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By Ben Dawes (Ed.)

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The literature is full of articles on the subject, and it would be odious to quote examples of what might almost be termed “wishful thinking”. As a justification for such a clinical picture there evolved the postulate of a diffuse amoebic infiltration of the liver, without abscess formation. However, with the exception of the report by Doxiades et al. , 1959). Powell et al. (1 959) found that dysenteric cases treated with tetracycline and di-iodohydyoxyquinoline (known to be ineffective in the prevention of liver abscess) were relieved of their tender hepatomegaly to the same degree as those who were given emetine or chloroquine in addition.

They refer to typical symptoms (dysentery or diarrhoea), to uncharacteristic symptoms (asyndromic) and to so-called healthy carriers. Amongst the variety of symptoms they quote are “distressing flatulence”, “irritability” and “sexual weakness”. This article was not specifically selected, but is unfortunately typical. 29 T H E E P I D E M I O L O G Y OF A M O E B I A S I S TABLE V Drug trials in amoebimis reported in 1960 Criteria Author No. Laboratory Place Clinical, etc. Africa El Sheikh Cairo Salem and Morcos Alexandria Marsden Lagos Shaldon Elsdon-Dew Nigerians in London Durban Chatterjee Calcutta Ghosh and Gupta Parekh and Patel Calcutta Bombay 52 28 4 13 10 151 17 4 1 880 v C V ?

It should be reasonable to draw comparisons between observations in the extensive series by Kuntz and his colleagues, and between those by Jones and Eyles, who were co-authors, as were Norman and Brooke. Subject to the usual reservations, it would seem that, in stable populations, E. hartmanni is commoner than E. histolytica. Table I1 also reveals that E. hartmanni is widely distributed. If indeed this organism has been labelled as E. histolytica, and the patient treated by some member of the Promethean school, there must have been a lot of unnecessary therapy, much of it not without danger.

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