Abstract
1. Amoebic Dysentery has constituted a considerable
problem during the War.
2. Large numbers of British troops suffered from Amoebic
Dysentery for the fist time in 1942 in Bengal. Most of
the patients were recent arrivals in India. 815 cases were
treated in eight months in a Hospital in Calcutta in 1942.
3. The incidence of Amoebic Dysentery was greater than
that of Bacillary Dysentery among British troops treated in
Calcutta in 1942.
4. There was a marked rise in the incidence of Amoebic
Dysentery at the time of the Monsoon, favouring a water
borne spread. Bacillary Dysentery showed a similar rise in
the Monsoon period.
5. The immediate mortality from fresh infections with
Amoebic Dysentery was low.
6. Emetine Hydrochloride injections and Carbarsone were
administered as routine treatment in 1942. The period of
observation of cases following treatment was unduly short.
The form of treatment and the short period of observation
were dicta /ted by conditions at the time.
Relapses occurred following this treatment and the
proved relapse figure of 5% within eight months is a
minimal one.
Carbarsone appeared to be of value in eradicating
Entamoeba Histolytica cysts.
Kurchi Bismuth Iodide was valueless as an Amoebicidal
agent and was of symptomatic use in relieving diarrhoea only.
7. Fifty chronic cases of Amoebiasis were treated in 1943
as the Hospital had become e Centre for the treatment of
Chronic Amoebic Dysentery.
All the cases had recieved repeated courses of Emetine
injections and it is postulated that they had experienced
relief from this treatment but had never been cured. The
unsatisfactory nature of treatment by Emine injections and
Carbarsone alone was thus displayed again.
8. Chronic Amoebic Dysentery leads to a state of
invalidism with mentalapathy, intermittent diarrhoea, weaknes
gross loss of weight and abdominal pain.
9. Sigmoidoscopy is an excellent method of assessing
progress in Chronic Ameóbiasis but stool examinations are
even more important in diagnosis. Thus 85% of cases in which
the stools were positive showed Sigmoidoscopic lesions.
It was interesting to observe the disappearance of
ulcers in three weeks in some cases of Chronic Amoebiasis
while other ulcers showed no response following Emetine
Bismuth Iodide and Chiniofon.
Sigmoidoscopy is a good test of cure but stool
examination is even more reliable.
10. Emetine Bismuth Iodide was a drug of low toxicity in
that the pulse and blood pressure were not affected
following treatment. .
11. Emetine Bismuth Iodide and Chiniofon alone cured only
42% of fifty chronic cases. This consitituted an advance
in that the patients had not been cured by Emetine injections
The result was nevertheless disappointing.
12. 125 of the cases relapsed during observation over a
period of one month, thus emphasising the importance of an
adequate period of surveillance.
13. The lack of response to Emetine Bismuth Iodide and
Chiniofon or Yatren was apparent to various workers when
chronic refractory cases from the India and Burma Theatres
returned to the United Kingdom.
14. Failure of previous methods of treatment give rise to
speculation on the causes of chronicity.
15. Hargreaves contended that secondary infection was
responsible for the failure of Chronic Amoebiasis to
respond to treatment by Amoebici dal drugs. He therefore
advocated a preliminary course of Penicillin and Sulpha-suxidine in all such cases.
A few cases were personally treated in this way in
the United Kingdom. Three cases of Chronic Colonic
Amoebiasis have progressed well to date and are still under
observation. A Haemolytic Streptococcus was cultured from
the Amoebic ulcers of one case.
16. Perusal of the researches of various workers corroborate
the importance of secondary infection in Amoebic Dysentery.
It is considered that this is the most important factor from
the therapeutic point of view. Cultures from Amoebic ulcers
on Desoxycholate and bloodfiger media from a large number of
Chronic cases would enable t e frequency of occurrence of
some of the various secondary organisms to be assessed.
17. An adequate period of surveillance after treatment of
Amoebic Dysentery is essential. Observation for three months
at least is suggested as fifty chronic cases treated in 1943
averaged two and a half months between recurrences of symptoms.
18. After witnessing the effects of this disease for four
years, one feels that no treatment, however prolonged, can
be too thorough in the eradication of the infection.
