The Probert Encyclopaedia of Medicine

DYSENTERY

Dysentery is of two main types, namely bacillary and amebic, caused by different forms of infection, but in both there is inflammation of the mucous membrane lining the lower or large bowel. The symptoms are those of enteritis and colitis, diarrhaea with small loose stools containing mucus and blood, abdominal tenderness, griping pain, and tenesmus during evacuation. Bacillary dysentery is a very infectious disease caused by various specific bacterial organisms (Sonne, Shiga and Flexner bacilli) which occur in impure water, contaminated food and excreta, and are often conveyed by flies or by 'carriers'.

The incubation period may be only a few hours, and is seldom more than three days. The disease is prevalent where insanitary conditions occur, and epidemics are common especially in the tropics. The disease develops suddenly with loss of appetite, lassitude, fever, shivering, heat of the skin, and a quick pulse. These are followed by griping pains in the bowels, and a constant desire to evacuate, and prostration. In general the stools are small and slimy, composed of mucus mixed with blood. Defaecation is attended and followed by severe griping and inclination to strain, called tormina and tenesmus; they are sometimes in the early stages attended by nausea and vomiting. The natural faeces are passed in the first few evacuations. Tenesmus continues and perhaps increases for several days, the discharges being mostly blood in some cases, and chiefly mucus in others. Having generally but little odour at first, these discharges become, as the disease advances, exceedingly offensive.

Vomiting is common, and there may be a high or low temperature, with headache. The disease may be severe or moderate in its course. In severe cases there are thirst, muscular pains, blueness of the face, extreme tenderness of the abdomen, hiccough, prostration, incontinence and a high mortality rate. If recovery follows convalescence is slow, with recurrent diarrhaea and various complications such as arthritis, iritis, chronic colitis, peritonitis, piles, boils, etc. In mild cases the symptoms abate after four or
five days.
Research Dysentery