﻿102 The Philippine Journal of Science lai* 



consists in (1) making a differential diagnosis between E. coli and 

 E. histolytica and treating only those infected with the latter 

 species or (2) treating all persons indiscriminately who are infected 

 with entamoebae. 



B. The exclusion of E. histolytica from an infection is impracticable 



for routine usage because of (1) the experience required to make 

 a correct differential diagnosis between E. histolytica and E. coli, 



(2) the time required for an experienced microscopist to make 

 such a differential -diagnosis, and (3) the frequency of E. histolytica 



in this locality. 



C. Prophylactic treatment should, therefore, be confined to expelling 



entamoebae from the intestinal tract. In order that such a treat- 

 ment may be widely used, it must be inexpensive, give good 

 results quickly, and the method of administration must be simple 

 and unattended by prolonged unpleasant reaction. 



3. A. Four preparations are now in use for entamoebiasis — ipecac, emetine, 



neosalvarsan, and bismuth. Reports of each and all of these 

 treatments deal chiefly with their application to the symptomatic 

 cure of dysenteric cases, whereas they should be applied also to 

 the cleansing of the bowel of entamoebae. 

 B. Results obtained by Winn in dysenteric, and by ourselves in non- 

 dysenteric, entamoebiasis with salvarsan and with neosalvarsan 

 indicate that this treatment may prove to be the most efficacious 

 of the 4 varieties in quickly relieving the dysenteric symptoms 

 and expelling entamoebae from the intestinal tract. 



4. A. Entamoebae are very unequally distributed in a given stool and in 



different stools from an infected individual. This makes it difficult 

 to estimate the intensity of an infection and to tell when a 

 specimen is truly negative. 

 B. More than 3 consecutive negative examinations are required before 

 one may state with safety that a person is free from entamoebae, 

 provided 4 cover-glass preparations be examined of each specimen. 



5. Rest and diet influence the clinical evidences of entamcebic dysentery 



favorably, and our results in control cases tend to show that they 

 are to be reckoned with in the elimination of entamoebae from the 

 intestinal tract. 



6. Because of the recurrent nature of entamcebic dysentery, it is to be 



remembered that some apparently good clinical results will be obtained 

 with any form of treatment. 



7. A. In our dysenteric cases emetine gave a larger percentage of symp- 



tomatic cures and acted quicker in this class of cases than ipecac. 

 B. Emetine and ipecac were about equally efficacious in expelling en- 

 tamoebae from the intestinal tract. The time required to expel 

 the entamoebae with the two preparations was also about equal. 



8. In our nondysenteric cases neosalvarsan freed the bowel of entamoebae 



in 100 per cent of cases, ipecac in 70.6 per cent, and emetine in 

 36.8 per cent. From the last two percentages an undetermined factor 

 which is less than 25 per cent must be subtracted, because this 

 percentage of cases would have given 2 consecutive final negative 

 examinations (an arbitrary standard adopted for comparative pur- 

 poses) in the time limits without treatment. 



