TRANSACTIONS OF SECTION D. 419 



2. Notes on the Amoebce from the Human Mouths By Dr. T. Goodey. 



3. The Flagellate Protozoa associated with Diarrhoea and Dysentery. 

 By H. B. Fantham, M.A., D.Sc, and Annie Poeteb, D.Sc. 



At the present time, when the conservation of life is so important, it is 

 well that attention should be directexi to all the pathogenic organisms produc- 

 ing disease in man. Entamabn histolytica, causing amoebic dysentery and liver 

 abscess, has had much attention directed to it, but until recently less notice 

 has been taken of the Mastigophora associated with diarrhoea or dysentery in 

 man. Between January and April 1916 we have taken an active share in and 

 supervised the examination of some 3,800 stools from dysentery patients, and 

 have c-onducted research on the same. The patients mostly contracted the 

 infections in Gallipoli, but a few had never left England until they went to 

 Flanders, while a very few became infected in England and had never been 

 outside the country. More recently, one of us (H.B.F.) has examined the 

 stools of a number of cases of diarrhoea and dysentery in the East, especially in 

 Salonika. 



The Mastigophora found in the stools include Trichomonns hoininis (also 

 called T. intestinalis), Chilomasbix (Tetramitus) mesnili, Giardia {Lamblia) 

 intestinalis, Ccrcomonas hominis and C. farva. Both single and multiple 

 infections of these flagellates with each other and with Entamceha histolytica, 

 E. coli, IsospoTdj Eiineriu, Spirochato curygyrata and Blastocystis occurred 

 some patients exhibiting as many as five different organisms in their stools. 

 The periodicity of the appearance of the parasites in the stools was found to 

 vary with the different parasites. A short account of the essential features of 

 each of these organisms will now be given. 



Trichomonas hominis or 7'. intestinalis as found in the human intestine is 

 pear-shaped, with three free flagella at the blunt or anterior end, a lateral 

 flagellum being attached to the body by an undulating membrane, and an axial 

 rod running towards the pointed end of the body from near the anteriorly 

 placed nucleus. The flagellate measures about 10 /t to l£/t by 5ju. Rounded 

 contracted forms may be found in the faeces. Similar Trichomonads occur in 

 rodents such as rats, mice, and rabbits. Possibly rats and mice act as reser- 

 voirs of the parasites. Trichomonads may also be water-borne. Mello Leitao 

 (1913) found T. hominis in cases of relatively benign dysentery in Rio de 

 Janeiro. Escomel (1913) found 152 cases of dysentery in Peru solely due to 

 Trichomonas. We have found Trichomonas in some patients from Gallipoli, 

 while in certain cases in Egypt these parasites were the cause of severe 

 diarrhoea. With regard to treatment, the use of turpentine, thymol, and 

 calomel, methylene blue and iodine irrigations have been recommended by 

 different workers. Prophylaxis is directed to the prevention of contamination 

 of food and water supplies by infected material, by rodent reservoirs and insect 

 carriers, and to the isolation of pronounced human parasite carriers. 



f'hilomastix (Tetramitus) mcsnili. This flagellate is allied to Trichomonas, 

 but possesses a large cytostome, hence its former name of Macrostomn vwsnili. 

 Three anterior flagella are preeent, and a fourth one (perhaps attached to an 

 undulatine membrane) vibrates in the cytostome. An axial rod or axostyle is 

 absent. The parasite measures about 14^ by In Encystment occurs. It has 

 been found to be tlie cause of a colitis. Cases of Tetramitus diarrhoea have 

 been frequently found in Salonika, and the disease also occurs in Egypt and 

 Gallipoli. Pure infections of Ghiloma.<5tix (Tetramitus) have been seen, and 

 mixed infections of Chilomaetix and Trichomonas have occurred in cases of 

 persistent diarrhoea. 



Oiaixlia (Lamblia) intestinalis exhibits bilateral symmetry. Eight flagella, 

 arranged in four pairs, are present. The axostyle may be' double, and two 

 karyosomatic nuclei are present. A concave sucking disc occurs on the nndpr 

 surface. Two parabasal granules, often situated near the middle of the 



' See Parasitology, vol. ix., part ii., 1917. 



