Medicine: Dum-Dum Fever

Kala-azar, or Dum-Dum fever, a mysterious disease somewhat similar to malaria, frequently fatal and extremely disabling, is so prevalent in Eastern India, particularly Assam, Bengal and Madras, that its transmission constitutes "probably the most important unsolved problem of tropical medicine," according to Dr. L. E. Napier and his colleagues, who have been doing research work on Kala-azar for several years at the

Calcutta School of Tropical Medicine. The Indian Medical Gazette, of Calcutta, devoted its July issue to a special Kala-azar number.

The treated cases of the disease have risen 200% in one province since 1913, though this is probably largely due to better diagnosis and popular enlightenment, and it is estimated that there are 2,500,000 cases in Bengal alone. The symptoms are: remittent fever, emaciation, roughening of, the hair and especially enlargement of the spleen and liver. There are several disturbances of the blood and the endocrine system.

The characteristic organisms, always present in Kala-azar are called Leishman-Donovan bodies (from the British surgeons who discovered them in 1903). They are most irregularly shaped and spotted little beasts, in one stage developing tails and called flagellates. How they get into the body or are transmitted from man to man is unknown. They are normally only a parasite of man and the bedbug. While this fact would seem suspicious, various thorough investigations have not been able to prove that the bedbug is the transmitting agent. It is believed by many that some species of biting and bloodsucking insect is guilty, and further work on the suspects is projected. But it is not inevitable that insects transmit it direct; possibly contaminated food is to blame.

The treatment is not yet as successful as desired, but best results seem to be obtained with the salts of antimony injected intravenously or intramuscularly. Experimentation on monkeys, rats, etc., is beginning to produce important results, and cooperation between the various researchers will undoubtedly in the near future lay bare the secret of Kala-azar, and devise another triumph of preventive medicine by cutting off the disease at its source of transmission.