(From difficult, and the intestines). Intestines with difficulty moved, though sometimes called diarrhaea carnosa and dissolutus morbus, often the blood flux, because blood occasionally appears in the stools: this, however, is not always a symptom, nor essential to the disease. Dr. Akeiiside calls the dysentery a rheumatism in the bowels, and thinks dysentery and rheumatism are the same: the

Latins call it tormina: Coelius Aurelianus, a rheumatism of the belly, preceded either by a diarrhoea, a cholera morbus, or a tumour of the abdomen. Dr. Cullen defines it, "a contagious fever, in which the patient has frequent mucous or bloody stools, accompanied with much griping and followed by a tenesmus; the alvine faeces being for the must part retained."the stools, though frequent, are generally small in quantity; the matter voided is chiefly mucus; sometimes blood. At the same time the natural faeces seldom appear; or they are small in quantity, compact and hardened. He places this disease In the class pyrexia, and order pro-ftuvia. There is but one species, which varies its name from different circumstances, e. g. dysenteria castrensis, from happening in a camp, on account of the soldiers being more exposed to the night air, which produces or aggravates the disease; dysenteria verminosa, from being occasionally accompanied with worms; dysenteria carnosa, when fleshy or sebaceous lumps are discharged; dysenteria intermittens, when accompanied with an intermittent fever; dysenteria alba, when the stools are not mixed with blood; dysenteria miliaria, when accompanied with miliary eruptions. The others are symptomatic. This disease is sometimes acute; but more frequently of a chronic kind.

As diarrhoea and dysentery equally consist of an increased discharge by stool, the diseases have been generally confounded; and a. diarrhoea, especially if attended with a discharge of blood, has been styled a dysentery. The more attentive observation of the moderns has corrected this confusion, from which even the work of Sauvages is not free; though the correction is, in a great degree, owing to the labours of nosologists.

Diarrhoea chiefly consists of the evacuation of foecu-lent matter, for the stools, even when watery, contain dissolved faeces: in dysentery the stools are retained, and the evacuation, discharged with much straining, is a small portion of mucus only. Each is attended with pain and tenesmus: but in dysentery, the pain and straining are extremely violent. Again: the diarrhoea and dysentery are both occasionally epidemic; the latter is not only epidemic in a more extensive degree, but may be traced by infection. It is sometimes also local in its attacks, and may be traced either to the influence of neighbouring marshes, or alternates, with remitting fevers. In diarrhoea the discharges are sometimes tinged with blood; in dysentery the sanguineous discharge is often considerable: in the former, fever seldom attends, or is inflammatory only; in the latter, the fever is of the nervous and putrid kind; the prostration of strength considerable.

Various observations have been recorded to distinguish the seat of the disease, according as the blood is more or less florid, more or less intimately mixed with the faeces. These are, however, trifling, and in general unfounded. The true seat of the dysentery is the large intestines, generally their lower part; and the disease is immediately owing to a spasmodic stricture producing increased, but ineffectual, exertions on the upper part; and this spasm, to inflammation of the villous coat.

It has been common to seek for the more remote causes in acrimony of the fluids, of the ingesta, of the bile, and the other abdominal secretions. Even Sydenham, who saw clearly that it was a febrile disease.

directed to the intestines, thought it owing to a morbid matter brought by the meseriac arteries. Hippocrates, however, long ago observed, that dysenteries are most common in summers that succeed cold and dry winters, followed by a rainy spring; that they occur also when a dry spring succeeds a rainy winter. Bontius remarks, that the hottest weather produces them when the nights begin to be cold. These are the periods when remittents and intermittents most prevail; when marsh miasmata are the most copious and active; when the exciting cause of cold most powerfully assists their action. In fact, it is a contagious remittent fever, with an erysipelatous affection of the internal coat of the intestines exciting a spasm, and its consequences already described; viz. increased action, sufficient to occasion the discharge of mucus, but not to evacuate the accumulated faeces. This discharge of mucus is common from every mucous membrane, when the action of the organs, which the membrane lines, is augmented, as in the bronchiae and bladder; and we know that the faeces are retained, both from their not appearing, and from their hardened state on the solution of the disease.

The diagnostics, according to Sydenham's celebrated description, are as follow: "The patient is attacked with a chillness and shaking, which are immediately succeeded by a heat of the whole body; soon after this, gripes and stools follow: it is indeed often not preceded by a fever; but the gripes attack first, and the stools soon succeed. Intolerable gripings, and a painful descent, as it were, of the bowels, accompany every evacuation. The discharges are chiefly mucous, except now and then an excrementitious one intervenes, without any considerable pain. The mucous stools are generally streaked with blood; but sometimes no appearance thereof is seen throughout the disease: nevertheless, if the stools are frequent, mucous, and accompanied with gripings, the distemper may as justly be entitled a dysentery as if blood were discharged along with them. If the patient is in the vigour of life, or hath been treated with cardiacs, a fever arises, and the tongue is covered with a thick, white mucus; and if he hath been much heated, it is black and dry: great loss of strength, a lowness of spirits, and all the signs of an ill-conditioned fever, are joined with it. This disease is attended with extreme pain and sickness, greatly endangering life if unskilfully treated; for, when the spirits are much exhausted, and the vital heat diminished by frequent stools, before the matter can be expelled from the blood, a coldness of the extremities ensues, and there is danger of death, even within the periods of acute diseases. But if the patient escapes for this time, several symptoms of a different kind succeed. Sometimes, in the progress of the disease, instead of the sanguineous filaments, which are usually mixed with the stools in the beginning, a large quantity of pure blood, unmixed with mucus, is voided at every stool; which, as it manifests an erosion of some of the larger vessels of the intestines, threatens death. Sometimes an incurable gangrene seizes the intestines, which is caused by a violent inflammation excited by the afflux of hot acrid matter to the affected parts. At the decline of the disease, aphthae frequently affect the internal parts of the mouth, especially if the patient hath been kept hot for a long time, and the evacuation of the matter hath been checked by astringents; the fuel of the disease not having been first carried off by cathartics: these aphthae generally foreshow imminent death. If the patient survives the foregoing symptoms, and the disease proves lasting, the intestines at length seem to be affected successively downwards, till it be driven to the rectum, and ends in a tenesmus; upon which the natural stools occasion great pain in the bowels, the faeces, in their passage through them, abrading the small guts; whereas the mucous stools only offend the rectum during the time that the matter is made and discharged. Though this disease is often mortal in grown persons, and especially in the aged, it is nevertheless very gentle in children, who have it sometimes for several months without any inconvenience, provided the cure of it be left to nature."