256 FAMILY: AMCEBIDiE 



but Sellards and Leiva (1923) have shown that, as a rule, amoebic dysentery 

 in kittens is so much more acute than it is in human beings that the action 

 of emetine in the two hosts is hardly comparable. By employing large 

 animals, in which the dysentery arising from injection of E. histolytica is 

 less acute than it is in kittens, and by treating the animals with emetine 

 solutions 'per rectum in a dose of 10 milligrams per kilogram of body-weight, 

 they have demonstrated a definite therapeutic action of the drug. Further- 

 more, by employing the same method of treatment in kittens immediately 

 infection has taken place, similar results were sometimes obtained. 



Ware (1916) reported an outbreak of what appeared to be amoebic 

 dysentery in a pack of fox-hounds in India. Seven of the animals, some 

 of which had been obstinately ill for several months, were given injections 

 of from I to 1 grain of emetine. There was an immediate response with 

 cessation of symptoms. All the animals recovered completely except 

 one, which relapsed. Whatever may be the mechanism of its action, it 

 is certain that in man emetine has a remarkable effect. Attacks of 

 amoebic dysentery are in most cases cut short by the hypodermic injection 

 of 1 grain of the drug on a few successive days, while the introduction 

 of the drug has diminished the number of secondary complications, such 

 as liver abscess, which formerly were of common occurrence. 



As in the treatment of so many protozoal diseases (malaria, trypano- 

 somiasis), though it is comparatively easy to suppress the parasites to 

 the extent that acute symptoms disappear, it is extremely difficult to 

 rid the host of E. histolytica entirely, and relapses are therefore prone to 

 occur. Very frequently, after the treatment of acute amoebic dysentery, 

 with the disappearance of symptoms the patient passes into the carrier 

 condition. In a certain number of cases it is possible by intensive treat- 

 ment to rid a patient entirely of an E. histolytica infection, but to obtain 

 evidence that this has happened it is necessary to continue the examina- 

 tions of the stools over a period of many months. 



It was shown by the writer and O'Connor (1917) that the administra- 

 tion of 1-5 grains of emetine hydrochloride daily (1 grain subcutaneously 

 each morning and | grain by the mouth each night) for a period of twelve 

 days would in a certain number of cases eradicate E. histolytica infections. 

 Another method of giving emetine is in the form of the powder of bismuth 

 emetine iodide in cachets. This drug was introduced during the war by Low 

 and Dobell (1916), and has been extensively used. A cachet containing 

 3 grains of the drug, corresponding to 1 grain of emetine hydrochloride, 

 is given each day for twelve days by the mouth. 



Emetine has a remarkable action in cases of threatened amoebic abscess 

 (hepatitis), though it is not quite clear if the drug alone, without operative 

 treatment, will cause an amoebic abscess which has already formed to 



