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Starr and other eminent neurologists have pointed out the close associa- 
tion of certain forms of neuritis and neurosis with disturbances of 
the gastro-intestinal tract, and to these must be added amcebic infection 
of the colon. Many old, nervous troubles, particularly sciatica, are 
excited by amoebic dysentery, and, in addition to this, the beginnings of 
various chronic types of nervous disease may be traced to the date of a 
previous dysentery. 
Acute chorea.—There are in the literature a few references to choreic 
movements complicating this disease, but, so far, no reference to Syden- 
ham’s chorea complicating dysentery of any kind has been found. I have 
seen two instances in which the association of true chorea and the ameebic 
infection of the colon was very close. Briefly, these cases are as follows: 
CasE I. Intestinal amebiasis ; rather severe infection; acute chorea; recovery ; 
recurrence of both dysentery and chorea; recovery; typhoid fever without chorea; 
permanent restoration to health. 
Miss X, American, 23 years of age, in Philippine Islands for eighteen months. 
No chorea in family and no previous history of choreic movements. No history 
of rheumatism, heart affection, or other disease or tendency to chorea. No 
previous illness of any kind. After about two weeks of indigestion with inter- 
mittent diarrhea she was taken suddenly during the early evening with 
acute abdominal pain and nausea. By next morning the bowel movements showed 
mucus and blood; there was about 1 degree of fever, and tenesmus and nausea were 
present; microscopically, the faces contained numerous amebe; there was much 
blood and mucus, sloughs and shreds of mucosa of the bowel. She was treated 
during the first forty-eight hours with cleansing enemas, mild saline laxatives, 
and the pain controlled by Dover’s powders. On the third day acute symptoms 
had so much subsided that she was placed on quinine enemas twice daily. The 
fourth and fifth days were comfortable, no fever, no nausea, but still considerable 
abdominal pain and rather frequent bowel movements. On the morning of the 
sixth day choreic movements of the hands were noticed, and by the next the 
movements were general, including those of the face and legs. There was decided 
hesitancy in speech; on the tenth day pain and slight swelling of both ankles 
developed, continued for about twenty days, and gradually disappeared. There 
was, for some days, considerable tachycardia, the pulse counting from 90 to 105 
per minute. The rhythm was a little irregular and a soft, systolic murmur was 
heard at the apex. There was no evidence of enlargement of the heart, and the 
murmur disappeared during convalescence. I do not believe there were organic 
changes in the heart. The chorea and dysentery subsided together during the 
next three weeks. About six weeks after the onset of the dysentery there was 
a moderate recurrence of this symptom, although treatment had been continued 
during this time. With the recurrence of the dysentery, there was return of 
slight choreic symptoms, confined to the hands and face, and lasting only a few 
days. Recovery from both the amebic infection and chorea was permanent. 
About six months later this patient passed through an attack of typhoid fever. 
No chorea was seen during this illness, and she has been entirely free from it up 
to the present time, two years since the dysentery. 
Case Il. Neurotic young woman, 22 years of age. Chorea in childhood, with 
rheumatism following scarlet fever. Amebiasis, severe. Chorea; recovery. 
The interesting factors of this case were the relation of the attacks of dysentery 
to those of the chorea which developed together. The chorea subsided about ten 
days after the bowel movements had become normal. 
ee was 
