246 Progress of Rational Pathology. 



almost solely in the stage of infiltration or of sloughing, 

 before its disappearance open ulcerations and even scars are 

 found. Dysentery is also an indication of the breaking up 

 of a typhus epidemic. Vegetable parasites (minute fungi) 

 have been observed by Langenbeck, Hannover and Bennett, 

 in typhus patients and in their corpses. 



e. Dysentery. — Rokitansky lays down four degrees or forms 

 of the dysenteric process. 1. The first, is characterised by 

 swelling, redness, and softening of the mucous coat of the 

 large intestine, especially the folds of the mucous membrane, 

 and by a serous exsudation in the form of a fine miliary 

 vesicular growth, after which the epithelium desquamates in 

 a clay-like state. 2. In the second degree, the mucous mem- 

 brane is softened like a jelly, wart-like or fungous protuberances 

 appear, which consist of serous inflammation of the submu- 

 cous cellular tissue (according to Siebert, the formation 

 of these protuberances commences with degeneration of 

 the mucous glands, which grow black, and are surrounded 

 with a chamois-yellow circle of the size of a lentil.) 3. In 

 the third degree, the protuberances are more compressed, 

 so that the inner surface of the bowel seems studded with 

 large glands. The mucous membrane is in part converted into 

 a black slough, or has disappeared entirely. 4. In the fourth 

 stage, the mucous membrane has degenerated into a black, 

 friable, as it were carbonised mass. The lymphatic glands of 

 the mesocolon are in a marked degree swollen and injected, 

 but without containing, as in typhus, a specific firm product. 

 The dysenteric process always gradually increases in violence 

 from the valve of the colon downwards towards the rectum. 

 The true dysenteric process occurs, according to Rokitansky, 

 also in the mucous membrane of the uterus, but only after 

 delivery. Some chronic diseases, especially tubercular ones, 

 seem to prevent the occurrence of dysentery; its predispos- 

 ing causes are, mucous discharges from the bowels, gout, 



