CHAPTER XXX
EPIDEMIC GANGRENOUS RECTITIS
So far as known, this very fatal disease seems to be confined to the natives of the low-lying, hot, damp regions in the north of South America, and, perhaps, to the natives of Fiji and other islands of the South Pacific. In Guiana it is known as " caribi" or "Indian sickness," in Venezuela as " bicho "or " el becho." It is said to be very contagious, and appears to be a form of rapidly spreading phagedæna, which starts from the neighbourhood of the anus. Occasionally it may begin higher up— in the colon. In the latter case it is called the " high " form; in the former, the "low" or rectal form. Animals as well as men are attacked.
I am indebted to Dr. Ackers, of Curacoa, formerly of Venezuela, for the following information on the subject:— " I have only seen cases of the disease in animals, principally fowls, though also in dogs and calves; but I have been told by medical men, who themselves attended the cases, of its occurrence in children of the poorer classes. The disease commences by an itching in the anus, which produces an inclination to frequent defæcation. This stage continues for a few days, when a severe inflammation of the mucous membrane of the rectum sets in, giving rise to symptoms of acute dysentery. There are frequent stools of a mucous, bloody substance, accompanied sometimes by bile or excrement; at the same time there is much straining, with considerable elevation of temperature, anorexia, and great thirst. At this period, if the animal or child is not attended to, the above symptoms become more alarming; a constant flow of a slimy, fetid, semi-liquid substance streaked with blood appears. Sometimes the discharge is of a bright-green colour, such as might be obtained by
