Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 1.djvu/161

drug. Sir Havelock Charles thought that Nature was the cure, coupled with the benefits of change of air by means of a sea voyage. No doubt the latter might be beneficial, but he thought the cure, when it did occur, must be attributed to Nature alone. There was no evidence that change of air such as was given by a sea voyage was,^;e7' se, of any use. Soldiers who contracted the disease in India were invalided home, but the Military Hospital at Millbank was seldom without a case of kala-azar, and he had never heard of any favourable result following the long sea voyage which they made on their way there. He gathered from the remarks of the President and Dr. Bass^tt-Smith that atoxyl had done good, and he himself looked upon that treatment with very great hope. Atoxyl, like all arsenical preparations, was a dangerous drug, yet it seemed to give the most promising prospects they could point to, though his last case, he should state, was carefully treated by atoxyl, unfortunately without the slightest benefit. With regard to diagnosis, a suggestion had been made to him some time ago by one of his brother officers. Major Cummins, who was now attached to the Egyptian Army, which he desired to bring to the notice of the Fellows, because the method seemed to him to be worth a trial. It was well known that difficulties were experienced in detecting the parasites in peripheral blood, and. apart from the actual danger of splenic and hepatic punctures, patients objected to these procedures. There was not the slightest doubt, however, that parasites regularly circulated in the peri- pheral blood, and Major Cummins had suggested that artificial pustulation might be produced by some irritant applied to the skin, and that a collection of polynuclears could thus be obtained. In that way there must be a better chance of detecting parasites which, if any were present, would be englobed by the leucocytes. He ought to say, however, that he had within the last few days