Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    131/976 (page 111)
    China. The men, when they lie clown on the deck to sleep, pnll np their frocks and coarse under flannel jackets, so as to expose the abdomen. When the cool night wind sets in, the exposed skin ot the sleepers, from being bathed in perspiration, becomes, dry and finally chilled, and in a very short time they awaken griped, and perhaps sick, and so commences very frequently an attack of what Dr. Mackay calls “ Sporadic Dysentery.” Impure Air.—Dysentery once established is propagated by the effluvia from the evacuations of those affected. In most Indian barracks a few years ago, the latrines were so badly constructed, so injudiciously placed, and so ill-kept, as to aid materially in propa- gating both dysentery and cholera, by exposing the healthy to the effluvia arising from the evacuations of those affected. I affirm from frequent observation, that barrack-rooms most exposed to the effluvia of latrines always furnish the largest number of dysenteric cases, and the heaviest mortality. In like manner I have seen the disease propagated in hospitals by the practice of preserving the evacuations of large numbers of dysen- teric patients, for the inspection of medical officers at morning and evening visit. Ho single measure of a preventive kind yet tried has exercised a more beneficial effect on the health of troops in India, than the improvement which has been introduced in the position, construction, and conservancy of barrack and hospital latrines. Symptoms.—These will of course vary with the type of the disease. It .is not pretended that in practice we can always expect to find the line separating one type of dysentery from another to be sharply defined. The distinctions are not, however, fanciful, or adopted here merely for the sake of convenience in description ; for those who have seen much of the disease in tropical countries must be familiar with the different forms about to be described. One form, it is true, often passes into another by insensible gradations, but a strong family likeness runs through them all. Mild Dysentery.—Careless exposure to cold night air, or to a chill after exertion, is, in malarious regions, the most common exciting cause of this form of the complaint. The chill is succeeded by slight heat of skm, loss of appetite, and sometimes nausea. Griping pains in the belly, technically termed tormina, follow, with frequent calls to stool, the evacuations consisting of semi-feculent mucus, with or with- out an admixture of blood, passed with painful straining, called tenesmus. There is seldom much abdominal tenderness on pressure The tongue is white and moist, thirst is not urgent, but even where the appetite is not much impaired, the griping which soon follows all nourislimrat 68 ^ makeS the Patieut averse to solid The course, duration and termination of every form of dvsenterv are so much influenced by the patient’s prudence or the reverse and jy the treatment to which he is subjected, that it is not ’easy