SARCODINA 1063 



followers in other parts of the world, had treated dysentery with 

 ipecac in massive doses, with wonderful results in some cases and 

 failure in others. The treatment was quite disagreeable and not 

 entirely satisfactory. Vedder, in 1911, examined the various al- 

 kaloids of ipecac and found that emetin was strongly amoebacidal, 

 and he recommended its use for this disease. Rogers, in India, 

 following out this suggestion, soon reported excellent results, and 

 the drug is now accepted as a specific. It is administered hypo- 

 dermically in 1/3-grain doses three times a day at first, then twice 

 and later once daily until a total of ten grains has been administered 

 (Vedder). In addition, the patient is put to bed and placed on a 

 milk diet. During convalescence large doses of bismuth subnitrate, 

 a heaping teaspoonful suspended in water or milk, may be given 

 (Decks). Relapses are of course treated in the same manner as 

 primary infections. As a result of the emetin treatment and exact 

 diagnosis the clinical picture of amoebic dysentery has completely 

 changed, and we no longer see the weak and emaciated dysenteries 

 who formerly crowded the wards of tropical hospitals. 



Epidemiology. One significant fact appears in the epidemiology 

 of the disease it always occurs sporadically and never in explosive 

 epidemics such as we see in water-borne diseases, like typhoid and 

 cholera ; house epidemics are, on the contrary, not uncommon. This 

 fact points to the importance of contact; and flies, as the chief 

 agents in its spread. Buxton 2 and others have examined the drop- 

 pings and intestinal contents of flies caught in latrines. Buxton 

 found 0.3 per cent of a thousand flies harboring E. histolytica cysts, 

 so that there remains little doubt but that the house fly is one of 

 the principal carriers of dysentery. Extreme cleanliness among the 

 servants and in the kitchen will prevent the transfer of histolytica 

 cysts from the ill to the well. The disease has disappeared from the 

 Panama Canal Zone, where it formerly was common, since the intro- 

 duction of good water and sewer systems and better hygienic 

 conditions. 



ENTAMffiBA COLI (grass! 1879) casa grand! et Barbagallo 1895 



This is a harmless parasite of man, and its presence in stools, at 

 one time, gave rise to much confusion, and in the minds of many, 



2 Buxton, P. A., The Importance of the House Fly as a Carrier of E. histoly- 

 tica. Brit. Mecl. Jour., London, 1920, 142. 



