Fever is absent and there are very few of the toxic manifestations which often accompany bacillary dysentery, such as headache, nausea and a mildly delirious state. There is progressive loss of weight and strength with the development of neurasthenic symptoms. The skin becomes dry and earthy and we have the picture of a more or less marked secondary anaemia. It is in these cases that we should be on the lookout for grayish green or grayish brown mucoid masses which can usually be found during an exacerbation. Sloughs of the gelatinous-like necrosis in the submucosa usually contain amoebae. The X-ray has been utilized to give location of amoebic ulcerations. Bismuth is used for several days prior to taking the photograph and fills the sites of ulceration. Such cases usually show a moderate leucocytosis in which the percentage of large mononuclears is increased and a very important point is that with tenderness about the caecum, plus a leucocytosis, one may diagnose appendicitis and operate on a normal appendix. Autopsy records however have shown that the appendix is not infrequently invaded by amoebae but in some of these cases, other than finding amoebae in the lumen of the appendix, I have been unable to note any change. Cases of amoebiasis confined to caecum and ascending colon may only show symptoms of slight anaemia. Besides the more common insidious chronic type we may have amoebic dysentery setting in quite acutely with severe griping and frequent scanty grayish green to reddish brown mucoid stools. Such cases may show anorexia and nausea with some fever but there is not present the manifestations of toxemia one associates with a severe case of bacillary dysentery in the tropics. Very confusing cases are those in which a bacillary dysentery sets in upon an amoebic one and this possibility should always be thought of when a severe bacillary dysentery does not respond to serum therapy or an amoebic one to emetine. Gangrenous lesions may occur in amoebic dysentery although more common in bacillary infections. Such cases will show extreme prostration and even give the clinical picture of cholera. =Complications.=—By far the most important and serious complication of amoebic dysentery is liver abscess, which occurs in about 20% of cases. This condition is treated of separately. Besides liver abscess quite a number of cases of amoebic abscess of the brain have been reported, 26 such cases occurring in Egypt alone. These abscesses almost always occur in those cases which have developed liver abscess and may appear after the liver abscess has healed. The pus of such abscesses is viscid and blood-tinged, resembling liver abscess pus. The amoebae are found in the abscess wall. The symptoms are those of brain tumor, meningitis not occurring. Necrotic processes of skin and muscles have also been reported in which amoebae have been found.