22,1 Sellards and Leiva: Amoebic Dysentery 33 



not by 10 cubic centimeters. A more-concentrated solution of 

 Brucea was employed. One cubic centimeter represented 4 

 grams of the original seeds, and subcutaneous injection of rabbits 

 with this amount resulted fatally in from twelve to twenty-four 

 hours; 0.5 cubic centimeter was without any apparent effect. 



Clinical results. — All of the patients studied were cases of 

 frank amoebic dysentery, seen either in the first attack or during 

 a typical recidive. Five patients were treated with Castela 

 nicholsoni, two with Brucea amarissima, and two with Harri- 

 sonia perforata. Preparations of these plants were always 

 given by mouth, except in one instance, where a few doses were 

 given by injection per rectum. Prompt relief of symptoms, 

 accompanied by the disappearance of amoebae from the stools, 

 was obtained only with Castela nicholsoni. With each of the 

 others, some clinical improvement occurred for a few days, 

 but in three of the four cases the amoebae persisted and the 

 symptoms returned while the patients were under treatment. 

 In four of the cases treated with Castela we have been able to 

 secure an examination of the patient after an interval of sev- 

 eral months. One patient relapsed; three remained entirely 

 free of symptoms, although one was passing cysts of Entamoeba 

 histolytica. The last case illustrates well that freedom from 

 clinical symptoms does not constitute a biological test for the 

 eradication of entamcebae. However, we would not belittle the 

 value of a drug which affords prolonged clinical relief. 



SUMMARY 



1. Three species, representing three genera of the Simaruba- 

 ceae, were tested for their efficacy in treating amoebic dysentery 

 in man; namely, Harrisonia perforata (Blanco) Merrill, Brucea 

 amarissima (Loureiro) Merrill, and Castela nicholsoni Hooker. 



2. Harrisonia perforata was not especially toxic for animals; 

 it was readily taken by patients but was inefficacious against 

 amoebae. 



3. Brucea amarissima was very toxic for animals, produced 

 nausea readily in patients when taken by mouth, and its action on 

 amoebae was of little value. 



4. Castela nicholsoni possesses a distinctly toxic principle, 

 therapeutic doses are well borne by patients, and in five cases it 

 gave prompt relief of symptoms accompanied by the disap- 

 pearance of the amoebae. 



5. After an interval of several months four of the cases 

 treated with Castela were reexamined. A relapse occurred in 



