General Subjective Symptoms

Aside from the diarrhoeal movements and the unpleasant sensations consisting in a feeling of pressure and fulness in the abdomen mentioned above, there may in light cases be perfect euphoria; usually a feeling of weakness exists which is especially marked in the lower extremities. A feeling of dizziness and slight nausea often also appear, especially shortly before and during evacuations. Vomiting may also occur, as a rule, in cases in which the stomach is likewise affected or when the process of inflammation is of a severer type (cholera nostras). Tenesmus is frequently present, if the process is in the lower part of the colon, even if not especially pronounced. This seems to be the result of the irritating action of the dejecta upon the rectum.

The general symptoms above described are much more pronounced in children and very old people. Here the appearance of collapse (cold extremities, blue lips, and apathy) is not very rare. Marshall Hall1 has described a condition under the name of acute hydrocephaloid disease which occurs in weak children with acute enteritis. The hydrocephaliod appears in consequence of severe attacks of gastro-enteritis with a temperature of 104°-106° F. There is sudden collapse. While the body is hot, the extremities become ice cold, the fontanelles sink in, the pulse becomes considerably accelerated, soft, and often irregular. In this condition the little patient lies apathetic unless suddenly disturbed with colicky pains when he utters a cry. The pupils do not react alike and the conjunctival reflex may be absent. Sometimes paralysis of the rectum is present, which I have seen in one case. In this condition the patient often dies within a short time from paralysis of the heart.

1 Marshall Hall. " Diseases and Derangements of the Nervous System," London, 1841, p. 153.