Kala-Azar in Children of North China.

Our experience with kala-azar among children is limited to that of two proviryces of North China, Hopei and Slantung, and covers the years 1921 to 1930 inclusive. The cases admitted to our service entered through our regular clinic in the city, as we have not attempted to handle these cases in the outlying endemic village districts. We recently had in the clinic at one time a case of chronic malarial fever, a left-sided psoas abscess and a case of kala-azar, each coming from a kala-azar region, and the parent, in each case, announced that he had brought the child for treatment of kala-azar. L. E. Napier' has published several detailed accouints of the clinical and laboratory findings of kala-azar as seen in India. His notes often record cases occurring in children, but we are unable to find any investigation of kala-azar, either in India or China, which is confined to the disease as it occurs in children. In discussing the signs and symptoms of kala-azar in India, Napier states that they ' are most characteristic from 4 to 14 years.' If this is true, it seems well to review the records of a number of children suffering from this disease, and to attempt to formulate a clinical picture of the child affected with it. With this purpose in view, we have reviewed the histories of one hundred children treated on our service. Fifty of these cases were treated between 1924 and 1.927, and fifty between 1928 and 1930. In both groups consecutive cases were taken, in order to avoid the possibility of selecting any outstanding symptoms. By recording a few typical case histories and the physical and laboratory findings in a number of cases of kala-azar occurring in children of North China, we hope to furnish information which may be of assistance to physicians caring for children suffering from this disease.