mucus lying on or thrown off by the inflamed bowel, but also in the sloughs on the ulcerated surface, in the tissues constituting the base and sides of the ulcef, and in the still living and relatively healthy tissues for some distance around the lesion, even in the muscular layers, and in the capillaries of the serous coat. This intimacy of association constitutes a good prima-facie reason for regarding the parasite as the cause of the disease. On the other hand, there are cases of relapsing dysentery with clinical characters such as are described as belonging to amœbic dysentery in which the amœba cannot be found. Moreover, as is well known, the amœba, or an amœba which to the clinician is hard to distinguish from Entamœba histolytica, is often found in perfectly healthy stools, in cases in which there is no reason whatever to suspect the existence of disease of the alimentary canal.*[1]
- ↑ *Gasser, in material supplied by 153 cases of dysentery—principally soldiers from Oran— although he found Amœba coliin 45 out of 109 acute cases, observed no relationship whatever between the number of amœbæ present in the stools and the severity of the disease. In 34 chronic cases he found the amœba in 13; and in 8 cases of chronic diarrhœa supervening on dysentery he found it in 5. In the stools of 20 healthy individuals from Oran he found the amœba in 4. He further states that he failed to find, or to recognize, the amœba in stained sections of dysenteric bowel. He concludes, therefore, against the amœba having anything more than an accidental relationship to the disease; and that, in place of the amœba causing the dysentery, it is, if anything, the dysentery which causes or, rather, favours the amœba; in other words, that the amœba finds in dysenteric discharges a favourable medium for multiplying in.
Celli and Fiocca studied the parasitology of dysentery in material from 62 typical cases— some from Italy, some from Egypt. They, too, conclude that Amœba coli is not a direct cause of dysentery, and for the following reasons: (a) Epidemic, endemic, and sporadic dysentery may occur without amœbæ in the stools, (b) Dysentery may be induced by the ingestion, or by the injection into the bowel, of dysenteric fæces which have been ascertained by microscopical examination to be quite free from amœbæ, (c) Amœbæ are very common in countries in which dysentery occurs, hence their frequency in the stools of dysenteries in these countries; they are there accidentally. They further point out that A. coli is not the only amœba to be found in the intestine; A. guttula, diaphana, Vermicularis, oblonga, and rectularis, besides proteus, have all been found there. A. coli has attracted attention, they consider, principally on account of its movements and size; whereas the other amœbæ,
