126 ^^6 Philippine Journal of Science 1917 



The first of these propositions is not plausible, when we con- 

 sider that amoebas have not been found in the upper part of the 

 intestine and in the gall bladder. However, Dr. B. C. Crowell, 

 of the department of pathology. College of Medicine and Surgery, 

 University of the Philippines, informs us that amoebae have been 

 found by him in the gall bladder. The second is tenable because 

 Woolley and Musgrave(23) have demonstrated that amoebse may 

 enter the blood vessels early in the disease and may be trans- 

 ported to the submucosa without producing lesions. Many other 

 observers, prominent among whom is Schaudinn,(24) corroborate 

 this fact. In the opinion of Musgrave(23) the third furnishes 

 the most satisfactory explanation, for it is an established fact 

 that the process of repair, even in very extensive lesions in the 

 intestine, is so complete that traces of the disease cannot be 

 detected macroscopically. 



Upon consulting the necropsy records of the department of 

 pathology. College of Medicine and Surgery, University of the 

 Philippines, of 3,630 cases, extending as far back as 1910, I find 

 83 cases of amoebic colitis among Filipinos, 16 of which were 

 associated with or complicated by liver abscesses. Crowell (H) 

 encountered 9 (29 per cent) out of 31 cases of amoebic colitis. 

 Oilman, (12) in a series of 100 autopsies, encountered 32 cases 

 of amoebic colitis, only 1 of which was associated with liver 

 abscess. 



In reviewing the first 42,246 cases admitted and treated at the 

 Philippine General Hospital, I find 3,561 cases of intestinal 

 amoebiasis, with 99 amoebic liver abscesses. Of the latter cases, 

 47 were discharged either cured or refusing operation, but with 

 nothing upon which to base the diagnosis except clinical findings 

 and, in some instances, their response to large doses of ipecac 

 and emetine hydrochloride. Fifty-two were proved cases, of 

 which 38 were Filipinos. Of the Filipino cases, 36 were 

 operated upon and 16 died, 12 coming to autopsy. With the 

 exception of 1, all showed ulcerations in the colon. However, 

 the case which showed no lesions in the bowels had symptoms 

 of dysentery while being treated at the hospital and showed 

 amoebse in the stools. Of these 12 autopsied cases, 5 gave no 

 history of dysentery nor was there any evidence of the disease 

 during life. In our entire series of 38 cases, 26 either gave a 

 history of dysentery or showed evidence of intestinal amoebiasis, 

 while in 12 cases no history of dysentery could be elicited. Four 

 of these 12 died, showing active amoebic lesions in the colon. 

 Therefore we have a total of 30 out of 38 cases, or 79 per cent, 

 with either history or evidence of intestinal amoebiasis. 



