PART III. TREATMENT 127 



(2) Treatment of Entamoeba coli Infections. 



During the course of the treatment of E. histolytica infections 

 by means of etnetin a good deal of information regarding the action 

 of this drug on E. coli has been obtained. Similarly during 

 attempts to get rid of flagellate infections by means of other drugs 

 the action of these on coincident E. coli infections has been 

 observed. 



Emetin. The general difference in the action of this drug in 

 E. coli and E. histolytica infections has been discussed, and it has 

 been suggested that E. coli is probably generally distributed through 

 the large intestine and not so easily acted upon, while E. histolytica 

 is more intimately associated with the ulcers and so comes more 

 directly under the action of einetin. 



In the series of cases treated by injections of emetin, one grain 

 a day for twelve days, it will be seen that in only one instance 

 (Osgood) did an E. coli infection, which was present before the 

 end of the emetin course, fail to appear after the course was 

 completed. It is thus evident that such a line of treatment cannot 

 entirely get rid of an E. coli infection. If one looks at the charts 

 of treatment of the individual cases it will be seen that in a few 

 the E. coli infection disappears temporarily, apparently as a result 

 of the treatment, but that in others there is no such action what- 

 ever. It seems that this line of treatment may influence the 

 infection to some extent, but only very slightly compared with the 

 action on E. histolytica. 



The administration of a grain of emetin a day by the mouth 

 was no better as regards a permanent result, though the temporary 

 disappearance of the infection was more marked than when the 

 emetin was given by injection. 



When we consider the combined injection and oral treatment 

 of 1 grains of emetin a day, we find there is a much more 

 decided action in the E. coli infections and indeed on all other 

 coincident protozoal infections. In nearly every case this line of 

 treatment has abolished all the intestinal protozoa including the 

 E. coli. In four cases (English, Liddle, Graham and Smith) there 

 was no return of E. coli infection during the period of control. It 

 is evident that, just as emetin by the mouth ( grain) combined 

 with injections (one grain) gives better results with E. histolytica 

 so it does with E. coli infection, but the outstanding feature of 

 the treatment is the specific nature of the action of emetin on 

 E. histolytica and its comparative inaction on E. coli as regards 

 permanency of cure. 



