18, 4 Haughwout: Human Coccidiosis 455 
That the patient had an infection with some species of amceba 
would appear evident from the findings in the Bureau of Science; 
but the species was not determined, and they never reappeared in 
the stool after the day they were discovered. The patient, it is 
true, had taken heavy doses of ipecac; but his stool, at no time 
while he was under my observation, showed any of the elements 
characteristic of dysentery of any type. 
The clinical symptoms seemed to be fairly constant, and they 
abated with the subsidence of the infection. The stools at times 
were watery, but always feculent and contained no pathologic 
elements aside from shed epithelial cells occurring in groups of 
five or even more cells, which despite their surroundings looked 
remarkably healthy—more as if they had been mechanically 
detached from their bases than as if they had been subjected to 
an inflammatory process. There was neither pain, griping, nor 
tenesmus, though, of course, there is no reason why the patient 
should experience tenesmus when one reflects on the anatomical 
site of the lesion. There was, however, a constant, dull feeling 
of discomfort in the abdomen, sometimes accompanied by flatu- 
lence, that the patient found very hard to define, but which, 
nevertheless, was perfectly real. The patient also suffered 
from fatigue and lassitude, restlessness at night, and occasional 
nausea. At times, particularly at night, he had a bad taste in 
: the mouth and his tongue usually was foul, notwithstanding his 
bowels moved every day. Anorexia was a prominent and per- 
sistent symptom. The patient, like ‘Noc’s recently reported 
case, (12) also lost weight. 
The general impression seems to be that these infections are 
extremely transitory, and at least one writer has placed three 
weeks as about the limit of their duration. I think there is no 
doubt that there are at least exceptions to that rule, if it is a rule. 
The infection persists long enough for the patient to journey 
from Mesopotamia to Bombay or from Germany to Senegal, or 
from France to America and lastly from the eastern United 
States to Manila, a journey of five weeks. This, added to the 
time the last-named patient was under observation, comprehends 
a period of more than four months, and he was still infected when 
he parted from me, which rather effectually disposes of the 
theory that these infections are “purely transitory.” During 
that time the patient’s stool yielded but one negative examin- 
ation, and I have little doubt that, if I had spent more time on 
it, I should have found some cysts. : 
