36 HUMAN INTESTINAL PROTOZOA IN THE NEAR EAST 



entamceba^ and some of the large macrophages and other cells 

 encountered in bacillary dysentery infections. It seems certain, 

 therefore, that the prevalence of amoebic dysentery must have been 

 considerably exaggerated. 



That amoebic dysentery did actually occur is an undoubted fact, 

 for Captain Archibald, who had had considerable previous experience 

 of the disease, met with it fairly commonly in his laboratory at 

 Mudros. Further, many of the cases were clinically of the amoebic 

 rather than the bacillary type, as Captain Campbell who was 

 working at Cape Hellas informs us. Evidence in another direction 

 is obtained from the results of one of us (C. M. W.) who examined 

 in London a large number of cases invalided from the Peninsula 

 in the latter part of 1915. Amongst these cases there was a 

 percentage of over ten of carriers of E. histolytica and protozoal 

 infections were generally high. These men had mostly come direct 

 from Gallipoli, so that E. histolytica infections must have been 

 common on the Peninsula. Captains Archibald and Hadfield, 

 working at Mudros East, state (Journal of the Royal Army 

 Medical Corps, June, 1916) that of 518 dysenteric stools examined 

 362, or seventy per cent., were due to amoebic infections. The 

 authors in explaining their method of diagnosis state "that entamcebae 

 containing phagocyted erythrocytes were regarded as pathogenic, 

 a view with which we entirely agree, but they do not assert that 

 all their cases were diagnosed on this basis, nor do they tell us in 

 what proportion of their cases the non-pathogenic E. 'coli was 

 found. Furthermore, they state that the evidence was obtained 

 by the direct examination of the amoebae or their cysts. Now it 

 would be interesting to know what was the number of cases 

 diagnosed by the occurrence of cysts in the stool. As will be 

 explained below, the presence of the cysts E. histolytica in the 

 stool, though it proves infection with this amoeba, does not 

 necessarily mean that the case is or has been one of actual amoebic 

 dysentery. Other forms of dysentery occur in cases which are 

 carriers of E. histolytica, and in such there is produced a dysenteric 

 stool in which cysts of E. histolytica may be found. The section 

 of the above report by Captain Campbell on the work done at Cape 

 Hellas shows that sixty-five per cent, of the stools with blood and 

 mucus contained amoebae, but he says definitely that phagocytosis 

 of red blood corpuscles was noted at times. It is evident, therefore, 

 that in many cases the amoebae found by him must have been E. coli, 

 which, judging by the results obtained in London, were more than 

 three times as common as E. histolytica in men on the Peninsula. 



