Dysentery is a disease in which there is an inflammation of the mucous or lining membrane of the bowels, accompanied by frequent stools, severe griping pains, soreness and smarting at the fundament, and some degree of fever; the stools, although frequent, being small in quantity, and without any natural faeces intermixed, but consisting principally of mucus, which is sometimes streaked with blood. When the natural faeces do appear, they are usually in the form of small compact, hard substances.

Dysentery occurs chiefly in the autumn, and is often occasioned by cold or moisture succeeding quickly to intense heat or great drought, whereby the perspiration is suddenly checked, causing a determination of blood to the intestines. It is likewise occasioned by a use of unwholesome and putrid food, and by noxious exhala tions and vapours; hence it appears often in armies encamped in the neighbourhood of low marshy grounds, spreads rapidly and proves highly destructive, particularly when the sick are crowded together, and there is a neglect of cleanliness and due ventilation.

A particular state of the atmosphere often seems to predispose or give rise to Dysentery, in which case it prevails epidemically. It frequently occurs about the same time with autumnal intermittent and remittent fevers, and with these it is often complicated. It is likewise frequently combined with Typhus, whereby the disease is-rendered more highly contagious and malignant.

Dysentery is much more prevalent in warm climates than in cold ones; and in the months of August, September, and October, which are the rainy months of the West Indies, it is apt to break out. It likewise prevails much in the unhealthy parts of the East Indies, and on the coast of Africa.

The difference between the symptoms of Dysentery and Diarrhoea have been already pointed out.

An attack of Dysentery is sometimes preceded by loss of appetite, costiveness, flatulency, sickness at the stomach, and a slight vomiting; and comes on with chills, succeeded by heat in the skin, frequent pulse, and dry mouth; the tongue is covered with fur, or it is red and polished. These symptoms are in general the forerunners of the griping and increased desire to go to stool, which afterwards occur; but sometimes the latter symptoms make their appearance first.

When the inflammation begins to occupy the lower part of the bowels, the stools become more frequent and less abundant; and in passing through the inflamed parts they occasion great pain, so that every evacuation is preceded by severe griping, as also a rumbling noise, caused by a great accumulation of wind in the bowels.

The motions vary both in colour and consistence, being sometimes composed of frothy mucus mixed with blood, and at other times of an acrid watery humour, like the washings of meat, and of a very fetid smell. Sometimes pure blood is voided; now and then lumps of coagulated mucus, resembling bits of cheese, may be observed in the evacuations; and in some instances a quantity of purulent matter is voided.

Sometimes what is passed consists merely of mucous matter, without any appearance of blood, exhibiting that disease which is known by the name of Dysenteria Alba, or White Dysentery.

While the stools consist of these various matters, and are voided frequently, it is seldom that we can perceive any natural faeces amongst them; and when we do, they appear in small hard balls, called scybala, which being passed the patient is sure to experience some temporary relief from the griping and tenesmus.

It frequently happens, from the violent efforts which are made to discharge the irritating matters, that a portion of the gut is forced beyond the verge of the fundament, which, in the progress of the disease, proves a troublesome and distressing symptom; as does likewise the tenesmus, there being constantly an inclination to go to stool, without the power of voiding anything, except, perhaps, a little vitiated mucus, or a small quantity of blood.

More or less fever usually attends with the symptoms which have been described, throughout the whole course of the disease, where it is inclined to terminate fatally, and is either of an inflammatory or putrid character. When the symptoms run high and are accompanied by violent irritation of the whole of the bowels, great prostration of strength, difficulty in making water, and hiccup, or with a putrid tendency, and fetid and involuntary discharges, the disease often terminates fatally in the course of a few days; but when they are more moderate, it is frequently protracted to a considerable length of time, and produces great emaciation and debility, but goes off at last by a gentle perspiration diffused over the whole body; the fever, thirst and griping then ceasing, and the stools becoming of a natural colour and consistence. When the disease is of long standing, it seldom admits of an easy cure, and when it attacks a person labouring under an advanced stage of scurvy or pulmonary consumption, or whose constitution has been much impaired by any other disorder, it is sure to prove fatal.

After recovery from an attack of Dysentery, exposure to cold, wet, or fatigue, or any imprudence in diet, is very apt to bring on a return of the complaint.

Treatment

Formerly Bleeding, Emetics, Calomel and Opium, followed by astringents, was the common mode of treatment for Dysentery. The opinions and the practice of the best members of the medical profession have wonderfully changed of late years. It is now considered that the best way to cure the disease is to give: the bowels rest; merely coating their inner surface with some mild mucilaginous substance sufficient to protect it from irritation, and mainly leaving the cure to nature. A warm bath will be serviceable, if the patient can obtain it without the risk of exposure to cold. He should then go to bed, be wrapped up warm, and kept as quiet as possible. Cloths wrung out in hot water may be laid over the belly, and renewed as often as the heat goes off, or a mustard poultice may be applied, and kept on till a considerable amount of redness is produced on the skin. Bottles of hot water may be placed to the feet, or they may be wrapped up in flannel.

Nothing in the shape of food must be taken except thick Oatmeal gruel, Arrow-root, Sago, or thick Starch; and this diet must be adhered to till the disease is completely subdued, For drink, thin gruel or Barley water may be taken.

In order to quiet the action of the bowels as much as possible,, the following sedative may be taken:-

Bromide of Ammonia,...................Two Drams.

Water,...........................................Halfa pint.

A large teaspoonful may be taken every two hours, and five grains of Extract of Henbane, made into a pill, may be taken every night at bedtime.

The patient should endeavour to avoid, as much as possible, straining at stool.

When convalescent, the patient must be very careful, for some time, in his diet; living on light puddings, Mutton broth, Beef tea, Poultry, and occasionally a little boiled Mutton; avoiding tough Beef, Pork, Pickles, Vinegar, Spices, and fermented liquors. He should also be warmly clad, and guard as much as possible, against extremes of heat and cold.