126 THE AMOEBAE LIVING IN MAN 



they are said to have been present in the vagina as well as the bladder. 

 I am at a loss to know why these structures were supposed to be 

 amoebae. It seems highly probable that they were cells, though of what 

 sort precisely one cannot determine from the inadequate description. 



Kartulis (1893, footnote p. 2) says he found " amoebae " in the urine 

 of a Cretan, but he gives no proper description of them — merely noting 

 that they measured 12-20 fi, had "finely granular" protoplasm, and 

 showed a nucleus in stained preparations. His reasons for regarding 

 these bodies as amoebae are not given. 



Posner (1893), in Berlin, describes and figures "amoebae" found in 

 the urine of a man with haematuria. They changed shape slowly, were 

 not motile, and usually measured 25-30 ^ in diameter. Although 

 the author speaks with confidence, and says that they " immediately 

 struck everyone who saw them as amoebae," his figures and descriptions 

 are not likely to impress anybody familiar with these protozoa. There 

 can be no doubt, I think, that the objects he saw were really cells. At 

 all events, there is no evidence that they were amoebae. Wijnhoff 

 (1895) studied four similar cases of "urinary amoebiasis" at Utrecht: 

 but although he describes " amoebae," "cysts," and " multiplying" forms, 

 it is clear from his account that the structures which he encountered 

 were not amoebae but cells of various sorts occurring in the urine. 



Craig (191 1, p. 233) mentions that he has studied a case of urinary 

 amoebiasis. The bladder is said to have been infected with E. liistolytica, 

 and a minute fistula between it and an intestinal amoebic ulcer is said 

 to have been detected post mortaii. No details are recorded. 



Fischer (1914) found amoebae in the urine of a Chinaman at Shanghai. 

 After one visit to the hospital — when the amoebae were found — the 

 patient unfortunately left. No proper history was obtained, and the case 

 was not followed up. A diagnosis of " ? Cystitis " was made. The 

 stools were not examined, and it is uncertain whether the patient had 

 ever had dysentery. The amoebae are stated to have been actively motile 

 and much vacuolated, and measured about 20-25 A' i'"* diameter. They 

 were not properly described, but are said to have been indistinguishable 

 from "Entamoeba tctragena," as seen in local cases of amoebic dysentery. 

 It is not stated whether they contained red corpuscles or not, and their 

 mode of entry into the urine was, of course, undetermined. 



Lynn (1914) has recorded the case of "an intelligent coloured man" 

 who washed out his rectum and then his bladder with the same syringe — 

 without sterilizing it — with the result that blood and pus appeared in his 

 urine, and " urinalysis " revealed " motile amoebae {Entamoeba tetra- 

 gena)," according to a laboratory report. No amoebae were found in 

 the stools. This case is said to have "responded" to emetine treat- 

 ment — though the evidence for this is, to say the least, meagre. In 

 the absence of any further evidence concerning the "amoebae," it is 

 impossible to accept them as E. liistolytica. 



Walton (1915) has published an important paper dealing with a case 

 of urinary amoebiasis. His patient was an Indian native with chronic 

 Bright's disease, whose urine contained very numerous highly active 

 entamoebae. Nearly all of these contained red blood corpuscles. 

 Rounded specimens measured usually 25-35 /j, in diameter in stained 

 preparations. No cysts were found. The amoebae are carefully 

 described, and the author concludes that they were " E. tetragena." 

 Amoebae, apparently of the same species, were found in the stools. 



