﻿BACILLARY DYSENTERY: THE MOST PREVALENT FORM IN 

 MANILA AND ITS TREATMENT 



By W. E. MUSGRAVE and A. G. SISON 

 (From the Department of Medicine, University of the Philippines, and the 



Philippine General Hospital) 



The word "dysentery" should not be used in medicine except 

 to represent the "clinical complex" of bloody stools, tenesmus, 

 etc., for which it was originally employed. In this sense, it 

 represents many diseases both pathologically and etiologically. 

 In fact, any type of colitis, whether primary or secondary, may 

 be expressed clinically as "dysentery." On the other hand, 

 definite pathologic lesions of the colon of specific etiology at one 

 time may be associated with "dysentery," and at other times may 

 exist without material disturbance of the bowel evacuations, and 

 in still other instances may be associated with constipation. Such 

 conditions are so well known that they need not be discussed. 



Scientific nomenclature, at least, should recognize diagnoses 

 based upon etiology as far as possible. When the etiology is 

 unknown, naming the pathologic condition as a diagnosis is 

 acceptable, and only when both etiology and pathology are not 

 known is it justifiable to use a "clinical syndrome" as a diagnosis. 



This is particularly true of diseases associated with disturb- 

 ances in the evacuation of the bowel contents, whether as "dysen- 

 tery," "diarrhoea," or "constipation." 



In no other classes of disease are "slipshod" methods of diag- 

 nosis, which are based upon the obvious clinical symptoms, 

 fraught with more danger to the patient; and there are no dis- 

 eases where there is less excuse for perpetuating the practice. 



The "bacterial dysenteries". — the subject assigned for this 

 discussion — include a large and important group of the colites 

 of the large intestine. 



The bacteria concerned are of many species. Some of them 

 are rather definite and positive in action, others are influenced 

 in their pathogenicity to a material extent by conditions of en- 

 vironment and resistance on the part of the host, and still others 

 produce definite lesions only under unusual conditions. The 

 unusual conditions may consist in intrinsic variations in the 

 toxicity of the bacteria, modifications in the resistance of the 

 host, or differences in environmental conditions within the intes- 

 tine or elsewhere, 



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