THE ANIMAL PARASITES OF MAN 



mouth has been used, and the authorities there consider that it is 

 better to combine the two drugs rather than use each singly. Emetine 

 probably acts as a direct poison to the amoebae, while the bismuth 

 probably acts by destroying the symbiotic organisms necessary for 

 their growth. 



With regard to preventive measures, all drinking water should be 

 filtered and boiled, and uncooked vegetables and salads avoided. 

 Scrupulous care with regard to personal cleanliness, and avoidance 

 of touching the mouth or lips after contact with dysenteric patients, 

 are essential. Isolation of parasite carriers is of great use in combat- 

 ing and controlling outbreaks of amoebic dysentery. The pollution 

 of soil and water must be rigorously prevented. 



Liver abscess due to amoebae must be localized by exploratory 

 punctures, and then opened and drained. Intramuscular injections 

 fo emetine hydrochloride, gr. to J gr. every day, will reduce the 

 temperature and afford relief. 



Oral endamcebiasis has been recently investigated by Bass and 

 Johns, Smith and Barrett and colleagues (see pp. 43, 733). It responds 

 to treatment with emetine, and gr. of emetine hydrochloride 

 administered hypodermically each day is of service. Rinsing the 

 mouth with a solution of fluid extract of ipecacuanha is also useful. 



Rogers 1 (1915) recommends a combined treatment of emetine 

 and streptococcal vaccines for pyorrhoea alveolaris. 



II. TRYPANOSOMIASES. 



The human trypanosomiases are those occurring in Africa, due to 

 Trypanosoma gambiense and T. rhodesiense and spread by Glossinae, 

 and that due to T. crnzi, occurring in South America and spread 

 by the Reduviid bugs, Triatoma spp. These trypanosomiases present 

 different clinical features and are best dealt with separately. 



African Sleeping Sickness. 



Sleeping sickness, due to Trypanosoma gambiense or varieties 

 thereof, was first reported from West Africa and is now present, not 

 only along the West Coast and in Nigeria, but throughout the Congo 

 basin into Uganda, north of which it exists in the Bahr-el-Ghazal 

 province of the Sudan. In Nyasaland and Rhodesia a more virulent but 

 less widely distributed disease is produced by Trypanosoma rhodesiense. 



There is a general similarity between the two diseases, and the 

 symptoms as described by the leading authorities agree in the main. 

 The malady due to T. rhodesiense has been known only since 1910 

 and the differences between the malady due to it and to T. gambiense 

 will be indicated. 



1 Ind. Mcd. Gazette^ April, 1915, 1, p. 121. 



