136 AMEB^ 



against dysentery amebse, though not so certain in its action as 

 the hydrochloride. It has an advantage in that it can be taken 

 in the form of tablets when a physician is not available and the 

 apparatus for hypodermic injection is not at hand. Some doc- 

 tors in southern United States have advocated the use of extract 

 of a common southern plant, Chaparro amargosa, to destroy in- 

 testinal amebffi. This extract is very cheap and entirely devoid 

 of danger in ordinary doses, but its use in place of emetin has 

 not yet been sufficiently justified. 



Walker and Emrich have recently (1917) reported the success- 

 ful use of oil of chenopodium for treatment of mild cases of amebic 

 dysentery, and especially of " carriers." It is pointed out that 

 emetin in its various forms is often inefficient in treatment of 

 carriers on account of its powerlessness against encysted amebse 

 and its inability to eliminate them. These investigators em- 

 phasize the importance, before giving the oil, of a preliminary 

 purgation with Epsom salts (magnesium sulphate) sufficient to 

 produce fluid bowel movements, the purpose being both to re- 

 move excess faecal matter from the intestine and to bring the 

 amebse out of their protective cysts and subject them in the 

 unencysted condition to the action of the chenopodium. The 

 treatment found most effective by Walker and Emrich is as 

 follows: (1) magnesium sulphate, from one-half to one ounce, 

 at 6 A.M. ; (2) oil of chenopodium, 16 minims in gelatine capsules 

 (to obviate disagreeable odor and taste), at 8 a.m., 10 a.m. and 12 M., 

 and (3) castor oil, one ounce, containing 50 minims chloroform, 

 at 2 P.M. This or any other treatment should be followed by 

 examination of the faeces at intervals for some weeks after treat- 

 ment, to make certain of the cure. 



The keynote to the prevention of dysentery whether it be 

 caused by amebse or other protozoans or bacteria is sanitation. 

 The efficacy of sanitary measures was well illustrated by the 

 fact that during the first month of the occupancy of Vera Cruz 

 by the Americans in 1914 there were four times as many cases of 

 dysentery as during the second month when sanitary measures 

 had been taken and were enforced. The fact that only the en- 

 cysted parasites as found in the fresh or dried fseces of infected 

 individuals can cause disease suggests a simple remedy in the 

 proper disposal of infected fseces. In tropical countries, however, 

 such a preventive measure is not so simple as it sounds. In 



