80 HUMAN INTESTINAL PROTOZOA IN THE NEAR EAST 



axostyles. The structure, though most readily seen in the osmic 

 vapour films, can, with careful examination in well differentiated 

 films, be made out in iron haematoxylin preparations fixed in 

 Schaudinn's fluid. As in other trichomonas, the axostyle appears 

 to take origin in the neighbourhood of the basal flagellar granule. 

 The structure of the undulating membrane with its attached 

 flagellum and the basal supporting fibre call for no special remarks. 

 In sublimate-fixed films the nucleus appears spherical with a 

 fine nuclear membrane and centrally placed karyosome. The 

 trichomonas in the human intestine are rarely above 10 microns 

 in length so that their study is very difficult. 



We have made most careful search, in a number of cases 

 followed from day to day, for encysted forms, and though we have 

 several possible structures in mind we have come to no definite 

 conclusions 011 the matter. 



It would seem that encysted forms must be present at some 

 time or another, for we now know that all the common protozoa 

 of the human intestine have such 'stages. 



In one case (Morris) which was being controlled daily on 

 account of Waskia intestinalis infection, Trichomonas sp. was found 

 in the mouth along with entamcebse in a pyorrhoea exudate. 

 The case had been most carefully watched for many weeks and at 

 no time were trichomonas found in the stool. The mouth 

 trichomonas persisted, so that the patient must have constantly 

 swallowed the flagellate, yet no intestinal infection was established. 

 This observation would seem to suggest that the mouth trichomonas 

 differs from the intestinal form as the mouth entamceba does. 

 The mouth trichomonas in this case had three flagella and possessed 

 a definite axostyle. Though the patient had a gut infection of 

 both waskia and tetramitus, these flagellates though specially 

 searched for were never found in the mouth. 



(15) The Course of Trichomonas Infections. 



In a former publication (Lancet, November 27, 1915) one of us 

 (C. M. W.) wrote that trichomonas infections did not appear to be of 

 very long duration, as the flagellates quickly disappeared from cases 

 under observation. We have had in Egypt a better opportunity of 

 studying the flagellate infections and it is quite evident that a 

 trichomonas infection may persist for long periods, the parasites, 

 however, only being present in the stool intermittently. They are 

 present perhaps for a week and then disappear only to return later. 



