124 HUMAN INTESTINAL PROTOZOA IN THE NEAR EAST 



have gone very carefully into the histories of the cases and have 

 obtained information as to previous dysentery. It will be seen by 

 the tables that the majority of carriers gave no history of previous 

 dysentery. Most of them had been on the Peninsula and had had 

 diarrhoea, and those who had had dysentery were, of course, unable 

 to state the kind of dysentery from which they had suffered. Still , 

 the history, whatever it is worth, is set out in Tables X, XI, and 

 XII. Of the thirty-seven carriers treated by one-grain emetin 

 injections and who did not relapse, fifteen gave some history of 

 dysentery, mostly on the Peninsula. Of the ten cases which 

 relapsed, only one had a history of dysentery, while of five who did 

 not react to the treatment two gave a positive history. It seems, 

 therefore, that as far as these carriers are concerned a previous 

 history does not affect the treatment. 



When we come to consider the acute cases we find that there 

 was a previous history in every case except three (Eushforth, 

 Wilkinson, and Gaskin), who were suffering from their first attack. 

 These three cases relapsed after a first course of emetin, though 

 a second course was successful in curing one (Rushforth). All the 

 other acute cases gave definite histories of dysentery, generally of 

 repeated attacks. Each had been repeatedly treated in various 

 hospitals with or without emetin. From each place the case had 

 been discharged as cured, but relapse had occurred later on. The 

 histories of these cases are most unfortunate, as the men rarely come 

 back to the same hospital, so that in each instance the same line of 

 emetin treatment is repeated, even if the patient has been fortunate 

 enough to have his condition correctly diagnosed. The danger of 

 ernetin in these acute cases is that it produces a false security, for 

 it very quickly abolishes the symptoms without ridding the patient 

 of an infection which can only be detected by expert microscopical 

 examination. 



As we have already explained, it seems that the carrier case 

 who has either had no dysentery at all or only a single attack, has 

 a condition of the intestine much more amenable to treatment than 

 that of the case which has repeated attacks of dysentery. The 

 patient whom one sees in the acute dysenteric condition does not 

 differ from the healthy or comparatively healthy carrier, except that 

 he has a more extensive or active ulceration of the large intestine, 

 and if this view is correct it is not surprising that these acute cases 

 are much more difficult to cure than the carriers. In this respect, 

 therefore, history of previous dysentery (if this has been definitely 

 amoebic) or, more especially, histories of repeated attacks as 



