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Hepatitis was diagnosed in numbers of patients who never suffered from liver abscess, and yet abscess has occurred in other patients whose colonic signs and symptoms have been indeterminate, at least without careful enquiry. Enlargement of the liver was suggestive of an amoebic lesion, but enlargement of the spleen, though stated to be a useful sign, was not found A M O E B IA S I S 25 helpful, since there were so many other causes. In fact, in service experi­ ence splenomegaly when associated with amoebic hepatitis was only secondary to hepatomegaly.

1947. E. V. KEOGH, Med. Journ. , 11 Sept. 1943. W. E. KING and E. L. FRENCH, Med. Journ. , 2 Aug. 1947. T. F. ROSE, Med. Journ. , 21 Jul. 1945. L. E. ROTHSTADT, F. J. FENNER and B . A. BAKER, Med. Journ. , 17 Api. 1943. W. C. SAWERS, Med. Journ. , 1943. R. WALL and J. M. GARVAN, Med. Journ. , 28 ApI. 1945. R. F. WEST, Med. Journ. , 17 ApI. 1943. , Army, Tech. lnstr. , No . 1, No . 2. Med. Journ. Aust. Vol. II, 1943. War Supplements on Med. & Surg. No. 22. n. tralian armed forces during the war, but by reason of the diagnostic and therapeutic problems involved, and the degree of disability they caused, they were important.

A number of these men complained of discomfort and flatulence after the fourth or fifth day; it was suggested that this was possibly due to a change in the bacterial flora of the bowel by the action of the drug. A trial was made of half doses ( 4 grammes initial dose followed by 2 grammes four hourly) and more satisfactory results were obtained. Fur­ ther investigation was not possible under existing conditions at the time. S. E. L. Stening, after observing the effects of diarrhoea and other infec­ tions in men with beriberi, thought that sulphonamides tended to exacer­ bate the oedema, and suggested that this might be associated with the alterations in bacterial flora in the intestine due to the drug.

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Clinical problems of war (Australia in the war of 1939-1945, series 5) by Allan S. Walker

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