The American Journal of Tropical Medicine and Hygiene - Volume s1-2, Issue 3, 1922

Infections with Filaria bancrofti are supposed to have been introduced in Charleston, South Carolina, by a cargo of negro slaves from a filarial district on the West Coast of Africa. In the same manner the infection must have been materially increased if not actually introduced in the northern portions of South America, in Central America, and in the West Indian Islands. The existence of filarial infection in the West Indies was, according to Manson (1) first recognized by Demarquay. In later years Manson, also Daniels (2), have stated that such infections occur in all the West Indian Islands and in those portions of the Western mainland already mentioned, and Ashburn (3) has given evidence of the prevalence of the condition in one island by finding microfilaria in the bloods of 12 per cent of the mounted battalion of the Porto Rico Provisional Regiment.

It has been conclusively demonstrated (1) that emetine hydrochlorid is not particularly toxic when applied directly to pathogenic entamoebae within the time limit of one to two hours. Inasmuch as emetine will generally abolish entamoebic dysentery in man, but has no effect on the same infection when transferred to cats, Dale and Dobell (2) have pointed out that emetine acts upon the host rather than upon the parasite.

We have undertaken to investigate the possibility of reproducing this reaction outside of the body by, first, mixing emetine with blood and serum from man and cat, and second, by injecting man and cat with therapeutic doses of emetine, withdrawing blood after absorption, and then applying these various mixtures to pathogenic entamoebae in stools.

The entamoebae for the first set of observations were obtained from a young white man who developed bloody painful dysentery on the Western Front in 1918 and who has several times been partially treated within the past two years.

In the course of the International Health Board's campaign against hookworm disease in the Republic of Panama, on August 26, 1921, in the village of El Pilon in the District of Montijo, Province of Veraguas, a baby girl twenty-two months of age died under the following conditions:

At 6:00 a.m. she was given ½ minim of the oil of chenopodium, and two hours later a dose of Epsom salts. There were no disagreeable symptoms in evidence at this time, but because the salts did not produce results within two hours, the microscopist who treated the child gave her a saline enema. In the resulting evacuation there were eighteen ascarides. In the movements which followed, innumerable ascarides were expelled.

About 5:00 p.m. the little girl became very weak. Several masses formed in her abdomen, and ascarides came from her mouth and nose. Many ascarides collected in her throat and some of them must have blocked the larynx, for her respiration ceased.

Blastocystis is a cell occurring in the feces and intestine of man and other animals about which considerable confusion has existed for a number of years. It is very often associated with intestinal protozoa and has been described in relation to one or another as a stage of encystment or degeneration by several parasitologists.

In 1915, the writer obtained the cell in culture in ascitic fluid but at the time confused it with a trichomonas cyst. Later, after recognizing it as the Blastocystis of Alexieff (1911), report was made of its prevalence and some of its characteristics in the intestinal content and feces in South Carolina (Lynch, 1917). Following a personal communication in November, 1919, with Dr. H. P. Barrett of Charlotte, North Carolina, in which it was learned that he had obtained blastocystis in culture in liquid human blood serum, further cultivation was attempted with some rather interesting results concerning the nature of the organism and its manner of reproduction.

In culture work with the so-called intestinal parasites danger of error and introduction of confusion exists from the likelihood of obtaining free-living organisms, ingested with food and water, which may pass through the intestine of man alive, although not growing there. From time to time new “intestinal parasites” have been thus encountered and described, adding to the confusion already existing.

The writer in recent cultivation experiments with intestinal protozoa and Blastocystis has encountered several forms which it is well to be informed about in this sort of work, some of which may be confused with Blastocystis. Those which it has been necessary to differentiate are probably of the fresh water algae and they must always be taken into consideration in cultivation of this organism as there are several which are apparently similar to certain forms of Blastocystis that may be reasonably expected to pass through the intestine at times.

TABLE OF CONTENTS I. Introductory 225

II. Review of literature 228

1. The typhoid group and the Widal reaction in typhus 228

2. The proteus reaction of Wilson, Weil and Felix 231

1. Technic 232

2. Technical errors 233

3. Significance of titer 234

4. Nature of reaction 234

5. O and H forms 235

6. Interpretation of reaction 236

7. The reaction with preserved cultures 238

8. Summary 238

9. Conclusions 238

3. Pathology in man and guinea-pigs. The guinea-pig test 239

4. Less important aids to diagnosis 241

1. Blood picture 241

2. Cerebro-spinal fluid 242

3. Weil-Kafka reaction 243

4. Complement fixation 243

5. Clouding reaction of Weltmann 243

6. Anaphylactic reaction 244

7. Skin reactions of Friedberger and of Lipschüts 244

8. Deitsch's congestion test 244

9. Wiener's color reaction 245

5. Miscellaneous observations 245

III. Conclusions in brief 246

I. INTRODUCTORY

The July, 1921, number of the American Journal of Tropical Medicine contained an article entitled “Relapsing fever in Panama” by Bates, Dunn and St. John, in which it was shown by human experimentation that relapsing fever in Panama is transmitted by the human tick, Ornithodorus talaje. The same article contains tabulations of results obtained by inoculating white rats, white mice and monkeys, Macaccus rhesus, with the Panama relapsing fever spirochete; also a short account of its measurements and appearance in cultures. The data at that time was insufficient to determine the identity of the spirochete under study. Since then the work presented in this paper, mostly in the form of tables, has been completed and is offered as evidence that the Panama strain of the relapsing fever spirochete is a distinct species of the relapsing fever spirochete, if these spirochetes may be divided into species.