Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 1.djvu/171

splenic leucocythaemia. He remembered another case of quite a different character, where a gentleman meeting with an accident in China fractured his lower jaw. A period of bad health set in, and he came home, touring about the Continent for a little while trying different cures. By-and- by he gravitated to his (the President's) consulting-room, where on examination an enormous spleen and liver with a certain amount of cachectic appearance were manifest. The Leishman body had just been " floated," and he jumped rather abruptly to the conclusion that this was a case of kala-azar. The patient was a Belgian, and he subsequently went to see him in Brussels, as he wished to be sure of his diagnosis. The blood count came out at 6,000,000 c.cm. There was quite a respectable number of leucocytes, and the fever was not of a very marked character. The man, instead of suffering from anaemia, had polycythemia; nevertheless, he thought he would like to know what was in his spleen and liver, but on puncturing both organs he found no Leishman bodies in them. The patient was suffering from some other disease. He ought not to have made that puncture, but curiosity made his fingers itch, and he could not keep his needle out of the patient's spleen and liver; but it was wrong, and in future he should not do such a thing again. Sir Havelock Charles attributed the recovery of his patient to the tonic influence of a sea voyage, and possibly he was right. Both ho and Colonel Leishman somewhat decried the use of specific treatment; but it might be the case that atoxyl was the cause of his own patient's recovery. He did not assert it was, although specific drugs undoubtedly existed which could influence parasites similar to those of kala-azar. Mercury certainly had an influence on the spirochaetes of syphilis; quinine had an influence on the plasmodia of malaria; ipecacuanha had an influence on dysentery, and why should not this drug have a specific influence on the