29 



attacks of dysentery. He had a more severe attack at Albert in 

 December 1916 — about 25 stools per diem, with blood and slime. 

 He was in hospital at Abbeville for nearly six months, and was 

 treated with emetine. After rejoining his unit in May 1917, he 

 had two more mild attacks, and then came home on leave in 

 November 1917. Whilst in England (his home is in Brighton) 

 he entered hospital for ulcers on his legs, and whilst in hospital 

 had another attack of dysentery and was transferred to the 

 2nd Eastern General Hospital, Brighton, where I first saw him 

 (March 1918). E. histolytica was found in his stools at the first 

 examination. He was treated first with emetine injections 

 (1 grain a day for 12 days), but remained positive during the 

 course, and cysts were afterwards found in his stools in great 

 numbers. He was then treated with emetine bismuth iodide 

 (3 grains daily for 12 days); but he again remained positive 

 during the course, and numerous cysts were passed afterwards. 

 As this treatment made him very ill, he was next treated with 

 ' Chaparro ' — the usual 10-day course. Ten subsequent negative 

 examinations made over a period of nearly a month allowed him 

 to be passed on to the Dysentery Ddp6t at Barton as 'negative'. 

 Here, however, he was again found positive at the third exami- 

 nation. He was then treated twice with emetine bismuth iodide 

 (at Barton) — each course lasting 16 days. After his second course 

 he was passed out of Barton as ' cured '. (He forgets exactly 

 how many negative examinations were made.) 



This patient was infected with E. colt, E. nana, and Tricho- 

 cephalus, in addition to E. histolytica. Save for his service in 

 France in the army, he had never at any time been abroad. 



Case 2. — This patient had never had dysentery or even severe 

 diarrhoea before the War. He had, however, travelled a lot in 

 Europe — France, Belgium, Holland, Germany, and Spain. (Only 

 once in Spain, in 1902 : never further south than Madrid.) He 

 joined the army in September 1916, when 39 years old, and went 

 to Aldershot about November 20, 1916. In Aldershot he shared 

 a room with five other men, one of whom had been in Mesopotamia, 

 and the other four in India. Several of these had had dysentery 

 out East. Patient's battery and another battery used the same 

 latrine ; and about December 10 a dispute arose between the two 

 batteries in regard to the cleaning of this joint latrine, with the 

 result that neither battery would arrange for the cleaning to be 

 done. The latrine remained in a dirty state for several days. 

 On December 13 my patient had a sudden attack of dysentery. 

 He was due to go on leave on December 15, so did not report sick, 

 but went home to Halifax. After he reached home he got rapidly 

 much worse, but was treated by his own doctor and had no labora- 

 tory diagnosis. He passed about 20 stools daily with much blood. 

 Returned to Aldershot in February 1917 and subsequently went 

 to France, where he had periodic severe attacks of diarrhoea. 

 He was invalided for trench fever in November 1917, and sent 

 to various hospitals. In January 1918 he went into training again 

 at Shoreham. His diarrhoea got worse, and he was invalided 

 (4131) A 9 



