CHAPTER LXXVIII 



THE DYSENTERIES 



The term ' dysentery ' — Dysentery and dysenteric diarrhoea — Dysenteries 

 caused by animal parasites — Protozoal dysenteries — Amoebic dysen- 

 tery — -Laveranic dysentery — Leishmanic dysentery — Ciliar dysenteries — 

 Balantidic dysentery — Spirochaetic dysentery — Entoplasmic dysentery' — • 

 Platyhelminthic dysenteries— Nemathelminthic dysenteries — Arthropodic 

 dysenteries — Dysenteries caused by bacteria — Pseu do- dysenteries' — 

 References. 



The Term ' Dysentery.' — The term ' dysentery ' is derived from 

 SvcrevTepia, signifying a bowel trouble, and was first employed by 

 Hippocrates. As used at present, it covers a large number of dis- 

 tinct affections, induced by various species of animal and vegetal 

 parasites. In England it used to be called iheBloody flux, in France 

 Tenesme, and in Italy Flusso sanguigno. The Latin equivalent is 

 Tormina, the German Ruhr ; while the native terms applied to it 

 are too numerous to be considered here, but we may mention 

 the Sinhalese term Lehedanpachanai (L^A=blood, hedan=mvicvi'&, 

 pachanai = dimhceo) , and the Indian term, RaUam-seedam-hanthala- 

 porado or Wayatholechell. 



Dysentery and Dysenteric Diarrhoea. — The occurrence of a bowel 

 disease in which blood appeared in the motions was well known to 

 the ancients, for descriptions of such a condition can be found in 

 the works of the old authors Charaka and Susruta, in which dysen- 

 tery was called' Atisar,' and acute dysentery ' Ama-apaka,' while the 

 chronic variety was called ' Pakitsar/ 



Hippocrates recognized two distinct types of disease of the bowels 

 — one characterized by the number and fluidity of the motions, 

 which he called Siappoea, and the other, by the presence of blood in 

 the motions, which he termed Sva-evTepta. 



At first the term ' dysentery ' included any disease in which there 

 was a discharge of blood per anum, but Aretaeus, Celsus, Archigenes, 

 Galen, and other ancient physicians, soon differentiated the 

 disease more clearly by emphasizing the fact that there should be 

 mucus as well as blood in the motions, and that the symptoms of 

 tormina and tenesmus must be present. They further stated that 

 the disease was due to an ulcerated condition of the bowels, and the 

 contagious nature of the malady was early recognized and it was 

 thought that its epidemics were due to miasmata. According to 

 these ancient writers, in order to make the diagnosis of dysentery, 



1824 



