130 
REPOKT OF TRAVELLING PATHOLOGIST AND PROTOZOOLOGIST 
Four stages 
of cyst of 
E. coH 
Malaria in the 
Southern 
Sudan 
Negative 
results of 
mosquito 
dissections 
Prevalence of 
syphilis 
Remarkable 
case of 
eosinophilia 
nuclei. These are merely different stages in the development. In the two-nuclei stage there 
is often contained within the protoplasm a refractile body which is sometimes so large as to 
nearly fill the cyst, reducing the protoplasm to a thin layer. This body was referred to by 
Schaudinn, and I have met with it. in the cysts of the mouse amoeba and also in the cysts of 
Eiitanuvba coli. As development proceeds this body breaks up into fragments, which appear 
to shrink hut never completely disappeai'. Cysts of an amoeba indistinguishable from 
those of Entamo'ha coli 1 found in the intestine of a monkey which died in the Wellcome 
Eesearch Laboratories at Khartoum. 
In Fig. 35 are shown drawings of four different stages of the cysts of Entavmba coli 
which were met with in the examination of cases at the military hospital at Khartoum. A 
represents the just encysted amoeba with the gelatinous covering and a single nucleus. B 
is the next stage with two nuclei. The large 
refractile body referred to above is also present. 
The gelatinous covering has contracted to a 
tough transparent envelope. C shows the 
cyst with four nuclei. Between the stages shown 
in B and C the sexual process would take 
place. D is the stage wnth eight nuclei and 
the final stage of development before escape 
from the body. Further development of these 
cysts takes place when they are eaten liy a new 
host. The protoplasm divides into eight small 
amceb®, which escape and infect the intestine. 
Alalaria was found in all parts of the 
Southern Sudan. The types most frequently 
encountered were the benign tertian and 
malignant varieties. Only on one occasion was 
the quartan parasite seen. At Nasser, on the 
Sobat, malaria was constant among the small 
cliildren. In older children it was difficult to find, while in the adults who were true natives 
of the district I never found it. In adults who had come to live in the neighbourhood from 
as far north as Khartoum, malaria! infection was common. The mosquito which was 
probably the carrier of malaria at Nasser was Myzomyia nili, as it occurred in large numbers. 
Dissections of these and other species gave only negative results. Leprosy, Mycetoma, 
and Ainhum were seen especially at Bor. Lesions resulting from Leprosy and Mycetoma are 
illustrated in Figs. 36-38 on page 131. Syphilis was common, and in several cases of what 
appeared to he secondary syphilitic eruptions on children about the age of ten, spirochietes, 
indistinguishable from Treponema pallkliim, were found. It is very probable that such cases 
of syphilis are of extra-genital origin, and that this kind of syphilis is more common than 
one imagines in such countries as the Sudan, where the habits of the people lead them to 
crowd together into a small space for sleep, with their bodies unprotected by any covering 
from contact with any one among them who may already be infected. Attention has recently 
been drawn to the probability of a similar condition existing in other places. 
At Nasser a remarkable case of eosinophilia was seen in a man who was suffering from 
a chronic skin eruption on the lower half of his body. The eruption took the form of localised 
thickenings of the skin, causing it to feel hard and rough. There was much irritation, as 
shown by the constant scratching and the presence of scabs. The man stated he had suffered 
from this disease for six or seven years. What the nature of the eruption might be I could 
form no opinion, unless it was some kind of chronic urticaria. .■\n examination of the blood 
Fi$. 35—Cyst cf '■ Entamceba coli." trom u case m the 
KhortouTQ Uilitaxy Hcspital. 
X 15U0 (Uifin 
