420 HOYT. 



and it can therefore easily be understood how simple a matter it is for 

 men who are stationed on shore in this vicinity and who take absolutely 

 no precaution against the disease, to become infected in a comparative 

 short time. 



As before mentioned, while these officers and hospital corps patients 

 were admitted to the sick list with the diagnosis of dysentery, the typical 

 signs and symptoms of dysentery in nearly all cases were absent and the 

 diagnosis was based chiefly on the results of stool examinations and lack 

 of other evident cause for the symptoms present. As a rule, these symp- 

 toms began with gradually increasing debility, loss in weight and strength, 

 anaemia, and in some cases digestive disturbances of various sorts; in- 

 digestion, slight diarrhoea or constipation and uneasy feelings over the 

 region of the colon. In a few cases a mild neurasthenic state developed. 

 Blood and mucus were not present in the stools and complaints of 

 tenesmus were not made in these cases. Antidysenteric treatment 

 (chiefly high irrigations of the colon), while causing an apparent relief 

 of symptoms in some cases for a short time, resulted in no permanent 

 good and eventually the patients whose terms of duty did not expire 

 within the eight months, were surveyed and sent to the United States. 



Some few of the other patients admitted to the hospital with diagnosis 

 other than dysentery gave histories somewhat similar to those described 

 above, and such symptoms as debility, anaemia, loss in weight and strength 

 and digestive disturbances could not be accounted for by the diagnosis 

 on admission. In these cases the physical and laboratory examinations 

 would fail to give any more positive results than the presence of motile 

 amoebae or flagellates in the stools. Many of these cases also seemed to 

 be temporarily benefited by high irrigations of the colon. 



It is uncertain as to whether the presence of amoebae plays any part 

 in the causation of these symptoms or whether they are unfavorably 

 influenced by a tropical climate, as is commonly believed; but reasoning 

 from a knowledge of the power of other forms of intestinal parasites to 

 produce symptoms of a general nature, such as those already mentioned, 

 and taking into consideration the reported findings at autopsy in many 

 cases of amoebic infection without apparent symptoms of dysentery, it 

 would be very unwise to ignore this organism as an etiologic factor 

 in affections other than typical dysentery. 



