Dysentery,
bloody flux, spurious remittent. This contagious disease has been before mentioned, under remitting and autumnal fevers. It is called by the sagacious Morton, the Spurious Remittent turned on the intestines; and by Sydenham also, who, perhaps undeservedly, is panegyrized as a superior oracle, the Fever of the Season turned on the bowels. The general symptoms are, frequent stools with severe colick, gripes, and tenesmus, or urgency to exonerate the intestines: these evacuations are slimy, generally with intermixture of blood, and fragments of feces concreted into hard globules, and unusually fetid. It is also accompanied with sickness at the stomach and pain, inappetency, vomiting, flatulence, restlessness, foul tongue, and more or less fever. When fatal, many are destroyed between the seventh and twentieth days; but when moderate, it may be protracted much longer. Relapses are frequent on any irregularity or intemperance. The causes, warm climates and seasons, marshy effluvia; cold nights followed by warm days; sudden suppression of perspiration, especially in warm climates; exposure to cold and moist air and rains, and wet cloaths and beds; long continuance of sultry and dry weather; excess and corruption of bile; symptomatick; dysenterick contagion from privies, beds, &c.——Vid. [Remittent Fevers].
Diarrhœa,
ventris profluvium; including the different species, the celiaca, lienteria, morbus hepaticus, niger, atrabilis. In the simple diarrhœa, the evacuation by the anus is unnaturally frequent and liquid. In the celiaca, or chylous diarrhœa, the aliments and chyle are ejected: and in the lienteria, like a bucket whirling into a well, food is no sooner taken than discharged. The morbus hepaticus is without pain or tenesmus, with flux of blood and serum, or like ink; in colour and consistence various. Diarrhœa is accompanied with gripes; but not so excruciating as in the dysentery, with inappetency, dry skin, thirst, hectic heat: but no considerable fever; nor is it contagious. In the severity and evacuation there are varieties: and in some cases it is salutary. The causes, excess of food and drink, or acrid putrescent aliment; new fermented liquors; vegetable laxative food; feculence in the intestines, stercorous, pituitous; vitiated digestion, with morbid irritability of the intestinal tube; irritability of this muscular canal, and increase of its peristaltic motion; atonia; excess and acrimony of bile, warm climates, broken constitutions, cachexy, chronic dysentery, immoderate flux of humours to the intestinal tube, and exhalation by the arterial extremities of that canal; suppression of perspiration, and of other evacuations; superfluity of serous humours; impediments in the absorption and passages of the chyle; obstruction in the vena portarum; laxity of the pylorus; palsy of the sphincter ani; ulcers of the stomach, repelled gout, and rash; sudden passions of mind; nervous irritation; erosion or rupture of the blood-vessels on the interior surface; obstruction of the spleen; acrid dissolution of the blood; colliquative; worms; symptomatic in fevers; purgatives; poisons. In infancy, acidity, dentition, and saliva swallowed to excess; corrupted milk and chyle, thin laxative vegetable diet; errors of the nurse in diet; gravel in the kidneys.
Colick.
From slight or serious attacks of this torture, few of the community are exempted. We here associate together the inflammatory, spasmodic, saturnine, bilious, flatulent, the infantile colick, and other species. Colick is generally a temporary disease; and with which some, much more than others, are afflicted at intervals. Inflammation of the intestines ileus, volvulus, enteritis; generally sudden assault of excruciating, fixed, and increasing pain, in some degree affecting the whole abdomen, but more pungent about the navel; with nausea, frequent vomiting of food and drink, and sometimes of intestinal feculence; obstinate costiveness, severe gripes, eructation, flatulence: the fever sometimes succeeding, sometimes preceding, the local pain; and of which there are exacerbations and remissions, and various gradations. The pulse at the beginning is not remarkably full nor frequent, from which fatal mistakes and irremediable procrastination, have often ensued in medical practice: the urine is in small quantity, or suppressed. It is much more frequent in the narrow than the wide part of the intestinal tube. In the rectum, constant tenesmus, excretion of mucus; and in the male sex strangury are natural consequences and symptoms. Inflammation or nephritick paroxisms in the kidneys and ureters, with which it has been confounded, are hereafter discriminated.
It is extremely dangerous and precipitate; frequently destroying in a few days, sometimes in one day, and is seldom protracted beyond nine. There is less danger in young than in old persons: abatement of pain, cessation of nausea and vomiting, discharge of flatulence and of feces, softer and freer pulse, are favourable symptoms: unfavourable are, unconquerable costiveness, immoderate vomiting, tumid belly, eructation, hiccup, cold extremities, gangrene; abscess rarely. Inflammation is sometimes the effect, and not the original cause of colick.
Under the spasmodick colick may be classed the colica pictonum, saturnina, plumbeia, and dry belly-ach of the West Indies. The symptoms, writhing pain in the abdomen, about the loins and back; retraction of the navel towards the spine, dysury, ischury, or strangury; costiveness with difficulty removed, and the feces in conglobated lumps, vomiting, anxiety, depression of spirits. In the saturnine the countenance is sometimes of a leaden colour, and there is a saccharine taste on the tongue. This infests various classes of artificers: sometimes terminating in chronic colick, in palsy of the lower extremities, and in convulsions.
Bilious colick is accompanied with severe pain in the stomach and intestines, nausea, sickness, vomiting of bile, costiveness, bitter taste on the tongue, anxiety, dejection of spirits, dysury, often flatulence. Its duration is short, but it is prone to return on any intemperance or irregularity; sometimes it ends in jaundice. Flatulent colick is distinguished by the pain being mobile, without much nausea or vomiting, or hard pulse and thirst, or fever; by considerable unusual distention of the abdomen, and flatulent explosion upwards and downwards; and sometimes efforts to vomit until the flatulence is ejected: respiration is also more or less interrupted.