The chief clinical features of the trypanosomiasis occurring in Brazil have already been indicated (see p. [87]). With regard to treatment, according to Castellani and Chalmers the indications are the same as those for African trypanosomiasis, together with treatment for hypothyroidism. Preventive measures are directed against the Reduviid bug, Triatoma megista, that transmits the disease. The bugs occur in numbers in the cracks of the houses of the poor of Minas Geraes, and may be destroyed by sulphur fumigation, lime-washing or whitewashing.
III.—FLAGELLATE DIARRHŒA AND DYSENTERY.
The chief causal agents are Trichomonas hominis (T. intestinalis), Chilomastix (Tetramitus) mesnili and allied organisms (see pp. [54] to 57), and Lamblia intestinalis (see pp. [57] to 60 and Appendix pp. [734] to 736).
These parasites and the associated diarrhœas occur in temperate as well as in warm climates. Probably some of the diarrhœas in India are thus caused. The same, or similar parasites occur in various Muridæ, especially rats and mice, which may act as reservoirs.
(i) Mello-Leitao[433] (1913), writing from Rio de Janeiro, states that there is a primary flagellate dysentery, due to Trichomonas intestinalis (Leuckart) and to Lamblia intestinalis (Lambl), either separately or in combination. He considers it a benign disease, and the most frequent form of dysentery in young children. Trichomonas and Lamblia were found to be pathogenic to children under 3 years of age.
Escomel[434] (1913) collected 152 cases of dysentery in Peru due solely to Trichomonas. Examination of the reservoirs containing the water used for drinking purposes showed the presence of Trichomonas. After the reservoirs were cleaned no more Trichomonas was found and the cases of dysentery ceased.
Brumpt[435] (1912) described a colitis due to Trichomonas intestinalis in a patient returned from Tonkin.
Cases of infection by Chilomastix (Tetramitus) mesnili, with colitis or dysenteric symptoms, are recorded by Brumpt (1912) from France, and by Nattan-Larrier[436] (1912) from the Ivory Coast respectively.
Marques da Cunha and Torres[437] (1914) describe five cases of chronic diarrhœa in Brazilian children due to the Chilomastix (Tetramitus).