APPENDIX 



205 



seen, though the stools were examined continuously for a fortnight before treatment was begun. 

 Entamcebae with included red-blood corpuscles were constantly present. The trichomonas 

 infection was present before, during, and after treatment, but disappeared later. 



CASE EDSSELL, H., aged 27. Patient, who had not been abroad before, left England in 

 June, 1915, and went direct to the Peninsula. In September he was invalided to Egypt for 

 dysentery, for which he was given a course of ernetin in Cairo. He was transferred to duty on 

 the western Egyptian frontier, where he again had dysentery. He was sent back to Alexandria, 

 where he was given another course of emetin. He was in the convalescent camp at Luxor and 

 then was on duty at Mustapha (Alexandria), where he had a third attack of dysentery and was 

 admitted to the Orwa-el-Waska Hospital on April 24, 1916. He was passing blood and mucus, 

 in which active free amoebae occurred in large numbers, many of which included red blood 

 corpuscles. The next day no amoebae could be found, but on April 26 amoebae with included 

 red blood corpuscles were again present in the mucus but not in the faecal part of the stool. 

 There were no cysts. Patient was given a 12-day course of emetin (one grain injection 

 each morning and grain by the mouth in tine, opii mixture each evening) ; patient was kept 

 in bed on milk diet. There was no vomiting. The amoebae were not found after the second 

 day of treatment, though some blood and mucus were found for some days after this. The stools 

 eventually became normal and patient went to the convalescent camp, where cysts of E. histolytica 

 appeared just a fortnight after the completion of the course of emetin. Patient continued to 

 pass cysts and amoebae till, on June 10, he was re-admitted to hospital with a recurrence of the 

 dysentery. The stool contained blood and mucus and only free amoebae in large numbers. 

 Patient was then given a 12-day course of methyl emetin sulphate (one grain injection each 

 morning and one grain in keratin-coated tabloid by the mouth each night). He was kept in 

 bed on milk diet. There was no desire to vomit and no feeling of nausea, as after the emetin 

 hydrochloride by the mouth. The amoebae disappeared after the fourth day of treatment but 

 cysts of E. histolytica and free forms were again present in large numbers three days after the 

 course was finished. Neither course of emetin had any effect on patient's pulse-rate, but a slight 

 irregularity in the temperature was noticed. 



