AMCEBJE OF THE INTESTINAL TRACT. 145 



even the tyro will not be confused if he has seen a 

 few cases of both varieties upon the autopsy table. 

 I have performed several hundred autopsies upon 

 cases of dysentery, including both the bacillary and 

 amoebic types, and can state positively that it is im- 

 possible to confuse the pathology of the amoebic type 

 with that of the bacillary. 



The lesions of amoebic dysentery are most com- 

 monly observed in the rectum and just below the ileo- 

 csecal valve. In mild cases they may be confined to 

 one of these regions, while in the most severe cases 

 the entire colon may be invaded. As showing the 

 relative frequency of the lesions in various portions 

 of the large intestine I may say that out of 78 cases 

 no less than 57 showed lesions below the ileocaecal 

 valve and in the rectum, the intervening portion of 

 the intestine being uninvolved; twelve cases showed 

 lesions extending the entire length of the colon, but 

 invariably most severe in the rectum and below the 

 ileocascal valve; while the remaining nine showed 

 lesions only in the rectum and for a short distance 

 above the sigmoid flexure. In only two of the cases 

 that came to autopsy have I observed any extension 

 of the disease above the ileocsecal valve. 



The most characteristic lesions of the early stage 

 of amoebic infection are small nodular areas which 

 project from the summit of the folds of the mucous 



10 



