1888 - 89 .] Dr R. W. Felkin on Tropical Diseases. 
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IX. Dysentery. 
(See Plate YI.) 
Synon. — Fr. Dysenterie; Ger. Dysenterie. 
Definition . — A specific febrile disease, characterised by consider- 
able nervous prostration and inflammation of the solitary and 
tubular glands of the large intestine, sometimes ending in resolu- 
tion, but frequently terminating in ulceration, occasionally in more 
or less sloughing or gangrene; always accompanied by tormina 
and tenesmus. 
Geographical Distribution . — The distribution of tropical dysen- 
tery is very wide, and to a great extent coincides with the area in 
which malaria is endemic. Commencing with its existence on 
the west coast of Africa, we find that it is extremely prevalent in 
Senegambia, on the Sierra Leone coast, in Upper Guinea, and on 
the Gold and Slave coasts, as well as throughout the area watered 
by the Niger. In all these regions it affects natives as well as 
Europeans. It is not so frequently met with in the Cameroons, and 
from thence southward to Cape Lopez it is also less frequent. From 
Cape Lopez along the Congo coast endemic areas of dysentery are 
only to be found in isolated spots. Fernando Po is severely 
affected by this disease, as are also the islands of St Iago and 
Nicolao. In Madeira it is only epidemic. Passing on to the Cape 
of Good Hope, we again meet with a wide area of its distribution, 
the natives being especially affected by it ; but it is to be noted 
that the disease is more severe in the interior of the country than at 
the coast. On the east coast of Africa dysentery is endemic at 
Mozambique, Madagascar, Reunion, and Mauritius; also at Zanzibar 
and along the adjacent coast, but it is much less severe in Mayotte, 
Nossi Be, and St Marie. It is very prevalent all over Abyssinia, 
except in the dry open tablelands, and it is met with throughout 
the whole of the southern Soudan and Nubia; it also passes down 
the valley of the Nile to the Delta. It is endemic in Algiers and 
along the coast regions of Morocco, Tunis, and Tripoli. 
In Asia dysentery is met with in the valleys of Syria, in the plain 
of Mesopotamia, and in many parts of Persia, but it is most severe on 
the western and southern coasts of Arabia. It is found in the deep 
mountain valleys of Beloochistan and Afghanistan, and throughout 
