322 PRACTICE OF PHYSIC. 



ducing those symptoms which properly and essentially consti- 

 tute the disease of dysentery (MLXVIL), 



MLXXVII. Of these symptoms the proximate cause is still 

 obscure. The common opinion has been, that the disease de- 

 pends upon an acrid matter received into, or generated in, the 

 intestines themselves, exciting their peristaltic motion, and there- 

 by producing the frequent stools which occur in this disease. 

 But this supposition cannot be admitted ; for, in all the in- 

 stances known of acrid substances applied to the intestines, and 

 producing frequent stools, they at the same time produce co- 

 pious stools, as might be expected from acrid substances applied 

 to any length of the intestines. This, however, is not the case 

 in dysentery ; in which the stools, however frequent, are gener- 

 ally in very small quantity, and such as may be supposed to 

 proceed from the lower parts of the rectum only. With re- 

 spect to the superior portions of the intestines, and particularly 

 those of the colon, it is probable they are under a preternatural 

 and considerable degree of constriction : For, as I have observ- 

 ed above, the natural faeces are seldom voided ; and, when they 

 are, it is in a form which gives reason to suppose they have 

 been long retained in the cells of the colon, and consequently 

 that the colon had been affected with a preternatural constric- 

 tion. This is confirmed by almost all the dissections which 

 have been made of the bodies of dysenteric patients, in which, 

 when gangrene had not entirely destroyed the texture and form 

 of the parts, considerable portions of the great guts have been 

 found affected with a very considerable constriction. 



" I conceive the colon to be in a state of constriction, which 

 divides it more exactly into its cells, giving occasion to the for- 

 mation of the hardened balls. With this constriction there is 

 some effort at a peristaltic motion ; but this only renders the con- 

 striction of the colon more violently spasmodic, and therefore 

 painful. This, therefore, accounts for the griping which com- 

 monly accompanies the attempts to go to stool. But a certain 

 degree of constriction is communicated downwards to the rectum, 

 producing the tenesmus and the little secretion which has been 

 mentioned. This more violent spasmodic affection in the rec- 

 tum may emulge its mucous glands to a certain degree, and 

 may squeeze out blood from the superficial blood-vessels, which 





