250 
Intestinal Protozoa of Man 
the organism occurred most frequently in the encysted state. I observed no 
evidence of its pathogenicity. 
When once an individual becomes infected with this parasite apparently 
he remains so for a long time. I have at present one case under observation 
who still has the infection after two years. This patient was first known to 
harbour the parasite shortly after it was named. Many of my cases have 
been controlled on culture to obviate the possibility of missing small free 
living amoebae of the limax group, which it so closely resembles. In none of 
my cases did a growth take place on agar. 
Tricercomonas. 
Owing to the minuteness of this parasite and to the difficulty, in con¬ 
sequence, of making out its essential points, namely the flattened side with 
attached flagellum passing beyond the tail prolongation, it is possible that I 
missed some infections and that the figures given by me do not represent 
the full numbers of infections which occurred in the series. The cystic stage 
described as occurring once in the Alexandria examinations was not met with 
at all amongst the desert cases. The flagellate was observed about 16 times 
for all cases examined on the desert. 
Coccidiosis. Isos for a hominis. 
The oocysts of Isospora were found in nine cases. Of these seven occurred 
in white troops, one in Indian troops and one in the sick Egyptians. Eimeria 
was not seen. Diagnosis was only made on examination of fully developed 
cysts containing sporoeysts with sporozoites. This development took place 
in from 24 to 48 hours after the passage of the stool. In warm weather cysts 
showing sporoeysts were generally found within 24 hours of defaecation. The 
greatest number of mature cysts in all seasons were found after three days. 
A considerable number of the cysts degenerated without forming sporoeysts. 
In these cysts the protoplasm of the sporoblast became swollen and finely 
granular, the nucleus disappeared and greenish oily looking globules appeared 
in the interior: with time the globules replaced the other elements, which 
disappeared. Degeneration usually took place in the sporoblast stage and 
before sporocyst formation had commenced. 
Two very heavy infections with this organism were observed. In one, 
Case S., the patient, a new recruit, said that he had not been out of England 
until January 1916. He was then sent to Alexandria and at once proceeded 
to the desert. He was amongst a guard placed at an Out Station where flies 
were a pest. Four weeks later he experienced dull pain in the epigastrium and 
right hypochondrium, and he had a feeling of nausea which became worse 
after food. Patient was well nourished, tongue slightly coated, abdomen 
distended with flatus. On palpation no swelling was felt, but there was slight 
tenderness at the lower edge of the liver on the right side. The patient was 
treated with Emetine Hydrochloride gr. 1 hypodermically for 12 days. 
