prominent features, will often lead to a correct diagnosis.
Treatment.— The treatment of dysentery requires much judgment and very careful supervision. In former days it was the fashion to bleed repeatedly and to a large amount, and at the same time to administer large doses of calomel— amounting in the aggregate to ounces— and of opium. It is not to be wondered at that the mortality was excessive.
Nowadays better and more rational methods prevail. A most important part of our modern plans has for its object not only the suppression of the germ cause of the disease, but also to afford the diseased organs favourable conditions for repair; not so much to endeavour to heal them as to give them the opportunity of healing themselves.
If called on to treat a case of what appears to be dysentery, our first duty is to assure ourselves that the diagnosis is correct. We must inspect the stools, though unfortunately we cannot differentiate from mere inspection alone to which form the dysenteric stool belongs, and, until the case is quite recovered, we must inspect them daily or frequently. Their condition is the surest guide in the management of this disease. From them we can form a fairly accurate idea of what is going on in the bowel, and from them we can judge of the effects of diet and of drugs.
Importance of rest.— It is with an inflamed bowel as with an inflamed joint: the first and all-important indication to fulfil is, after removing the causes of irritation, to place the part at rest. Could these two indications— the removal of the cause of irritation and the repose of the organ affected— be fulfilled thoroughly, repair would at once set in. Unfortunately, the affected surface being so inaccessible, we cannot always remove the irritant by directly applied local treatment, nor can we place the parts involved at absolute rest. We can, however, partially meet these indications— quite sufficiently, as a rule, to ensure recovery.
The patient, then, should at once be sent to bed. This in itself has a marked influence on the bowel.
