﻿90 The Philippine Joiirnal of Science i9i4 



compared are furnished by Vedder " and Ashbum and Craig ^* 

 (compare Table III). Their differential diagnoses, however, 

 are open to the criticism that they were made upon forms found 

 in stools obtained by the administration of magnesium sulphate. 

 It is noteworthy that Vedder recorded not only E. coli infections, 

 but also other evidences of intestinal parasitism. Apparently, 

 not a single infection with E. histolytica was found, since none 

 is given in his results. In as much as these investigators ex- 

 amined apparently healthy individuals and my series of cases 

 is composed of hospital patients, it may be advanced that one 

 would expect to find a higher percentage of persons infected 

 with E. histolytica in the latter than in the former class of 

 individuals. As a matter of fact only 6, or 8 per cent, of the 

 76 cases upon which a differential diagnosis was rendered 

 entered the hospital because of dysenteric symptoms. All of 

 these were infected with both E. coli and E. histolytica. Five 

 of them were chronic cases and one was a slightly acute case. 

 The differentials, of course, were made upon cysts found in 

 formed stools obtained after the subsidence of the dysenteric 

 symptoms. 



It has been noted that the entamoebae found in the evacuations 

 of patients suffering from pronounced dysentery (as evidenced 

 by the presence of entamcebae in great numbers in the stools, 

 by therapeutic results, and by anatomical findings at autopsy, 

 when the cases did not yield to treatment) conformed almost 

 exclusively to the description of active E. histolytica. In other 

 words, these infections as a rule were apparently pure. Ac- 

 cording to the literature on the subject, this is a common finding 

 in dysenteric stools, and it seems rather remarkable when com- 

 pared with the results obtained in the 76 cases in which a 

 differential diagnosis was made upon encysted entamoebae. Of 

 the 49 individuals infected with E. histolytica, the infection was 

 pure in only 4, or 8.2 per cent, and associated with E. coli in 

 45, or 91.8 per cent. Six of these 45 cases, as already stated, 

 entered the hospital because of entamcebic dysentery. Most of 

 the remaining 39 cases may have been carriers, but surely some 

 of them were destined to develop dysentery. In other words, 

 the E. histolytica infection occurring in some of these individuals 

 was in the incubation period. These considerations force me 

 to raise the following questions, which have occurred to me 

 repeatedly. What happens to an associated E. coli infection 



"Journ. Am. Med. Assoc. (1906), 40, 870. 

 '*Milit. Surgeon (1907), 21, 348. 



