34 HUMAN INTESTINAL PROTOZOA IN THE NEAR EAST 



healthy men passing normal stools. During the course of treat- 

 ment, on account of the administration of salines or emetin, the 

 stools became liquid or unformed, and with this change flagellate 

 infections which had not been evident in the formed stools often 

 made their appearance. It will be noted that in the tables the 

 two flagellates, Tricercomonas and Waskia, which are described on 

 pages 86-90, do not appear. This is due to the fact that though 

 they were found in carriers of E. liistolytica it was not at the first 

 examinations when the stools were normal but only later in the 

 observation when the stools had become soft. It seems quite clear 

 that the percentage of flagellate finds in a group of healthy men 

 would be considerably increased if the stools were first rendered 

 liquid or soft by the administration of salines for a few days. 



The Question of invaliding for Flagellate Infections. 



At the present time, there are being admitted to the hospitals 

 in many of the war areas cases of intestinal disorder which are 

 associated with flagellate infections of the intestine. Many of 

 these cases are finding their way to England and others are being 

 discovered there, and it becomes a matter of importance to decide 

 whether such infections are to be regarded in themselves as a 

 sufficient cause for the invaliding of a man. Microscopic examina- 

 tion of the stool for protozoal infections has never been undertaken 

 before to the extent it has reached in the present War. Formerly 

 this branch of examination was completely neglected and it is only 

 during the last year or so that the subject has attained any 

 importance. But very few, even of those who have taken an 

 interest in tropical diseases and have been accustomed to teach 

 this branch of medicine, have had any previous knowledge of the 

 subject apart from the fact that amoebse produce a form of dysentery 

 and that the flagellates may be found in diarrhoeic conditions. 

 Since the commencement of the War, however, the interest in the 

 intestinal protozoa of man has extended very much, and many 

 microscopists have taken up the study of these protozoa and are 

 able now to differentiate between the various intestinal amoabse 

 and flagellates of man. 



We think there is a danger that undue importance will be 

 attached to the mere presence of protozoa in the intestine. It is 

 an undoubted fact that from the point of view of efficiency the vast 

 majority of men showing protozoal infections are quite normal and 

 capable of undertaking their regular duties. This is true even of 



