61 



this patient were also examined. . The husband was apparently 

 free : the children were, however, both infected (Cases 6 and 7) . 

 -- Case 6. — Daughter of preceding. She had occasionally suffered 

 from bowel trouble, and had passed some blood and slime in the 

 previous year. Typical E. histolytica cysts were present in the 

 stools. 



Case 7.^Daughter of Case 5. No symptoms of intestinal 

 trouble. A few E. histolytica cysts found in the stools. 



Case 8. — A married woman, aged 33, a native of Wormerveer, 

 iiow living at Haarlem. Since the age of 18 she had suffered 

 from occasional severe attacks of diarrhoea. Large numbers of 

 E. histolytica cysts were found in her stools. The husband and 

 the son of this patient were also examined, but not found to be 

 infected. 



--- Kuenen discusses these cases at some length; but I will 

 merely note here that he concludes — in my opinion very pro- 

 perly — that it is a mistake to regard E. histolytica as a parasite 

 peculiar to the tropics, and to seek an imported origin for all in- 

 fections discovered in Holland. E. histolytica probably occurs 

 indigenously in that country ; and if, as Kuenen believes. Case 5 

 contaminated her two children (Cases 6 and 7), infection can 

 evidently be spread there without foreign intervention. 



It may be added that Nolen (1918).was reminded, by Kuenen's 

 paper, of a case which he studied in 1908. His patient was 

 a Dutch fisherman^ aged 42, belonging to Vlaardingen, who had 

 suffered for 3 years from dysentery. In his bloody mucous stools 

 numerous active amoebae containing red blood corpuscles were 

 found. This was doubtless, therefore, a case of true amoebic 

 dysentery. Its interest lies in the circumstance that the patient 

 had never been, in the exercise of his calling, further afield than 

 England. He had never been in the tropics or in Eastern Europe, 

 and must therefore have contracted his infection either in Holland 

 or in England. 



llie Occurrence of E. histolytica in Germany. — In a recent 

 paper Fischer (1920) has recorded several cases of indigenous 

 amoebic dysentery in Germany. This observer — who has had 

 experience of amoebic dysentery in China — appears to be un- 

 aware of the work already accomplished in England, France, and 

 Holland : and it is clear from his paper that he is not abreast of 

 the present state of knowledge of the amoebae of man. His 

 findings, in so far as they are of interest in this connexion, are 

 briefly as follows : 



The author has examined the stools of 120 patients, suffering 

 from various complaints (mostly stomach and bowel affections) 

 in a hospital at Grbttingen. He found E. histolytica in 2 (or 3 ?) 

 cases, and other intestinal protozoa in several others. The 

 positive cases were the following : 



Case 1. — A young woman of 18, with clinical dysentery. In 

 the bloody mucous stools amoebae containing red blood corpuscles 

 were found, but no cysts. They were diagnosed as E. histolytica. 



