DYSENTERY, a general term connoting a series of diseased conditions of the large intestine or colon (q.v.). These may be of an infectious, nervous or chronic inflammatory origin. At the present time, it is becoming recognized that most cases of dysentery are due to different micro-organisms, and within recent years a bacillus has been described by a Japanese observer, Shiga, which is thought to be respon sible for a number of the cases of dysentery, both in adults and in children. Certain mild cases of dysentery have been shown to be de pendent upon the pernicious activities of certain bacteria belonging to the genus Proteus. And it has now been known for a long time that a certain lowly organized animal form, the Entamoeba, can induce a peculiar type of dysen tery known as amoebic dysentery. Thus the dysenteries may be divided into (1) Animal parasite dysenteries: (a) Protozoa; (b) Pla thelmint, Schistoma, etc.; (c) Nemathelminth; (d) Arthropods. (2) Bacterial dysenteries.
The general mode of onset of dysentery of the non-amcebic form, that is particularly epi demic dysentery, is rapid, with diarrhcea follow ing perhaps a mild constipation or alternating constipation and diarrhcea with a mucous or serous discharge. Symptoms of indigestion fre quently precede the attack, and it is character istic that diarrhcea is accompanied, with much wind. The faecal movements are large, loose, very fetid and usually mixed with blood and mucus. The movements are accompanied with great pain of a colicky or gripy nature. Tenes mus, or straining, is a very frequent symptom. There is usually much general pain, some rise in temperature, loss of appetite, nausea, restless ness and irritability. In favorable cases formed faces commence to reappear in the stools and there is disappearance of the griping and strain ing. In the patients in whom the disease be
comes more acute, the passages become looser, watery, slimy and of a dark red color. The odor is mawkish, and in later stages may even become putrid. The fluid that is passed consists largely of an albuminous serum with epithelium blood cells, pus cells, tissue fibres and small sloughs, and if the disease becomes even more pronounced the stools become dark brown in color, with sloughs and blood clots, and have a distinctly gangrenous odor. These sloughs from the intestine usually indicate an extremely severe form of the disease and ofttimes the patient dies with completely relaxed anus, with subnormal temperature, shrunken features and in complete collapse.
Amoebic dysentery is, as a rule, a more grad ual form of disease. It is extremely inter mittent in its course and much protracted, run ning on sometimes months and even years. It very frequently begins with painless diarrhcea, alternating with constipation; the stools being loose and yellowish, containing much mucus and a little blood. The patient commences to lose flesh, becomes weak and anamic, and the compli cation of abscess of the liver is extremely com mon. Chronic dysentery is a form of chronic colitis and can be found under that head. The treatment of dysentery consists in rigid hygiene and skilled medical attendance, as the different type of parasites must be recognized by the microscope and appropriate remedies for each type administered. See AMOEBA; CHOLERA; COLITIS; ENTERITIS; ENTEROCLYSIS ; INTESTINE; PARASITISM AND ANIMAL PARASITES.