PART I. INCIDENCE 37 



In other laboratories in the Eastern Mediterranean, cases of 

 amoebic dysentery were met with, but none of these with whom we 

 have discussed the subject are willing to admit that amoebic 

 dysentery was present to the extent that has been made out. 

 Captain Campbell tells us that the conditions were not necessarily 

 the same all over the Gallipoli war area. He suggested that foci 

 of amoebic infection might exist and that in this manner discordant 

 results would be obtained., 



The results obtained by Ledingham, Penfold and Woodcock, at 

 the King George V. Hospital in London (British Medical Journal, 

 November 13, 1915), throw some light on this question. Cases 

 returning from Gallipoli were examined both bacteriologically and 

 protozoologically. In one series representing cases which had 

 left the Peninsula, in June, July and August, dysenteric stools 

 occurred in fifteen cases and dysentery bacilli (chiefly Shiga) were 

 recovered from all of these, while E. histolytica occurred in none. 

 This result is difficult to explain if it is assumed that amoebic 

 dysentery was more prevalent than bacillary during the first 

 months of the campaign. In a later series of cases these observers 

 found by the agglutination test that 47'5 per cent, gave evidence of 

 past bacillary dysentery, while none were amoebic. Even allowing 

 for a possible reduction of amoebic infection by emetin, it would 

 seem that bacillary dysentery was more common on the Peninsula 

 during the early months of 1915 than has been supposed. 



The general character of the outbreak on the Peninsula in its 

 epidemic form is so contrary to what we know of amoebic dysentery 

 that one hesitates to ascribe the bulk of the dysentery to the 

 E. histolytica. It seems more probable that many factors were 

 at work, some of them not yet identified. We feel, therefore, that 

 there is a tendency to over-estimate the amount of amoebic dysentery 

 on the Peninsula during the summer months of 1915, though we 

 recognize that this disease undoubtedly was an important factor in 

 the invaliding of our troops from this section of the Mediterranean 

 area. 



Summary of Matter discussed in Part I. 



<fc 



(1) The collection of samples of stools from healthy men in 

 camps for purposes of bacteriological and protozoological examina- 

 tion can be successfully carried out, provided a definite system 

 is established. Such a method, which yielded all that was required, 

 is described in the text. 



