98 HUMAN INTESTINAL PROTOZOA IN THE NEAR EAST 



of the cases, but the results we have obtained throw light not 

 only on the course of the E. histolytica infections and the effect 

 emetin has on these but has brought out many other interesting 

 points in connection with other protozoal infections of the human 

 intestine. 



(a) Treatment by Emetin Hydrochloride. The emetin used in these 

 observations was the tabloid product of Messrs. Burroughs Wellcome 

 & Co. For injection purposes it was dissolved in the strength of 

 one grain in one cubic centimetre of distilled water. For oral 

 administration we employed the same product, one grain dis- 

 solved in tinct. opii fifteen minims, or the half-grain keratin-coated 

 tabloids. Emetin administered subcutaneously was always given 

 in one single injection daily, as this causes far less worry to the 

 patient, who naturally does not like to have his injections unneces- 

 sarily multiplied, and, furthermore, it saves the labour of those who 

 have to give the drug. It has yet to be proved that two injections 

 of half a grain a day are better in any way than a single injection 

 of one grain. The cases we have treated fall naturally into three 

 groups according to the method of emetin administration. In 

 Group I the cases were in hospital with four exceptions. They 

 were not kept in bed entirely but were allowed about during the 

 greater part of the day. They were given hospital chicken diet 

 and were treated by the administration of a single injection of one 

 grain of emetin a day for twelve days, while the bowels were kept 

 loose by a mixture containing sodium sulphate one dram taken 

 three or four times a day. 



In Group II the cases were treated in the same manner as those 

 in Group I, with the difference that the drug was given by the 

 mouth instead of by injection. The emetin was dissolved in tinct. 

 opii one grain in fifteen minims, and this was given each night in 

 a cup of tea. The salines were not given so regularly, as the 

 emetin by the mouth tends to keep the bowels loose. 



la Group III the cases were confined strictly to bed, were kept 

 on milk diet and were given 1 grains of emetin a day for twelve 

 days (one grain injection each morning and half a grain in keratin- 

 coated tabloid by the mouth at night). In this group of cases 

 salines were not administered regularly but were given if there 

 was any sign of the stool being formed. In addition to the cases 

 which fall into these three groups there are others which were 

 treated differently, and these will be described in due course. 



In the early part of our investigation the cases were treated as 

 in Groups I and II, and, as the tables show, certain cases relapsed, 



