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Report on Kála-ázar

SECTION V.

THE PATHOLOGY AND NATURE OF KÁLA-ÁZAR.

      In this section the pathological anatomy, both macroscopic,
as seen in the post-mortem room, and microscopic, as far as
this has been worked out by means of cutting sections of the
diseased organs, will first be given, and then the true nature
of the disease will be discussed in the light of all the facts
which have been adduced in the first five sections of this
report.

      With regard to the pathology of the disease, again, but
little help is to be obtained in the literature of the subject, and
the value of that little is greatly diminished by the former
confusion between kála-ázar and anchylostomiasis. I much
regret that I have not been able to devote as much time to
the microscopical part of the work as I should like to have
done, owing to the pressing claims of the more immediately
practical work of studying the mode of spread and present
limits of the epidemic which has necessitated prolonged
tours; while at the time of writing I am anxious to submit
my report without delay, so as to allow of a full consideration
of my recommendation before the next cold weather arrives,
which is the only time for action being taken on them. As
I still have the material by me, I shall hope to go into this—
the more scientific side of the question—as soon as I shall
have any leisure time, and only the more important facts will
be given here.

      The following description of the changes found post-
mortem is based on 25 autopsies on cases of kála-ázar, which
have been made by myself, with the exception of a few which
were kindly performed for me, in accordance with a
scheme I drew up, by Mr. McNaught and Dr. Dodds Price.
Four others on cases of anchylostomiasis, and seven
medico-legal ones were performed for the sake of control
observations.

      These have been described in the clinical part of this