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Chronic Dysentery.This disease is usually found in those who have suffered an acute attack in warm climates, and is especially frequent, in our latitude, among the soldiers of the late war ; cases were still more numerous among the United States troops who were engaged in the war with Mexico forty years ago. It is an extremely obstinate affection. Dr. Flint, in discussing the subject, says : " Chronic dysentery is one of the most intractable and hopeless of diseases. For a time, if the evacuations be held in check by palliative measures, the appetite and digestion not being greatly impaired, the general aspect and strength may not show much deterioration, but at length the appetite and digestion fail, and a continued irritation and loss of fluids induce progressive emaciation and debility. The duration of the disease embraces usually several months, and sometimes years. If not destroyed by some inter- current affection, the patient becomes extremely emaciated, reduced almost to a skeleton ; the surface is usually dry, cool or cold ; the pulse becomes more and more feeble ; the mental faculties are weakened, delirium rarely occurring, but the mind, in certain cases, falls into an apathetic state, the patient being indifferent to and taking but little notice of persons and things around him. The appetite is lost, and vomiting, in some cases, is a prominent symptom. " The diet for this class of patients should be restricted theoret ically, at least, to those articles of food which are as completely digested as possible. This is done upon the principle of keeping an inflamed part at rest. Our object is to prevent as far as pos sible the exercise of any function by the large intestine-that is, we administer nourishment which leaves but little matter to pass into this portion of the alimentary canal. Cold water and ice ap plied to the rectum sometimes relieve the straining. Warm sooth ing applications over the abdomen usually afford a certain measure of relief. We are to be guided to a certain extent by the instincts and desires of the patient, and I am willing to say that in almost every disease, if the patient has a well-defined desire for any article of food, it is wise to allow it to be taken. We are much safer in following the instincts of the patient in this respect than in follow ing out any set of dietetic rules with theoretical form. I cannot but think that adopting the same general dieting rules and endeav oring to apply them to every case is harmful. " Next, with regard to the treatment of the severer cases of dysentery, which are usually epidemic. In severe cases of epidemic dysentery we have to deal with a very formidable disease. So far as medical treatment is concerned our chief reliance must be placed upon opium. It is a noteworthy fact that the quantity of opium which can be administered in these cases without exposing the patient to danger from over use of the drug, is sometimes very large. For example, I have given a patient suffering from epidemic dysentery, a grain of the sulphate of morphia every hour-twenty- four grains in the day-and continued such doses for several days without producing the least manifestation of narcotism ; and the patient was a person not accustomed to taking opium. That was an extraordinary case, it is true, but I have been repeatedly led to observe a greatly increased tolerance of opium in this class of cases. In our climate we rarely see a case of chronic dysentery. It is essentially a disease of the tropical climates. With regard to sporadic and epidemic dysentery, as it occurs in this climate, there is scarcely any tendency to the supervention of the chronic form of the disease, whereas in tropical climates there is considerable tend ency to this result. These patients are to be sustained by tonic remedies and a nutritious diet. More advantage may perhaps be derived from hygienic treatment than from any other. A change of climate is a most important element in the treatment of chronic dysentery. I am speaking particularly of cases occurring in a tropical climate. A change from a warm to a temperate or cold climate is beneficial. A uniformly cold and dry atmosphere is best suited to these cases. During the late civil war and also during the Mexican war, we had occasion in New York to treat numerous cases of chronic dysen- tary contracted in the Southern States and in Mexico, and the most effectual measure for their relief was a change of climate. " But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
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