1'AHT I. INCIDENCE 33 



sooner or later. Such cases are quite incapable of going back to 

 duty and they have to be watched carefully for some weeks after 

 any course of emetin treatment, for the latter is very misleading 

 in giving a sense of false security, as in nearly every case it brings 

 about a temporary cure. 



In dealing with convalescents from dysentery or other intestinal 

 disorders in war time we would, therefore, suggest the following 

 rules : 



(i) If the case has clinically recovered and is able to take full 

 diet and perform light duty and passes a normal stool, it is not 

 necessary to submit the stools to microscopic examination for the 

 detection of E. histolytica or other protozoa. Such cases if 

 examined would yield a certain number of E. histolytica carriers, 

 but these would be hardly more numerous than the carriers amongst 

 a group of healthy men who have not been invalided. These men 

 can return to full duty. 



(ii) If the case has not recovered, being still ill or passing 

 abnormal stools, microscopic examination should be carried out and 

 any E. histolytica infection treated, as this may be the cause of the 

 trouble. 



(iii) Supposing, however, it is decided to isolate and treat all 

 the carriers amongst the dysentery convalescents, this is not 

 to say that it is necessary to control the healthy carriers after 

 treatment. In nearly every instance the treatment as explained 

 below will lead to a permanent cure, and it is only a waste of time 

 to detain for purposes of control men who were not suffering from 

 their infection even when it was present. In the case of men who 

 have suffered from repeated attacks of amoebic dysentery and are 

 chronic amoebic dysenteries a careful control of at least one month 

 after treatment is complete is indicated. As will be shown below 

 the treatment of such cases is very unsatisfactory. 



(5) Flagellate Infections. As regards the flagellate infections 

 the most noticeable feature is the fact that the highest percentages 

 found were amongst the hospital cases and the men in Gabarri 

 Prison. As we have already explained, these two groups resembled 

 one another as regards the character of the stools. It might be 

 urged that this is an argument in favour of the pathogenicity of 

 the flagellates, but it seems more probable that the flagellates have 

 become evident because the stools are liquid or soft. Evidence 

 in this direction is to be obtained from the E. histolytica carrier 

 cases which were taken into hospital for treatment and were 

 examined every day. These men were to all intents and purposes 



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