Although Hippocrates was the first accurately to describe the disease we now know as dysentery yet there is good ground for believing that the disease existed in Egypt and India for centuries before Christ.
Many of the older writers failed to differentiate conditions which showed admixtures of mucus and blood in the stools from those with blood alone.
Commencing with the last century, authorities have considered the association of mucus with the blood as essential in clinical diagnosis.
It is interesting that with a better knowledge of etiology we are now recognizing as of dysenteric nature diarrhoeal conditions in which there is an absence of the typical stool of dysentery.
Our views as to the etiology and epidemiology of bacillary dysentery have been fairly definite for at least twenty years, while those relating to amoebic dysentery, notwithstanding the important researches of Kartulis, Councilman and Lafleur, Schaudinn and others have remained rather chaotic until quite recently.
The Term Dysentery.—By the term dysentery we understand a symptom-complex of more or less characteristic stools and more or less characteristic pains.
As a rule the stool is composed of one or more teaspoonfuls of greenish yellow or dirty brown mucus, the altered blood being intimately admixed with the mucus, or we may have a whitish to grayish muco-purulent mass with streaks or flecks of blood on the outside. These mucoid masses may be found suspended in serous, sanguineous or more or less feculent discharges which are usually small in amount and passed with much frequency.
The terms tormina and tenesmus are the ones used to designate the characteristics of the pains of dysentery, tormina for the griping colicky pains, which center about the umbilicus or run in the direction of the large intestine, and tenesmus for the painful spasmodic contractions of the sphincter ani to which is due the sensation of lack of ability to complete the act of defecation leading to straining and justifying Manson’s description “glued to the commode.”
It is usually stated that the nearer the dysenteric process is to the rectum, the greater the tenesmus and the nearer to the caecum, the greater the tormina.