PART III. TREATMENT 133 



Summary of Matter Discussed in Part III. 



(1) The cases treated by emetin hydrochloride fall into three 

 groups, all of which were treated for twelve days : (1) those treated 

 with a daily one-grain injection of emetin ; (2) those treated with 

 a daily one-grain dose of emetin by the mouth ; and (3) those treated 

 with a daily one-grain injection of emetin together with half a grain 

 dose by the mouth. The result is based on a control of each case 

 for at least one month after treatment. 



Under group 1 were treated fifty-two carriers. Of these 

 37 were cured, 10 relapsed, and 5 showed no reaction to treatment. 

 Six acute cases all relapsed after treatment. 



Under group 2 were treated nine cases. Of these 6 were 

 cured, 2 relapsed, and 1 showed no reaction to treatment. Of three 

 acute cases, two relapsed and one did not react to treatment. One 

 very chronic case was cured by emetin 5 grains by the mouth 

 during seven days. 



Under group 3 were treated thirty carrier cases. Of these all. 

 were cured. Of seven acute cases two were cured and five relapsed. 



(2) Methyl .emetin sulphate in a dose of two grains a day for 

 twelve days (one-grain injection each morning and one grain by the 

 mouth each night) failed to cure two acute cases but was successful 

 in curing one carrier case. Methyl emetin sulphate does not 

 produce vomiting so easily as emetin hydrochloride. 



(3) One case which did not react to emetin hydrochloride was 

 treated without result with thymol and pulvum ipecacuanha. 



(4) In the treatment of carriers the object is to kill the amoebae 

 and not the cysts which are harmless to the individual who passes 

 them. 



(5) A comparison of the three lines of treatment adopted shows 

 that the best results are obtained by the combined injection and 

 oral administration of emetin (a total of 1 grains of emetin daily). 



(6) It is evident that the healthy or comparatively healthy 

 carrier is much more easily cured of his infection than the acute 

 case with actual dysentery, especially when there is a history of 

 repeated attacks of dysentery. It is possible that in some long 

 standing cases the condition of the ulcers in the intestine prevents 

 the emetin reaching the amoebaB. 



(7) It appears at first sight that in certain cases emetin-resistant 

 strains of amoebae exist. The resistance is, however, only apparent, 

 and is probably due to the emetin not having reached the amoebae. 



(8) There is no evidence to prove that injections of emetin tend 

 to make the amoebae encyst or to increase the number of carriers. 



