The early use of astringents in this disease has often bad consequences. When the flux is stopped too soon, the grumous blood, by being confined in the vessels, may produce inflammations, abscess, and ulcers. If however the case be urgent, or the patient seems to suffer from the loss of blood, gentle astringents may be necessary. In this case the patient may take three or four ounces of lime-water, with half an ounce of the tincture of Peruvian bark, three times a-day.
OF THE DYSENTERY, OR BLOODY FLUX.
This disease prevails in the spring and autumn. It is most common in marshy countries, where, after hot and dry summers, it is apt to become epidemic. Persons are most liable to it who are much exposed to the night-air, or who live in places where the air is confined and unwholesome. Hence it often proves fatal in camps, on shipboard, in jails, hospitals, and such like places.
CAUSES.——The dysentery may be occasioned by any thing that obstructs the perforation, or renders the humours putrid; as damp beds, wet clothes, unwholesome diet, air, &c. But it is most frequently communicated by infection. This ought to make people extremely cautious in going near such persons as labour under the disease. Even the smell of the patient’s excrements has been known to communicate the infection.
SYMPTOMS.——It is known by a flux of the belly, attended with violent pain of the bowels, a constant inclination to go to stool, and generally more or less blood in the stools. It begins, like other fevers, with chillness, loss of strength, a quick pulse, great thirst, and an inclination to vomit. The stools are at first greasy and frothy, afterwards they are streaked with blood, and at last have frequently the appearance of pure blood, mixed with small filaments resembling bits of skin. Worms are sometimes passed both upwards and downwards through the whole course of the disease. When the patient goes to stool, he feels a bearing down, as if the whole bowels were falling out, and sometimes a part of the intestine is actually protruded, which proves exceeding troublesome, especially in children. Flatulency is likewise a troublesome symptom, especially towards the end of the disease.
This disease may be distinguished from a diarrhœa or looseness, by the acute pain of the bowels, and the blood which generally appears in the stools. It may be distinguished from the cholera morbus by its not being attended with such violent and frequent fits of vomiting, &c.
When the dysentery attacks the old, the delicate, or such as have been wasted by the gout, the scurvy, or other lingering diseases, it generally proves fatal. Vomiting and hiccuping are bad signs, as they shew an inflammation of the stomach. When the stools are green, black, or have an exceeding disagreeable cadaverous smell, the danger is very great, as it shows the disease to be of the putrid kind. It is an unfavourable symptom when clysters are immediately returned; but still more so, when the passage is so obstinately shut, that they cannot be injected. A feeble pulse, coldness of the extremities, with difficulty of swallowing, and convulsions, are signs of approaching death.
REGIMEN.——Nothing is of more importance in this disease than cleanliness. It contributes greatly to the recovery of the patient, and no less to the safety of such as attend him. In all contagious diseases the danger is increased, and the infection spread, by the neglect of cleanliness, but in no one more than this. Every thing about the patient should be frequently changed. The excrements should never be suffered to continue in his chamber, but removed immediately, and buried under ground. A constant stream of fresh air should be admitted into the chamber; and it ought frequently to be sprinkled with vinegar, juice of lemon, or some other strong acid.
The patient must not be discouraged, but his spirits kept up in hopes of a cure. Nothing tends more to render any putrid disease mortal, than the fears and apprehensions of the sick. All diseases of this nature have a tendency to sink and depress the spirits, and when that is increased by fears and alarms from those whom the patient believes to be persons of skill, it cannot fail to have the worst effects.
A flannel waistcoat worn next the skin has often a very good effect in the dysentery. This promotes the perspiration without overheating the body. Great caution however is necessary in leaving it off. I have often known a dysentery brought on by imprudently throwing off a flannel waistcoat before the season was sufficiently warm. For whatever purpose this piece of dress is worn, it should never be left off but in a warm season.