INTESTINAL AM0EB1AS1S WITHOUT DIARRHOEA. 

 A STUDY OF FIFTY FATAL CASES. 



By W. E. Musgeave. 



(From the Biological Laboratory, Bureau of Science, Manila, P. I., and the 

 Department of Clinical Medicine, Philippine Medical School.) 



Notwithstanding the fact that such careful and experienced observers 

 as Osier, Dock, Councilman, Laffleur, Kartulis, Tuttle, and many others 

 have mentioned the absence of diarrhoea in certain severe and even fatal 

 cases of amoebic infection of the colon, the fact does not appear to have 

 received the general recognition which its importance deserves. 



In 1904 Musgrave and Clegg again called attention to this condition, 

 having in several articles which have appeared since that time, reported 

 cases and emphasized its occurrence. The purpose of the present paper is 

 not to establish a new fact, but to show that the prevalence of amoebic 

 infection of the colon without diarrhoea is of sufficiently frequent occur- 

 rence to deserve careful consideration by clinicians and to make evident 

 the necessity of altering our conception of the disease to conform with the 

 acceptance of such observations. 



In selecting the 50 cases for this report, only those in which the 

 clinical observations were of sufficient accuracy for publication and 

 in which the diagnosis was confirmed by autopsy have been used. Of the 

 50 cases, 8 were foreigners and 42 natives of the Philippine Islands, 47 

 were males and 3 females. The causes of death were as follows : 



Three from peritonitis following perforation of the appendix — two of these 

 produced by amcebic ulceration, the other by an unknown cause, not amcebic. 



Four from liver abscesses — one perforating into the right pleura, one into the 

 abdominal cavity, and two were without perforation. 



One from acute pericarditis. 



Eight from pulmonary tuberculosis, and in three of. these abdominal tuber- 

 culosis was also present. 



Two from chronic restivo-autumnal fever. 



Five from perforation of amcebic ulcers in the large intestine — four times in 

 the csecum and ascending colon and once in the transverse colon. 



Seven from acute beriberi. 



Twenty from lobar pneumonia. 



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