44 DISEASES DUE TO PROTOZOA 



Sir Patrick Manson recommends simaruba officinalis as follows : — 



Simaruba bark ... ... ... ... ... Grm. 15 



Pomegranate fruit rind ... ... ... ... ,, 15 



Gum Arabic ,, 15 



Add water to one litre and boil to half its bulk. 



Give one ounce (30 grm.) thrice daily. 



Dapter suggests a creosote rectal wash, i — 100, twice daily. He 

 maintains that the creosote is absorbed, and acts upon the amoebae in 

 the tissues and in the localities where other drugs have failed to reach 

 them. 



The administration of sulphates at the same time as other treatment 

 will assist in washing out the bowel, but patients must not be exhausted 

 by their prolonged use. 



A dry but varied diet is most generally useful. 



Men, dogs and cats act as carriers without obvious symptoms, and 

 should be treated pro bono publico. 



Remark. — The Entamoeba tetragena can cause a serious cystitis of 

 the urinary bladder quite apart from any dysenteric affection (Wright). 



CILIAR DYSENTERY. 



(i) Balantidium coli (sometimes B. minutum) may cause trouble- 

 some intestinal disturbances, such as occasional, remittent or persistent 

 diarrhoea, in which the parasites can be found. 



Blood and mucus are present in all the severe cases. 



Peritonitis may occur with or without perforation. 



Extensive ulceration is found in fatal cases, most marked near the 

 rectum, and less so in the direction of the caecum. 



Sometimes there is vomiting, with oedema of the face and ex- 

 tremities. It is chiefly confined to the large intestine. 



The diagnosis can only be made by the microscope. 



There is no specific treatment. 



The mortality is about 30 per cent. 



It is most common in the Philippines, Japan and Europe. 



THE PARASITE. 



It is an oval-shaped, large, ciliated infusorian, 30 — 200 fx x 20 — 70 ju,. 

 It reproduces by division, budding and conjugation. 

 It may lose its cilia and become encysted. 

 It is a common parasite of the pig. 

 It is very active in liquid human stools. 



It has been found post-mortem in the exudate, follicles, ulcers, 

 muscular coat, blood-vessels and lymphatics of the intestine. 

 The method of infection is unknown. 



