OF THE ALIMENTARY TRACT 87 



ful amoebicicle is necessary, referring probably to the 

 difference in location of the amoebae. The action of 

 emetine appears to be rather indirect than direct on 

 the amoeba. 



The manner of administering the drug varies and 

 this undoubtedly effects the success attending it. 

 Emetine may be given hypodermically or orally or 

 by both avenues simultaneously. 



Dobell's (1921) method of giving emetine bis- 

 muthous iodide (double iodide of emetine and bis- 

 muth) is as follows: 



Emetine bismuthous iodide is an insoluble brick 

 red powder. It should be obtained from a trust- 

 worthy source and be guaranteed to contain not less 

 than 26% of the alkaloid. The dose should be three 

 grains daily, by mouth, for twelve consecutive days, 

 not less. This may be attended by some nausea, but 

 this can usually be controlled by a small dose of tinc- 

 ture of opium previously and by giving the drug af- 

 ter going to bed at night and not on an empty stomach. 

 Dobell believes that this course will usually remove 

 an infection with Endamoeha histolytica perma- 

 nently, without giving symptoms of emetine poison- 

 ing. When it does not rid of the amoeba a further 

 course should be given, three grains daily for twenty- 

 four consecutive days or an ordinary twelve day 

 course supplemented by emetine hydrochloride (% 

 to 1 gr. daily) hypodermically at the same time. 



Wenyon and O'Connor (1917) advocate the com- 

 bined oral and hypodermic administrations of eme- 



