ACUTE DYSENTERY
Dysentery is a disease in which the seat of inflammation is the colon. The bowels are distended and tender, the pain at times is acute and spasmodic, and the fever moderate. The constant desire to defecate and the straining which accompanies each effort, as well as the small stools, containing both blood and mucus, furnish the characteristic symptoms of this disease. Rest in bed is absolutely necessary; the patient must be induced to use a bedpan.
Dietetic Treatment.—The diet consists entirely of liquids as in acute diarrhea, the same careful régime being observed as in those conditions. The soreness in the abdomen is at times relieved by spice poultices or a hot turpentine stupe.
CHRONIC DYSENTERY
When the above conditions become chronic, the patient loses weight and strength rapidly, becomes anemic and emaciated. The treatment, like that used in the acute disease, consists of rest and liquid diet. The medicinal treatment is left entirely in the hands of the physician.
APPENDICITIS
Appendicitis is an inflammation of the vermiform appendix. It may be acute or chronic in form.
Symptoms.—The disease is manifested by sudden pain in the right side, tenderness over the seat of the inflammation, and a localized rigidity of the right iliac fossa. The attack is as a rule accompanied by fever which may run as high as 103° or 104° F. The patient may suffer from nausea and vomiting. Constipation is generally an annoying symptom of the disease.
Rest in Bed.—The treatment of the acute attack consists of total abstinence from food for twelve or more hours until the most acute stage has passed and the patient either passes into the hands of the surgeon or the symptoms begin to subside in violence. It is necessary that the patient be kept in bed, not being allowed to rise for anything. The nurse must make him understand that his recovery, possibly his very life, depends upon his absolute quiet during the early stages of the disease.
Dietetic Treatment.—When the first acute symptoms have passed, the diet must consist of fluids, well-skimmed meat broths, buttermilk, peptonized milk, albumen water or albumenized orange juice. No solid food must be given until the acute symptoms have disappeared. When the tenderness in the right side has entirely left him and he no longer suffers the pain or nausea, a gradual return to a normal diet may be made. The patient must be cautioned against eating indigestible foods, as an attack of intestinal indigestion may readily start up an irritation in the susceptible appendix and cause a second attack of appendicitis which is often of a more serious nature than the first.