APPENDIX 



179 



origin. During 1914 and 1915 he had many attacks of amoebic dysentery, for which he was 

 treated as follows : 



1914. May .. 

 July .. 

 August . . 

 October. . 

 December 



1915. August . . 

 October. . 

 November 

 December 



1 week 

 3 days 

 1 week 

 1 ,, 



1 ,, 



2 days 

 2 ,, 



1 week 

 1 



12 injections of emetin (6 grains) 

 3 



10 

 G 

 8 



6 

 G 



10 

 10 



(5 

 (3 



(4 



(3 

 (3 

 (5 

 (5 



During January end February, 1916, patient on two occasions had two injections of emetin 

 (i grain at each inject/ion) as he felt as if an attack of dysentery was impending. He has also 

 been in the habit of taking a |-grain keratin-coated tabloid of emetin when any trace of blood 

 and mucus appeared in the stool. This he had done on four occasions. He was convinced that 

 this procedure warded off attacks of dysentery. When seen on February 19, 1916, patient was 

 thin and sallow looking, and was evidently not well. The stool brought for inspection was soft 

 and semi-formed with flakes of mucus distributed through it. There were present enormous 

 numbers of amoebae, which the subsequent observations proved to be minuta forms of 

 E. liistolytica. As patient could not very well come into hospital he was treated while on 

 duty (office work) with emetin injections (one grain a day for 12 days). He was put on 

 light chicken diet and was to avoid all alcohol. A stool examined three days after treat- 

 ment showed E. liistolytica cysts in enormous numbers. These he continued to pass through 

 the whole course of emetin injections. Emetin by the mouth was then given one grain at 

 night for two nights and then grain at night for seven nights. After the first dose by the 

 mouth the cysts showed signs of degeneration, while none were found after the second dose. 

 The patient was kept under observation for over a month after treatment. There was no 

 recurrence of the amoebae in the stool and the patient continued to improve in health. The 

 intestinal symptoms completely cleared up, and patient passed normal stools for the first time 

 since his dysenteric attacks commenced. 



CASE HEALY, E., aged 26. Patient, who had lived in the Federated Malay States, had his 

 first attack of dysentery there in the spring of 1911. He was in hospital three weeks and 

 did not have another attack till 1912, for which he was given emetin. Another attack in 1913 

 or beginning of 1914 occurred for which emetin was again administered. Patient came home 



