86 PROTOZOAN PARASITISM 



one must be guarded in speaking of bringing about a 

 cure by any measure merely on the evidence of a 

 return of the patient to apparently normal health. 

 One may assist in relieving the disturbance of the 

 disease but to cure intestinal amoebiasis necessitates 

 the eradication of the amoeba from the host. With- 

 out ascertaining conclusively that this is the case one 

 should not speak of a cure. This can be determined 

 only by examining for the amoeba over a fairly 

 lengthy period, bearing in mind that its numbers 

 naturally vary and that after any ordinary thera- 

 peutic attack, especially if there has been recovery 

 from the clinical state of amoebic dysentery, it may 

 be very sparse for some time. 



Absence of the amoeba from the stool by repeated 

 careful examination, such as has been previously 

 detailed, for a month or longer may be taken as rea- 

 sonable proof of the eradication of the parasite. 



The drug of longest specific use in the treatment 

 of intestinal amoebiasis is ipecac. While ipecac 

 itself is still used by some it has been largely replaced 

 by its alkaloid emetine. This drug, although lethal 

 to Endamoeba histolytica only when as strong as 1 

 to 10,000, according to Kofoid and Wagener (1925), 

 exerts a powerful specific effect on the amoeba in the 

 tissues of its host, it being particularly valuable in 

 the active phases of the disease, usually controlling 

 amoebic dysentery promptly. It is less effective 

 against the ''carrier" or the host who does not exhibit 

 signs of tissue invasion. In that case a more power- 



