Pathology and nature of kála-ázar.

113

loss of digestive powers, which so greatly retards recovery
of strength and weight after the fever has become less,
or has ceased, and to them must be attributed much of the
fatality of the disease.

      Analyses of the iron
in the liver after death.

      Portions of the livers of five cases were sent to Cal-
cutta for analysis of the amount of iron in
them, which was kindly carried out for me
by Dr. Waddell, Chemical Examiner to
Government, at the Medical College. The object was
to determine if there was an excess of iron such as is
present in chronic malaria, or a diminished quantity, as was
found in some cases of anchylostomiasis by the late Dr. Bevan
Rake. Unfortunately the specimens which were obtained
at the time they were required, were a singularly unfavour-
able series for the purpose, as the case of anchylostomiasis
was complicated by malaria, while three out of the four
kála-ázar cases were complicated by anchylostoma in con-
siderable numbers, considering that two of them were
children.

      An examination of the amount of iron found in the liver
by different observers in health, vary so much that it must
depend greatly on the exact method adopted in the analysis.
Thus, while William Hunter gives eight analyses of the liver
in pernicious anæmia by different observers to average.713
per cent., and that in 14 cases of other disease to average
.203, Ralph Stockman found an average of.185 in
two cases of pernicious anæmia,.07 in five normal livers,
and.03 in four cases of anchylostomiasis. My figures
are lower still, in spite of the fact that an excess of iron was
found in some of these livers by microscopical examination,
and only average.023. It is then obvious that the methods
of analysis were not sufficiently similar to allow of accurate
comparisons between the figures obtained by different ob-
servers, and those of any series will only be comparable with
one another.

Q