22 HUMAN INTESTINAL PROTOZOA IN THE NEAR EAST 



stools yet encysted ; E. liistolytica were found fairly frequently in 

 this type of stool. (In an examination made subsequently to the 

 tabulating of these results, an active entamoeba with included red 

 blood corpuscles was found in a stool which was unformed, and 

 which contained no blood or mucus either macro- or microscopically. 

 Similarly trichomonas was found on one or two occasions in 

 bacillary dysentery stools consisting of nothing but blood and 

 mucus examined after the table was completed.) 



If we compare these results obtained from hospital cases mostly 

 admitted for intestinal disorder with the findings in healthy men 

 and in convalescents (see Table IX, page 26), the most striking feature 

 is the low percentage of E. histolytica'&nA. E. coli infections, while 

 the flagellate infections are higher, especially in the case of the 

 unformed and liquid stools. This does not necessarily mean that 

 the flagellates are the cause of the unformed or liquid stools, though 

 they may be in some cases. With trichomonas, and to a lesser 

 extent with tetramitus, which has a recognizable encysted stage, 

 there is a difficulty of recognition in the formed stool. It is almost 

 certain that if the stools of the healthy men, which are mostly 

 formed when examined, were rendered liquid by the administration 

 of salines, then the percentage of recognized flagellate infections 

 would be increased. This is borne out by the fact that in the case 

 of the E. liistolytica carriers which were brought into hospital for 

 treatment, flagellate infections were only recognized in many cases 

 after the patients had been treated with salines. An examination 

 of the charts produced at the end of this paper, and giving the 

 histories of these E. liistolytica carrier cases, will show how 

 frequently the flagellates appear as the stools become soft. All the 

 cases referred to, it must be remembered, were carriers of 

 E. liistolytica, which were found during the course of routine 

 examinations of healthy men. 



As we have already remarked, the majority of the 165 cases 

 showing blood and mucus were undoubtedly cases of bacillary 

 dysentery.* Definite amoebae with included red blood corpuscles 

 were found in only 6*1 per cent, of these cases. The remaining 

 93'9 per cent, of cases were probably of a bacillary nature, making 

 bacillary dysentery over sixteen times more frequent than amoebic 



* About sixty of these cases were plated for culture of dysentery bacilli. 

 In over half of these B. dysenteries either Shiga or Flexner was isolated. This 

 gives a percentage of success which is quite up to the average for the isolation 

 of B. dysenteries from cases of this disease. 



