APPENDIX 



185 



The faecal portion contained numerous smaller amoebae (minuta forms of E. histolytica} and 

 cysts of E. histolytica, together with tetramitus and trichomonas. The case was undoubtedly 

 one of a carrier relapsing into an attack of acute dysentery. On the following day a similar 

 stool was passed, and patient was put on a course of emetin by the mouth (one grain a day 

 for 12 days). The dysentery quickly cleared up and the amoebae disappeared after the 

 second dose, but not the trichomonas and tetramitus. Patient vomited only on one occasion 

 30 minutes after the second dose of emetin. During treatment patient was on liquid diet 

 and was kept in bed. After treatment he returned to duty in the hospital kitchen, where 

 he was kept under observation. Eleven days after the course of emetin was completed, 

 E. histolytica (free and encysted) were found in the stool. Patient was then given a course 

 of emetin injections one grain a day for 12 days. The E. histolytica again disappeared but 

 not the tetramitus or trichomonas. During this course patient was on full diet and continued 

 duty as cook. Twenty-four days after this course was finished E. histolytica again appeared 

 in the stool and persisted to the end of the observation, when patient was sent home to 

 England. During the latter part of the observation patient had an infection of the small 

 flagellate hitherto undescribed Tricercomonas intestinalis. 



