XII. B, 3 Manlove: Balantidial Colitis ' 151 



ments, which stopped after several days without treatment. 

 Following this attack he had some irregularity of defecation 

 with alternation of diarrhoea and constipation. During the 

 month previous to admission there was a daily chill and fever, 

 which continued until the present attack. 



The present attack began about February 22, 1916, nine days 

 before admission, with frequent bloody bowel movements which 

 occurred almost every fifteen minutes. During this attack there 

 was a moderate grade of fever, abdominal pain, and malaise. 



He was treated at first for amoebic dysentery, and in an ex- 

 amination of the faeces, which was made before his admission 

 to the Philippine General Hospital, no pathogenic organism was 

 found. After his admission, before a laboratory examination 

 had been made, a tentative diagnosis of bacillary dysentery, 

 pulmonary tuberculosis, and malaria was made. 



A summary of the physical findings is as follows : 



The patient was restless, weak, and very much emaciated. 



The pulse was small, weak, and rapid, and it fluctuated be- 

 tween 85 and 120, with an average of about 110 per minute. 



The temperature varied between 36° and 38.5° C. It was 

 generally subnormal in the early morning and might gradually 

 or suddenly rise, sometimes varying as much as 3° C. in two 

 hours. 



The respiratory system showed areas of dullness and some 

 crepitant rales over the apices. The respiratory rate averaged 

 thirty per minute. 



The nervous system was apparently normal, though the pa- 

 tient was dull and apathetic. 



There was a more or less continuous diarrhoea throughout 

 the course of the disease. 



General course of treatment. — Throughout the eight days the 

 patient was in the hospital, a continual proctoclysis of normal 

 salt solution by the drop method was used. Proctoclysis of 

 adrenalin chloride, 25 drops to 1 liter of salt solution, was also 

 used. Quinine enemas of varying strength were used daily. 

 On the second and third days after admission he received 30 

 cubic centimeters of normal horse serum intramuscularly, which 

 produced a very appreciable effect in decreasing the amount of 

 blood in the faeces. 



Laboratory reports. — The number of bowel movements while 

 in the hospital was 24, of which 15 occurred during the first 

 three days. The faeces were thin, watery, blood-colored, and 

 contained at all times large numbers of Balantidium coli, blood 

 cells, mucus, and ova of Trichuris. 



