INTESTINAL HEMORRHAGE AS A FATAL COMPLICATION IN 



AMOEBIC DYSENTERY AND ITS ASSOCUTION 



WITH LIVER ABSCESS. 



Bv Richard P. Strong, M. D., Director Biological Laboratory. 



Death may occur in amoebic dysentery from the gravity of the 

 intestinal lesions; from exhaustion in protracted cases; from severe 

 complications, particularly such as peritonitis due to the perforation 

 of an ulcer in the large intestine or appendix or an abscess of the 

 liver or lung ; from a terminal infection sometimes entering through 

 the ulcerations in the large bowel ; from intercurrent disease, and 

 from severe intestinal hemorrhage. The last is of unusual occur- 

 rence and is a particularly rare fatal complication. 



While the presence of more or less blood in the stools in this 

 variety of dysentery is in fact a common symptom of the disease, 

 and while at times the discharges consist almost entirely of blood 

 and mucus, it is obviously not to these conditions that I wish 

 to refer in this paper; instead it is to the copious intestinal hemor- 

 rhage in which several hundred cubic centimeters of fresh blood are 

 passed — such as one sometimes sees, for example, in typhoid fever 

 and from which patients may succumb — that I wish here to invite 

 attention. 



Upon reviewing the literature I find that but little notice has 



been attracted to this complication. Of the recent text-book 



articles on the subject Scheube,^ in his description of gangrenous 



dysentery, states that occasionally large quantities of pure blood are 



passed and even death may result from bleeding. Manson - calls 



attention to the fact that whenever, in gangrenous dysentery, sloughs 



separate, hemorrhage is always possible and that sudden collapse 



may occur from this cause even in otherwise mild cases. Sodre' 

 I — 



* Die Krankheiten der Warmen Lander. 



' Manual of Tropical Diseases. 



' Tiretilicth Cenluri/ Practice of Medicine, Vol. XVI. 



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