The bites of the leeches, he thought, had a constitutional effect, and the disorder much resembled a disease met with in horses in Queensland, which was known as swamp cancer.
Dr. Frederick Johnson (the patient) said that at Baghdad, though most of the native children had the disease, the people were completely indifferent to it, and no steps were taken for its cure from beginning to end. They were equally indifferent as to the prevention of infection.
Sir Patrick Manson, in reply, said that Dr. Low's question as to whether the parasite was the actual cause of the disease was difficult of complete answer. The solution and proof was obviously to be obtained only by getting the parasite in pure culture, and then finding the insect medium by which it was conveyed. In the meantime, as parasitic growth was extraordinary, and as every endothelial cell was crowded with parasites seen in no other disease, it forced itself upon their belief, and they were justified in assuming, that they must be causative. As to spirochaetse, no doubt, after search, plenty of spirochaetse would be found in the tissue and discharges. They had been found in ulcerating granuloma by Wise in British Guiana, but investigators would get no nearer a solution in that way, on account of the difficulty of determining the relationship of any special spirochaeta to the disease in which it was found. He had tried and failed to cultivate the parasite, because he could not keep his cultures sterile, and as they knew, bacterial growth was absolutely fatal to the kala-azar parasite. As to the distribution, kala-azar, it was well known, was a disease of low-lying riverine districts, and Oriental sore a disorder of dry, sandy countries; it was difficult to reconcile this with identity of the parasites, and in the meantime, he had no explanation to offer. Treatment by lead compress would be followed by
