CHAPTER XXVI. 



DYSENTERY. 



DYSENTERY is an acute, subacute, or chronic, infectious coli- 

 tis, usually characterized by an acute onset, mild fever, 

 pain in the abdomen, rectal tenesmus, and the passage of 

 frequent, usually small, mucous and bloody evacuations 

 from the rectum. 



The disease was known to the ancients. It was probably 

 dysentery that is meant by "emerods" in describing an 

 epidemic that took place among the people of Israel during 

 the time of the Judges. Hippocrates differentiated between 

 diarrhea and dysentery. 



Sporadic cases of the disease occur in almost all countries, 

 the number of such increasing as the equator is approached. 

 In addition to these sporadic cases epidemics not infrequently 

 appear. Though such may break out at any time in towns 

 or cities, they are more apt to occur when unusual activities 

 of the people are in progress. The most frequent of these 

 is military, and armies are apt to be the greatest sufferers. 

 The incidence of dysentery in the Federal Army during the 

 War of the Rebellion was appalling. Woodward* states 

 that there were 259,071 cases of acute and 28,451 of chronic 

 dysentery. 



Endemics also occur from time to time and assume devas- 

 tating proportions, as in Japan, where between 1878 and 1899 

 there were 1,136,096 cases, with 275,308 deaths a mortality 

 of 25.23 per cent.f Osier quotes Macgregor as saying, "In 

 the tropics dysentery is a destructive giant compared to 

 which strong drink is a mere phantom. It is one of the 

 great camp diseases and has been more destructive to armies 

 than powder and shot." 



The disease early came under the observation of the bac- 

 teriologists, and Klebs, Ziegler, Ogata, Grigorieff, de Silvestri, 



* "Medical and Surgical History of the War of the Rebellion," Medi- 

 cal, n. 



t "Public Health Reports," Jan. 5, 1900, xv, No. i. 



687 



