34 PROTOZOA AND DISEASE 



Amoebic Dysentery. 



The recognition of the Entamceba histolytica (Schaudinn) as the 

 cause of one form of dysentery has made it important to grasp the 

 outlines of recent work on this subject. 



First with regard to the disease itself. Amoebic dysentery is to 

 be distinguished from dysentery due to the bacillus discovered by 

 Kruse in Germany and Shiga in Japan. Schaudinn observed that the 

 B. dysenteric was not to be found in cases of amoebic dysentery 

 examined by him, and Castellani, 1 in the course of the examination 

 of twenty-five cases of dysentery, found only two in which liver 

 abscess and amoebae were present, and in these two cases Kruse's 

 bacillus was not present. A very striking illustration of the condition 

 of the bowel in an advanced stage of amoebic dysentery has been 

 given by L. Rogers. 2 The patient died from peritonitis, caused by 

 perforation of an amoebic ulcer in the vermiform appendix. In the 

 caecum and ascending colon two-thirds of the mucous membrane was 

 occupied by large sloughing patches separated from each other by 

 narrow areas of inflamed mucous membrane. The remainder of the 

 colon presented ulcers diminishing in size towards the anus. The 

 abscess cavity in the liver was lined with a wash-leather-like slough, 

 and the adjoining liver-tissue was intensely congested. 



A. M. Marshall, 3 giving the pathological anatomy of a fatal case, 

 described the wall of a liver abscess as follows : ' Sections from the 

 wall of the abscess showed from within outwards a layer of mucoid 

 necrotic material lining the abscess cavity ; in this many amoebae 

 were found. Next came a reticular layer, also containing amoebae ; 

 deeper came granulation tissue containing connective-tissue cells and 

 swollen fatty liver-cells ; and, deeper still, firm fibrous tissue showing 

 compressed liver-cells, distorted bile-ducts, and amoebae lying both 

 free and in the capillaries.' The same writer emphasizes the 



1 Aldo Castellani, Journal of the Ceylon Branch of the British Medical 

 Association. 



2 L. Rogers, 'Amoebic Dysentery in India,' with coloured plate, Brit. Mcd. 

 Journ., June 6, 1903. 



3 A. M. Marshall, Brit. Med.Journ., June 10, 1899. 



