It is well known that lambliasis is of rather frequent occurrence in mice and rats so that these rodents may be factors in spreading the infection through the agency of their faeces deposited about human food.
Of other drugs recommended in treatment Dobell and Low have had no success with methylene blue, turpentine or beta-naphthol. These authors failed to find any increase in either large mononuclears or eosinophiles in a case of the infection.
Since Lamblia inhabit the upper parts of the small intestine, it may be that the administration of drugs by the duodenal tube will prove an effective method of treatment. Owens reports successful results in the treatment of amoebic dysentery from ipecac so administered. Stiles has recommended sulphur in lambliasis.
3. Ciliate dysenteries (Balantidium coli).
While various ciliates may cause a severe type of dysentery it is very exceptional that others than Balantidium coli do so. This oval ciliate is from 60 to 100 microns long by about 50 to 70 microns broad. It is a commensal of hogs and the disease in man is usually found in those having the care of hogs. Infections have been reported from various parts of the world, temperate as well as tropical regions. These ciliates may be found in the faeces of persons apparently well but in such cases symptoms may eventually appear. The parasites multiply in the submucosa and the pathologic process is similar to that observed in the large intestine in amoebic dysentery.
The parasite is so large and has such an active motility that it would be impossible to fail to detect it in a microscopic examination of the faeces. Encysted parasites are round. The onset is rather insidious with diarrhoea which may be followed by dysentery. A severe form of anemia may be noted.
Ipecac, emetine, arsenic and quinine appear to be of little value in the treatment, but Walker considers the organic silver compounds, as protargol, etc., of value. Methylene blue enemata (1-3000) and 2-grain pills by mouth have been recommended.
Fig. 58.—Important pathogenic Protozoa of the intestinal tract. (1a) Motile E. coli. Note large amount of peripheral arrangement of chromatin in nucleus. (1b) Encysted E. coli. Note larger size than E. histolytica cyst, 8 ring form nuclei and absence of chromidial bodies. (2) Motile E. histolytica from acute dysenteric stool. Note histolytica nucleus with scanty chromatin. (3) Tetragena type of E. histolytica from case of chronic dysentery. Note greater amount of chromatin and central karyosome with centriole. (4a) Preëncysted E. histolytica from carrier. Note small size and heavy peripheral ring of chromatin in nucleus making this feature of chromatin in nucleus similar to the larger E. coli. (4b) Encysted E. histolytica from dysentery convalescent. Note small size, 4 ring nuclei and a dark chromatin staining mass, “chromidial body.” (5a and 5b) Motile and encysted cultural amoebae from Manila water supply. (6a and 6b) Oocyst and sporozoite production in 4 spores of Eimeria stiedae. (7a and 7b) Oocyst with 2 sporoblasts and oocyst with 2 spores containing 4 sporozoites of Isospora bigemina. (8a and 8b) Vegetative and encysted Trichomonas intestinalis. (9a and 9b) Vegetative and encysted Lamblia intestinalis. (10) Balantidium coli. Illustrations of amoebae from Walker—others from Doflein.