Balantidium Diarrhea 695 



Morphology.— In young cultures the cells are round or slightly oval; in old cul- 

 tures cells are of many forms; oval, elongate, elliptical, round, or irregular; giant- 

 cells are common. Septate mycelium develops in gelatin hanging-drop and in 

 old cultures. Budding occurs from any point on the young cells, but usually near 

 the ends of articles in old cultures. The size is 4.5 X Si". 



Cultural Characters. — On glucose agar the streak is filiform, raised, glistening, 

 chalk- white and smooth; later the central portion may become rugose or ribbed; 

 the edge of the streak may remain entire or may become decidedly filamentous, 

 due to the outward growing hyphal elements under the surface of the medium. 

 There is a growth in gelatine stab, at first filiform, later it develops scattered, 

 bushy clusters of filaments. In liquid sugar medium, and beer-wort a very evi- 

 dent ring formation occurs; no pellicle is present. Giant colonies occur. 



Physiological Properties. — It ferments glucose, maltose and levulose; occasion- 

 ally sucrose and galactose are fermented. Yeast- water sugar mediums, with an 

 initial acidity of +1, become more alkaline. Litmus milk is rendered alkaline 

 in two weeks, but is not clotted. Gelatin is rarely liquefied. 



This species strongly resembles the fungus variously called Oi'dium albicans, 

 Monilia albicans, and Endomyces albicans. Castellani has, however, reserved 

 the name Monilia albicans for a species which always clots milk and liquefies gela- 

 tine. Monilia albicans, Monilia psilosis, Oidium albicans and Endomyces 

 albicans are synonyms. 



Specific Therapy. — Michel* has treated a number of cases of sprue 

 with a moniha vaccine and claims good results. 



BALANTIDIUM DIARRHEA 



Balantidium Coli (Malmsten) 



In certain rare cases a severe form of diarrhea, or a mild form of dysentery 

 appears to depend neither upon Entamoeba histolytica nor Bacillus dysenterije, 

 but upon a protozoan parasite known as Balantidium coli. This organism was 

 first observed by Malmstenf in 1857 in the intestines of a man who had suffered 

 from cholera two years before and had ever since suffered from diarrhea. Upon 

 investigation, an ulceration was found in the rectum just above the internal 

 sphincter. In the bloody pus from this ulcer numerous balantidia were seen 

 swimming about. Although the ulcer healed, the diarrhea did not cease. Since 

 his original observation and up to 1908, BraunJ had been able to collect 142 cases 

 of human infection. In all of these cases the presence of the balantidium was 

 accompanied by obstinate diarrhea with bloody discharges (dysentery) in some, 

 and many of the cases ended in death. 



Morphology. — The Balantidium coli is a ciliate protozoan micro-organism of 

 ovoid or ellipsoidal form, measuring from 30 to 200 n in length and from 20 to 70 ft 

 m breadth. The body is surrounded by a distinct ectosarc completely covered 

 by short fine cilia. The anterior end, which is usually a little sharper than the 

 posterior, presents a deep indentation, the peristome, which continues, in an infun- 

 dibuliform manner, deeply into the endosarc. The peristome is surrounded 

 by a chcle of longer cilia — adoral cilia — than those elsewhere upon the body. 

 At the opposite pole there is a small opening in the ectosarc, the anus. The mouth 

 is the simple termination of the infundibuliform extension of peristome and 

 opens directly into the endosarc, so that the small bodies upon which the organism 

 feeds, and which are continually being caught in the vortex caused by the rapidly 

 vibrating adoral cilia are driven down the short tubulature directly into the 

 endosarc. 



The endosarc is granular and contains fat and mucin granules, starch grains, 

 bacteria, and occasionally red and white blood-corpuscles. 



There are usually two contractile vacuoles, sometimes more, and as the quiet 

 organism is watched these large clear spaces can be seen alternately to contract 

 and expand. 



* "Jour. Inf. Diseases," 1918, xxii. No. i, p. 53. 



t "Archiv f. pathologische Anatomic," etc., xii, 1857, p. 302. 



I "Tierische Parasiten des Menschen," Wurzburg, 1908. 



