1872 



EPIDEMIC GANGRENOUS RECTITIS 



etiology. — This is entirely unknown. The disease occurs in 

 man and animals, fowls, dogs and calves, and is said to be very 

 contagious. The Venezuelan natives say that it arises from children 

 chewing the green tender stalks of unripe maize. 



Pathology. — The disease presents two pathological pictures — 

 viz., a high infection in the colon, which is rare, and a low infection 

 in the rectum. 



Symptomatology. — The disease begins as an itching about the anus, 

 followed by symptoms of acute dysentery, which increase in severiiy 

 until there is a constant discharge of blood-stained or greenish foetid 

 fluid. Prolapse and gangrene of the rectum may now occur, or 

 convulsions may supervene, but in either case the patient dies. 



Diagnosis. — In an endemic area severe dysenteric symptoms in 

 a native child would lead one to suspect the disease. 



Prognosis. — This is extremely bad, as the disease appears to be 

 a,lways fatal. 



Treatment. — Natives treat the disease by enemata of strong 

 lemon-juice mixed with dilute rum, a dose of castor oil being given 

 at the same time. Enemata and decoctions of Spigelia anthelmia 

 are also prescribed. In children a portion of a lemon is roasted and 

 inserted per anum. According to local medical men, this native 

 treatment is more efficacious than boric acid and similar enemata. 



Prophylaxis. — Nothing can be said with regard to this until the 

 disease is scientifically investigated and its setiology discovered. 



REFERENCES. 



Ackers (1900). Quoted by Manson. 



Chalmers and Archibald (1914). Proceedings of the Royal Society of 



Medicine, vii. (Section of the History of Medicine), q8-io6. London. 

 Manson {1900), Tropical Diseases (Ackers' account). London. 



