The diagnostics and treatment of tropical diseasesStitt, E. R. (Edward Rhodes)
Science
The diagnostics and treatment of tropical diseases
Stitt, E. R. (Edward Rhodes)
Tropical medicine
Darling has been so successful in his experimental work with
kittens that he compares the colon of a kitten to a test tube and
suggests the procedure of rectal injections of material containing
amoebae as a means of differentiating the two human amoebae.
On the other hand Walker was unable to infect kittens and
monkeys with material containing pathogenic amoebae and he makes
the statement that such failures would indicate the greater
susceptibility of man to infection, as he was able to infect 17 out
of 20 men with one feeding of such material.
Sellards and Baetjer note that inoculation of kittens per rectum
or by feeding dysenteric stools rich in amoebae has resulted in
infection in about 50% of experiments.
By inoculating the material directly into the caecum they were
able to infect every one of their kittens. They were also able
to propagate a strain of amoebae through a series of animals for
several months.
The intracaecal inoculations yielded positive results in diagnosis
of human amoebiasis when the clinical manifestations were obscure
and the amoebae in the discharges so few and atypical as to make
such an examination unsatisfactory.
_Other Intestinal Amoebae._—It is a remarkable fact that one of
the most common of the intestinal amoebae, _Endolimax nana_, has
only recently been reported (Wenyon and O’Conner in 1917). In the
examination of the stools of American soldiers Kofoid found it
present in 28% of his examinations while _E. coli_ was present
in 23% of cases and _E. histolytica_ in 9.3%. In examining 156
British soldiers Dobell noted its presence in 33% of them. The
general view is that it is not pathogenic but its great importance
is in the possibility of its being mistaken in its cyst form for
_E. histolytica_. The living amoeba averages about 8 microns but
in stained specimens it is somewhat smaller. In freshly passed
faeces the amoeboid motion is sluggish and the nucleus indistinct.
This amoeba is best identified by haematoxylin stained specimens
when the nucleus shows a measurement of about 2 microns with a
large eccentric karyosome which exhibits a variety of form. Unless
perfectly fresh material is stained the degenerative changes in the
amoebae may give a signet ring appearance of karyosome and ring
nucleus. Such an appearance may suggest the limax nucleus. The
mature cysts are usually oval, but sometimes round, and contain
4 nuclei, but when newly formed may only have one nucleus. The
nucleus is large in the uninucleate form (up to 3 microns) but
in the quadrinucleate forms it is about 1.2 microns with a large
eccentric mass of chromatin. Chromidial bodies are rarely, if ever,
present in these cysts.
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