48 REVIEW — TEOPICAL MEDICIN 6 ETC. 



Dropsy — skeletons. But these case?- of emaciation .ire able to move their li .i- 1 about in bed, thougti they are feeble. In 

 continued '^'^7 '"■'Se outbreak of beri-beri those cases of atrophy with ex^-^nsive and severe paralysis are present in quite 

 largo numbers and are often b'^iti :jii(.n for many mouths. 



(/) A marked featur i heri-l)eri is the sudden dci»' .;hat occur in addition to the distressing deaths 

 vrith dyspnoea and ortho ich .as al > ."'cur ."^ "l'?"'' ^ropsy. These sudden deaths occur not alone in 



cases with paralysis •■- but in per^ Hii ' ontly vs. , or who have but the mildest .symptoms. 



(g) There ■' ' isis and aiue.. -« (diminution, of Jjsemaglobin) in epidemic dropsy, but in beri-beri 



ansemia is not ' - ■ ■ ' 



(A) Of n '.ho ii''P'' ' olrasii'.- j%:iix!uticular mottling and staining along the course of 



superficial vJ »li.^ .csquaiW't n iod initial fever in epidemic dropsy. 



(i) Lasi ./i-beri are cs.=- i\ illy those of peripheral neuritis, and the central nervous 



system is unal c.»se. (Hunter and ' ..'L, Manson, Braddon, Wright). 



Eeane-i "jguments against Delany's view that bed-bugs may be the carriers. 



Dust./ ->'S arc of more importance than this in the Northern Sudan, and 



hence a pa 1 .ist Problems^ merits attention. "A road to be dust proof," it says, 



" should have a, .^-nooth, impermeable, enduring surface, and a hard foundation which will not 

 work out through the top ; such a road can be built by using slag taken hot from the furnace 

 and dipped in tar until soaked from surface to centre, after a method invented by Mr. Hooley, 

 of Nottingham, under the name of ' tarmac' " While this is good for new roads it would 

 not pay to lift and relay those already existing, and in Khartoum no slag is available. 

 Palliatives, known as " Westrumite " and " Akonia " are said to be inexpensive, and their 

 effect on dust much more enduring than mere watering. They were considered for the 

 Khartoum streets, but the cost was found to be prohibitive. 



Dysentery. A vast deal of literature has accumulated on this important subject 

 and it is no easy matter to pick out the papers most profitable for review. No doubt many 

 have been missed, but it is hoped those selected will prove useful. 



Waters^ brings out very strongly the influence of soil contamination as a factor in the 

 spread of dysentery, and especially in camps, jails and institutions. He cites South African 

 experience, the role j)layed by flies and the filthy habits of native prisoners. He also points 

 out that men who have suffered much from malaria are very prone to dysentery, and that 

 previous dysenteric attacks also predispose to the disease. He found that hard, out-door 

 labour, necessitating exposure, favoured dysentery,. and he mentions the substances used by 

 malingerers to produce a condition like the disease. As regards the blood state, a general 

 increase in the small lymphocytes was noted. 



Hewlett* reviews the findings of Schaudinn as regards the differences between 

 Enfamceba histolytica and Entauuela coli [vide infra), and alludes to Musgrave's and Clegg's 

 work on Amoebiasis and the cultivation of amcebse. The most important point to which he 

 refers is the apparent necessity for symbiosis with bacteria for the growth of the 

 amoebae. In this connection he cites Lesage, who found, along with Entamoeba histolytica, 

 a bacillus which he termed the Paracolon hacillus. 



McWeeney' mentions briefly the vegetative and sexual cycles of both forms of amcebse 

 and refers to Schaudinn's classical and careful experiment of feeding a young and healthy 

 cat with meat and milk infected solely with the small, brown spores of Entamoeba 

 histolytica. The cat died of dysentery and showed characteristic ulceration of the large 

 intestine, while crowds of amoebae were found in the ulcers and penetrating the wall 

 of the gut. 



The amoeboid stage of the parasite was found incapable of transmitting the disease. 

 It would seem that the disease is not propagated by amoebae introduced per os. The older 

 experimenters had often succeeded in producing infection by the introduction of amoebae per 

 rectum, but, as this can hardly be realised under natural conditions, it is to the dried-up 

 spore-containing faeces present in dust and water that we must look for the propagation of 

 dysentery. These spores can be conveyed by flies and can be blown about by the wind. 



» Reaney, M. P. (July, 1908), "Epidemic Dropsy." Indian Medical Gazette. 



- " Dust Problems." British Medical Journal, p. 1763, December 31st, 1904. 



^ Waters, E. E. (December 1st, 1903), " Dysentery." Journal of Tropical Medicine, p. 363, Vol. V. 



■* Hewlett, R. T. (April, 1905), " Pathogenic Amoebae and their Cultivation." Journal of Preventive Medicine, 

 p. 237, Vol. XIII. 



' McWeeney, E. J. (March 2.ith, 1905), "On the Relation of Parasitic Protozoa to each other and to Human 

 Disease." Lancet, p. 783, Vol. I. 



