16,6 Haughwout et al.: Protozoal Dysentery 635 
and contained no balantidia. The patient had received no ben- 
zyl benzoate since February 6. 
Autopsy was performed one hour after death, the body still 
being warm. Scrapings were taken from points along the in- 
testinal tract and search made in them for Balantidium. None 
was found. The site of the dysenteric process was found in 
the region of the splenic flexure. The ulcerative process had 
healed. This area was cut out with some of the neighboring 
gut, divided between the two operators (W. de L. and F. G. H.), 
and immediately placed in flxing solution. Subsequently it was 
all cut into many small blocks and embedded in paraffine. Sev- 
eral sections were cut from each block and stained. Study of 
these gave ample evidence of the former presence of the para- 
sites, but we utterly failed to And the parasites themselves. 
This is in such marked contradistinction to the findings in the 
intestines of persons who have died of balantidial dysentery, 
that we are inclined to suspect that our patient had lost his 
balantidial infection some time before death. 
The patient was a male Spaniard, 54 years old, and was ad- 
mitted to the psychiatric ward of San Lazaro Hospital, Manila, 
on January 18, 1917, by the attending physician. Dr. Samuel 
Tietze. Doctor Tietze informs us that the man showed no 
symptoms of balantidiosis prior to the onset of the acute attack 
on December 21, 1919. The patient, previous to his admission 
to San Lazaro Hospital, had been confined in the Hospicio San 
Jose in Cavite. No earlier history was forthcoming from that 
institution. He was fairly well nourished and fairly neat in 
his habits. Mentally, he was depressed, idle and seclusive, 
mumbling in speech, and his answers to questions were sense- 
less and irrelevant. Nothing in his history or habits gave us 
any clue as to the manner in which he became parasitized with 
Balantidium. A diagnosis was made of terminal dementia of 
the senile, arteriosclerotic type. 
The dysenteric symptoms developed abruptly on December 
21, on which day he was found lying on his bed, too weak to 
move about. He was having frequent watery stools, that were 
greenish in color and apparently was suffering much pain. 
Throughout the course of the disease we frequently were com- 
pelled to draw conclusions regarding the presence or absence of 
pain and tenesmus from a study of the patient’s countenance, 
for his answers, when he answered at all, were misleading. We 
likewise found it difficult to determine the exact number of 
17168i 
