47 



Eholand ■ 



f Carnarvon 

 Wales Cardigan 



Carmarthen 

 ( Glamorgan 



and for other reasons — and were found, consequently, in places 

 to -which they did not properly belong. For example, the Welsh 

 colliers examined by Matthews and Smith at Liverpool did not 

 belong to this city: and it seems probable that they had con- 

 tracted their infections in their native country rather than in 

 Lancashire. . Yet this is not absolutely certain, of course : and 

 this uncertainty must be borne in mind in attempting to draw 

 conclusions from the incomplete records which are available. 



With the foregoing reservation, it may be stated that cases of 

 indigenous E. histolytica infection have now been found in 

 England — north, south, east, west, and the midlands ; and in 

 natives of Wales, Scotland, and Ireland. The records, from all 

 sources, contain instances of the occurrence of -E histolytica in 

 persons usually resident in the following counties : 



' Lancashire 

 Yorkshire 

 Cumberland 

 Westnaoreland 

 Cheshire 

 Sliropshire 

 Staffordshire 

 V^arwickshire 

 Monmouth 

 G loucestersliire 

 Somerset 

 Berkshire 

 Hertfordshire 

 Northamptonshire 

 Sussex 

 London 



iEast Lothian 

 Shetland Isles 



I have not thought it worth while to record the precise 

 localities ; for the incomplete records at present available do not 

 supply sufficient evidence for attempting to estimate the geo- 

 graphical distribution of E. histolytica in detail. It is possible 

 that the parasite is commoner in some places- than in others, but 

 there is no clear evidence of this in the records. The largest 

 numbers of cases have been found in the places where the longest 

 search has been made for them ; and since no cases have yet 

 been looked for in many areas, a complete survey is out of the 

 question at the present moment. 



Nevertheless, I believe that the available evidence indicates 

 clearly that E. histolytica infection is prevalent throughout the 

 length and breadth of the British Isles. Probably no region — not 

 excepting even the smallest inhabited islands — will be found, if 

 investigated, to be free from infection. This conclusion harmo- 

 nizes with what is already known about the distribution of this 

 parasite in the rest of the world : for the evidence is steadily 

 accumulating to show that its occurrence is world-wide, and is 

 not limited to any particular region of the globe or race of 

 mankind. 



Relation to Disease. — The workers at Liverpool ' have, ap- 

 parently, found no evidence that the large number of healthy but 



Scotland 



Ireland 



Derry 

 Cork 



