APPENDIX D. 



AMCEBIC DYSENTERY. 



IN a previous chapter it has been pointed out that the term " dysen- 

 tery " has been applied to a number of conditions of different etiology 

 and the relations of bacteria as causal agents have been discussed (vide 

 p. 349). We shall here consider that variety of tropical 1 dysentery 

 which is believed to be due to an amoeba, and hence often known as 

 amoebic dysentery. 



Amongst the early researches on the relation of organisms to dysen- 

 tery probably the most important are those of Losch, who noted the 

 presence and described the characters of amoebae in the stools of a per- 

 son suffering from the disease, and considered that they were probably 

 the causal agents. Further observations on a more extended scalje were 

 made by Kartulis with confirmatory results, this observer finding the 

 same organisms also in liver abscesses associated with dysentery. The 

 subject was, however, complicated 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 research confirmed these results. 

 Two questions thus arose. In the first place, Is there an amoeba pe- 

 culiar to dysentery (amoeba dysenteriae) and distinguishable from the 

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

 ism the cause of the disease? Both of these questions may now be 

 said to be practically answered in the affirmative. Further, Councilman 

 and Lafleur, working in Baltimore, have found that this variety of dys- 

 entery can be distinguished from other forms, not only by the presence 

 of amoeba, but also by its pathological anatomy. The intestinal lesions, 

 to which reference is made below, are of a grave character, mortality is 

 relatively high, and recovery, when it occurs, is protracted on account 

 of the extensive tissue changes. The results of these observers have 

 been confirmed by those obtained in Egypt by Kruse and Pasquale, who 

 have also supplied important facts regarding the pathogenic effects of 



1 The term tropical is misleading, as amoebic dysentery is known to develop 

 independently in temperate regions, cases being not infrequent in Baltimore, Phila- 

 delphia, and New York, in the United States, and cases have also been reported in 

 Germany. 



2 M 529 



