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
The next experiments were with _Entamoeba coli_. In the 20 cases
fed with material containing _Entamoeba coli_ there was a uniform
failure to recover them culturally and in no instance was dysentery
produced. Seventeen became parasitized as the result of a single
feeding in from one to eleven days, the entamoebae being found
in the stools and persisting in their appearance in the stools
for extended periods. They concluded that _Entamoeba coli_ is an
obligate parasite, nonpathogenic, and cannot be cultured.
The third series of 20 feedings, carried on by Walker alone, was
with _Entamoeba histolytica_. The material was mixed with powdered
starch or magnesium oxide and given in gelatin capsules. In these
experiments they obtained tetragena cysts in the stools of men
fed only motile _Entamoeba histolytica_, and motile _Entamoeba
histolytica_ in the stools of men who were fed only tetragena
cysts and, finally, an alternation of motile _E. histolytica_ and
tetragena cysts in the stools of a man having a recurrent attack of
amoebic dysentery.
=Results.=—Seventeen of the men became parasitized after the first
feeding; 1 required three feedings, and 2, who did not become
parasitized at the first feeding, were held as controls. The
average time for parasitization was nine days. Only 4 of the 18
parasitized men developed dysentery, which came on after twenty,
fifty-seven, eighty-seven, and ninety-five days, respectively,
after the ingestion of the infecting material.
In 4 cases fed with material from acute dysenteric stools or
from amoebae-containing pus from liver abscess, and containing
motile amoebae, there was no resulting dysentery, the 4 cases of
experimental dysentery resulting from feeding of material from
normal stools of carriers.
As regards the cases which became parasitized, but did not develop
dysentery, it is suggested that the amoebae live as commensals in
the intestine of the host and only penetrate the intestinal mucosa
and become tissue parasites when there occurs depression of the
natural resistance of the host or as the result of some lesion of
the intestine. That the pathogenic amoebae are more than harmless
commensals, however, is shown by the fact that they alone, and not
the nonpathogenic _Entamoeba coli_, are capable of penetrating a
possibly damaged intestinal mucosa.
=Epidemiology.=—The chief factor in the spread of amoebic dysentery
would seem to be the encysted amoebae in the stools of convalescents,
or symptomless carriers, rather than the motile amoebae in dysenteric
stools. When such carrier has to do with the preparation of food, he
becomes a particular source of danger.
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