571 
In both of these cases the intimate relationship between the dysentery 
and the chorea was such as strongly to indicate that something was being 
absorbed from the diseased bowel which caused or aggravated the chorea. 
When we remember the close association of chorea and rheumatism, and, 
as Just mentioned, that there is also a rather close relation between dysen- 
tery and certain cases of rheumatism, the instances described above appear 
in a more natural light. In both the cases treatment was directed to a 
cure of the dysentery. In the first one the enemas were stopped for a 
few days, as it was thought they might have something to do with the 
trouble, but their interruption was without influence on the character 
or intensity of the nervous disease. 
ALBUMINURIA is very common in long-standing cases of amcebiasis, 
and organic changes undoubtedly frequently exist as late complications 
and after effects. However, excepting the association of the two diseases 
(which has already been discussed) where the kidney trouble is clearly of 
other etiology, permanent impairment of the kidney function does not 
appear to be a serious outcome of the ameebic disease. 
Antong the other complications of amebiasis, which have from time 
to time been reported, are mentioned fibroid degeneration of the heart, 
terminal pericarditis, purpura, gangrenous ulcers of the stomach, mastoid 
abscess, abscess of the brain (Kartulis), pseudoparalysis, gangrene of 
the foot, ete. 
IV. 
AFTER EFFECTS. 
The degree of restoration of function which will occur after the 
most extensive ameebic ulceration of the colon has been repeatedly 
pointed out. In the majority of well-treated cases of simple amebic 
colitis there are no serious sequela, and even in some of long stand- 
ing, with the passage of blood and mucus and even of sloughs, re- 
generation may be so satisfactory that perfect function of the foal 
may be restored. However, sequele are not rare in amecebiasis, and, 
while not of so great a variety as the complications, are nevertheless of 
great importance. Like the complications, they divide themselves into 
sequela directly due to the amebie infection, those due to the complica- 
tions of the disease, and those but remotely connected with the amcebic 
disease. ‘This latter group is a somewhat large one, including consti- 
tutional disturbances (conditions arising as a result of wasting, lowered 
resistance, etc.), and it need not here be entered into in detail. There 
are several important conditions of the other two groups to be discussed 
of which the first and one of the most frequent is sprue. 
Sprue.—The superficial, clinical picture and the anatomic findings in 
sprue are fairly constant; enough so, perhaps, to justify its consideration 
as an entity, but the Subibey is surely multiple, and therefore, at least 
etiologically, tt must be regarded as a symptom complex and not as 
