PREVENTION OF AMEBIC DYSENTERY 130 



and its inability to eliminate them. These investigators em- 

 phasize the importance, before giving the oil, of a preliminary 

 purgation with Epsom salts (magnesium sulphate) sufficient to 

 produce fluid bowel movements, the purpose being both to re- 

 move excess faecal matter from the intestine and to bring the 

 amebae out of their protective cysts and subject them in the 

 unencysted condition to the action of the chenopodium. The 

 treatment found most effective by Walker and Emrich is as fol- 

 lows: (1) magnesium sulphate, from one-half to one ounce, 

 at 6 A. M. ; (2) oil of chenopodium, 16 minims in gelatine capsules 

 (to obviate disagreeable odor and taste), at 8 A.M., 10 A.M. and 

 12 M., and (3) castor oil, one ounce, containing 50 minims chloro- 

 form, at 2 p. M. This or any other treatment should be followed 

 by examination of the faeces at intervals for some weeks after 

 treatment, to make certain of the cure. 



The keynote to the prevention of dysentery whether it be 

 caused by amebae or other protozoans or bacteria is sanitation. 

 The efficacy of sanitary measures was well illustrated by the fact 

 that during the first month of the occupancy of Vera Cruz by 

 the Americans in 1914 there were four times as many cases of 

 dysentery as during the second month when sanitary measures 

 had been taken and were enforced. The fact that only the en- 

 cysted parasites as found in the fresh or dried faeces of infected 

 individuals can cause disease suggests a simple remedy in the 

 proper disposal of infected faeces. In tropical countries, however, 

 such a preventive measure is not so simple as it sounds. In 

 many districts where amebic dysentery is endemic the first ru- 

 diments of sanitation are unknown and every possible method of 

 transmission of amebic dysentery is given full opportunity. 

 Polluted drinking water, uncleanliness, transmission by flies, 

 and the almost universal use of " night-soil " (human faeces) 

 for fertilizer, all help the cause of dysentery and account for its 

 prevalence. 



The segregation and cure of dysentery patients, and the care- 

 ful disposal of their faeces, is not enough to eradicate the disease 

 entirely since there are many immune carriers of the disease who, 

 though apparently well, harbor the encysted amebae in their 

 faeces and thereby constitute a source of danger to the community. 

 Thorough sanitation throughout the community is the only pre- 

 ventive measure which is adequate. 



