Etiology

Colitis, acute or chronic, caused by amebic dysentery, is not very frequently met with, yet often enough to be noticed in this place. It is said that in these cases there is a strong tendency for abscesses to form in the liver. This is a disease that prevails in the eastern countries, Egypt, and Europe. It is in reality a tropical disease; yet we do occasionally run across cases of it in this country. I believe I have not seen more than two. It is very intractable, and when it is once thoroughly established, and the patient highly enervated, the prognosis is doubtful. I have been favorably located for the practice of my profession, so far as not having many cases of this disease to treat is concerned. It belongs to the warmer countries, and is more inclined to develop in the southern states of this country than in the northern and western.

Morbid Anatomy

These cases present lesions on the order of ulcerations. The mucous membrane is very edematous, and there is more or less sloughing. This may even be seen in the mucous stools which the patient passes. It is said that the disease is inclined to be wholly confined to the large intestine, and to the cecum more than any other part of the intestinal canal except the sigmoid flexure of the colon.

Symptoms

In mild cases the disease may exist for several months before a patient is aware of it. There are vague symptoms of headache, tired feeling, weakness, slight pain in the intestines, occasionally diarrhea. There is but one way to be absolutely sure of the existence of this disease, and that is by having the stools examined with the microscope, when the ameba will be found. Patients suffer very greatly and become very much emaciated. They will spend hours out of each twenty-four on the stool. They know that they can have very little action from the bowels, notwithstanding a great desire; yet they are compelled to prepare and get into position for soliciting a stool, and try to have a movement, even if the trying is injurious. Where the bearing down is very great, a pint of hot water should be introduced into the rectum before attempting to have the bowels move, and always bear down as little as possible.

In all such cases it would be well, if possible, to induce the patient not to wear out the nervous system by going to the closet seat. Use either a bed-pan or cloths; for there will seldom be an amount beyond a tablespoonful of mucous. Of course, occasionally there will be a movement of the bowels; but in the majority of instances when the patient is called upon to have a movement there will be nothing to pass, except a small amount of mucous and the necrosed tissue.

Treatment

Patients should be kept in bed. When a person finds he has this disease--it matters not how much strength he has left, it matters not if he has strength to go and attend to his business--he should make his business that of getting rid of this disease; for, when it is once established and the constitution is broken, the chances for recovery are very slight, as stated before.

The feeding should be fruit juices, vegetable juices, lamb or chicken broth, or coddled eggs; fruit juices for breakfast, lamb or chicken broth, with fruit juices, for dinner, and buttermilk for the evening meal. But if the patient is in good flesh, he should fast for one or more weeks, depending upon the severity of the symptoms. There is nothing that drugs can do. It would be well to use copious enemas. The object of treatment should be to restore the patient's health to the normal standard--to the point of being able to furnish enough of the digestive secretions--enzymes--to digest the ameba.

It should not be forgotten that parasites will not find lodgment in the intestinal tract of normally healthy people. To find anyone troubled with any kind of parasitic disease is proof positive that his nerve energies have been broken down, and, as a consequence, his digestive power is below normal; hence everything must be done to restore his resistance. While he should be kept in bed, he should go through a course of exercise daily. Everything should be done for him that is done to restore people suffering from any other disease. Exhaustion from exercise must be avoided.