PART I. INCIDENCE 31 



of amoebic dysentery, but the disease is unlikely to gain a per- 

 manent footing in the country, for the British carrier will never in 

 the long run aid the spread of the disease as does the insanitary 

 native of Egypt. 



> 



(c) The Advisability of examining all Convalescents with a 



View to the Isolation of Carriers of E. histolytica ? 



With such a high percentage of E. histolytica carriers amongst 

 healthy men in Egypt, it is evident that at least the same per- 

 centage of carriers will be found amongst convalescents. This has 

 actually been the case amongst men who have been invalided not 

 only for various intestinal diseases, but for quite other conditions. 

 Men convalescing from many different diseases are constantly 

 being invalided from Egypt, Mesopotamia, and other areas in which 

 amoebic dysentery is endemic. The great majority of these men 

 when they reach England have recovered from their illnesses, and 

 many of them are able to return to duty. A certain number, how- 

 ever, are still ill. In the case of those men who have recovered, it 

 would seem quite unnecessary to institute examinations with a view 

 to isolating the carriers of E. histolytica. These men are in the 

 position of the healthy troops who are still on full duty, and 

 amongst them the carriers are almost, if not quite, as numerous. 

 If these men are clinically fit to return to duty, there does not seem 

 any just reason for detaining them longer, for they will in no way 

 increase the percentage of carriers amongst the healthy troops who 

 have been removed from areas in which amoebic dysentery is 

 endemic. In our opinion there is at the present time no justification 

 for detaining a man just because he has been accidentally found to 

 be a carrier of E. histolytica in the course of routine examination, 

 even though he was invalided for dysentery in the first place. 



With men, however, who are ill, whether their condition leads 

 one to suspect that E. histolytica is or is not the cause of their 

 illness, the question is a different one. Such cases can be suitably 

 treated with emetin if E. histolytica is present. In these cases 

 there would be no unnecessary detaining of healthy men. 



It seems to us, therefore, that in dealing with convalescents at 

 the present time from the point of view of E. histolytica infections 

 the test should be a clinical one. If the men are clinically fit they 

 should be discharged to duty, whereas if they are not fit an 

 E. histolytica infection should always be looked for and treated, 

 for it may be the cause of trouble, and involves no unnecessary 



