BALANTIDIC DYSENTERY 



1837 



mind, however, that most cases of dysenteric colitis in malarial patients are, 

 in reality, of amcebic and bacillary origin, and not of Laveranic origin. 



Treatment. — Quinine should be given in large doses, best by intramuscular 

 injection, and the intestinal symptoms first treated with castor oil or salines, 

 and then with astringents, such as bismuth subnitrate, tannalbin, and salol. 



(c) Leishmanic Dysentery. 



Definition. — An acute enteritis and colitis caused by Leishmania donovani 

 Laveran and Mesnil, and characterized by the passage of blood and mucus in 

 the motions. 



Symptomatology and Treatment. — As already mentioned in the chapter 

 on Kala-Azar, dysenteric symptoms closely allied to true dysentery may 

 appear during the course of that disease, and must be treated on the same 

 lines as those laid down for the treatment of kala-azar, together with sympto- 

 matic treatment as indicated above. The diagnosis is based on the presence 

 of Leishmanic bodies in the spleen or liver and absence of amoebae and dysentery 

 bacilli in the stools. True bacterial or amoebic dysentery is far from rare in 

 cases of kala-azar. 



{d) Ciliar Dysenteries. 



One variety of the ciliar dysenteries may be briefly described — 

 viz., that caused hy Balantidium coli Malmsten. Other less known 

 causes diVeColpoda cucullus Schutz, Balantidium minutum Schaudinn, 

 Nyctotherus faba Schaudinn, Nyctotherus giganteus P. Krause. 

 Other possible causes are Uronema caudatum Dujardin, Balantidium 

 italicum Sangiorgi and Ugdulena, and Nyctotherus africanus 

 Castellani. For description of these parasites see p. 544. 



(e) Balantidic Dysentery. 



Definition. — An acute or chronic ulceration of the large intestine 

 caused hy Balantidium coli Malmsten, 1857. 



History. — Leeuwenhoek originally discovered the parasite 5^?/^;^- 

 tidium coli, but Malmsten described and named it. The latter 

 observer found it in the motions 

 of a man suffering alternately 

 from diarrhoea and constipation. 

 Other cases have been recorded 

 by Stieda, Henschen, Treille, 

 Graziadei, Railliet, Blanchard, 

 Collmann, Strong, Bowman, 

 Manlove, Mason, and others. 



Climatology. — The disease is 

 known to occur in man in the 

 Philippine Islands, Japan, and 



Euro'pl while the parasite is mS^F^c^.sTx'^s^oXm^?.^^)''' 

 said to be constantly found m 



pigs. We have seen a case in (Photomicrograph.) 

 Ceylon. 



iEtiology. — The cause of the disease is Balantidium coli Malmsten, 

 which may be different from the parasite found in pigs (for descrip- 

 tion of the parasite see Chapter XVIIT, p. 547). 



Pathology.— The method of infection is unknown. The parasite 



