22,1 Sellards and Leiva: Amoebic Dysentery 17 



straight, large bowel of the cat permits local treatment more 

 readily than in the case of man. 



Occasionally the intravenous injection of emetine is recom- 

 mended. This route permits the maximal toxic action of emetine 

 on the patient and would seem to us to be the poorest mode 

 of administration. For the treatment of abscess of the liver 

 without operation, the theoretical possibility suggests itself that 

 a very slightly greater concentration of emetine might be ob- 

 tained in the liver by rectal rather than by intramuscular or 

 intravenous injection, with perhaps a little less of the general 

 toxic manifestation. 



The beneficial effect of emetine on amoebic dysentery in cats 

 provides an experimental method for studying the strains of 

 amoeba? from patients who fail to respond to emetine therapy. 

 These patients may, theoretically, be infected with some emetine- 

 resistant strain of amoeba?, or the failures may be due to the 

 vague condition of lowered resistance of the patient. The dis- 

 tinction between these two possibilities has not been approached 

 experimentally; indeed, the solution of the question may lie in 

 some simpler explanation. 



The interpretation of the therapeutic action of emetine in 

 amoebic dysentery in cats necessitates some detailed study. 

 The complete picture requires consideration, not only of the 

 protozoological and pharmacological features, but also of the 

 pathology of the experimental disease and its bacteriology, as 

 well as an accurate knowledge of the clinical behavior of patients 

 under treatment. The details of the pathology of the disease 

 appear to us to be worthy of discussion. In young kittens the 

 disease commences in the lowermost portion of the large bowel, 

 producing an intense diffuse inflammation without any trace of 

 normal mucosa in the infected area. In some kittens, sacrificed 

 one day after injection, it appeared that the process begins 

 diffusely, and not as discrete ulcers. In man, in neglected cases 

 coming to autopsy, it is characteristic that large islands of 

 normal mucosa are found in the affected areas. In older cats, 

 the process approximates much more closely the conditions 

 found in man. In two animals, which we have already men- 

 tioned, the infection started with a discrete lesion instead of 

 a diffuse generalized inflammation. In cats, as contrasted with 

 kittens, the disease begins less abruptly, runs a slower course, 



