APPENDIX D. 

 DYSENTERY. 



AMONGST the early researches on the relation of organisms 

 to this disease probably the most important are those of 

 Losch, who noted the presence and described the characters 

 of amoebae in the stools of a patient suffering from dysen- 

 tery, and considered that they were probably the causal 

 agents. Further observations on a more extended scale 

 were made by Kartulis with confirmatory results, this 

 observer finding the same organisms also in liver abscesses 

 associated with dysentery. The subject was, however, com- 

 plicated by the fact that the same or closely similar 

 organisms had been previously found in the intestine in 

 normal conditions and in other diseases than dysentery (by 

 Cunningham and Lewis and others), and additional re- 

 search confirmed these results. Two questions thus arose. 

 In the first place, Is there an amoeba peculiar to dysentery 

 (amoeba dysenteriae) and distinguishable from the amoebae 

 present in other conditions ? In the second place, Is this 

 organism the cause of the disease ? Both of these questions 

 may now be said to be practically answered in the affirmative. 

 It has, moreover, been found that so far as etiology is con- 

 cerned there are several forms of dysentery, and that it is 

 the endemic dysentery of the tropics and of some sub-tropical 

 countries which is produced by amoebae. Hence this 

 form is often now called amoebic dysentery, and Councilman 

 and Lafleur, working in Baltimore, have found that it can be 



