BACILLARY DYSENTERY
DEFINITION:-
Bacillary dysentery is an infectious disease caused by the ‘shigella group of bacilli’ and characterized by frequent passage of loose stools containing mucus, blood and pus. Griping abdominal pain and tenesmus and constitutional symptoms including fever.
TYPES:-
Acute catarrhal, tropical or amoebic dysentery, malignant or diphtheric and malarial.
CAUSES AND TRANSMISSION:-
The dysentery is mainly caused by shigella groups of bacilli (dysenteriae, sonnei and flexneri).
- The disease spreads by contamination of food and water supply by faeces of patients or carriers of the disease.
- Housefly is main responsible for dissemination of the disease.
- Maximum incidence occurs during summer months.
- Children’s are more commonly affected than adults.
PATHOLOGY:-
There is hyperaemia and inflammation of the mucous membrane of the colon, with redness and swelling. The swelling of the mucous membrane closes the follicles, which also become swollen from the retention of their contents. Often, some of the capillaries in the walls of the follicles rupture and fills them with blood. The follicles may discharge their contents and form ulcers. In the amoebic dysentery we find amoebae in these ulcers. In the malignant form there is the formation of a false membrane, which ulcerates and sloughs off.
The incubation period varies from 1-7 days.
SYMPTOMS:-
- Onset is sudden.
- Increased frequency of stools containing mucus and blood, gripping abdominal pain.
- Tenesmus, high fever and vomiting.
- In severe cases, the frequency of stools is so increased that the patient is almost ‘ glued to the commode’.
- Dehydration and severe prostration.
COMPLAINTS:-
- Arthritis.
- Iritis.
- Abscess of the liver.
- Peritonitis.
- Typhoid fever.
TREATMENT:-
- For the control of diarrhoea, codeine (30 mg thrice a day) or loperamide (1-2 tablets, tid) may be used.
- Plenty of water along with oral rehydration solution (ORS) or powder may be given orally.
- Liquid or semi solid diet should be given.
HOMEOPATHIC DRUGS:-
1. ACONITE:-
At the very commencement, with fever, anxiety, restlessness and fear of death, knows he is going to die, the pulse is full and hard. The stools are bloody, slimy, mucous, scanty and frequent with tenesmus. In the very beginning, is often able to cut short dysentery, without any other remedy. If sets in with violent fever. Aconite in many cases cures the whole disease in 2 -3 days.
2. ALOES:-
Violent tenesmus, the stools consists of lumps of mucous or bloody mucus. Sense of weakness in the rectum, as if stool would escape involuntarily. Weakness and faintness after stool. Sensation of plug between symphysis pubis and os coccygis with urging to stool. Constant bearing down in rectum; bleeding, sore, and hot; relieved by cold water. Jelly-like stools, with soreness in rectum after stools.
3. ARSENICUM ALBUM:-
In the last stage, when there is extreme prostration, anguish, restlessness and fear of death. Violent, burning thirst, drinks little and often. Rapid and scarcely perceptible pulse. The stools are dark, watery, frequent and offensive. Painful, spasmodic protrusion of rectum. Tenesmus, Worse at night, and after eating and drinking; from chilling stomach, alcoholic abuse, spoiled meat.
4. BAPTISIA:-
As soon as the disease shows a typhoid tendency, face dark red, with a besotted look. Cannot sleep, feels scattered about, tosses about to get him together. Sore, bruised feeling all over the whole body. Tongue is dry, coated yellowish brown in the centre, with red, shinning edges. The stools are pure blood, very offensive and often painless. Extended clinical observation has proved its value when dysentery assumes the typhoid type. When the discharges are offensive and blood contain. Showing an alarming dipression of vitality.
5. BELLADONNA:-
Flushed face, dilated pupils, throbbing of the carotids, head hot, hands and feet cold, the child is stupid, drowsy, starting, and twitching of the muscles during sleep. The abdomen is very sensitive to touch. The passages are bloody and frequent. Often the only remedy required for severe cases of infantile dysentery.
6. CANTHARIS:-
Anxious, restless. Violent pains in the abdomen. Burning in the abdomen, stools white or pale reddish mucous. Like scrapings of the intestines, bloody mucus. Tenesmus, frequent, painful, ineffectual desire to urinate. Retention of the urine.
7. CAPSICUM:-
Stools mucous, streaked with blood, expelled with force. Thirst drinking causes shuddering. Tenesmus after stools. Intense craving for stimulants. Bloody mucus, with burning and tenesmus; drawing pain in back after stool. Thirsty after stool, with shivering.
8. COLOCYNTHIS:-
Intense cutting, griping, squeezing in the intestines, aggravated from eating or drinking, relived by lending double. Stools mucous or bloody. Tongue rough, as from sand, and feels scalded. Colic with cramps in calves. Jelly-like stools.
9. KALI BICH:-
The tongue is dry, red, smooth and cracked. Debility, with desire to lie down. The stools are bloody, jelly like, look like chopped up blood and mucus. Occurs periodically every year. Nausea and vomiting after beer. Gastric symptoms are relieved after eating, and the rheumatic symptoms reappear. Jelly-like, gelatinous; worse, mornings. Dysentery; tenesmus, stools brown, frothy.
10. MERCURIUS COR:-
Cold face and hands, with small feeble pulse. Distension and soreness of the stomach. Continual urging to stool, with a never get done feeling, must strain. Faint, sickish, colicky pain in the abdomen, amilorated by the stool, and prolonged tenesmus after the stool. Stool bloody, slimy, containing shreds of mucous membrane, they are scanty and frequent with continued urging. Tenesmus vesicae, faintness and weakness.
11. NUX VOMICA:-
The patient is irritable and desires to be left alone, wants to be lie down. The stools are thin, bloody mucous and with each evacuation of blood and mucus, there is a small portion of natural faeces passed, severe pain in the back, and tenesmus before stools with complete relief after stool.
12. RHUS TOXI:-
In late stage when dysentery shows tendency to assume the typhoid form. The patient is restless, wants to constantly change his position. The tongue is dry and rough, with red edges and triangular red tip. Excessive craving for milk. Laborious dreams of excessive bodily exertion. The stools are thin, bloody, jelly mucus, bloody water like washings of beef.
13. SULPHUR:-
Tendency to relapse or when our well chosen remedies fail to act. Morning diarrhoea, painless, drives out of bed, with prolapsus recti.
Some of other remedies are arg. Nit, carb.veg, colchicum, chamomilla, hepar sulph, ipecac, opium, pulsatilla, staphysagria, veratrum album.
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