Medical Record, Vol. 40: A Weekly Journal of Medicine and Surgery; July 4, 1891-December 26, 1891 (Classic Reprint)

Excerpt from Medical Record, Vol. 40: A Weekly Journal of Medicine and Surgery; July 4, 1891-December 26, 1891

The first report on the presence of the amoeba coli in dysentery in the New World was made by Professor Osler.' The patient was a physician, aged twenty-nine, for six years a resident of Panama, where he contracted a chronic dysentery. He came north in May, 1889, went to Germany, and in Vienna had a severe recurrence of his disease. He returned to Baltimore in December. Soon after, an irregular fever began, with occasional chilly sensations, sweats, loss of flesh, and sallow complex ion. Signs of abscess of the liver developing, the-liver was aspirated, incised, and two large abscess cavities found in the right lobe. In the thick, creamy pus Dr. Osler found amoeba in large numbers. The organisms could be found in the pus removed at the dressings up to the time of the patient's death, two weeks later. In this case diarrhoea was a marked feature. Tenesmus was rarely present; the frequency of the.stools from four to twelve in twenty-four hours. Their character varied much, Sometimes there were large brownish evacuations with little or no mucus more frequently three to four ounces were passed at a time, and scattered through the brown ish liquid mucus blood and small whitish sloughs could be seen. On several occasions the stools seemed to be made up of a gelatinous mucus streaked with blood, and twice large grayish sloughs were found. The amoeba were rarely found in the brownish liquid stools. In the mucus they were more frequent, but they were met with in large numbers only in the small grayish fragments, por tions no doubt of sloughs which were found in variable numbers in almost every mucoid stool.

Dr. Osler goes on to describe the amoeba, from which it appears that they resembled those of others, though not reaching the maximum size, measuring in his case ten to twenty micro millimetres in diameter.

Dr. Osler concludes by saying that it is impossible to speak with certainty of the relation of the organisms to the disease. The subject is worthy of extended study, and a point of especial interest will be the determination of their presence in the endemic dysentery of this coun try.

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