PART III. TREATMENT 97 



The cases have all been treated as hospital patients with the 

 exception of four, who continued their duties as usual during the 

 course of emetin. 



The stools were in almost every instance examined for a few 

 days before treatment was commenced in order to obtain some idea 

 of the course of the infection before an attempt was made to get 

 rid of it, and a careful record was kept of the kind of stool passed 

 and the various other protozoal infections present besides the 

 E. histolytica. While the patients were in hospital at least one 

 entire stool was inspected each day, an arrangement having been 

 made whereby the stools passed into bed-pans were brought at once 

 to a lavatory near the laboratory which was set apart for this 

 purpose. After the course of treatment was completed the patients 

 were sent to a convalescent camp and were quartered in a special 

 section. Here they were given ordinary diet and were placed on 

 light duty. Stools were collected from them on alternate days. 

 As will be seen from the records of the cases at the end of the paper 

 it was possible in this way to follow exactly the effect that treat- 

 ment had upon the infection and to note when any return of this 

 occurred. 



Each case was kept under control for at least one month after 

 the completion of the course of emetin before being discharged as 

 cured. Of course an unavoidable fallacy entered into the control, 

 and that was the impossibility of excluding the chance of reinfec- 

 tion. That infection might occur in the convalescent camp is 

 shown very clearly in some cases by the fact that certain protozoa 

 not hitherto present in the stools appeared a few days after the 

 patients had joined the camp. That this may have occurred equally 

 well with E. histolytica we recognize quite clearly, but if it has 

 done so in any case it can only have had the effect of making our 

 results appear worse than they actually were. 



In carrying out the treatment we have had direct control of all 

 the cases owing to the kindness of the hospital authorities in 

 placing beds at our disposal for this purpose. The temperature 

 and pulse-rate of the cases were taken regularly and a careful 

 watch was kept for any signs of heart irregularity which might be 

 attributable to the emetin which was being administered. A record 

 was kept of the number of times patients vomited after emetin was 

 administered by the mouth. 



The observations on the series of cases here recorded have 

 occupied about six months and have entailed an enormous number 

 of stool examinations, as can very readily be seen from the protocols 



7 



