The discovery of nephrouroameba: was it real or not?

In 1938 Procaccini showed scientific interest in a new kind of ameba, and called it "nephrouroameba" from which the disease "nephrouroamebiasis" is derived. He wrote a paper titled "La Nefrouroamoebiasi" thus describing its history, the biopathogenetic evolutionary cycle of the protozoon, its therapeutic, epidemiological, anatomo-biological, diagnostic, cultural, biological and morphological features. Between 1934 and 1939, Procaccini had the opportunity to follow many patients belonging to a group of Italian soldiers serving in the Eastern Italian Army in Ethiopia. At that time he was responsible for the biopathological laboratory. After a short preclinical stage of fatigue, patients suffering from nephrouroamebiasis showed a nephrotic syndrome with gross hematuria. The symptoms ceased within a few days but residual microhematuria, albuminuria and urine casts persisted for many months. After microscopic observation, he reproduced some protozoons and classified them as a kind of ameba. Critical analysis of his report leads to the morphological identification of Trichomonas, thus excluding his classification as nephrouroamebas.

Ramanujan's illness

A January night in 1913 found the two renowned Cambridge mathematicians G.H. Hardy and J.E. Littlewood, in the latter’s rooms in Trinity College, poring over an unsolicited manuscript of mathematical formulae, which had arrived that morning in Hardy’s mail. The letter was from a 25-year-old Hindu clerk, Srinivasa Ramanujan (1887-1920), who lived in Madras and was as regards mathematics entirely self-educated. Many mathematicians receive letters from cranks and hoaxers, but it was at once obvious that this author was no crank, since not one of his theorems, as E.H. Neville later pointed out, could have been set in even the most advanced mathematics examination in the world. The suspicion of a hoax by a competent mathematician, where familiar theorems are skilfully disguised, was dispelled by Hardy’s recognition that a few of the results defeated him completely; he had never seen anything the least like them before. ‘A single look at them is enough to show that they could only be written down by a mathematician of the highest class’. When they parted that night both Hardy and Littlewood were satisfied that their Indian correspondent was a mathematical genius, and within weeks Littlewood was comparing him with Jacobi, the great German master of formulae. This famous episode bore immediate fruit for Ramanujan. Hardy at once joined forces with others in Madras in obtaining a research studentship for him so that he could pursue mathematical research full-time, and in arranging his coming to Trinity College, Cambridge in April 1914 to work with Hardy and to have first-hand contact with European mathematicians.

Entamoeba histolytica and Homo sapiens

Blind acceptance of the dicta of the great has led to much confusion as to the relationship between amoeba and man. A review of the mistakes of the past may lead to a better appreciation of the present, and higher hopes for the future. An hypothesis is presented.

Massive development of amebas in the large intestine. Fedor Aleksandrovich Lesh (Lösch)

Fedor Aleksandrovich Lesh (Lösch) 1840-1903. Although Lösch was a distinguished Russian physician, little has been written about him in English. A graduate of the Medico-chirurgical Academy in St. Petersburg (1863), he defended a doctoral thesis on pulmonary embolism and infarction in 1866, and became an assistant professor of medicine in 1871. From 1872 to 1885 he was a lecturer on diagnosis at the Women's Medical College and a consultant to the Nikolayev Military Hospital. In 1885 he became Professor of Diagnostic Medicine at Kiev University where he remained until his retirement in 1897. In 1870, Lösch found Balantidium coli in the stools of two patients and made a detailed study of the clinical aspects of balantidiasis. In the same year he described in detail Giardia lamblia and Blastocystis hominis. Altogether, he published some 20 papers on the diagnostic and clinical aspects of various diseases, with special emphasis on the microscopic aspects of coprology. It was in 1875 (exactly 100 years ago) that Lösch, in this monumental paper, reported the clinical aspects of recurrent intestinal amebiasis, identified and described its cause, Entamoeba histolytica, and produced the disease in an experimental animal. This work on amebiasis was completed while he was assistant professor at St. Petersburg, on the wards of Prof. E. Eichwald. Clinicians will cherish the description of the patient's symptoms; protozoologists must be delighted by the description of the parasite and its motility; experimentalists will be nervous about his luck in infecting one of three dogs; and iconoclasts must derive satisfaction from Lösch's caution in not automatically assigning a direct causal relationship between the presence of the parasite and the disease.