extensive series, however, was tliat studied at Liverpool by 

 Mr. A. Malins Smith and Mr. J. E. Matthews, who have published 

 two detailed reports on theirfindings (Smith and Matthews, 1917, 

 1917 a). Taken together, their two series of cases show tlaat, of 

 450 non- dysenteric patients, 35, or 7-7 per cent., were infected 

 with E. histolytica} All the cases were patients in hospitals — 

 200 soldiers invalided for various diseases other than dysentery, 

 and 250 non- dysenteric patients in a civil hospital. 



It should be noted here that E. histolytica was not, of course, 

 the only intestinal protozoon which was sought and found among 

 non-dysenteric cases. Other amoebae, and all the flagellates 

 which were so frequently encountered in the stools of the 

 dysenteric patients, were also found to be not uncommon : some- 

 times, indeed, there seemed to be but little difference — if any — 

 between the incidence of intestinal protozoal infections in the 

 two classes of cases. It must be remembered, also, that these 

 cases — whether they were returned as ' dysenteric ' or ' non- 

 dysenteric ' — were nearly all derived from similar areas. The vast 

 majority of them came from Egypt and Gallipoli ; and although 

 the ' non-dysenteric ' class consisted of men who were not 

 invalided to England for dysentery, a very large proportion of 

 them, when carefully questioned, were found to have suffered 

 recently from dysentery or diarrhoea or some other intestinal 

 disorder during their service abroad. Nevertheless, there were 

 some 'non- dysenteric' patients — though comparatively few — who 

 were certainly infected with E. histolytica and from whom no 

 history of intestinal disorder could be elicited. These men 

 appeared to be true contact carriers of the parasite — as defined 

 by Walker (1913) ; but how long they had carried their infec- 

 tions, and whether they had acquired them originally abroad or at 

 home, were questions upon which the findings threw no light. 



There were, in 1916, two individual cases, well known to all of 

 us working in London, which were of special interest. The first 

 of these was studied and described by Dr. C. M. Wenyon (1916). 

 The patient was ' a labourer in London, who had never been out 

 of England ', but who ' had worked on a transport then lying in 

 dock '. He contracted dysentery and was admitted to the London 

 Hospital, where his symptoms disappeared. He remained ill, 

 however, and was found to have a liver abscess, which was opened 

 and drained. In the scrapings from its wall, active E. histolytica 

 amoebae were found, and the cysts of the same parasite were 

 found in his stools. The patient died, and at autopsy a second 

 abscess was found in his liver, and a few small amoebic ulcers in 

 his large intestine. This was undoubtedly, therefore, a case of 



1 In their first report, Smith and Matthews (1917) remark (p. 365) that their 

 results — namely, the finding of a considerable percentage of E. histolytica infectious 

 among soldiers Invalided for diseases other than dysentery — were ' confirmed ' by 

 mine (Walton Hospital, 1916). This is a somewhat misleading statement, as my 

 results were obtained and published first, and theirs actually supplied a confirmation 

 of mine. The work of Smith and Matthews was, indeed, carried out at my 

 suggestion— as they fully acknowledged (p. 389) ; and I made the suggestion because 

 of the results that I had already obtained whilst working along similar lines. 



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