OF THE ALIMENTARY TRACT 81 



tenesmus, frequent small stools of glairy mucus with 

 fresh blood, and straining at stool. 



Disturbed digestion, tenderness over the intestine 

 on pressure and colicky abdominal pains are promi- 

 nent disturbances. 



Systemic debilitation, loss of weight, weakness, vary 

 with the severity of the attack. As it is prolonged 

 they become prominent, and anemia, exhaustion and 

 emaciation may be pronounced in the severe or fatal 

 case. 



Enlargement of the liver with or without sensitive- 

 ness varies in the experience of different observers. 

 Early amoebic hepatitis may give an enlarged sen- 

 sitive liver and a trace of jaundice. 



Later amoebic liver abscess may produce a more 

 pronounced state of a similar kind, probably with 

 evening fever, chilly sensations or actual chills, and 

 blood leucocytosis. 



Proctoscopic or sigmoidoscopic examination m.ay 

 or may not reveal ulcers of the examined intestine. 

 Negative findings here by no means exclude amoebic 

 colitis, since there may be extensive involvement of 

 the higher colon. Fever may or may not occur and 

 when there is a blood leucocytosis it is probably due to 

 a secondary bacterial infection. 



An attack of amoebic dysentery may occur as the 

 first evidence of intestinal amoebiasis or it may occur 

 as an acute flare during the course of the chronic 

 disease ot as its end result. 



In recovery from the acute attack there is gradual 



