ON A PARASITE FOUND IN PERSONS SUFFERING FROM ENLARGEMENT
OF THE SPLEEN IN INDIA, SECOND REPORT.

IN my first report I recorded briefly the result of the researches of different
observers on the parasite recently discovered by Leishman and Donovan in
cases of tropical splenomegaly. Such investigations, in many cases of enlarged
spleen, have shewn in blood drawn during life from the spleen and liver or in films
of these organs post-mortem the presence of certain very definite bodies of peculiar
nature and uniform morphology. In the case of preparations made during life
a matrix-like substance is conspicuous in which many of the bodies lie embedded.
The actual nature of the matrix has given rise to much discussion. It is con-
sidered by Laveran and Mesnil to be altered red corpuscle, by Ross a parent
mass producing the bodies, by Manson and Low it is termed a " zooglea mass."
In my last report I gave many reasons for considering the matrix to be largely,
if not entirely, the fragmented, budded and vacuolated cytoplasm of cells in which,
in sections, the bodies are seen lying.

       In all the researches mentioned the attention of the observer had been entirely
occupied with the presence of the parasite in the blood.

       Wright's announcement that similar or very closely related bodies occurred
in large numbers in the tissues of tropical ulcer gave rise therefore to considerable
surprise.

       The microscopical appearances of tropical ulcer were described by Cunningham
in 1885.¹ He notes extensive infiltration of the corium and subcutaneous tissues
by granulation tissue containing bodies which he considered to be parasitic in
nature. From Cunningham's drawings it would appear that these were macro-
phages or other cells containing the bodies described by Wright, though
Cunningham figures no structure in these latter and terms them nucleoid bodies.

       Wright ² defines tropical ulcer as a single or multiple focal lesion of the skin
characterised by the formation of elevated and indurated areas which ulcerate and
eventually cicatrise. He draws attention to the resemblance to certain forms
of cutaneous tuberculosis and syphilis. He describes, and gives photographs.
shewing an extensive infiltration of the corium and subcutaneous tissue with
cells. In addition to plasma cells and various kinds of lymphoid cells, he notes
large cells with vesicular nuclei, the cytoplasm of which contains numerous
peculiar bodies having a very constant morphology and structure. An examina-
tion of the excellent photographs of these bodies leaves no doubt as to their

B