The term dysentery is used to denote an inflammation of the large intestine accompanied by mucous and bloody discharges from the bowels.

In mild cases the inflammation is not severe and may be confined to the rectum. In severe attacks of the disease, the inflammation is not only intense but extensive, involving the greater part of the large intestines, the mucous membrane of which becomes reddened, swollen, and ulcerated. The ulcers are greater or less in number, some being small and others of considerable size.

Causation

Excesses in eating, food decomposed or improperly cooked, foul drinking water, exposure to cold and rain storms are among the generally recognized causes. In many cases it is not easy to trace the origin of the disease under consideration to any obvious agency.

Symptoms

The affection is generally preceded by a diarrhoea of a variable duration, with which some pain has been associated. The appetite is lessened and the manner dull and listless.

The development of the disease is denoted by characteristic discharges consisting of mucus with which more or less blood is commingled. The effort to move the bowels is frequently made and the quantity passed at each act is generally small. Slight evacuations may take place every hour and even much oftener.

The quantity of mucus expelled is in some instances quite abundant and appears in a jelly-like mass, for which the popular term applied is slime. Sometimes fecal matter is mingled with the discharges but they are more commonly dysenteric in character, consisting of mucus and blood. At times the evacuations present a greenish color. The amount of mucus and blood voided constitutes measurably a standard for judging the extent of the intestinal surface affected.

Pus sometimes appears in the discharges in the acute form of the disease, but more commonly it is observed in the chronic stage. The inflammation of the rectum occasions a sensation as if the bowel were filled causing a frequent desire to evacuate; the effort is strained and painful.

The abdominal walls are usually retracted and the back arched. The pulse is not materially changed excepting in extreme cases. Great frequency of the pulse denotes gravity and danger, but the reverse does not hold good as sometimes in fatal cases it is but little quickened.

Fever is exceptional although at times it may run very high. The nose is hot and dry, the tongue often coated. Thirst is a prominent symptom. Vomiting may occur and a greenish matter be expelled. The loss of strength varies according to the intensity of the intestinal Inflammation. In extreme cases running to a fatal termination, the discharges become putrid) the breath offensive, the respiration more rapid, the eyes sunken, the expression pinched and anxious. The pulse grows weak and feeble, evacuations occur more frequently, and at last are involuntary and beyond the control of the animal. Paralysis seems to invade the extremities, the skin becomes cold and clammy, the stench intolerable, finally death ensues from exhaustion.

Prognosis

The disease intrinsically tends to recovery. It is a distressing affection, but properly treated need seldom result fatally, provided the system has not been weakened by some previous disease or some co-existing derangement. Exceptionally dysentery eventuates in the chronic form of the disorder.

Treatment

It is desirable that as early as possible the contents of the intestines, and more especially the larger, be effectually removed. Nature evidently endeavors to relieve the bowels by a diarrhoea which precedes the dysenteric discharges. The treatment should be commenced with an effective purgative; castor oil is the more appropriate remedy and a tablespoonful should be given. Following the oil, opium must be relied upon. The following mixture is recommended. -

℞ Morph. Sulph. gr.ij.

Sodae Sulphatis ℥ iij.

Aquae Cinnamon. ℥ i i j Ft. Mist. Sig. Dose one teaspoonful every five or six hours.

It will be necessary in very many cases to repeat the castor oil especially if fever manifests itself, or the discharges assume an offensive odor. The writer has had too little success in the use of the so-called astringents to advise their administration in the early stage at least. Where the discharges assume a character near the normal but watery, then the following mixture may be given. -

℞ Misturae Cretae ℥ iijss Tinct. Catechu ℥ ss Ft. Mist. Sig. Dose a dessertspoonful every three or four hours.

Vomiting sometimes occurs as a prominent symptom at times early in the disease, preventing the administration of medicine by the mouth. In such a case morphine can be given subcutaneously, or thirty drops of laudanum in starch-water be injected into the rectum. These methods need only be employed while the stomach is too irritable to bear what enters it.

The food should be bland and easily digestible; rather withhold it entirely than unwisely select that which is liable to be vomited, or add to the irritation.

Milk and lime-water in small quantities given frequently, will be quite sufficient at first. This can be varied by giving alternately broths, into which a raw egg has been broken. When any diet but milk is allowed some form of pepsin should be administered with the food; of the French preparation, five grains is the dose, of the American or saccharated, from five to ten grains.

The elixir bark pepsin and bismuth is an admirable combination and can be given in teaspoonful doses three or four times a day. If the symptoms indicate failure of the vital powers, concentrated nourishment and possibly stimulants will need to be given freely.

When the disease is under control and convalescence commenced, tonics should be employed.

The beef wine and iron at first in dessertspoonful doses four times daily, then the elixir calisaya bark iron and strychnine, one teaspoonful twice a day. The pepsin should be persisted in until recovery is complete.