DYSENTERY (ante). Two forms of dysentery are usully recognized by medical authorities, sporadic and epidemic. The causes, however, are supposed to be the same in both. It is essentially a disease of hot weather, or hot climates. There being no doubt of the epidemic character of the disease in certain seasons and in certain locali ties, i s, it follows that a peculiar poison must be the generating cause, heat perhaps oper ating to aid in generating the poison or contagious matter. Post-mortem examinations show the mucous membrane of the colon and rectum (see ALIMENTARY CANAL) to be the seat of much morbid action. Extensive ulcerations are frequently found, which are the seats of the hemorrhage or bloody discharges, having been caused by the inflam mation of the parts, abundant evidence of which exists, the 'membrane often being found greatly engorged with blood, thickened and pulpy, in some cases of a very dark color and aknost disorganized. The portal circulation (see LrvEn) is greatly obstructed in nearly all cases, probably in all severe cases, and it is certain, under the circum stances, the peculiar materiel morbi or morbid principle or matter of dysentery paralyzes or greatly arrests the functions of this organ. Now, as all the blood from the intestines passes through the liver on its return to the lungs and heart, the functional disturbance which exists in this organ must necessarily produce more or less obstruction in the capillary circulation in the intestines, and greatly interfere with their nutrition and relative functions. Practically, therefore, the treatment of the disease involves the consideration of those remedies which are supposed to exert a decided influence upon the functions of the liver. One of these remedies, which has been greatly lauded, and also greatly condemned, is mercury, particularly that preparation of it called calomel; one party contending that the administration of the drug in minute and repeated doses (especially when alternated with alkaline carbonates to restore the alka linity of the blood) exerts a powerful influence in restoring the tone of the capillary circulation in various organs, and consequently their functional activity; above all, that this power is peculiarly manifested with reference to the liver; and they adduce numer ous examples to establish the correctness of their opinions. On the other hand, several
eminent authOrities deny the correctness of the theories and positions of these advo cates, and affirm that their experience and experiments, as well as all sound therapeu tical theories, are decisive against the opinion that calomel possesses the peculiar virtues which are claimed for it. If this remedy be used, it should be in minute and frequently repeated doses—} to I of a grain every 2 hours; and sometimes oftener to of a grain every hour. It should always be combined with sufficient opium in some form to allay the griping and other pain,' and arrest the straining. Alkaline carbonates should also be given. It is recommended by many authorities that when a laxative is given in the commencement of the treatment, a saline, as sulphate of magnesia or Rochelle salts, should be preferred. Hygienic measures are of the greatest importance. The strictest attention should be paid to cleanliness and ventilation. Pure, fresh air is necessary, not only as a tonic to the nervous system, but as one of nature's principal means of eliminating effete and poisonous matter. Counter-irritants in the form of sinapisms, made weak and continued, are frequently of great advantage in aiding to restore the capillary circulation in the diseased parts, by arousing a reflex influence in the nervous system. The diet is of no secondary importance, and should be bland and nutritious. Eggs, raw or very slightly boiled, mixed with Catawba or sherry wine, or brandy; rice water, as a beverage, combined or alternated with beef-tea, will often afford nourishment not easily supplied in other ways. Rare beefsteak, if chewed and the juice swallowed, often affords a good form of food; toast and tea also may be taken. Tea for he sick-room should always be of the most delicious kind, and freshly prepared, and weak. Pure water, actively boiling, should be poured upon a proper quantity of tea in an earthen vessel, and allowed to stand not more than two or three minutes before being turned off, as the continued presence of the leaves allows of the absorption of too much tannin and other extractive matter, by which the fragrance and best qualities of the beverage are injured.