VIII, B, 4 Walker and Sellards: Entamcebic Dijsentery 319 



latent infections with Entamceba histolytica have been treated 

 during this experimental investigation and followed with mi- 

 croscopic examinations of the stools. While the dysenteric 

 symptoms, in such cases as they existed, were always promptly 

 relieved and the entamoeba in both the acute and the latent cases 

 always disappeared temporarily, the entamoebae in every case, 

 except one, reappeared in the stools of the patient in from ten 

 to fifteen days after treatment. In one case of latent infection 

 the entamoebse disappeared from the stools of the patient after 

 treatment and were absent for thirty days, when he was dis- 

 charged from the hospital and passed from observation. A 

 further study of the efficience of ipecac and of the soluble salts 

 of emetine in killing all of the entamoebse in the intestine of the 

 patient, especially of latent cases, is greatly to be desired. The 

 effects of varied doses, the administration by different methods, 

 and especially the tests of prolonged and repeated treatment, 

 controlled by daily stool examinations over long periods of time, 

 should be investigated. Ipecac, especially its alkaloid emetine, 

 is probably the most efficient drug that we possess for the 

 treatment of entamcebic dysentery, but it is extremely important 

 that a method of treatment be worked out that will permanently 

 free the intestine of the patient from entamoebse in order to 

 prevent relapses and to repress "carriers." 



In consequence of the frequent failure of ipecac treatment as 

 at present administered to kill all of the entamoebse in the intes- 

 tine of infected persons, treatment should always be controlled 

 by stool examinations. The usual routine examinations made 

 during and immediately after treatment are useless, since the 

 entamoebse almost always disappear temporarily after treatment. 

 The examinations should be made at frequent intervals for some 

 months after treatment, and if the entamoebse reappear in the 

 stools the treatment should be repeated. With this precaution 

 it is believed that relapses, so common in entamoebic dysentery, 

 can be prevented. 



The prophylaxis of entamoebic dysentery in many, if not most, 

 parts of the Tropics has been based upon the erroneous con- 

 ceptions concerning the etiologic agent of this disease. In 

 consequence of the cultivation^ and infection experiments of 

 Kartulis (1891), Celli and Fiocca (1894), Musgrave and Clegg 

 (1904), Noc (1909), Greig and Wells (1911), Gauducheau 

 (1912), Chatton and Lalung-Bonnaire (1912), and others, 

 together with gross carelessness of investigators in the identifi- 

 cation of species of amoeboid organisms, the opinion has been 

 widely held, at least in the Far East, that, if not all amoebae living 



