SUPPLEMENT 625 



Southern United States, and had been in the habit of drinking 

 unfiltered surface water in the localities in which they lived. Mello- 

 Leitao 1 used magnesium sulphate and water or milk diet. Sometimes 

 enemata of collargol (i per cent.) or electrargol were required. 

 Rosenfeld recommended calomel. Methylene blue has also been 

 tried. Recently, Escomel 2 (1914) recommends enemata of an aqueous 

 solution of iodine (i per 1,000) and farinaceous diet. Lynch 3 (1915), 

 working in South Carolina, recommends a mouth wash of saturated 

 solution of bicarbonate of soda three times daily in oral infections. 

 A similar solution was used as a douche in vaginal trichomoniasis. 



Stiles (1913) points out that when amoebae or flagellates are found 

 in a large percentage (10 to 40, or even 60) of the members of a 

 community, means should be taken to improve the methods for the 

 disposal of the dejecta, so that the food-supply may be carefully 

 protected against faecal contamination. Cysts of the parasites may be 

 air-borne or conveyed to food on the bodies of house-flies. 



(ii) Lamblia intestinalis in man may cause diarrhoea with dysenteri- 

 form stools. The diarrhoea may be of a chronic recurrent character. 

 The flagellate, or a variety of it, is fairly common in the digestive tract 

 of rats and mice. 



Mathis 4 (1914) gives an interesting account of cases in Tonkin. 

 In a child, aged 3, the stools were at first glairy and blood-stained, 

 containing many encysted Lamblia. The child's home was infested 

 with mice. In another case, the house of the patient harboured 

 numerous rats. 



According to Mathis, prognosis is favourable, but emetine hydro- 

 chloride is without action on Lamblia. Prowazek and Werner 5 

 (1914), however, state that emetine will act upon the flagellates, but 

 not upon the cysts. They recommend uzara (two tablets, three times 

 daily) and extract of male fern as useful in certain cases. Martin 

 Mayer (1914) found emetine hydrochloride successful in a case in the 

 Hamburg Seamen's Hospital, but Assmy (1914) points out that a 

 suitable diet and daily doses of magnesium sulphate are sufficient, 

 in his experience, to effect an improvement, and he doubts the specific 

 action of emetine. Escomel (1914) recommends milk diet, then 

 calomel succeeded by castor oil. 



According to Noc, Lamblia may also be water-borne. Healthy 

 carriers of Lamblia cysts are known. Food should be protected 

 from being soiled by rats and mice. 



1 Brit, fourn. Children's Diseases, x, p. 60. 2 Bull. Soc. Path. Exot., vii, p. 657. 



8 Amer. Journ. Trap. Dis. and Prevent. Med., ii, p. 627. 



4 Bull. Soc. Med. Chirurg. Indo-Chine, v, p. 55. 



'' Beihefte z. Arch. f. Schiffs- u. Tropen-Hyg., xviii, 5, p. 155. 



