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the patient has frequent stools, accompanied with much griping, and followed by a tenefmus. The ftools, though frequent, are generally in fmall quantity; and the matter voided is chiefly mucus, fometimes mixed with blood. At the

fame

fame time, the natural fæces feldom

ap

pear; and, when they do, it is generally in a compact and hardened form.

MLVXIII.

This disease occurs especially in fummer and autumn, at the fame time with autumnal intermittent and remittent fevers; and with thefe it is fometimes combined or complicated.

MLXIX.

The disease comes on fometimes with cold fhiverings, and other symptoms of pyrexia; but more commonly the symptoms of the topical affection appear firft. The belly is coftive, with an unusual flatulence in the bowels. Sometimes, though more rarely, fome degree of diarrhoea is In moft cafes the difeafe

the first appearance.

disease begins with griping, and a frequent inclination to go to ftool. In indulging this, little is voided; but foine tenefmus attends it. By degrees the ftools become more frequent, the griping more fevere, and the tenesmus more confiderable. Along with these symptoms there is a loss of appetite; and frequently sickness, nausea, and vomiting, alfo affecting the patient. At the fame time there is always more or lefs of pyrexia present, which is sometimes of the remittent kind, and observes a tertian period. Sometimes the fever is manifeftly inflammatory, and very often of a putrid kind. These febrile states continue to accompany the disease during its whole course, especially when it terminates foon in a fatal manner. In other cafes, the febrile state almost entirely disappears, while the proper dyfenteric fymptoms remain for a long time after.

MLXX.

In the course of the difeafe, whether of a fhorter or longer duration, the matter voided by stool is very various. Sometimes it is merely a mucous matter, without any blood, exhibiting that disease which Dr Roederer has named the morbus mucofus, and others the dyfenteria alba. For the moft part, however, the mucus discharged is more or lefs mixed with blood. This fometimes appears only in ftreaks amongst the mucus; but at other times is more copious, tinging the whole of the matter dif charged and upon fome occafions a pure and unmixed blood is voided in confiderable quantity. In other refpects, the matter voided is variously changed in colour and confiftence, and is commonly of a ftrong and unusually fetid odour. It is probable, that fometimes a genuine pus is voided; and frequently a putrid fanies,

proceeding from gangrenous parts. There are very often mixed with the liquid matter, fome films of membranous appearance, and frequently some small maffes of a feemingly febaceous matter.

MLXXI.

While the ftools confifting of these various matters are, in many inftances, exceedingly frequent, it is feldom that natural fæces appear in them; and when they do appear, it is as I have mentioned, in the form of scybala, that is, in fomewhat hardened, separate balls. When these are voided, whether by the efforts of nature, or as folicited by art, they procure a remiffion of all the fymptoms, and more efpecially of the frequent ftools, griping, and tenefmus.

VOL. III.

H

MLXXII.

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