Dysentery is a serious condition affecting the large intestine. It is characterised by inflammation and ulceration of the bowel, a colic pain in the region of the abdomen and passing of liquid or semi-formed stools with mucus and blood. Chidden are more prone to this disease than adults.

The pathological condition of dysentery is caused by two organisms, protozoa and bacilli. The dysentery caused by former is generally known as amoebic dysentery and by latter as bacillary dysentery. An attack of amoebic dysentery is milder in comparison with bacillary dysentery. But while bacillary dysentery can respond quickly to treatment, amoebic dysentery does not, unless the patient is very careful.

Dysentery is prevalent all over the world, except in very cold countries. Places, where poor sanitary conditions prevail, are particularly affected. The disease is most common in late summer, and in hot, tropical climates.

Symptoms

Dysentery in children may be acute or chronic. The acute form is characterised by pain in the abdomen, diarrhoea and dysenteric motions. Yellowish white mucus and sometimes only blood from the intestinal ulcers is passed with stools. The evacuations are preceded by pain and tenesmus. The child feels a constant desire to evacuate his bowels, although there may be nothing to throw off except a little mucus and blood. There is a feeling of pain in the rectum and along the large intestine. With the advance of disease, the quantity of mucus and blood increases.

Occasionally, casts or shreads of skin-like mucous membrane, from small fragments to 12 inches or so, long and an inch wide, are seen to pass out with motions. Sometimes pus is also thrown out with motion and often the small of the stools becomes very foetid. All the digestive processes are upset and secretions are changed or stopped.

Chronic cases are after-effects of acute attacks. The child does not recover completely. Stool remains putrid and may contain blood, while diarrhoea and constipation may alternate, and general health is disturbed. In severe cases, the temperature may rise to 104 o to 105 o F . It may occasionally become subnormal also.

Causes

Dysentery is caused by either protozoa or bacilli. However, the germs develop in the colon as a result of petrefaction of excessive quantity of animal protein food, fried substances, too-spicy foods and hard-to-digest fatty substances. Thus dietary indiscretion and eating of excessive amounts of fresh food in hot weather or tropical climate results in indigestion of such foods. The other precipitant factors include debility, fatigue, chill, lowered vitality, intestinal disorders and over-crowed, poor sanitary conditions.

The incidence of amoebic dysentery is very high in areas devoid of proper sanitary facilities. The infection may occur due to contamination of water with human sewage containing amoebic cysts. Various foods may be contaminated by being fertilized with human sewage or by flies exposed to infection or by careless food handlers who have the disease. Children may infect themselves by playing in muck contaminated with amoebic cysts.

Bacillary desentery is caused by certain germs of the shigella group, of which there are several varieties. These oganisms are spread from one person to another by contact, as well as through contaminated food and water. The disease may also be spread by flies. It is common in younger children. The germs pass directly into the intestine, causing swelling and superficial ulcerations. The inflammation in severe cases may involve whole of the colon and also the lower part of the small bowel.

Treatment

The treatment of dysentery should aim at removing the offending and toxic matter from the intestines and for alleviating painful symptoms, stopping the virulence of the bacteria and promoting healing ofthe ulcer. The child-patient should be kept on liquid diet for the first 24 hours. The use of butter milk will be especially beneficial as it combats offending bacteria and helps establishment of helpful micro-organisms in the intestines.

The child may be given about 15 to 20 ml. of castor oil with milk. This will facilitate quicker removal of offensive matter, minimise the strain during motion and also act as a lubricant to the ulcerated surfaces. The child should be kept on complete bed rest as movement induces pain and aggravates distressing symptoms. Hot water bag may be applied over the abdomen.

After acute symptoms are over, the child may be allowed rice, curd, fresh ripe fruits, especially bael, banana and pomegranate and skimmed milk. Solid foods should be introduced very careful and gradually according to the pace of recovery. Fresh fruits and vegetable salads which have a detoxifying and cleansing effect upon the intestine, should form the major portion of the future diet. Flesh foods of all kinds should be avoided in future as far as possible. Other foods which should be avoided are tea, coffee, white sugar, white flour and products made from them.

Among specific food remedies, bael fruit is, perhaps, the most efficacious in the treatment of dysentery of both the varieties. A sherbet can be made from this fruit by mixing 30 grams of the pulp in 60 ml. of water. This sherbet should be administered to the child in doses of two teaspoons thrice daily. In acute cases of dysentery with inflammation of mucous membrane, best results can be obtained when dried bael or its powder is used. The unripe or half ripe fruit should be sliced and dried in the sun. These slices may be powdered and preserved in bottles. This powder may be administered in one gram dosage to the child twice daily.

The use of pomegranate (anar) rind is another effective remedy for dysentery. About 60 grams of the rind should be boiled in 250 ml. of milk. It should be removed from the fire when one third of the milk has evaporated. It should be administered to the patient in three equal doses at suitable intervals. It will relieve the disease very soon.

Lemon juice is very effective in dealing with ordinary cases of dysentery. Two medium sized lemons, peeled and sliced, should be added to 250 ml.of water and boiled for a few minutes. The strained infusion should be administered thrice daily.

Mashed banana together with little salt is a very valuable remedy for dysentery. According to Dr. Kirticar, a combination of ripe plantain, tamarind and common salt is most effective in treating dysentery. He claims to have cured several cases of both acute and chronic dysentery by this treatment. When children have dysentery, ripe bananas mashed and beaten to cream must be used.

Apple is also considered beneficial in the treatment of acute and chronic dysentery in children. Ripe and sweet apples should be turned into soft pulp by steaming and given to the child several times a day, from one to four tablespoons, according to age. The American Medical Association has also advocated the use of apples as therapeutic agent in dysentery.