§ 66. We now pass to the treatment of dysentery, commencing with naming the remedies which have been used against the various kinds of the disease generally. The principal remedy is Mercurius corro-sivus, next to which we rank Mercurius solub. H., and other mercurial preparations; Colchicum autumnale, Capsicum, Carbo veg., Colocynth, Ipecac, Aloes, Can-tharides, Acidum nitric, and Sulphur; Flores and Hepar sulph., Rhus, Staphysag., Nux vom., Bellad., Pulsat., Chamom., Arsenic, China, Tart, emet., Sepia, Plumbum, Veratrum.

Those kinds of dysentery which authors have denominated catarrhal rheumatic, and which do not occasion any great derangements in the digestive functions, offer a variety of rheumatic complaints, together with the characteristic symptoms of dysentery, such as: drawing and shooting stitches in the muscles and extremities, tearing in the nape of the neck, in the head and shoulders. The fever is a continua remittens; the local intestinal affection which sets in simultaneously with the fever is not very violent, the evacuations generally consist of mucus, and are streaked with blood.

This kind of dysentery is generally epidemic, but it sometimes exists as a sporadic disease, and generally accompanies catarrhs, rheumatisms, and diarrhoea; it is principally occasioned by variable, alternately warm and cool and damp weather, and is frequently endemic in those districts where climate and locality make fever and ague likewise endemic.

If the attack have been occasioned by atmosphere and climate, and marshy emanations be the principal and most striking cause, China will remove the whole disease in a very short time, especially if the fever have the character of an intermittent. If, on the contrary, the rheumatic symptoms should be the most prominent, a few doses of Aconite will be found sufficient to cure the disease. If Aconite should not suffice, or if it should not be indicated, Chamom., Rhus or Pulsat., would be the best remedies, especially if the stools consist of blood-streaked mucus. Other remedies may likewise be indicated. (See the remedies for catarrhal and rheumatic fevers.)

The pure inflammatory, or the bilious inflammatory, dysentery, sets in without any precursory symptoms; it is characterized by all the symptoms of a local inflammation. The fever is a synocha; it sets in with a violent chill, followed by a dry, burning heat, with great thirst, dry tongue and skin, and fiery urine. The local symptoms of this kind of dysentery are as clearly marked, and are very much like those of enteritis; both in dysentery and enteritis the abdomen is very sensitive to the touch, hot and distended, the patient is tormented with retching, vomiting of the ingesta, and coldness of the extremities.

Inflammatory dysentery is very rare, sometimes sporadic, but scarcely ever epidemic; it prevails mostly at the end of summer and the beginning of autumn, when the days are hot and the nights cool.

The first thing we have to attend to in the treatment of inflammatory dysentery, is to remove the synochal fever, which we accomplish by means of a few doses of Aconite. This remedy is frequently sufficient to subdue the whole disease. If the disease should not be subdued entirely, Belladonna has to be used. To confirm our assertion we will mention the symptoms of the disease more in detail. Without dwelling upon the febrile symptoms themselves, which have been described with sufficient completeness, under the head of synocha, we will at once proceed to treat of the local affection, premising that Belladonna deserves consideration if the dysenteric patient be of a plethoric constitution, and have a lively, ardent temperament. The exacerbation commences in the afternoon and lasts until midnight, when the fever remits; nevertheless the patient is prevented from sleeping by a violent restlessness, and a great desire for cold drinks and baths. There are moments when the patient is delirious, especially on waking from a light slumber; his face is then red, and the head hot; gradually he falls into a whining mood, which cannot be subdued except by emphatic remonstrances, or which alternates with a firm resolution to jump out of the bed, and to look for the chamber. The tongue is lined with a whitish fur; the tip, which is not coated, inclines to be dry; the patient has lost all appetite, or has a positive aversion to food; the pains in the bowels are either spasmodic and colicky, or else cutting-burning, the abdomen is somewhat distended in the umbilical region, there is a constant urging for stool, and small discharges of a bloody mucus.

In other cases Nux or Mercurius is indicated. Nux is indicated by discharges of a sanguineous mucus, mixed with single hard lumps of feculent matter, and accompanied with violent cutting in the umbilical region, and pressing in the rectum. Merc, is a principal remedy when, after the removal of the inflammatory symptoms, frequent discharges of bloody mucus, or liquid feculent matter, remain, accompanied with cutting and tenesmus, which causes burning and soreness of the anus; every evacuation is preceded by a cold sweat in the face, as from anguish and excessive uneasiness.

§ 67. The gastric dysenteries, together with the ca-tarrhal-rheumatic, are the most frequent, and are characterized by the fetid smell and putrid bilious nature of the evacuations. According to authors there exists in the first place a bilious dysentery, which is apt to occur when the nights are cold and the days hot, and which sets in with all the symptoms of a bilious fever; the stools are frequent, consisting from the commencement of a fetid, green or brown bile; colic and tenesmus are very violent, accompanied with great restlessness and oppression of breathing. The bilious dysenteries resemble, to a certain extent, the inflammatory variety; spontaneous vomiting affords relief. They occur most generally as an epidemic disease, towards the end of very hot summers, and at the commencement of the fall, after a continuous heat.