the parasites occur in
the peripheral circulation in a suitable condition for further development and
that in those cases with extensive ulceration of the large intestine they are often
found in large numbers.
In order to prove the truth of this theory a number of feeding experiments
were carried out with the common blood-sucking insects of Madras, and at the
outset it was shown that the parasite could be found in the midguts of lice,
Pediculus capitis, fed on patients suffering from Kala Azar, but no changes
towards development were observed. In the bed-bug, Cimex rotundatus, *
however, the parasites were not only frequently found but had in a few
instances shown evidences of considerable development.
Since writing my first report I have been able to study in the bed-bug all
the intermediate stages of the development of the parasite up to the formation
of the long free swimming flagellates, and in the present paper I propose to
describe these changes and some further observations on the peripheral blood of
cases of Kala Azar.
I have had the opportunity of examining three more patients in whose
peripheral blood parasites occurred in large numbers. In each case diarrhœa
was a prominent symptom. The last patient was a man aged 25, a carpenter
by trade, whose illness began in August 1906 with an attack of fever of a con-
tinuous type lasting about 14 days. During the month of September he
occasionally had fever, but was able to continue his work till the first week in
October. He then noticed that his feet were beginning to swell and after a short
* Cimex macrocephalus Fieb, was first described by Signoret2 in 1852 from the Island of Réunion. I
have recently adopted the name Cimex rotundatus,3 which was originally given it by Signoret.
B
2
time he was obliged to give up his work owing to the œdema having spread to
his ankles and legs. He was treated as an outpatient in the General Hospital,
Madras, during November and December. In the first week of December he
began to get diarrhœa and his relatives noticed that the right side of his face
was swollen, and as his condition was much worse and the œdema had become
general he was admitted to hospital on the 18th.
On admission, the patient was suffering from general œdema, his face was
swollen, the right side being more prominent owing to a hard brawny swelling
involving the whole cheek. On examining his mouth no ulcer was seen, there
was marked pyorrhœa alveolaris and his breath had an offensive smell. On
palpating his abdomen the spleen was found to be five inches below the costal
margin, but the liver could not be felt. He complained of great pain over the
region of the large intestine and there was evidence of a quantity of fluid in his
peritoneal sac. His scrotum was also distended with œdema. On auscultating
his heart there was no sign of valvular disease though the sounds in all the areas
were muffled ; both lungs were œdematous and there were signs of consolida-
tion at the right base. His pulse rate was 86, his temperature 97ºF. and his
urine on being tested showed no trace of albumen. On December the 23rd the
patient was much worse, the swelling on the right side of the face having con-
siderably increased, involving the right eye and the upper and lower lips ; and
the skin over the most prominent part was glistening and suggested the early
formation of an abcess. On this day I examined a film of finger blood and found
twenty-three parasites, all of which were in the polymorphonuclear cells. On
the 26th the patient was in a semi-conscious condition and passed his motions
under him in bed ; his pulse rate was 126 and the bases of both lungs were con-
solidated. On the 27th there was a marked change for the worse, his face was
enormously swollen, the right eye being closed while the left was only just open.
The skin over the swelling of the cheek was not much changed and there was
no appearance of ulceration in the mouth. I took a film of finger blood and fed
some bugs half an hour before the patient's death, which took place at
10-30 P.M. on the 27th. Next day on examining this film I found 359 parasites,
almost every polymorphonuclear cell containing one or more. Plate I, fig. 1,
shows a polymorphonuclear cell containing six parasites and Fig. 3 on the
same plate an eosinophyl cell containing two ; in this film I also found a large cell
(Plate I, fig. 2) containing forty-nine parasites and a large mononuclear cell
(Fig. 6) containing ten. In the large cell one of the parasites is seen to be dividing
longitudinally ; it is oval in shape measuring 4.5 µ and contains two macronuclei
at one pole and two micronuclei lying at opposite sides of the periphery ; its
protoplasm stained faintly blue and had three vacuoles in it. The close apposi-
tion to each other of many of the parasites in this cell suggests recent division