Dysentery

[Fr. dy enterie, from Lat. and Gr. dysenteria-Gr. dys, bad, and enteron, intestines, from entos, inside.] ( Med. ) A disease characterized by frequent mucous or bloody stools, attended with griping pains in the abdomen, straining, and tenesmus. It differs from diarrhea in that, while in the. tter the stools are fæcal, in this there is a retention of t e natural fæces, or they are expelled from time to time in small, hard, separate lumps, termed scybalæ. D. consists e entially in inflammation of the mucous membrane of the large intestines, and, in the acute form or stage of the disease, is attended with fever. D. is one of the pests of hot climates, and in all tropical countries, at certain seasons of the year, it is very prevalent and destructive. It is, however, among fleets and armies that this malady most displays its deadly power; so that it has been termed the Scourge of armies and the most fatal of all their diseases. The forms of this disease, and the circumstances under which it prevails, are infinitely various, and many speculations have been formed regarding it. It is now a primary, now a consecutive, and now a symptomatic disease. It has been ascribed to exposure, to wet, and to cold; to the use of unwholesome food, to the agency of malaria, and to contagion. Generally the most violent forms of this disease occur in warm climates, and in situations where the body is exposed to extreme alternations of heat and cold; and hence there is every reason to believe that these influences are largely concerned in its production. It is doubtful, however, whether the use of unwholesome food or malarious poison would induce it as a primary disease; and the general opinion among medical men is that it is not contagious. Generally one of the earliest symptoms of D. is an uneasine of the abdomen, soon amounting to pain of a griping character, particularly in the umbilical region, attended with an inclination to go to stool, and temporarily relieved by evacuation. As the disease becomes developed, the relief is but transient; the desire to go to stool is more frequent and importunate; the discharge is scanty, and what is voided is either altogether a jelly-like mucus, or, more commonly, it is mucous and bloody - the bloody - flux of old authors-mixed with films and membranous shreds and fragments resembling flesh. The scanty evacuations now produce distre rather than ease, and the patient is tormented by a sensation that there is still something to come away, the expulsion of which would cure him, and is irresistibly impelled to strain violently to get rid of the irritation. In an advanced state the stools become greenish or black, and very fœtid the bladder frequently sympathizes with the rectum, and nausea and vomiting sometimes ensue. The patient pa es sleeple or dreamy and disturbed nights, and is low-spirited and desponding. In fatal cases the pulse becomes very small and rapid, the features sharpen, the surface grows cold, and death at length sets in. The duration of this disease is very various. In some cases it may prove fatal in a few days, or even hours; in others it may last for weeks or months. Two stages of this disease are recognized - the inflammatory, and that of ulceration. In the inflammatory form, when the fever is high, and the pain intense, blood-letting from the arm is generally recommended, and also the local abstraction of the blood by leeches or cupping. Dover's powder is also given as a sudorific, and profuse "weating encouraged. Purgatives are to be employed with great caution. If the colon be distended with feculent matter which it cannot discharge, then the mildest purgatives, such as castor-oil, should be administered, and cautiously repeated until the whole of the irritating matter is removed. If, on the contrary, there is no accumulation of feculent matter, the use of purgatives is to be avoided. After the inflammatory state has been reduced by blood-letting, and the accumulated fæces ejected by purgatives, the great object is to soothe the irritated membrane by opiates, and to strengthen the system by gentle tonics and a light, nourishing diet. If the disease is not cut short by this method, but has reached the second stage, and become chronic, the most effectual remedies appear to be laxatives and opiates given alternately, and combined with such medicines as promote perspiration. The abdomen should be swathed in flannel, and much benefit may be obtained from the employment of clysters, if there is not too much tenesmus to admit of the introduction of the pipe. The food should be farinaceous and simple, and great care must be taken during convalescence to prevent a return to improper diet, and any fresh exposure to cold.