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556"
A
PRELIMINARY NOTE ON THE OCCURRENCE OF
PECULIAR" BODIES" OF PROBABLY PROTOZOAN
NATURE'FREQUENTLY FOUND IN THE STOOLS
OF DYSENTERIC PATIENTS.
J. GORDON THOMSON.
Royal Army Medical CmjJs.
Protozoologi8t to School of T1'opical Medicine, London.
By
CAPTAIN
AND
D. THOMSON.
Royal Army Medical Corps.
CAPTAIN
No pathologist will deny the extraordinarily difficult and com-.
plex nature of the problems presented by a microscopical study of
the cells found in the fffic'es from cases, of dysentery in the human
subject.
The cells encountered, apart altogether from the fact that they
are of seveJ;al different kinds, are frequently so altered by cytolytic
and karyolytic changes that the most remarkable appearances are
often presented.
In many instances where the more commonly occuring forms of
cell-degeneration are comparatively slight in degree, little difficulty
is experienced in placing them in their proper category in suitably
fixed and stained film· preparations. But it. is in cases where
pyknosis, 'karyorrhexis, vacuolation and similar phenomena characteristic of various stages of degeneration culminating in death of
the cells are present, that the pr:otozoologist who believes that he
has found "bodies" of ext~'a corporeal> origin, finds himself confronted with the greatest difficulty.
.
It is with a full consciousness of the perplexities which surround
this subject that we venture to call the attention of other workers
to series of peculiar cells which have attracted our attention for
some time past, and which we are strongly inclined to regard as of
proto;.>;oan nature.
They have never appealed to us as cells ~f human ,origin, and in
this opinion we are supported by Major Ferguson, R.A.M,C., who.
as Director. of the Central Laboratory in which we are working,
has hadfrequen.t opportunities of seeing our preparations, and also
by Lieutenant Bartlett, R.A.M.C., Pathologist,. who is making
further researches in. this subject.
.
.
,The number, character and disposition of their nuclei-to men~
a
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J. Gordon 'l'homson and D. 'l'homson
557
tion only one feature-leads us to regard these cells as probably
representing different phases in the development 'of a proto'zoon.
. It is, of course, quite impossible at present to offer any outline of
the possible life-history of this organism. Our immediate object in
,writing this note is to induce other protozoologists who are devoting themselves to a microscopical study of the fleces from cases of
human dysentery to corroborate the occurrence' of these peculiar
forms in the hope that additional evidence will soon be forthcoming as to their real nature.
We invite a careful study of the drawing~ which accompany
this short paper and which illustrate most of the varied appearances and contents of this cell-organism. Many of these cells are
seen to possess two nuclei of unequal size. These nuclei are
extremely definite in structure. Even in fresh films 'of fleces containing these" bodies" their nuclei are very obvious, but in Zenkerfixed preparations stained by either Heidenhain's or Weigert's iron..'
hlematoxylin methods their peculiar structure is , strikingly
demonstrated. They a,re absolutely spherical in form, with an
extremely fine limiting pellicle of chromatin, to ,the peripheral
interior of w,hich is attached a densely staining sharply circumscribed mass of chromatin, lenticular or cresci:mtic in form. The
smaller nucleus possesses essentially the same structure, but in this
case the thromatin mass appears to be always of crescent
shape. The larger nuclei have a distinct compact karyosome, as
shown' in figs. 15 and 16; the sma.lle'r nuclei also possess karyosomes, which are visible in the same drawings, but in some cases
they seem to be absent (see fig. 14). The cell-bodies are either
round or oval in shape; the cytoplasm stains beautifully and shows
no evidence of degeneration or vacuolation. The number of
nuclei varies froIp. one to four. There may be only one large
nucleus, or one small nucleus, or there may be two of Bach, as is
well seen in figs. 15 and 16. There is another cell often found
associated with the foregoing in the same specimens, but this is of
quite a different character. In this cell, the nucleus contains a
densely staining spherical karyosome surrounded by a darker halo,
as illustrated in figs. 24 and ~5. The nucleus is not the same as
that of Arna;ba limax whe,re the karyosome is surrounded by a
clear refractile zone.
,Ve have seen two of these cells in close juxtaposition, suggesting the occurrence of ,conjugation.
Another cell which we are quite unable to explain, and which
IS certainly not a body cell, is ,seen in fig. 14., This curious ce1139,
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558 "Boclies"
jo~mcl
in the Stools of Dysenteric Patients
25ft by 18ft-has in its endoplasm a large spherical
,
« body," about
8ft in diameter, with a reticulate interior, and a central irregular
mass of chromatin. In close proximity to this are two small
rings· of chromatin with crescentic masses of chromatin at the
periphery.
Another ~ell of great interest is depicted in fig. 27, and illustrates what might be regarded as a process of schizogony with
the formation of five spores, each having a distinct" body" and a
mass of chromatin. Fig. 30 shows similar "bodies" lying free.
Again, in the same specimens, we have found oval "bodies"
with a thick capsule (40ft by 32ft) the capsule being between 2ft.
and 3ft thick, and these are found to be crammed with hundreds of
" spores" such as are represented in fig. 28. We' think these
" spores" bear no relation to the other cells drawn. They belong
to an entirely independent organism, and are in our opinion a
'
species of yeast cell.
We have found very commonly in the fmces large cells as
depicted in fig. 20 which, from its nuclear character, is, in all
probability a connective tissue cell from the submucous layer. The
figure shows that these cells are capable of phagocytic action in a
wonderfu,l degree; in the one which we have had drawn (fig. 20) we
see a large round cell, which is probably a parasite. These macrophages of connective tissue origin, besides ingesting para'sites of all
kinds, have been often observed! to englobe polymorphonuclear
leucocytes. Indeed, the phagocytic power of cells found in the
mucus and blood passed by dysenteric patients is quite remarkable.
This power is chiefly exhibited by these large cells, probably
derived from the mucosal connective tissue, which are particularly
fond of swallowing polymorphonuclears. The polymorphs, on the
other hand, show quite a remarkable power of ingesting red cells,
and we have in our possession films in which nearl'y all the pus cells
are literally crammed with ~ed blood corpuscles.
There is still another curious cell found in these cases which is
probably the commonest of all. This is represented in figs. 21, 22
and 23. Fig. 21 shows an ingested polymorph lying in a vacuole.
There is no visible nucleus at the margin of the ingesting cell, but
simply a dense, deeply staining mass of chromatin. Figs. 2~
and 23 show two similar cells, but in the vacuoles are to be' seen
two" bodies "-probably protozoa.
It is quite impossible at present to try and correlate all these
remarkable cells, but certain of them strongly suggest that we
. may have to deal, with a protozoan. VVe hope to be able with
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27
PLATE.
'fo illuf;tratp "A Preliminary Xote 011 the OCCl1rrC1We of I'e(;uliar 'Bonifl;<' of
prohuLlr Protolofl n Na~lIrc frequently found ill thfl ~LooIs of Dysent.edc Pa.tiflnt~,"
by Capta i n J. (JORDO N THOMSON, TI,.,\.]'LC., a1)(l C;l,ptain D. TlIomwl\". n . . A.i\1.0.
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\,
J. Gordon" Thomson and' D. Thornson
559
further study to throw some light on the significance of these'
peculiar "bodies."
Dr. Bartlett, pathologist to the London
Hospital, is making a careful study of these cells.
We may say that we have usually found them in the blood and
mucus of dysenteric stools in which it was quite impossible to
demonstrate entamoobffi. They are not to be found in all stools of
dysenteric cases, but they have occurred with sufficient frequency
to entitle them to careful study.
We wish to cordially thank Major Ferguson, R.A.M.C.,
Director of this Laboratory, for his great help and kindness in
assisting in every way in this work; and also Lieutenant Bartlett,
R.A.M.C., who has also given most valuable assistance. It was
while working with him that the cells were first noticed. It is
very interesting to note that these cases recovered after a course
of emetine.
DESORIPTION OF PLATE.
FIG. I.-Shows a large oval cell with a large circular nucleus. No'karyosome is
seen and the chromatin is collected into a leI;lticuJar mass at one margin. Other
chromatin bodies are seen in the endOplasm of th,e cell-body.
FIG. 2.-Shows a cell similar to that in fig. 1, hut this has two masses of chromatin
attached to the nuclear memhrane.
'
FIG. 3.-A large cell, with large nucleus, with ag,tin the peculiar masses of c1uomatin on the nuclear memhrane. The cytoplasm is filled with dark spherical masses
of chromatin.
, FIG. 4.-Shows a small cell with a large nucleus.
FIG. 5.-Shows a peculiar" body" with a lenticular mass of chromatin at one
,margin.
,FIG. 6.-Shows 'a smaller "body" than
~hat
in fig. 5, but otherwise resembles it.
FIG. 7.--,-Shows a 'cell with the large type of spherical nucleus, and this has
ingested a polymorphonuclear leucocyte.
FIGS. 8 and g.-Shows peculiar" bodies," with chromatin at the margins.
:B'IG. lO.--Shows a group of rounded" bodies" of unknown significance.
FIGS. 11 and 12.-These show" bodies" of unknown nature.
FIG. 13.-Large cell, with one large nucleus and one smalLnucleus, both showing
the peculiar semilunar arrangement of the chromatin.
'
FIG. 14.-This shows a curious ceJl with large circular" body" in endoplasm, and
two small cjrcular masses of chromatin near it.
FIG. 15.- An oval cell with Ifour nuclei, arranged in pairs of unequal size, and
all showing the characteristic sharply crescentic masses of peripherally arranged
chromatin.
FIG. 16.-A larger cell resembling the foregoing but circular in shape with two
larger and two smaller nuclei of the same character.
FIG. 17.-A very large cell with three large nuclei and an ingested polymorphonuclear leucocyte.
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560 "Bodies" found in the Stools of-Dysenteric Patients
FIG. 18.-A large spherical cell with four large nuclei, tbe chromatin in which is
broken up into minute peripherally arranged masses. In the upper part of the body
of tbis cell will be observed a round" body" of small size containing two minute dots of
chromatin. This little "bod~ " resembles closely the" bodies" drawn in fig. 11.
FIG. 19.;-A large cell with a peculiar small oirole of chromatin on the left, and
showing an ingested polymorphonuclear leucocyte.
FIG. 20'.-A large cell with nucleus of the type seen in fibroblasts which contains
in a vacuole a spherical" body" of considerable size and probably of protozOl),nnature.
FIG. 21.-A curious cell, with no evident nu:cleus, containing a polymorph
leucocyte in a vacuole: In the course of our investigations on the protozoa found in
the sand of Egypt, we have observed and illustrated forms almost identical with this.
FIG. 22 and 23.-These are probably the same cells as that shown in fig. 21 ; each
contains a rounded body, probably of protozoal nature, in tbe cytoplasm.
FIGS. 24 and 25.-0e1l8 with nuclei of a different character to those described
above.
They contain a dense karyosomatic mass surrounded by a dark area.
FIG. 26.-Large elongated cell, with peculiar nucleus.
FIG. 27.-0ell showing bodies strongly suggestive of schizogony.
FIG. 28.-Spores, with bipolar staining, probably yeast cells.
FIG. 29.-Two· spores showing peculiar oblique arrangement of dark· staining
extremities which are probably yeast cells.
,
FIG._ 30.-Little free" bodies ,. probably the result of rupture of a cell in which
schizogony has occurred, such as is seen in fig. 27.
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A Preliminary Note on the
Occurrence of Peculiar
''Bodies'' of Probably
Protozoan Nature
Frequently Found in the
Stools of Dysenteric
Patients
J. Gordon Thomson and D. Thomson
J R Army Med Corps 1916 27: 556-560
doi: 10.1136/jramc-27-05-02
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