The Lost City of the Monkey God

by Douglas Preston

When the Spanish conquistadors arrived in South America in the sixteenth century, they were horrified at the facial deformities they saw among native people in the lowlands of the Andes, especially among the coca growers. The Spanish thought they were looking at a form of leprosy and called the disease lepra blanca, “white leprosy.” Over the years, mucosal leish has acquired many nicknames in Latin America: tapir nose, hoarse voice, spongy wound, big canker. Mucosal leish didn’t exist in the Old World. But the even deadlier visceral form, the kind that invades the internal organs, had long plagued the Indian subcontinent. It first gained the attention of Western medicine as the British extended their empire into India. Eighteenth-century writers described it as “kala-azar” or “black fever.” Visceral leish easily spreads from person to person via the bite of sand flies, using human beings as its primary reservoir host. It was so deadly and spread so fast that in certain regions of India in the nineteenth century, leishmaniasis would sweep through an area, killing everyone and leaving a landscape of empty villages, entirely bereft of human life.