Amoebic Dysentery in Massachusetts

Abstract

THE fact that amoebiasis is more common in temperate zones than was previously thought lias been mentioned at different times by authors who are familiar with the organism which causes this infection. In spite of this, however, the number of cases of amoebic dysentery reported in Massachusetts are very few. In fact the differentiation of bacillary and amoebic types of dysentery is seldom made, and when made, is open to considerable doubt inasmuch as the cases are usually reported on clinical evidence alone.The occurrence of dysentery is relatively common, the disease being mentioned by the most ancient writers in medicine. It was not until 1859, however, that any attempt was made at classification of the various forms of the disease.In that year Lambl1 discovered amoebae in the intestine of a child who died of dysentery.Sixteen years later Losch2 first noticed the presence of amoebae in the stools of an infected person.It was not known, however, at that time, that the organisms found were pathogenic and, therefore, responsible for the condition produced in these patients. In 1903 Schaudinn3 was really the first to realize that two species existed, one pathogenic for man, the other nonpathogenic. Work done since then has shown that there are at least five different species of intestinal amoebae belonging to four distinct genera. Only one of these however, is pathogenic, namely, entamoeba histolytiea. Amoebic dysentery is regarded by the vast majority of medical men to be a distinctly tropical disease. That it is endemic in tropical and sub-tropical regions is true, but that it occurs in hot climates alone has been disproved by the increasing number of cases discovered in the temperate zone, especially since the World War.It seems that the disease is found more now in the temperate zone than formerly for the reason that foreign travel has become more common, and people who have resided in the tropics or where the disease is endemic very often become carriers and in this way spread the disease. *"There is a mass of evidence directing attention to the fact that many cases occur in those who have never been in the tropics but have lived in regions very remote from them. Amoebic dysentery has occurred in England, Prance and other portions of northern Europe as well as in northern United States in people who have not "been outside of their respective countries.The purpose of this article is to report four cases of amoebic dysentery occurring in Wor\s=d\Brooke\p=m-\Assistant Physician, Worcester City Hospital.Goodale\p=m-\Resident Pathologist, Worcester City Hospital. For records and addresses of authors see "This Week's Issue," page 159. cester, Massachusetts, and another which came to Worcester from another part of the state for treatment of a condition which was thought to be malignant. So far as is known, one case was never out of New England, and one was never out of the temperate zone. Of the other three, one was in Bermuda twenty years before the onset of symptoms, one was in the West Indies ten years before the ...