Kala-azar is also known as visceral leishmaniasis, Dum Dum Fever, and Black fever. The Assamese population of India calls it `black disease`. It is a chronic disease, which occurs along the shores of the Mediterranean, North Africa, Sudan, Assam in India, China, and the tropical zone of South America.

This is basically a chronic and potentially fatal parasitic disease of the viscera i.e. the internal organs, particularly the liver, spleen, bone marrow and lymph nodes. This happens due to infection by the parasite called Leishmania donovani. This Leishmania donovani is the agent of kala-azar and is transmitted by sandfly bites in parts of Asia, Africa and South America primarily Brazil where all together there are an estimated half million cases per year. There are also several hundred cases yearly in Europe and a few in North America.

Kala-azar can cause no or few symptoms but typically it is associated with fever, loss of appetite or anorexia, fatigue, enlargement of the liver, spleen and nodes and suppression of the bone marrow. Kala-azar also increases the risk of other secondary infections. The first oral drug found to be effective for treating kala-azar is miltefosine.

The term `kala-azar` comes from India where it is the Hindi for black fever. The disease is also known as Indian leishmaniasis, visceral leishmaniasis, leishmania infection, dumdum fever, black sickness, and black fever.

Causes and Symptoms: Allopaths believe an organism that is transmitted by the bite of a sandfly causes that kala-azar. This is usually called the Phlebotomus argentipes. According to the virulence of the infection the onset of kala-azar is acute or insidious. There is irregular fever, progressive anaemia in which the white blood cells are found to be diminished and marked enlargement of the spleen. The spleen of a kala-azar patient is sometimes found to weigh four to five kilograms.

The onset of fever in kala-azar is subtle. The fever rises gradually. But in about 25% of cases, the attack is sudden, the temperature reaching 104°C within a couple of hours. The fever attacks twice or three times in twenty-four hours. That is what distinguishes it from other intermittent fevers. It is irregular and may leave the patient after three to six weeks. But it recurs and leads to enlargement of the liver and the spleen. Many patients suffer from blue or black spots on their forehead, face, palms, or soles of the feet. A continuous distension of the stomach is also noticed. There is emaciation if the attacks continue, and there is a constant pain in the bones of the arms and the legs. The appetite of the patient is generally not affected and that probably explains the long course of the disease.

Diet and Other Regimen: Nourishing food such as milk, milk products, eggs, fruits, and vegetables should be given to the patient in keeping with his condition. Excessive physical exertion should be avoided