OBSERVATIONS ON KALA-AZAR IN KASSALA PROVINCE 119

Liver and spleen were considerably enlarged, the conjunctive were yellow, and the urine contained bile and a trace of albumen.

The spleen decreased in size under quinine injections, but this drug had no effect on

his temperature.

On February 4th, 1908, a spleen puncture was performed, but no parasites found. On February 19th, 1908, a second splenic puncture was mete typical ‘‘ bodies ”’ were found, but in very small numbers.

On February 22nd, 1908, he was started on the Pe Gen oublitidcs treatment,

but though no untoward symptoms appeared, yet there was no improvement. Weakness and emaciation steadily increased, edema of legs appeared on March 14th, 1908, trouble- some and persistent epistaxis on March 22nd, 1908, and he died on March 26th, 1908.

An autopsy was not performed owing to the strong objections of his relations, so it was

not possible to prove if the parasites had disappeared from spleen and liver.

It is greatly to be regretted that more autopsies were not performed, but the feeling

is so strong against this procedure that it was considered unwise to insist, for undoubtedly by doing so very great harm would have been done to the civil work.