DIFFERENTIAL DIAGNOSIS OF THE DYSENTERIES 203 



This refers not so much to the recent progress in cytodiagnosis 

 as to the rich store of primeval lore that has found its place in 

 medical practice and even in supposedly serious scientific litera- 

 ture. 



There are, to be sure, many perfectly legitimate unsolved 

 problems bearing on the diagnosis of dysentery that hang on in- 

 completely elaborated fact ; but there also are, alas, many others 

 conceived in ignorance and born in misapprehension that, none 

 the less, now require to be dealt with in serious and scientific 

 fashion in order that we may arrive at a semblance of the truth 

 concerning them. Had I the space I gladly would review the bril- 

 liant achievements of clinical medicine, pathology, bacteriology and 

 medical zoology in the field of intestinal pathology. They have 

 given us a solid footing on which we shall be able to deal with 

 a great mass of superficial, misdirected and inaccurate effort, that 

 has embellished the literature during the past twenty-odd years. 

 The product of this effort has been the formulation of a congeries 

 of amazing speculations and fantastic problems which, in certain 

 quarters, pass current for the last word. However, I must devote 

 this space to an exposition of what I consider to be the more im- 

 portant unsolved problems in the microscopic diagnosis of the 

 dysenteries. ^lany of these questions have been raised largely by 

 the method, or lack of method, employed by certain investigators. 

 While a number of them have no real merit, all must sooner or 

 later be disposed of by scientific method. This is as much for the 

 correction of the moral effect they have produced as anything 

 else. 



Before we can hope to settle these questions we must travel 

 far afield and carry our quest far beyond the mere consideration 

 of animals in their role as the real or fancied producers of disease. 

 The picture of dysentery is a panorama — not a vignette. Xo one 

 can study amoebic dysentery and close the problem at its borders, 

 missing all acquaintance with bacillary dysentery. Neither may one 

 study the group of reactions legitimately comprehended under the 

 term dysentery and ignore the other numerous acute and chronic 

 affections of the intestine that cloud the issue. Accordingly, if I 

 seem to stray from the narrow path indicated by the title of this 

 chapter, and if I seem extravagant in my views as to what factors 

 must be weighed in dealing with the broad aspects of our prob- 

 lems, I can only ask that the reader suspend judgment until he 



