Remarks on the nature and treatment of acute tropical dysentery / by Robert Lewins.

  • Lewins, Robert.
Date:
[1841]
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on the nature and treatment of acute tropical dysentery / by Robert Lewins. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    are apt to produce dysentery, which, to a newly arrived Euro- pean, is the most common serious abdominal disorder; and in this respect, the custom of washing decks is much to be depre- cated, as the evaporation which goes on for some hours afterwards, renders the atmosphere damp, chills the men, and, when con- joined with other deleterious agencies, may prove an exciting cause of the disease. Having made these preliminary remarks, I now proceed to speak of the symptoms of acute dysentery; and here I shall be brief, confining my observations solely to the result of my own experience, and I trust that the descriptions which I give will be recognized as true to nature by those who have had an opportunity of marking the progress of this malady within the tropics. Acute dysentery has been considered by many as a purely inflammatory disease, the more modern French writers con- ceiving it to be the most intense form of colitis. That this is a sound pathological view, I am inclined to doubt, at least the doctrine must admit of some modification. No one can deny that an inflammatory condition is induced during the course of the disease; but in the earlier stage I conceive that there is merely irritation in the intestines, produced by vi- tiated secretions, as we see in diarrhoea, cholera morbus, and other forms of disease, and which, if not relieved in dysen- tery, terminates in inflammation. This opinion is strengthen- ed by the absence of many phenomena in this stage, which usually accompany extensive inflammation of any important viscus. The disease is in general not ushered in by pyrexia. The tongue does not indicate abdominal inflammation. There is not a constant pain increased on pressure, but wandering pains, with tormina and borborygmus, which come on at intervals, and are momentarily relieved by going to stool. The remedies most useful in inflammatory states are not immediately so bene- ficial as we might expect; and lastly, there is not that concen- tration of heat over the abdomen which is generally found in in- flammation, and which is a prominent symptom in a later stage of dysentery. The morbid appearances on dissection certainly favour the opinion, that inflammatory action has existed; nor do I (Ques- tion that such has been the case, as the stage of irritation inevitably terminates in inflammation if unrelieved ; but even the morbid lesions, striking though they be, do not positively tes- tify as to the intensity of this action, as in few diseases do we observe so extensive a disorganization of the mucous membrane of the intestinal tube, as in the typhus abdominalis of the Germans, the misnamed dothin entente of the French pathologists; and yet there are, 1 believe, few who will assert, (notwitlistanding the