SUPPLEMENT 637 



should be well drained. Much good has followed the use of such 

 measures in Panama, Egypt, British Guiana and other places. The 

 ideal conditions for malaria reduction appear to consist in a combina- 

 tion of general quinine prophylaxis with anti-mosquito measures. 



VII. BALANTIDIAN DYSENTERY. 



This disease is also known as ciliate or ciliary dysentery. The 

 chief causal agent is Balantidium coll. Others are Balantidium 

 minutum, Nyctotlierus faba, etc. (see pp. 200-206). 



Balantidiasis is insidious and is marked by alternate attacks of 

 diarrhoea and constipation with vomiting, while mucus is passed in 

 the motions, which are foul smelling. There may be chronic ulcera- 

 tion of the colon. (Edema of the face and limbs and anaemia may 

 occur. 



Treatment is at present rather unsatisfactory. Castellani and 

 Chalmers state that "the symptomatic treatment for entamcebic 

 dysentery may be tried." Various treatments, more or less empiri- 

 cal, by calomel, quinine, carbolic acid in pill form, salicylic acid, 

 extract of male fern, methylene blue, iodine solution, rice water and 

 tannin enemata are mentioned by Prowazek 1 (1913) and by Seifert. 

 E. L. Walker 2 (1913) found, from experimental work, that organic 

 compounds of silver, e.g., protargol, were most effective. Local treat- 

 ment by large enemata of collargol or protargol seems to be indicated. 

 Behrenroth 3 (1913) successfully treated a Prussian case with thymol, 

 given in 4 grm. doses every two days, followed at the end of a 

 fortnight by de-emetinized ipecacuanha, given in pills containing 

 6 eg. each, to the number of thirty a day. In about another fort- 

 night the symptoms had subsided. The thymol checked the 

 diarrhoea, but it was necessary to give the de-emetinized ipecacuanha 

 to kill off the balantidia still present. Phillips (1915) also recom- 

 mends thymol. Ardin-Delteil, Raynaud, Coudray and Derrieu (1914) 

 found neither emetine hydrochloride nor protargol of use. 



As regards prophylaxis Walker states that pigs " should be 

 confined and not allowed to run in yards and dwellings." Behren- 

 roth considers that dirty hands, for example, those of farm workers 

 brought into contact with pigs, are probably the medium of infec- 

 tion. The personal cleanliness of such persons is, then, of the 

 greatest importance. 



1 Beihefie z. Arch. f. Schiffs- u. Tropen-Hyg., xvii, 6, p. 371. 



2 Philippine Jl. Sc., Sect. B, viii, pp. 1-15, 333-349- 



3 A'-ch. f. Ve>-dann'is Krankhdten, xix, p. 42. 



