632 Dysentery 



bers in the colon of a case of dysentery occurring in St. Petersburg. 

 Not much notice was taken of his paper or much made of his obser- 

 vation until eight years later, when Koch and Gaffky,* in studying 

 the cholera in Egypt, also observed amebas in the intestinal dis- 

 charges in certain cases, and Kartulisf wrote upon the " Etiology of 

 the Dysentery in Egypt," which he referred to them. In America 

 the study of these amebas was quickly taken up. Osier { dis- 

 covered the organisms in the evacuations of a case of dysentery 

 contracted by a patient during a visit to Panama. Councilman and 

 Lafleur wrote a fine monograph upon "Amebic Dysentery," while 

 Quincke and Roos|| and Kruse and Pasquale** confirmed the ob- 

 servations and results in Europe. 



Thus it came to be recognized that an ameba might be the cause of 

 dysentery. It was soon pointed out, however, that there were cases 

 of dysentery in which no amebas could be found in the intestinal dis- 

 charges, or in which they were so few that it seemed impossible that 

 they could be the cause of the disease. This was particularly im- 

 pressive throughout the years of the endemic dysentery in Japan, 

 already referred to. Great numbers of cases occurred, great num- 

 bers of people died, no amebas were found to account for the disease. 

 It therefore occurred to Kitasato that some other causal agent must 

 be looked for, and Shiga took up the problem, which was a difficult 

 one, and might not have been solved had he not made use of a then 

 new means of investigation, viz., the phenomenon of agglutination. 

 By studying such bacteria as could be cultivated from the intes- 

 tinal discharges, with particular reference to the agglutinating 

 effect of the blood of dysenteric patients upon them, Shiga f| suc- 

 ceeded in discovering a new micro-organism which he called Bacillus 

 dysenteriae. Two years afterward KruseJI investigated an outbreak 

 of dysentery in an industrial section of Westphalia and found the 

 same bacillus and Flexner showed it to be present in the epidemic 

 dysentery of the Philippine Islands. 



Thus through the discovery of Shiga it became evident that 

 there are two forms of dysentery, one amebic the other bacillary. 

 Both occur sporadically and endemically in the tropics and in tem- 

 perate climates, and both may occur epidemically, though of the 

 two the bacillary form is the more liable to do so. Of the chronic 

 cases of dysentery 90 per cent, are amebic. 



""Bericht uber die Erforschung der Cholera," 1883; "Arbeiten aus dem 

 Kaiserl. Gesundheitsamte.," in, 65. 

 t "Virchow's Archives," 1886, cv. 

 j "Centralbl. f. Bakt. u. Parasitenk.," 1890, vn, 736. 

 "Johns Hopkins Hospital Reports," 1891, n. 

 "Berliner klin. Wochenschrift," 1893. 

 1 "Zeitschrift f. Hygiene," etc., 1894, xvi. 

 "Gentralbl. f. Bakt. u. Parasitenk.," 1898, xxrv, 817. 

 tt "Deutsche med. Wochenschrift," 1900, No. 40. 

 "Centralbl. f. Bakt. u. Parasitenk.," 1900, xxvm, No. 19. 



