49
The following table shows the result of the examination of the blood :—
Name
Age.
Date of
exa-
mination.
R. B. C.
W. B. C.
PERCENTAGES.
Para-
s i t e i n
blood—
malaria.
P. N. S. M. L. M.
E.
G.
.
.
36
21st May 1909
36,720
75
20
3
—
23rd May 1909
6,416,000
26,140
25th May 1909
6,920,000
20,700
61
34
3
2
28th May 1909
17,280
63.5
31
4.5
1
1st June 1909
15,200
59
37.5
3.5
0
4th June 1909
13,200
R E M A R K S . — T h i s c a s e , a l s o , h a d a s e v e r e a n d e x t e n s i v e l e s i o n o f t h e c o l o n , a n d t h e r e w a s c o n s i d e r a b l e p a i n . T h e l e u c o c y t o s i s w a s
very high, but gradually fell as the symptoms improved. It may be that the severity of the infection in these cases is due to higher
virulence of the particular strain of amœba. This opens up an interesting field for investigation, but, at the moment, there does not
appear to be any method of conclusively deciding this point experimentally.
The general effects of amœbic infection have received hitherto little attention,
and in the above study of the blood changes, etc., an attempt has been made to
open up this important line of investigation. An interesting problem to deter-
mine is the relationship of hepatic disease, functional and organic, apart from he-
patitis and liver abscess, to amœbic infection. It is known that cirrhotic changes
in the liver are common in India. A careful study of the fauna of the intestine,
and, particularly, of the amœbæ, might throw more light on this important
subject, just as the investigation of the intestinal flora has led to many new ideas.
VI.—Diagnosis of Amœbic Infection.
The diagnosis can be made only by determining the presence of the amœba.
This is by no means an easy matter, and it is necessary to be familiar with the appear-
ance of the parasite at its different stages. A glance at the plates (Nos. I and II)
will show the different appearances ; the size varies from that of a red blood cor-
puscle up to 30-40 microns in diameter. Further, the parasite at times is non-
motile, and hence it is often difficult to distinguish it from other cells. Accordingly a
considerable amount of experience is required before an accurate diagnosis in all cases
can be given. It is always desirable to examine microscopically fresh material
in the first place, subsequently the specimen may be stained if it is desired to study
structural characters. The cultivation of amœbæ as a means of diagnosis must be
regarded as still in its experimental stage. Cultivation affords a very simple and easy
means of detecting amœbæ in the stools. The method adopted by us was as follows :
—
The medium of Musgrave and Clegg was poured into small Petri plates and
allowed to dry. A loopful of the stool was taken and parallel strokes were made
on the surface of the agar with a platinum loop. The plates were set aside at room
temperature (average 79°F.) They were daily examined under a low power of
the microscope, and if present, the amœbæ were observed readily growing out
from bacteria on .the stroke. We made a parallel series of observations on the
detection of amœbæ in the stools, namely, by microscopic examination and by
cultivation, the object of the observations being to ascertain whether we could cul-
tivate an amœbæ from a stool in which, after careful microscopic examination, we
were unable to detect it, or it was present in a non-motile condition making its
determination difficult.
H