brown mucus blood-tinged or streaked and dotted with little hæmorrhages. Very soon the desire to stool becomes increased, the griping and tenesmus being accompanied, perhaps, with most distressing dysuria. The patient is glued, as it were, to the commode. Fever, which at the outset may have been smart and preceded by rigor, subsides, so that when the patient is seen it may be absent or inconsiderable. The tongue soon becomes white or yellow-coated; there may be thirst also; very generally anorexia is complete.
In either case, after perhaps four, five, or six days, the urgency of the symptoms may gradually diminish and the acute stage taper off into a subacute or chronic condition; or it may terminate more quickly in perfect recovery.
Ulcer ative dysentery.— Should, on the contrary, the disease advance, the urgency of the symptoms shows hardly any abatement; the stools become very offensive, and now contain, besides blood, large or small shreddy, ash-coloured, stinking sloughs. This may go on, better or worse, for days or weeks. Recovery from this condition is, necessarily, a slow process, seeing, as the presence of sloughs in the stools indicates, that there is deep ulceration which must take some time to cicatrize. Such a condition tends to drift into that most dangerous and most distressing complaint, chronic dysentery, relapsing and improving during many months or even years, and causing, if severe and prolonged, great wasting, pain, and misery.
Fulminating dysentery.— The attack generally begins suddenly, often in the middle of the night, with chills or smart rigor, vomiting, headache, and a rapid rise in temperature to 102 or even 104 F. Co-incidently with the rigor, or very soon afterwards, but occasionally not for a day or two, purging begins, the stools quickly assuming dysenteric characters. In from two or three days to a week or thereabouts, fever persisting to the end, or collapse setting in with a sub-normal temperature, the patient dies. So virulent is the blood-poisoning in some instances that death may take place before dysenteric stools are emitted, and it
