or even slight indulgence in alcohol, the old symptoms reappear. In such cases sudden attacks of diarrhœa are common. Some patients for months, or even years, never pass a perfectly healthy stool, the unformed motion always containing slime or mucopus, and at times blood. Often there is a tendency to scybalous stools, or to constipation alternating with diarrhœa. If such symptoms are at all severe, or persist for a long time, the digestion may deteriorate and the patient become thin and cachectic, his complaint assuming many of the characters of sprue. On the other hand, general nutrition may not suffer, although the patient may continue for years to pass two or three unhealthy stools daily. In mildness and severity the more chronic types of dysentery are as manifold and varied as are the earlier and more acute phases of the disease. They, too, are usually of amœbic nature.
Anomalous types of dysentery have been described from time to time. Thus in a special report on an outbreak among Polynesian immigrants to Fiji which occurred on board ship in 1890, Daniels describes a disease of high fatality (15 deaths in 31 cases), manifestly infectious, running a rapid course— death taking place in from two to ten days. In 6 cases there was extensive superficial ulceration of the mouth, and in 2 cases diphtheritic inflammation of the prepuce. Post-mortem examinations were made in four cases. In all, the whole of the colon and at least half of the small intestine were found acutely inflamed, superficially ulcerated, or covered with a firm, dry, green or grey layer adherent to or continuous with the subjacent intestinal wall. In a special report (1898), Dr. Corney, of Fiji, remarks that at least six similar epidemics had occurred in Melanesian immigrant vessels in twelve years. The high degree of infectiveness, the diphtheritic lesions in intestine and prepuce, and the great mortality clearly indicate a special form of enterocolitis, due probably, according to later researches, to a very virulent form of dysentery bacillus. Such cases do not occur under the better hygienic conditions
