Sellards and Leiva: Amoebic Dysentery ■ 35 



; of Castela was given for four days. On the third day after 

 treatment no amoebae were found in the stools; there was marked consti- 

 pation during the latter half of the first week after treatment was started. 

 Treatment was suspended for eight days, the stools remaining negative 

 for amoebae. Then a second course of Castela was given, using 5 cubic 

 centimeters daily for one week. An examination of the stools four days 

 after the last dose of Castela showed no amoebae. The patient insisted on 

 leaving the hospital, to return to the harvest fields. He has not been 



Case 3. — Adult Filipina. Duration of disease, four months. During 

 this time there have been several partial remissions and a few isolated 

 doses of emetine have been given. At present the patient is having as 

 many as twenty scanty, bloody, mucous stools daily with much tenesmus. 

 She suffers from general malaise, abdominal pain, and marked tenderness 

 along the ascending, descending, and transverse colon. The stools show 

 numerous Entamoeba histolytica, and kittens were readily infected (Strain 

 IV). Castela was given in 4 cubic centimeter doses daily for one week. 

 Constipation set in after the second dose. A stool obtained by a saline 

 purge on the third day of treatment showed no blood, mucus, nor amoebae. 

 The patient left the hospital against advice at the end of the first week. 

 This patient was seen nine and one-half months later. She had remained 

 entirely free from symptoms and had gained markedly in weight. An exam- 

 ination of the stool showed no amoebae, and concentration by the method of 

 Cropper and Row (2) showed no cysts. 



Case U. — Adult Filipina. Onset of dysentery three days ago during 

 convalescence from typhoid fever. Large numbers of Entamoeba histolytica 

 were present in stool; these were virulent for kittens (Strain IV). Daily 

 doses of Castela of 5 cubic centimeters were given for five successive days. 

 Constipation developed on the third day of treatment. A stool specimen 

 examined one week after discontinuing Castela was negative for blood 

 and amoebae. Nine months later the patient was in good health. A speci- 

 men of stool showed no amoebae, and no cysts were found after concentra- 

 tion. A second stool specimen obtained two weeks later after a saline 

 purge was likewise negative. 



Case 5. — Filipino child, aged 10 years. Duration of disease two weeks. 

 Acute onset with bloody, mucous stools. Entamoeba histolytica abundant, 

 producing a typical infection in kittens (Strain V). Castela given in 2 

 cubic centimeter doses daily for eight days. The symptoms improved 

 promptly. On the second day after starting treatment, no amoebae were 

 seen; on the fourth day a single amoeba was found; from the fifth day 

 on the examinations were uniformly negative. Ten days after treatment 

 was discontinued the boy was discharged from the hospital. Eight months 

 later he was found to be entirely free from symptoms. A specimen of 

 stool after salts showed four-nucleated cysts of E. histolytica. 



