18 The Philippine Journal of Science 1923 



and there is usually more opportunity for treatment with emetine 

 before a fatal bacterial invasion terminates the experiment. 



The clinical behavior of patients under emetine treatment is 

 by no means uniform. Occasionally the symptoms and the 

 amoebae persist under emetine therapy in cases of only ordinary 

 severity. Shepheard and Lillied5) studied eighty cases of 

 Entamoeba histolytica carriers which failed to respond to treat- 

 ment with emetine bismuthous iodide. Extremely acute infec- 

 tions have been described in which emetine was without value. 

 Although it has not been demonstrated, it seems probable that 

 bacterial invasion might occasionally be an important factor in 

 these acute cases. 



Notwithstanding the marked differences between experimental 

 infection and the spontaneous disease, it seems to us that the 

 action of emetine on amcebic dysentery in cats reproduces with 

 very reasonable faithfulness the effects seen in man. Moderately 

 severe infections in adult cats were eradicated by the early 

 and vigorous use of emetine. Inadequate dosage or delay in 

 treatment gave imperfect results or ended fatally, just as we have 

 seen happen altogether too frequently in the practice of medicine 

 in the Tropics. Indeed, it is useless to trifle with minimal dos- 

 ages of emetine. The absence of any beneficial effect in the 

 treatment of well-established hyperacute experimental infections 

 is closely paralleled by the behavior of fulminating cases in 

 man. Our experimental evidence does not agree with the 

 statement that emetine is specific for Entamoeba histolytica only 

 in certain special hosts. (5) 



The production of dysentery in kittens receiving prophylactic 

 dosages of emetine seems a little surprising at first glance; the 

 conditions, however, are highly artificial. These strains had 

 been well adapted to their new host by several rapid sub- 

 passages. Animals at an extremely susceptible age were selected 

 for the test. Moreover, the quantity of the amoebic material 

 injected was enormous, corresponding in Dale and Dobell's 

 work to 600 cubic centimeters for a man of 60 kilograms, 

 furthermore, actively multiplying tissue-invading forms were 

 injected directly into the rectum, in contrast to the ordinary 

 spontaneous infection with the encysted stage introduced by 

 mouth. In our own work the prophylactic use of emetine per 

 rectum resulted in a marked prolongation of the period of in- 

 cubation Curiously enough, this partial failure in the prophy- 

 lactic action of emetine is offset in a measure by the beneficial 



