NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
48
Social condition.—Has been in Bombay one year, formerly in Calcutta ; was
in South Africa.
Present condition.—Well nourished, abdomen retracted. Tenderness on
pressure all along the course of the colon. Liver and spleen not enlarged.
May 23rd, 1909.—Motions 5-6 in 24 hours. Pain in abdomen severe. Re-
peated vomiting. Tongue fairly clean.
May 31st, 1909 .—Tongue clean, no vomiting. Pain about umbilicus and right
iliac fossa. Motions 5-6 daily.
June 4th, 1909.—Tongue clean, 3-5 loose motions daily.
June 6th, 1909.—Feels well, 1-2 motions daily. Discharged. Examination of
his stools by microscope and by culture showed the presence of amœbæ.
The following chart shows the course of the disease and the total number of
W. B. C. per c.m.m. of blood :—
CHART XII.
50
The following table shows the results of the examination of the stools of a series
of cases of dysentery :—
Serial
N o .
Number of
case.
Date of admission to
hospital.
Date of examination of
stool.
AMŒBA.
Microscopic
examination. Cultivation
1
167 C
29th March 1909 .
. 31st March 1909 .
.
+
+
2
66 M
27th March 1909 .
. 1st April 1909
.
.
+
+
3
171 C
31st March 1909 .
. 1st April 1909
.
.
+
+
4
176 C
4th April 1909
.
. 7th April 1909
.
.
+
+
5
71 M
31st March 1909 .
. 7th April 1909
.
.
+
+
6
183 C
12th April 1909 .
. 13th April 1909 .
.
–
+
7
73 M
13th April 1909 .
. 15th April 1909 .
.
–
+
S
186 0
12th April 1909 .
. 16th April 1909 .
.
–
+
0
74 M
12th April 1909 .
. 16th April 1909 .
.
+
+
10
75 M
15th April 1909 .
. 15th April 1909 .
.
+
+
11
77 M
12th April 1909 .
. 17th April 1909 .
.
–
+
12
185 C
10th April 1909 .
. 15th April 1909
. .
–
+
13
78 M
16th April 1909 .
. 21st April 1909 .
.
–
+
14
191 C
23rd April 1909 .
. 26th April 1909 .
.
–
+
15
80 M
22nd April 1909 .
. 26th April 1909
.
–
+
16
89 M
29th April 1909 .
. 30th April 1909 .
.
–
+
17
201 C
2nd May 1909
.
. 3rd May 1909
.
.
–
18
203 C
3rd May 1909
.
. 4th May 1909
.
.
–
+
19
204 C
4th May 1909
.
. 5th May 1909
.
.
–
+
20
206 C
19th April 1909 .
. 8th May 1909
.
.
–
+
21
82 M
8th May 1909
.
. 10th May 1909
.
.
–
+
22
208 C
12th May 1909
.
. 14th May 1909
.
.
–
+
23
218 C
20th May 1909
.
. 22nd May 1909 .
.
–
+
24
213 C
18th May 1909
.
. 24th May 1909
.
.
–
+
25
216 C
20th May 1909
.
. 21st May 1909
.
.
+
+
26
220 C
28th May 1909
.
. 29th May 1909
.
.
–
+
27
222 C
2nd June 1909
.
. 3rd June 1909
.
.
–
+
28
84 C
30th May 1909
.
. 1st Juno 1909
.
–
+
20
224 C
6th June 1909
.
. 8th June 1909
.
.
–
+
51
This table shows that the amœba could be recovered from the stool in every
case in which it had been determined microscopically and, also, in 21 cases
out of the 29 in which it could not be determined by microscopic examination.
Hence cultivation gives a more accurate estimate of the total amœbic content of
the stools than microscopic examination. The relationship of cultivable amœbæ
to the etiology of dysentery is a matter for further investigation, but the method of
cultivation affords an excellent means for the study of amœbæ of the intestine.
This method of observation was applied, also, to the liver pus, and the follow-
ing table shows the results of the observations on the pus from a series of cases
of liver abscess :—
Serial
No.
Number of
case.
Date of operation.
Date of examination
of pus.
AMŒBA.
Microscopic. Cultivation.
1
196 C
24th April 1909 .
. 29th April 1909 .
.
+
+
2
193 C
25th April 1909 .
. 1st May 1909
.
.
+
+
3
217 C
20th May 1909
.
. 29th May 1909
.
.
—
+
4
219 C
22nd May 1909 .
. 29th May 1909
.
.
+
—
In order to determine whether amœbæ could be cultivated from the stools of
patients suffering from liver abscess, but without symptoms of dysentery, the
following table is given :—
Serial
No.
Number of
case.
Date of operation.
Date of examination
of stools.
AMŒBA.
Microscopic
examination. Cultivation.
1
196 C
24th April 1909 .
. 29th April 1909 .
.
—
+
2
193 C
25th April 1909 .
. 1st May 1909
.
.
—
+
3
217 C
20th May 1909
.
. 29th May 1909
.
.
—
+
4
219 C
22nd May 1909 .
. 29th May 1909
.
.
—
+
5
85 M
26th May 1909
.
. 26th May 1909
.
.
—
+
It will be seen from this table that the amœba could be cultivated from the
stools of patients suffering from liver abscess, but with no symptoms of dysen-
tery, and the microscopic examination failed to show the presence of amœbæ.
H 2
52
The diagnosis of the early stage of amœbic invasion of the liver has been dis-
cussed already, and. the importance of careful study of the blood changes, as a means
of recognising these cases, should be remembered.
VII.— General Conclusions.
1. That bacillary dysentery occurs in Bombay, but the incidence, so far as
our observations show, is low.
2. That dysentery associated with amœbæ is more prevalent.
3. That amœbæ can be cultivated from the stools of dysentery cases and
the pus of liver abscess cases and grown outside the human body on a suitable
medium.
4. That the prevalence of amœbæ shows a marked seasonal variation. The
curve of amœbic prevalence closely follows the humidity curve and has no definite
relationship to the temperature curve in Bombay.
5. That the season of greatest prevalence of amœbæ in Bombay corresponds
to the season of greatest prevalence of dysentery as shown by the admission rate for
dysentery for ten years in the Jails of Bombay.
6. That the amœbæ cultivated from the stools of dysentery cases and pus of
fiver abscess cases are not Ent. histolytica or coli, but are probably the same or
similar forms to the amœbæ cultivated by Noc from dysentery and liver abscess
cases in Cochin China.
7. That the same, or apparently the same, amœbæ can be cultivated from tap
water.
8. That amœbæ can be cultivated from the stools of a large number of normal
animals.
9. That the amœbæ forms cysts both inside and outside the body to resist
conditions unfavourable to its life, and that the cystic stage is important both
in regard to the treatment and prevention of the disease, and cases of dysen-
tery should not be considered cured until the stools are found to be free from cysts.
10. That amœbæ may be cultivated from the fæces of a person suffering from
abscess of the liver, although he at the time shows no signs of dysentery.
11. That the evidence at present available indicates that water is a channel
by which amœbæ of dysentery may be disseminated in endemic areas.
12. That a high leucocytosis, in cases of amœbic dysentery with an extensive
lesion of the colon, may occur.
13. That a moderate leucocytosis, with little alteration of the relative percent-
ages, may occur in cases of slight amœbic dysentery, or in cases where, at the time
of examination, no symptoms of dysentery exist. This associated with rise of
temperature may indicate an early hepatic invasion by amœbæ ; other signs of
53
hepatitis may or may not be present at first, but sooner or later will develop, and,
if not treated, may culminate in the grave complication of abscess of the liver.
14. That the administration of ipecacuanha in full doses, as pointed out by
Major L. Rogers, I.M.S., in the class of case referred to in 13 will produce a reduction
to normal of the temperature and leucocyte curves and prevent the formation
of liver abscess. These observations are of particular importance in regard to the
treatment of dysentery among the European troops in India, amongst whom
amœbic abscess of the liver is, next to enteric fever, the most fatal disease which
has to be dealt with. (In 1908 enteric fever caused 188 deaths and abscess of the
liver 55 deaths in the European army in India.)
15. The specific identity of the amœbæ which are demonstrable microscop-
ically in the fresh stools with those appearing in cultures from the same material
does not seem to be clearly established, and the interpretation of the results of
cultivation of amœbæ from the fæces presents peculiar difficulties.
Dofleinl, after considering the various amœboid organisms which have been
described as occurring in the fæces, dwells upon the difficulty of coming to a
decision as to which of the following headings such organisms should come
under :—
(i) " Gelegentliche Passanten des Darms” , i. e ., casual visitors in the gut, or
pseudo-parasites. This group would include free-living amœbæ
swallowed in the encysted condition and excreted unchanged, as
Werner2 described for Amœba limax in the case of the house-fly ;
(ii) Facultative parasites; and
(iii)
A m œ b æ s p e c i f i c a l l y a d a p t e d t o t h e p a r a s i t i c h a b i t .
Moreover, from our observations of the occurrence of amœbæ in cultures
from tap water (p. 19), and from the excreta of flies (p. 21), it seems that specimens
of fæces collected in the ordinary way are open to contamination with amœbæ
outside the body, e.g., from the walls of the containing vessel and from direct
deposit by flies.
Since the report went to press, one of us (R. T. W.) has found that growths
of amœboid organisms may appear in association with moulds and other
bacteria collected by exposing plates of uninseminated Musgrave's agar to the air.
These observations, which might indicate a further fallacy in cultivation
experiments, applicable not only to the fæces but to liver abscess, pus, and to any
other material, will be included in a later report.
1 Doflein.—Lehrbuch der Protozœnkunde 1909, p. 514.
Werner.—Beihefte Z. Archiv f. Schiff u. Trophyg. Vol XII, No. 11, 190
8
55
PART II.
APPENDIX.
Table I.
Showing results obtained by observations on cases of Bacillary Dysentery.
NOTE.—In this table are recorded the daily observations on a number of
cases of bacillary dysentery. The fæces of each case were examined for a consider-
able period after the stools had become feculent. (Vide page 9 of this Report for a
discussion of results.)
BACILLARY DYSENTERY, CASE NO. 1.
Rank.—No. 976, Musician.
Name.—R. R.
Regiment.-116th Mahrattas.
Date of observation.
Character of stool.
1
DYSENTERY BACILLI IN
S T O O L .
Shiga.
Flexner.
22nd January 1909 .
.
Blood and mucus .
+
23rd January 1909
.
.
. .
D i t t o .
.
.
.
—
25th January 1909 .
.
.
.
Ditto
.
.
.
.
+
26th January 1909 .
.
.
.
Ditto
.
.
.
.
+
27th January 1909 .
.
.
.
Ditto
.
.
•
•
+
28th January 1909 .
.
.
.
Ditto
.
.
.
.
+
30th January 1909 .
.
. Partly feculent
.
+
3rd February 1909 .
.
.
.
Ditto
.
.
.
.
—
4th February 1909 .
.
. Feculent semi-solid
—
5th February 1909 .
.
.
.
Ditto
.
.
.
—
6th February 1909 .
.
.
. Feculent
.
.
.
.
.
—
8th February 1909
.
. .
.
D i t t o .
. .
.
.
—
9th February 1909 .
.
.
.
Ditto
.
.
.
—
10th February 1909 .
.
.
.
Ditto
.
.
.
.
.
—
11th February 1909
.
.
.
Ditto
.
.
.
.
.
—
12th February 1909
.
. .
.
Ditto
.
.
.
.
.
—
13th February 1909
.
.
.
Ditto
.
.
.
—
16th February 1909
.
.
.
Ditto
.
.
.
.
.
—
REMARKS.—This was a mild case of dysentery. He had suffered from simple diarrhœa for three days before admission to hospital,
on 26th January 1909. He was relieved in about three days by treatment with magnesium sulphate. He has been in Bombay for the
past year. This demonstrates the result of an infection with B. dysenteriæ (Flexner).
56
BACILLARY DYSENTERY, CASE No. 2.
Rank. —No. 27336, Gunner.
Name.—M.
Regiment. —R. A.
Date of observation.
Character of stool.
DYSENTERY BACILLI IN
STOOL.
Shiga.
Flexner.
9th January 1909
.
.
.
. Blood and mucus .
. .
.
—
11th January 1909 .
.
.
.
Ditto
.
. .
.
—
16th January 1909 .
.
.
.
Ditto
.
.
.
.
+
19th January 1909 .
.
.
.
Ditto
.
.
.
.
—
22nd January 1909 .
.
.
.
Ditto
.
.
.
.
+
23rd January 1909 .
.
.
.
Ditto
.
.
.
. —
25th January 1909 .
.
.
.
Ditto
.
.
.
.
—
28th January 1909 .
.
.
.
Ditto
.
.
.
.
—
29th January 1909 .
.
.
.
Ditto
.
.
.
.
+
30th January 1909 .
.
.
.
Ditto
.
.
.
.
+
1st February 1909 .
.
.
.
Ditto
.
.
.
.
—
3rd February 1909 .
.
.
.
Ditto
.
.
.
.
—
4th February 1909 .
.
.
.
Ditto
.
.
.
.
—
5th February 1909 .
.
.
. Mucus shreds
.
.
.
.
—
6th February 1909 .
.
.
. Mucus
. .
.
.
.
—
8th February 1909 .
.
.
.
Ditto
.
.
.
.
.
—
9th February 1909 .
.
.
.
Ditto
.
.
.
.
.
—
10th February 1909 .
.
.
.
Ditto
.
.
.
.
.
—
12th February 1909 .
.
.
.
Ditto
.
.
.
.
.
—
15th February 1909 .
.
.
.
Ditto
.
.
.
.
.
—
16th February 1909 .
.
.
. Feculent
.
.
.
.
.
—
26th February 1909 .
.
.
.
Ditto
.
.
.
.
.
—
27th February 1909 .
.
.
.
Ditto
.
.
.
.
.
—
1st March 1909
.
.
.
.
Ditto
.
.
.
.
.
—
REMARKS.—This patient had dysentery in October last at Kirkee. The present illness is a relapse. He has an intermittent tem-
perature. This case illustrates the results of a Shiga infection. The signs and symptoms were more severe and the illness more pro
- onged than in the case of an infection with Flexner's bacillus.
57
BACILLARY DYSENTERY, CASE No. 3.
Rank.—No. 2053, Sepoy.
Name.—F. M.
Regiment- 109th Infantry.
Date of observation.
Character of stool.
DYSENTERY BACILLI IN
STOOL.
Shiga.
Flexner.
7th December 1908.
. Blood and mucus .
.
.
.
+
9th December 1908
D i t t o
–
10th December 1908. Mucus
.
.
.
.
.
+
11th December 1908. Feculent
.
.
.
.
.
–
12th December 1908
.
. .
Ditto
.
. .
.
.
–
14th December 1908.
.
.
Ditto
.
.
.
–
REMARKS.—This case is one of infection by B. dysenteriæ (Shiga). It was a first attack and was treated early with the result that
the symptoms rapidly cleared up.
BACILLARY DYSENTERY, CASE No. 4.
Rank.
—
Name.—V. R.
Regiment.— Police Constable, Bombay.
Date of observation.
Character of stool.
DYSENTERY BACILLI IN
STOOL.
Shiga.
Flexner.
4th December 1900.
.
.
....
+
REMARKS.—This was a very mild case of Shiga infection and readily responded to treatment.
I
58
BACILLARY DYSENTERY, CASE No. 5.
Rank.—
Name.—K. S.
Regiment.—Police Constable, Bombay.
Date of observation.
Character of stool.
DYSENTERY BACILLI IN
STOOL.
Shiga.
Flexner.
4th December 1908 .
.
.
.
. . . .
+
REMARKS.—This case was also of a mild type. It is probable that such cases, presenting few symptoms and causing the patient
little or no inconvenience, are the means of maintaining the existence of the bacillus. Many such cases must never come for treatment,
and are in a position to infect others.
BACILLARY DYSENTERY, CASE No. 6.
Rank.—
Name.—S. S.
Regiment.—Police Constable, Bombay.
Date of observation.
Character of stool.
DYSENTERY BACILLI I
N
STOOL.
Shiga .
Flexner.
14th January 1909. . .
.
Blood and mucus
.
.
.
.
. . +
20th January 1909.
.
.
.
Ditto
.
.
.
.
. . +
21st January 1909.
.
.
.
Ditto
.
. . .
. . +
22nd January 1909.
.
.
.
Ditto
.
. .
.
..
+
25th January 1909.
.
.
Ditto
.
.
.
.
..
+
26th January 1909.
.
.
.
Ditto
. . . .
. . +
27th January 1909.
.
.
.
Ditto
.
.
.
..
–
28th January 1909.
. Semi-solid feculent
.
.
.
..
–
29th January 1909
.
.
.
Ditto
.
. . .
..
–
30th January 1909.
.
.
.
Ditto
.
.
.
.
..
+
10th February 1909.
.
.
.
Feculent
.
.
.
.
.
. . –
11th February 1909.
.
.
.
Ditto
.
. .
.
..
–
16th February 1909.
.
.
.
Ditto
.
.
.
.
.
..
–
17th February 1909.
.
.
.
Ditto
.
. . . .
. . –
19th February 1909.
.
.
.
Ditto
.
.
.
.
. .
–
REMARKES.—It will be noted that in this case the excretion of the bacilli ceased when the stools became feculent. No recurrence was
noted.
59
BACILLARY DYSENTERY, CASE No. 7.
Rank.—Sepoy, No. 1806.
Name.—A. K.
Regiment.— 109th Infantry.
Date of observation.
Character of stool.
DYSENTERY BACILLI IN
STOOL.
Shiga.
Flexner.
27th February 1909
. .
.
Blood and mucus.
.
.
.
..
+
1st March 1909.
. . .
Ditto
. . . .
..
+
2nd March 1909.
.
.
.
Ditto
. . .
..
+
3rd March 1909.
.
.
Ditto
.
.
.
.
..
+
4th March 1909
.
.
. .
Ditto.
. . . .
..
+
5th March 1909
. . . .
Feculent
.
.
.
..
–
11th March 1909
.
.
.
.
Ditto
. . . .
..
–
12th March 1909
.
.
.
. Feculent (formed)
.
.
.
..
–
13th March 1909
.
.
. .
Ditto.
. . .
..
–
15th March 1909
.
.
.
.
Ditto.
. . .
..
–
22nd March 1909
.
.
.
.
Ditto.
.
.
.
–
23rd March 1909
.
.
. .
Ditto.
.
.
.
..
–
24th March 1909
.
.
. .
Ditto.
.
.
.
..
–
25th March 1909
.
.
.
Ditto.
.
.
.
..
–
26th March 1909
.
.
.
.
Ditto.
.
.
.
..
–
29th March 1909
.
.
.
.
Ditto.
.
.
.
..
–
30th March 1909
.
.
.
.
Ditto.
.
.
.
..
–
31st March 1909
.
.
.
.
Ditto.
.
.
..
–
1st April 1909 .
.
.
. .
Ditto.
.
.
.
..
–
2nd April 1909.
. . .
Ditto
.
.
.
.
. .
–
3rd April 1909 .
.
. . .
Ditto.
. . .
..
–
REMARKS.—This case illustrates the type of dysentery frequently met with amongst the Native troops. Under treatment the
symptoms quickly cleared up and the stools became normal. It will be noted that the bacilli were not found after the stools became
formed. This man was ill in the lines for three days before admission. This is a common history in cases of dysentery and has an
important bearing on the prevention of the disease. This man had no fever during his illness.
60
BACILLARY DYSENTERY, CASE No. 8.
Rank.—No. 933, Sepoy.
Name.—H. J.
Regiment.—116th Mahrattas.
Date of observation.
Character of stool.
DYSENTERY BACILLI IN
STOOL.
Shiga.
Flexner.
4th January 1909.
.
.
.
Blood and mucus . . . .
..
–
6th January 1909. . .
.
Ditto
. . . .
. .
–
7th January 1909.
.
.
.
Ditto
. . . .
..
–
19th January 1909.
.
.
.
Ditto
. .
.
. .
–
20th January 1909.
.
.
.
Ditto
. . .
. .
–
21st January 1909.
.
.
.
Ditto
. . . .
. .
–
22nd January 1909.
.
.
.
Ditto
. . . .
. .
–
23rd January 1909.
.
.
.
Ditto
. . . .
. .
–
25th January 1909 .
.
.
.
Ditto
. . .
.
. .
–
26th January 1909.
.
.
.
Ditto
.
.
.
.
. .
–
27th January 1909 .
.
.
.
Ditto
. . .
.
. .
–
2Sth January 1909.
.
.
.
Ditto
. . .
.
..
–
29th January 1909.
.
.
.
Ditto
. . . .
. .
–
30th January 1909.
.
.
.
Ditto
. .
.
. .
–
1st February 1909.
.
.
.
Ditto
.
.
.
.
..
+
3rd February 1909.
.
.
.
Ditto
. . .
.
. .
–
4th February 1909.
.
.
.
Ditto
. . . .
. .
–
+
–
5th February
February 1009.
.
.
.
Ditto
.
.
.
Amœba
–
6th February 1909.
.
.
.
Ditto
. . . .
..
–
Sth February 1909.
.
.
.
Ditto
. . . .
. .
–
9th February 1909.
.
.
.
Feculent
. . .
.
. .
–
10th February 1909.
.
.
.
Ditto
.
.
.
.
. .
–
11th February 1909.
.
.
.
.
.
Ditto
.
. .
..
–
12th February 1909.
.
.
.
Ditto
. . .
. .
–
REMARKS.—This is an instructive case. The patient, whilst on field training, developed dysentery and was sent to hospital. The
symptoms were sub-acute. At first he was given Mag. sulphate without benefit ; on the 6th February 1909 he was placed on ipecacu-
anha and be rapidly recovered. The bacteriological findings were instructive : for some time no dysentery bacilli were cultivated, but
on one occasion, 1st February 1909, Flexner's bacillus was recovered ; on the 6th February 1909 amœbæ were detected in the stools by
microscopic examination. The fact that the symptoms cleared up under ipecacuanha points to their being due to amœbic rather than
qacillary infection.
61
BACILLARY DYSENTERY, CASE NO. 9.
Rank.—Sepoy No. 2287.
Name.—J. K.
Regiment.— 109th Infantry.
Date of observation.
Character of stool.
DYSENTERY BACILLI IN
STOOLS.
Shiga.
Flexner.
7th January 1909
.
.
.
.
Mucus and blood
.
.
.
..
+
8th January 1909
.
.
.
.
Ditto
.
.
.
.
..
–
11th January 1909
.
.
.
.
Ditto
.
.
.
.
..
–
12th January 1909
.
.
.
.
Ditto
.
.
.
.
. .
+
15th January 1909
.
.
.
.
Ditto
.
.
.
.
..
+
16th January 1909
.
.
.
.
Ditto
.
.
.
.
..
–
18th January 1909
.
.
.
.
Ditto
.
.
.
.
..
–
19th January 1909
.
.
.
.
Ditto
.
.
.
.
. .
–
23rd January 1909
.
.
.
.
Ditto
. . .
. .
+
25th January 1909
.
.
.
.
Ditto
.
.
.
.
..
+
26th January 1909
.
.
.
.
Ditto
.
.
.
.
..
+
27th January 1909
.
.
.
.
Ditto
.
.
.
..
+
28th January 1909
.
.
.
.
Feculent
.
.
.
.
.
..
–
30th January 1909
.
.
.
.
Ditto
.
.
.
.
..
–
1st February 1909
.
.
.
.
Feculent, some mucus
.
.
. .
–
3rd February 1909 .
.
.
Ditto
.
.
.
.
..
–
4th February 1909
.
.
.
.
Ditto
.
.
.
.
..
–
5th February 1909
.
.
.
.
Feculent
.
.
.
.
.
.
..
–
6th February 1909
.
.
.
.
Ditto
.
.
.
.
. .
–
8th February 1909
.
.
.
.
Ditto
.
.
.
.
..
–
9th February 1909
.
.
.
.
Ditto
.
.
.
.
..
–
10th February 1909 .
.
Ditto
.
.
.
.
.
. .
–
12th February 1909
.
.
.
.
Ditto
.
.
.
.
..
–
16th February 1909
.
.
.
.
Ditto
.
.
.
.
.
..
–
REMARKS.—The symptoms were sub-acute with a small quantity of blood in the stools. The temperature was normal throughout:
His condition improved under treatment with Mag. sulphate. It is noteworthy that no bacilli were detected in the stools after they
became feculent.
62
BACILLARY DYSENTERY, CASE No. 10.
Rank.—Sepoy No. 1032.
Name.—A. G.
Regiment.- 116th Mahrattas.
Date of observation.
Character of stool.
DYSENTERY BACILLI IN
STOOLS.
Shiga.
Flexner.
15th January 1909 .
.
.
. Blood and mucus
.
..
–
18th January 1909 .
.
.
.
Ditto. .
.
. .
+
21st January 1909 .
.
.
.
Ditto .
.
. . .
..
–
22nd January 1909
.
.
Ditto .
.
.
.
..
+
23rd January 1909 .
.
.
.
Ditto .
.
.
. .
. .
–
25th January 1909 .
.
.
.
Ditto .
. . . .
..
–
26th January 1909 .
.
.
.
Ditto .
.
.
.
.
..
+
27th January 1909 .
.
.
.
Ditto .
.
.
.
. ..
+
28th January 1909 .
.
.
.
Ditto .
. . .
..
–
29th January 1909
.
.
. Feculent
.
.
.
.
.
..
–
30th January 1909 .
.
.
.
Ditto
.
.
. . .
. .
–
1st February 1909 .
.
.
. Feculent, mucus presen
t
.
..
+
3rd February 1909 .
.
.
.
Ditto
.
.
.
.
..
–
4th February 1909 .
.
.
. Feculent .
.
.
.
.
..
–
5th February 1903 .
.
.
.
Ditto
.
. . .
..
–
6th February 1909 .
.
.
.
Ditto
. . . .
..
–
8th February 1909 .
.
.
.
Ditto
.
.
.
.
. .
–
10th February 1909 .
.
.
.
Ditto
.
.
.
.
. ..
–
11th February 1909 .
.
.
.
Ditto
.
.
.
.
.
..
–
12th February 1909 .
.
.
.
Ditto
.
.
.
.
. .
–
13th February 1909 .
.
.
.
Ditto
.
.
.
.
. ..
–
15th February 1909 .
.
.
.
Ditto
.
.
.
.
.
. .
–
16th February 1909
.
.
.
Ditto
.
.
.
..
–
17th February 1903 .
.
.
.
Ditto
.
.
.
. .
–
REMARKS.—This patient developed slight symptoms of dysentery whilst under treatment for gonorrhœa on 21st November 1908.
U n d e r M a g . s u l p h a t e t h e s y m p t o m s o f d y s e n t e r y i m p r o v e d . B e h a d a r e l a p s e o n 1 4 t h J a n u a r y 1 9 0 9 . T h e b a c i l l i i n t h i s c a s e d i s a p -
peared from the stools on their becoming feculent.
63
BACILLARY DYSENTERY, CASE NO. 11.
Name.—R. F.
Hospital.—St. George's.
Date of observation.
Character of stool.
DYSENTERY BACILLI IN
STOOL.
Shiga.
Flexner.
23rd January 1909
.
.
.
. Trace of blood and mucus
.
.
..
+
254th January 1909 .
.
.
.
Mucus
.
.
.
.
.
. .
—
26th January 1909 .
.
.
. Mucus (feculent) .
.
.
.
..
—
27th January 1909
.
.
.
.
Ditto .
.
.
.
..
—
28th January 1909
.
.
.
.
Ditto .
.
.
.
.
..
—
29th January 1909
.
.
.
.
Ditto .
.
.
.
.
. .
—
30th January 1909
.
.
.
.
Ditto .
.
.
.
..
+
4th February 1909 .
.
.
.
Ditto .
.
.
.
.
. .
—
5th February 1909
.
.
.
.
Ditto .
.
.
.
.
..
—
6th February 1909
.
.
.
.
Ditto .
.
.
.
.
. .
—
8th February 1909
.
.
.
. Feculent
.
.
.
.
.
. .
—
9th February 1909
.
.
.
.
Ditto
.
.
.
.
.
..
—
REMARKS.—This patient had suffered from attacks of "diarrhœa," which lasted two—three days, for the last two years. On admis-
sion to hospital he was suffering from fever and diarrhœa. He had benign tertian parasites in his blood. Flexner's bacillus was found
on several occasions in his stools : the ova of ankylostoma were present also.
BACILLARY DYSENTERY, CASE NO. 12.
Name. —M. A.
Hospital. —J. J. Hospital.
Date of observation.
Character of stool.
DYSENTERY BACILLI IN
STOOL.
Shiga.
Flexner.
25th January 1909
.
.
.
. Mucus and blood .
.
.
.
. . +
26th January 1909
.
.
.
.
Ditto .
.
.
.
.
..
+
27th January 1909 .
.
.
.
Ditto .
.
.
.
.
..
+
28th January 1909 .
.
.
.
Ditto .
.
.
.
.
. .
+
29th January 1909
.
.
.
. Feculent, semi- fluid
.
.
.
..
+
1st February 1909
. .
.
.
Ditto .
.
.
.
.
..
—
REMARKS.—This patient left hospital on the 1st February 1909. There was nothing noteworthy in his case.