CHAPTER XXIX
DYSENTERY
Definition.— A term applied to several specifically distinct diseases of which the principal pathological feature is inflammation of the mucous membrane of the colon, and of which the leading symptoms are pain in the abdomen, tenesmus, and the passage of frequent small stools containing slime, or slime arid blood.
Geographical distribution.— From time to time forms of dysentery have extended as epidemics of great severity over vast tracts of country. These great epidemics, or, rather, such of them as have been recorded, have been confined principally to temperate latitudes. There can be little doubt that similar visitations have occurred and do occur in tropical countries. At the present day dysenteric disease of local origin is rare in Britain. Small circumscribed epidemics break out occasionally among the general population, and in certain public institutions, particularly lunatic asylums, endemic dysentery is common; but, in comparison to what was the case in pre-sanitary days, and with what obtains in tropical countries at present, our indigenous dysentery is altogether insignificant. The same remark applies to the continent of Europe. But when, in Europe or elsewhere, war breaks out, or when there is wide-spread scarcity of food, dysentery is almost sure to appear. In most places in the tropics dysentery of one form or another is always to be found; in some places and seasons more than in others. On the whole, it may be advanced that wherever the general hygienic conditions are bad, wherever the soil is much fouled by excreta, and especially where the water supply is polluted, wherever many people are crowded together in one building or camp, where the food is
