APPENDIX D. 

 DYSENTERY. 



AMONGST the early researches on the relation of organisms 

 to this disease probably the most important are those of 

 Losch, who noted the presence and described the characters 

 of amoebae in the stools of a person suffering from dysen- 

 tery, and considered that they were probably the causal 

 agents. Further observations on a more extended scale 

 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 re- 

 search confirmed these results. Two questions thus arose. 

 In the first place, Is there an arnceba peculiar to dysentery 

 (amoeba dysenteriae) and distinguishable from the amoebae 

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

 organism the cause of the disease ? Both of these questions 

 may now be said to be practically answered in the affirma- 

 tive. It has, moreover, been found that so far as etiology 

 is concerned there are several forms of dysentery, and that 

 it is the endemic dysentery of the tropics and of some sub- 

 tropical countries which is in all probability produced by 

 amoebae. Hence this form is often now called amcebic 

 dysentery, and Councilman and Lafleur, working in Balti- 

 more, have found that it can be distinguished from other 



